Norgestrel, ethinyl estradiol, and ferrous fumarate

Generic name: Norgestrel, Ethinyl Estradiol, And Ferrous Fumarate
Drug class: Contraceptives

Usage of Norgestrel, ethinyl estradiol, and ferrous fumarate

Norgestrel, ethinyl estradiol, and ferrous fumarate combination is used to prevent pregnancy. It is a birth control pill that contains two types of hormones, norgestrel and ethinyl estradiol, and when taken properly, prevents pregnancy. It works by stopping a woman's egg from fully developing each month. The egg can no longer accept a sperm and fertilization (pregnancy) is prevented.

This medicine also contains ferrous fumarate. Ferrous fumarate is an iron supplement.

No contraceptive method is 100 percent effective. Birth control methods such as having surgery to become sterile or not having sex are more effective than birth control pills. Discuss your options for birth control with your doctor.

This medicine will not prevent HIV infection or other sexually transmitted diseases. It will not help as emergency contraception, such as after unprotected sexual contact.

This medicine is available only with your doctor's prescription.

Norgestrel, ethinyl estradiol, and ferrous fumarate side effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common

Breast discomfort

change in the color, amount, or odor of vaginal discharge

change in the pattern of monthly periods

cramps

dull ache or feeling of pressure or heaviness in the legs

heavy bleeding

itching skin near damaged veins

medium to heavy, irregular vaginal bleeding between regular monthly periods, which may require the use of a pad or a tampon

swollen feet and ankles

unusual stopping of menstrual bleeding

Rare common

Absent, missed, or irregular menstrual periods

blurred vision

dizziness

headache

headache, severe and throbbing

nervousness

pounding in the ears

slow or fast heartbeat

Incidence not known

Bloating

chest pain or discomfort

chills

clay-colored stool

confusion

constipation

dark urine

diarrhea

difficulty breathing

difficulty in speaking

double vision

fever

inability to move the arms, legs, or facial muscles

inability to speak

indigestion

itching, skin rash

large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs

loss of appetite

nausea

pain in the chest, groin, or legs, especially the calves

pain or discomfort in the arms, jaw, back, or neck

pains in the stomach, side, or abdomen, possibly radiating to the back

pelvic pain

slow or slurred speech

stomach pain

sudden loss of coordination

sudden, severe weakness or numbness in the arm or leg

sweating

unpleasant breath odor

unusual tiredness or weakness

vomiting

vomiting of blood

yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

Acne

depression

increased appetite

patchy brown or dark brown discoloration of the skin

stomach cramps, discomfort, or pain

swollen mouth and tongue

unpleasant taste

urge to have a bowel movement

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Before taking Norgestrel, ethinyl estradiol, and ferrous fumarate

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies on the relationship of age to the effects of norgestrel, ethinyl estradiol, and ferrous fumarate combination have not been performed in the pediatric population. However, pediatric-specific problems that would limit the usefulness of this medicine in teenagers are not expected. This medicine may be used for birth control in teenage females but should not be used before the start of menstruation.

Geriatric

Appropriate studies on the relationship of age to the effects of norgestrel, ethinyl estradiol, and ferrous fumarate combination have not been performed in the geriatric population. This medicine is not indicated for use in elderly women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Dasabuvir

