What is Tri-Lo-Mili: Uses, Warnings & Interactions

Updated Jul 21, 2025  •  Published Dec 30, 2020

Tri-Lo-Mili is a generic prescription birth control pill, even though it has a brand name. Each pill contains two female hormones: a low dose of ethinyl estradiol (an estrogen) and a normal dose of norgestimate (a progestin). Tri-Lo-Mili is a triphasic oral contraceptive that comes in three different dosage strengths. Each dosage strength is taken for one week during the cycle, followed by one week of inert pills.

Tri-Lo-Mili overview

BRAND NAMES:

  • Tri-Lo-Estarylla, Tri-Lo-Marzia, Tri-Lo-Mili, Tri-Lo-Sprintec, Tri-Vylibra Lo

Generic Names:

  • Tri-Lo-Mili 

Uses:

  • Prevents pregnancy.

Therapeutic Classes:

  • Oral contraceptive, triphasic contraceptive combination

Forms:

  • Tablet

How it’s taken:

  • By mouth

What is Tri-Lo-Mili used for?

Tri-Lo-Mili is an oral contraceptive that prevents pregnancy.  

What form(s) does Tri-Lo-Mili come in

  • Tablets

    • 0.18 mg norgestimate / 0.0215 mg ethinyl estradiol | 0.25 mg/0.025 mg | 0.25 mg/0.025 mg

What are common Tri-Lo-Mili doses?

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

Common Tri-Lo-Mili prescriptions

  • Tri-Lo-Mili
    1 package (28 tablets), 0.18-25/0.215-25/0.25-25mg-mcg disp pack

How to take Tri-Lo-Mili

  • Please read and follow the Instructions for Use included with the medicine.

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

    • Pills are started on the first day of menstruation or the first Sunday after menstruation starts. 

  • For women switching from another form of hormonal birth control, Tri-Lo-Mili pills are started on:

    • The day a new birth control pill pack is scheduled to start 

    • The day a vaginal ring or patch is scheduled to be replaced

    • Or the day an implant or IUD is removed.

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

    • Take the tablets in order.

    • The first week of pills consists of seven white pills making up the top row of the blister pack. 

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

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

    • The last week of pills consists of seven green “reminder” pills in the bottom row.

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

    • Always start a new blister pack on the same day of the week each cycle. 

  • Take the tablets 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. Start a new pack on the day after the last pill is taken.

    • If you vomit or have diarrhea for longer than one day, continue through the current blister pack and call the doctor. Use backup birth control until the prescriber advises otherwise.

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

What to do if you miss a dose of Tri-Lo-Mili

  • Do not miss doses. Missed doses can increase the risk of pregnancy.

  • If a white or blue pill is missed:

    • Take it when remembered. 

    • Take the next pill at its normal time.

    • Two doses can be taken in a single day if necessary. 

    • Backup birth control is not required.

  • If you miss two white or blue pills in a row in the first two weeks:

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

    • Use backup birth control for at least seven days.

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

    • Day 1 starters should immediately start a new blister pack and throw away the old one.

    • Sunday starters should continue taking pills from the old pack and start a new pack on Sunday. 

    • Use backup birth control for the first seven days after starting the new pack.

  • If you miss three or more white or blue pills in a row in any week:

    • Day 1 starters should immediately start a new blister pack and throw away the old one.

    • Sunday starters should continue taking pills from the old pack and start a new pack on Sunday. 

    • Use backup birth control for the first seven days after the new pack is started.

  • If you’re not sure, use backup birth control.  

Tri-Lo-Mili contraindications

  • Although Tri-Lo-Mili is safe for most women to take, several medical conditions make it too risky for some women to take. 

  • Do not use Tri-Lo-Mili if you are:

    • Pregnant

    • Older than 35 and smoke

    • Older than 35 and have migraines

    • Of any age and have severe migraine headaches with aura, numbness, vision changes, or weakness

  • Do not use Tri-Lo-Mili if you have blood clots, have had blood clots, or have risk factors for blood clots including:

    • Coronary artery disease

    • Cerebrovascular disease

    • High blood pressure that is not corrected by medications

    • Diabetes with blood vessel, kidney, eye, or nerve damage

    • Certain types of heart valve or irregular heartbeat problems

  • Tri-Lo-Mili is also contraindicated in women with:

    • Uterine bleeding that a doctor has not checked

    • Liver disease or liver tumors

    • Current or past breast cancer that is hormone-sensitive 

Tri-Lo-Mili warnings

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

    • This drug can interfere with important blood tests.

    • Tri-Lo-Mili may need to stop at least four weeks before surgery and should not restart until two weeks after surgery. 

  • Regular doctor’s visits and blood tests are necessary to monitor for possible side effects. Keep all appointments with healthcare providers.

  • 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

    • Have recently given birth

    • Smoke

    • Are depressed or have ever been depressed

    • Have experienced jaundice or had brown spots develop on your face during pregnancy or while taking oral contraceptives

  • Also tell the prescriber if you have:

    • Heart problems

    • Blood vessel problems

    • High blood pressure

    • Diabetes

    • High cholesterol

    • Migraines

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

  • Oral contraceptives 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

    • New or worsening headaches

    • Swelling of the face, mouth, or throat (angioedema)

  • Bleeding may decrease or go away entirely during your period. If it is accompanied by pregnancy symptoms or happens two months in a row, talk to the prescriber.

    • If you miss two periods in a row, the doctor will perform a pregnancy test.

  • When first starting Tri-Lo-Mili, women may experience digestive system problems such as nausea and stomach pain. This should improve in a few weeks.

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

  • This medicine does not protect women from HIV/AIDS or other sexually transmitted diseases. 

  • Tri-Lo-Mili may decrease milk production in nursing women.

Tri-Lo-Mili interactions

  • Do not take Tri-Lo-Mili 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: 

    • Antiseizure drugs

    • Barbiturates

    • Macrolide antibiotics

    • Antifungal drugs 

    • Antiviral drugs that treat HIV/AIDS or hepatitis C

    • Thyroid hormones

    • St. John’s wort

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

  • Avoid grapefruit and grapefruit juice when taking Tri-Lo-Mili.

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

Tri-Lo-Mili side effects

Serious side effects

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

  • Symptoms of a blood clot:

    • Persistent leg pain, particularly in the calf

    • Sudden vision changes, sudden loss of vision

    • Numbness or weakness on one side of your body, sudden or severe headache, trouble seeing, trouble walking, trouble speaking

    • Chest pain, chest tightness, trouble breathing, coughing up blood

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

  • Breast lumps, breast tenderness, breast pain 

  • Stomach pain, nausea, vomiting

  • Worsening or new depression

  • Allergic reaction: Rash, hives, itching, trouble breathing, skin swelling around the mouth, eyes, and in the throat

Some potentially serious side effects may not have symptoms, so regular doctor’s visits are required to spot these problems:

  • High blood pressure

  • High cholesterol and fats

Less serious side effects

  • Headache

  • Nausea

  • Vomiting

  • Breast tenderness and other problems

  • Stomach pain

  • Painful periods

  • Mood changes

  • Acne

  • Vaginal infection 

  • Bloating

  • Weight gain

  • Fatigue

  • Light spotting or bleeding between periods

Sources:

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