What is Norgestimate-Ethinyl Estradiol Triphasic: Uses, Warnings & Interactions

Please read and follow the Instructions for Use that come with this medicine.

The prescriber will tell you when to take the first pill.

• It will either be on the day your period starts or the first Sunday after your period starts. 

• When switching from another type of hormonal birth control, take the first pill the day you would have started a new blister pack, replaced a vaginal ring or patch, or the day an implant or IUD is removed.

Take one pill daily at the same time each day. Do not miss doses.

• The first week of pills consists of seven active gray pills in the top row of the blister pack. 

• The second week of pills consists of seven active light blue pills in the second row. 

• The third week of pills consists of seven active blue pills in the third row. 

• The last week of pills consists of seven inactive white pills in the bottom row.

• When the last white pill is taken, start a new blister pack of pills the next day.

• You should always start a new pack on the same day of the week each cycle. 

Take tablets at the same time each day without regard to food.

Swallow the tablet whole with a drink of water.

If you vomit or have diarrhea three to four hours after taking a tablet, take a similarly colored pill from your extra blister pack.

• If you don’t have an extra blister pack, take the next pill in the current blister pack and finish the blister pack. 

• If you vomit or have diarrhea for longer than one day, continue through the current blister pack but use additional birth control until contacting the prescriber.

Store the tablets at room temperature in the original carton. Protect from light.

Do not miss doses. Forgetting doses increases the risk of pregnancy.

If a colored pill is missed:

• Take it as soon as possible. 

• Take the next dose at its regular time.

• You can take two doses in a single day to make up for a missed dose. 

• Pregnancy is not a risk, so you don’t need backup birth control.

If you miss two colored pills in a row in the first two weeks:

• Take two pills on the day you remember and two pills the next day.

• Missing two pills in a row increases the risk of pregnancy. Use backup birth control for at least seven days.

If you miss two blue pills in a row in the third week: 

• Immediately start a new blister pack if you are a Day 1 starter.

• If you are a Sunday starter, continue to take the blister pack pills until Sunday. Start a new pack on Sunday. Use backup birth control. 

• You can get pregnant in the first seven days of starting a new kit. Use backup birth control for the first seven days.

If you miss three or more colored pills in a row in any week:

• Start a new blister pack if you are a Day 1 starter.

• If you are a Sunday starter, continue to take pills from the current blister pack until Sunday. Start a new pack on Sunday. Use backup birth control.

• You can get pregnant for the first seven days after starting a new blister pack. Use backup birth control.

If you’re not sure if you missed a dose, use backup birth control.  

This medicine is not right for everyone. 

Do not use norgestimate-ethinyl estradiol if you are:

• Pregnant

• Older than 35 and smoke

• Older than 35 have focal headaches or migraines with aura

Do not use norgestimate-ethinyl estradiol if you have blood clot problems, a history of blood clot problems, or risk factors for blood clots:

• Coronary artery disease

• Cerebrovascular disease

• Uncontrolled high blood pressure

• Diabetes with blood vessel problems

• Certain types of heart valve problems

Norgestimate-ethinyl estradiol is also contraindicated in women with:

• Uterine bleeding that has not been checked by a doctor

• Liver disease or liver tumors

• Current or past breast cancer that is hormone-sensitive

Tell any healthcare provider or other healthcare provider who treats you that you are using this medicine. 

• This drug can alter the results of important blood tests.

• Doses may need to stop at least two weeks before surgery and should not restart until four weeks after surgery. 

Keep all appointments with the prescriber.

Immediately tell the prescriber if you become pregnant, think you’re pregnant, or miss two periods in a row. 

Before starting birth control pills, make sure the prescriber knows if you are pregnant or breastfeeding, or have recently given birth.

Tell the prescriber if you smoke or if you have:

• Heart or blood vessel problems

• High blood pressure

• Diabetes

• High cholesterol

• Migraines

• Depression

• A history of face, neck, and throat swelling (angioedema)

Also tell the prescriber if you’ve had problems during pregnancy, particularly:

• Skin yellowing (jaundice) 

• Brown patches on your face (chloasma)

Combination birth control pills can cause serious problems, including:

• Increased risk of blood clots, heart attack, and stroke

• Increased risk of breast or cervical cancer

• Liver problems

• Gallbladder problems

• High blood pressure

• High cholesterol and fats

• Severe or long-lasting headaches

You may have no bleeding or only a little bleeding during your period. If it is accompanied by pregnancy symptoms (like morning sickness) or happens two months in a row, talk to the prescriber.

• If you miss two periods in a row, you will need a pregnancy test.

Birth control pills can darken skin on the face. Use sunscreen and avoid exposure to the sun or tanning lights.

This medicine will not protect you from HIV/AIDS or other sexually transmitted diseases. 

Birth control pills may decrease milk production in nursing women.

Do not take norgestimate-ethinyl estradiol with any hepatitis C drug containing ombitasvir/paritaprevir/ritonavir.

To avoid potentially hazardous drug interactions, tell the prescriber about all the prescription drugs, over-the-counter medications, and supplements regularly taken, particularly: 

• Macrolide antibiotics

• Drugs that treat fungal infections 

• Drugs that treat seizures

• Barbiturates

• Antiviral drugs called protease inhibitors

• Thyroid hormones

• St. John’s wort

• Aprepitant, atorvastatin, bosentan, clofibrate, colesevelam, cyclosporine, felbamate, prednisolone, rifampicin, rosuvastatin, rufinamide, theophylline, tizanidine

Avoid grapefruit and grapefruit juice when taking norgestimate-ethinyl estradiol.

Tell other healthcare providers you are using this medicine before they prescribe new medications.