What is Heather: Uses, Warnings & Interactions

Updated Jul 28, 2025  •  Published Dec 30, 2020

Heather is a progestin-only birth control pill or “mini-pill.” Its only active ingredient is a progestin hormone (norethindrone). Though not as effective as combination birth control pills, mini-pills are a working alternative for women who cannot take birth control pills with estrogen. Like other oral contraceptives, Heather is taken on a 28-day cycle: 24 days of tablets with hormones and four days of “reminder” tablets without hormones.

Heather overview

BRAND NAMES:

  • Affodel, Camila, Deblitane, Emzahh, Errin, Heather, Incassia, Jencycla, Lyleq, Lyza, Meleya, Nora-BE, Orquidea, Sharobel.

Generic Names:

  • Norethindrone

Uses:

  • Prevents pregnancy.

Therapeutic Classes:

  • Oral contraceptive, progestogen-only contraceptive

Forms:

  • Tablet

How it’s taken:

  • By mouth

What is Heather used for?

Heather prevents pregnancy

What form(s) does Heather come in

  • Tablet

    • 0.35 mg

What are common Heather doses?

  • For the prevention of pregnancy: One tablet daily for 28 days

Common Heather prescriptions

  • Heather
    28 tablets disp pack

How to take Heather

  • Please read the Patient Information sheet and follow the instructions.

  • Take Heather tablets at the same time each day. 

  • Have backup contraception ready.

  • Take one pill daily at the same time every day.

    • Do not miss a dose by more than three hours.

    • Swallow the tablet whole with a drink of water. Do not crush, break, or chew it.

  • Take the first tablet (number 1) on the day your period starts.

    • If you cannot take it on the first day of your period, use backup birth control for 48 hours after taking the first pill.

    • For women switching from another birth control pill, take the first Heather tablet the day after taking the last pill of the previous prescription.

    • Women who are fully breastfeeding should start Heather six weeks after delivery.

    • Women who are partially breastfeeding should start Heather four weeks after delivery.

    • When first starting a blister pack, place the day label strip at the top of the blister pack. 

  • Take all pills in the blister pack, one per day.

    • All the pills in the pack are yellow, including the inert pills.

    • Take the first pill in the next pack the day after taking the last pill (number 28) from the previous pack.

    • The first pill should be taken on the same day of the week each cycle.

  • If you vomit soon after taking a tablet, use backup birth control for 48 hours.

What to do if you miss a dose of Heather

  • A missed dose is any dose that is taken three hours after its regularly scheduled time.

  • Take the dose as soon as it’s remembered.

  • Return to the regular dosing schedule.

  • Use backup birth control for the next 48 hours.

  • If you are not sure a dose has been missed, continue taking pills from the blister pack but use backup birth control for at least 48 hours.

Heather contraindications

  • While most women can take progestin-only birth control pills safely, some women cannot take the drug because of safety concerns. 

  • Heather cannot be prescribed to pregnant women and must be stopped immediately when a woman becomes pregnant. When taking Heather, immediately tell the prescriber if:

    • You get pregnant

    • Suspect you may be pregnant

    • Miss two periods in a row

    • Miss one period in a cycle where Heather doses have been missed

    • Experience morning sickness

  • Heather is also contraindicated in women who have:

    • Breast cancer

    • Vaginal bleeding that a doctor has not checked

    • Liver disease or liver tumors

    • Known allergies to norethindrone or any of the other ingredients in the tablets

Heather warnings

  • Immediately stop taking Heather if you are pregnant or suspect you’re pregnant.

  • Stop taking Heather tablets if you are planning to become pregnant.

  • This medicine may cause serious problems, including:

    • Increased risk of breast cancer or cervical cancer

    • Liver problems, including liver tumors

    • Ectopic pregnancy

    • Ovarian cysts

    • Menstrual changes

  • Heather does not provide protection from HIV/AIDS or other sexually transmitted infections. Use barrier control to prevent infection. 

  • To prevent possible side effects, keep all appointments with the prescriber and other healthcare providers.

    • Women taking oral contraceptives should have a yearly physical examination.

  • Tell all other healthcare providers treating you about this medicine.

Heather interactions

  • To avoid pregnancy or other problems, tell the prescriber about all the prescription drugs, over-the-counter medications, and supplements regularly taken.

  • Tell other doctors or prescribers about Heather before starting new drugs. 

  • Some drugs significantly reduce the effectiveness of norethindrone tablets, increasing the risk of pregnancy. These include:

    • Drugs that treat seizures (including barbiturates)

    • Drugs that treat tuberculosis

    • Antiviral medications called protease inhibitors

    • St. John’s wort

    • Aprepitant, armodafinil, bosentan, griseofulvin, mifepristone, modafinil, Paxlovid, tizanidine

  • Use backup contraception when these drugs are used. If you are uncertain, ask the prescriber or pharmacist.

Heather side effects

Serious side effects

Talk to a doctor if you notice any signs or symptoms of a possible serious side effect, including:

  • Unexplained vaginal bleeding

  • Prolonged vaginal bleeding, severe abdominal pain

  • Repeated missed periods

  • Breast lump

  • Severe lower abdominal pain

  • Dark urine, pale stools, appetite loss, yellow skin or eyes

  • New, severe, or worsening headaches

  • Allergic reaction: Skin rash, itching, hives, swelling in your face, mouth, or throat, trouble breathing

Less serious side effects

  • Menstrual irregularities 

  • Frequent and irregular vaginal bleeding

  • Headache

  • Breast tenderness

  • Nausea

  • Dizziness

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