Ombitasvir

Paritaprevir

Ritonavir

Tranexamic Acid

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Amifampridine

Amobarbital

Amoxicillin

Ampicillin

Amprenavir

Anagrelide

Apalutamide

Aprepitant

Aprobarbital

Armodafinil

Artemether

Bacampicillin

Baloxavir Marboxil

Barbital

Belzutifan

Betamethasone

Bexarotene

Bictegravir

Butalbital

Carbenicillin

Cefaclor

Cefadroxil

Cefdinir

Cefditoren

Cefixime

Cefpodoxime

Cefprozil

Ceftazidime

Ceftibuten

Cefuroxime

Cenobamate

Ceritinib

Clobazam

Cloxacillin

Cobicistat

Colesevelam

Cyclacillin

Cyclosporine

Dabrafenib

Darunavir

Dexamethasone

Dicloxacillin

Dimercaprol

Dipyrone

Dolutegravir

Donepezil

Doxycycline

Efavirenz

Elagolix

Eltrombopag

Elvitegravir

Encorafenib

Enzalutamide

Erdafitinib

Eslicarbazepine Acetate

Eterobarb

Ethinyl Estradiol

Etravirine

Felbamate

Fosamprenavir

Fosaprepitant

Fosphenytoin

Fostemsavir

Glecaprevir

Grazoprevir

Griseofulvin

Guar Gum

Heptabarbital

Hexobarbital

Indinavir

Iron

Isotretinoin

Ivosidenib

Lesinurad

Lixisenatide

Lopinavir

Lorlatinib

Lumacaftor

Magnesium Sulfate

Mavacamten

Mephobarbital

Meropenem

Methohexital

Minocycline

Mitapivat

Mitotane

Mobocertinib

Modafinil

Mycophenolate Mofetil

Mycophenolic Acid

Nafcillin

Nelfinavir

Nevirapine

Nirmatrelvir

Octreotide

Oxacillin

Oxcarbazepine

Oxytetracycline

Paclitaxel

Paclitaxel Protein-Bound

Penicillin G

Penicillin G Procaine

Penicillin V

Pentobarbital

Phenobarbital

Phenylbutazone

Phenytoin

Pibrentasvir

Piperaquine

Pitolisant

Prednisolone

Prednisone

Primidone

Raltegravir

Red Clover

Rifabutin

Rifampin

Rifapentine

Rilpivirine

Ritonavir

Rufinamide

Saquinavir

Secobarbital

Simeprevir

Somatrogon-ghla

St John's Wort

Sugammadex

Sultamicillin

Tazemetostat

Telaprevir

Telotristat Ethyl

Tetracycline

Theophylline

Thiopental

Thioridazine

Ticarcillin

Tigecycline

Tirzepatide

Tizanidine

Topiramate

Troglitazone

Ulipristal

Valproic Acid

Voxilaprevir

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Amitriptyline

Atazanavir

Atorvastatin

Carbidopa

Cefdinir

Ciprofloxacin

Clomipramine

Delafloxacin

Demeclocycline

Diazepam

Doxepin

Doxycycline

Etoricoxib

Gatifloxacin

Ginseng

Grepafloxacin

Imipramine

Lamotrigine

Levodopa

Levofloxacin

Levothyroxine

Licorice

Liothyronine

Lomefloxacin

Lorazepam

Methyldopa

Minocycline

Moxifloxacin

Mycophenolate Mofetil

Mycophenolic Acid

Norfloxacin

Ofloxacin

Omadacycline

Omeprazole

Parecoxib

Penicillamine

Roflumilast

Selegiline

Temafloxacin

Temazepam

Tetracycline

Tipranavir

Triazolam

Troleandomycin

Trovafloxacin Mesylate

Valdecoxib

Voriconazole

Warfarin

Zinc

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

Caffeine

Dairy Food

Phytic Acid Containing Food

Relate drugs

How to use Norgestrel, ethinyl estradiol, and ferrous fumarate

It is very important that you use this medicine exactly as directed by your doctor. Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered.

This medicine comes with patient instructions. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.

This medicine is available in blister packs. Each blister pack contains 28 tablets with different colors that need to be taken in the same order as directed on the blister pack.

When you begin using this medicine, your body will require at least 7 days to adjust before a pregnancy will be prevented. Use a second form of contraception (eg, condom, spermicide, or diaphragm) for the first 7 days of your first cycle of pills.

Take this medicine at the same time each day. Birth control pills work best when no more than 24 hours pass between doses.

Do not skip or delay taking your pill by more than 24 hours. If you miss a dose, you could get pregnant. Ask your doctor for ways to help you remember to take your pills or about using another method of birth control.

You may have light bleeding or spotting when you first take the pill.

You may feel sick or nauseous, especially during the first few months that you take this medicine. If your nausea is continuous and does not go away, call your doctor.

If you vomit or have diarrhea within 3 to 4 hours of taking this medicine, treat this as a missed dose and follow the instructions in the patient leaflet or call your doctor.

If you are switching from another birth control method to using Lo/Ovral®:

Transdermal patch, vaginal ring, implant, or injection—Start Lo/Ovral® on the day that you would usually apply, insert, or inject the medicine.

Intrauterine device (IUD)—Start Lo/Ovral® on the day of removing the IUD. Use a second form of birth control for the first 7 days if the IUD has not been removed on the first day of your menstrual cycle.

If you have a miscarriage or an abortion in the first trimester of your pregnancy, you may start using this medicine right away. You do not need a second form of birth control. If you start this medicine 5 days or more after the miscarriage or abortion, you should use a second form of non-hormonal birth control for the first 7 days of your first pill cycle. If you have a miscarriage or abortion after the second trimester, you should wait for 4 weeks before starting this medicine. Use another form of birth control for the first 7 days of your first pill cycle if you use this medicine on a Sunday.

Do not drink grapefruit juice while you are using this medicine. Grapefruit juice may change the amount of this medicine that is absorbed in the body.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

Your doctor may ask you to begin your dose on the first day of your menstrual period (called Day 1 Start) or on the first Sunday after your menstrual period starts (called Sunday Start). When you begin on a certain day, it is important that you follow that schedule, even if you miss a dose. Do not change your schedule on your own. If the schedule that you use is not convenient, check with your doctor about changing it. For a Sunday start, you need to use another form of birth control (eg, condom, diaphragm, spermicide) for the first 7 days.

For oral dosage forms (tablets):

For contraception (to prevent pregnancy):

Adults and teenagers—One white tablet (active) taken at the same time each day for 21 consecutive days followed by one brown (inert) tablet daily for 7 days per menstrual cycle.

Children—Use and dose must be determined by your doctor.

Missed Dose

Call your doctor or pharmacist for instructions.

If you miss one white active tablet in weeks 1, 2, or 3: Take the tablet as soon as possible and take the next tablet at your regular schedule. Continue taking one tablet a day until you finish the pack.

If you miss two white active tablets in week 1 or 2: Take the two tablets as soon as possible and the next two tablets the next day. Continue taking one tablet a day until you finish the pack. Use a second form of birth control (eg, condom, spermicide) for 7 days after you miss a dose.

If you miss two white active tablets in week 3, or you miss three or more white active tablets in a row in weeks 1, 2, or 3:

Day 1 start: Throw out the rest of the pack and start a new pack that same day. Use a second form of birth control (eg, condom, spermicide) for 7 days after you miss a dose.

Sunday start: Continue taking one tablet a day until Sunday, then throw out the rest of the pack and start a new pack that same day. Use a second form of birth control (eg, condom, spermicide) for 7 days after you miss a dose, to prevent pregnancy.

You could have light bleeding or spotting if you do not take a pill on time. The more pills you miss, the more likely you are to have bleeding.

Make sure your doctor knows if you miss your period 2 months in a row, because this could mean that you are pregnant.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Warnings

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly and does not cause unwanted effects.

Although you are using this medicine to prevent pregnancy, you should know that using this medicine while you are pregnant could harm your unborn baby. If you think you have become pregnant while using the medicine, tell your doctor right away. Make sure your doctor knows if you had given birth within 4 weeks before you start using this medicine.

Do not use this medicine together with medicine to treat hepatitis C virus infection, including ombitasvir/paritaprevir/ritonavir, with or without dasabuvir (Technivie®, Viekira Pak®).

You might have some light bleeding or spotting during the first 3 months of use. This is usually normal and should not last long. However, if you have heavy bleeding or the bleeding lasts more than a few days in a row, call your doctor.

Do not use this medicine if you smoke cigarettes or if you are over 35 years of age. If you smoke while using this medicine, you increase your risk of having a blood clot, heart attack, or stroke. Your risk is even higher if you are over age 35, if you have diabetes, high blood pressure, high cholesterol, or if you are overweight. Talk with your doctor about ways to stop smoking. Keep your diabetes under control. Ask your doctor about diet and exercise to control your weight and blood cholesterol level.

Using this medicine may increase your risk of having blood clotting problems. Check with your doctor right away if you have pain in the chest, groin, or legs, especially the calves, difficulty with breathing, a sudden, severe headache, slurred speech, a sudden, unexplained shortness of breath, a sudden loss of coordination, or vision changes while using this medicine.

Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin. These could be symptoms of a serious liver problem.

This medicine may increase your risk of having gallbladder disease. Check with your doctor if you start to have stomach pains, nausea, and vomiting.

This medicine may cause skin discoloration. Use a sunscreen when you are outdoors. Avoid sunlamps and tanning beds.

Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery or certain medical tests.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (eg, St. John's wort) or vitamin supplements.

Disclaimer

Every effort has been made to ensure that the information provided by Drugslib.com is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Drugslib.com information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Drugslib.com does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Drugslib.com's drug information does not endorse drugs, diagnose patients or recommend therapy. Drugslib.com's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners.

The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Drugslib.com does not assume any responsibility for any aspect of healthcare administered with the aid of information Drugslib.com provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.