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Ethinyl estradiol/norgestrel (By mouth)
Ethinyl Estradiol (ETH-i-nil es-tra-DYE-ol), Norgestrel (nor-JES-trel)
Prevents pregnancy. This medicine is an oral contraceptive (birth control pill).
There may be other brand names for this medicine.
Low-Ogestrel 28, Lo/Ovral-28, Ogestrel-28, Cryselle, Low-Ogestrel, Lo/Ovral, Ovral-21
When This Medicine Should Not Be Used
You should not use this medicine if you have had an allergic reaction to ethinyl estradiol or norgestrel, or if you are pregnant. Do not use this medicine if you have liver disease or liver cancer, breast cancer, cancer of the uterus, a blood vessel disorder, heart disease, high blood pressure that is not controlled, or a history of blood clots, heart attacks, or strokes. Do not use this medicine if you have unusual vaginal bleeding, or certain types of headaches. Do not use this medicine if you have ever had jaundice (yellow eyes or skin) caused by pregnancy or birth control pills, or if you are having a surgery that requires bedrest for a long time.
How to Use This Medicine
- Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to.
- This medicine comes with patient instructions. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.
- Carefully follow your doctor's instructions about when to start taking your medicine. You may begin taking the pills on the first day of your menstrual period, or on the Sunday after your period begins.
- You may need to use a second form of birth control when you first start using this medicine. Talk with your doctor about this. Some other forms of birth control include condoms, diaphragms, or contraceptive foams and jellies.
- Take your pill at the same time every day. Birth control pills work best when there is no more than 24 hours between doses. It is very important that you take this medicine on time every day.
- Keep your pills in the container you receive from the pharmacy. Take the pills in the order they appear in the container.
If a dose is missed:
- This medicine has specific patient instructions on what to do if you miss a dose. Read and follow these instructions carefully, and call your doctor if you have any questions.
- If you miss one white pill, take it as soon as you can. Then take your next pill at the regular time. This means you may take two pills in one day. Use a second form of birth control until you have been taking white pills for seven days in a row.
- If you miss two white pills in a row during Week 1 or 2, take two pills as soon as you can. Take two more pills on the next day. Then go back to your regular schedule of taking one pill every day. Use a second form of birth control until you have been taking white pills for seven days in a row.
- If you started this medicine on Day 1 of your period and you miss two white pills in a row during Week 3, throw out the rest of your pills and start a new pack the same day. If you miss three or more white pills in a row during any week, throw out the rest of your pills and start a new pack the same day. Use a second form of birth control until you have been taking white pills for seven days in a row.
- If you started this medicine on the Sunday after your period started and you miss two white pills in a row during Week 3, keep taking one pill every day until the next Sunday. Then throw away the rest of your pills and start a new pack on that same Sunday. Use a second form of birth control until you have been taking white pills for seven days in a row.
- If you started this medicine on the Sunday after your period started and you miss three or more white pills in a row during any week, keep taking one pill every day until the next Sunday. Then throw away the rest of your pills and start a new pack on that same Sunday. Use a second form of birth control until you have been taking white pills for seven days in a row.
- If you miss your pills and change your schedule, you may not have a period for that month. Make sure your doctor knows if you miss your period two months in a row, because you may be pregnant.
- You could have light bleeding or spotting any time you do not take a pill on time. The more pills you miss, the more likely you are to have bleeding.
How to Store and Dispose of This Medicine
- Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
- Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any leftover medicine after you have finished your treatment. You will also need to throw away old medicine after the expiration date has passed.
- Keep all medicine away from children and never share your medicine with anyone.
Drugs and Foods to Avoid
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.
- Make sure your doctor knows if you are using acetaminophen (Tylenol®), ascorbic acid (Vitamin C), cyclosporine (Gengraf®, Neoral®, Sandimmune®), modafinil (Provigil®), morphine (Astramorph PF®, Duramorph®), phenylbutazone (Butazolidin®), salicylic acid, St. John's wort, or theophylline (Theo-Dur®).
- Tell your doctor if you are also using certain antibiotics (such as ampicillin, griseofulvin, rifabutin, rifampin, penicillin, tetracycline, troleandomycin, Grifulvin V®, Mycobutin®, Omnipen®, Rifadin®, Rimactane®, Sumycin®, Tao®), medicine for seizures (such as carbamazepine, felbamate, oxcarbazepine, phenobarbital, phenytoin, primidone, temazepam, topiramate, Dilantin®, Felbatol®, Mysoline®, Restoril®, Solfoton®, Tegretol®, Topamax®, Trileptal®), or steroid medicine (such as dexamethasone, prednisolone, Decadron®, Delta-Cortef®).
- Make sure you doctor knows if you are also using medicine to treat HIV or AIDS (such as indinavir, ritonavir, Crixivan®, Norvir®), medicine to treat a fungus infection (such as fluconazole, itraconazole, ketoconazole, Diflucan®, Nizoral®, Sporanox®), or medicine to lower cholesterol (such as atorvastatin, clofibric acid, Lipitor®).
Warnings While Using This Medicine
- Although you are using this medicine to prevent pregnancy, you should know that using this medicine while you are pregnant could harm the unborn baby. If you think you have become pregnant while using this medicine, tell your doctor right away.
- Make sure your doctor knows if you are breastfeeding, or if you have high blood pressure, high cholesterol or triglycerides (fat) in your blood, diabetes, breast lumps, a family history of breast cancer, migraine headaches, a history of depression, gallbladder disease, heart disease, kidney disease, or irregular monthly periods.
- If you smoke while using birth control pills, you increase your risk of having a heart attack, stroke, or blood clot. Your risk is even higher if you are over 35 years old, if you have diabetes, high blood pressure, high cholesterol in the blood, 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.
- This medicine may also increase your risk of certain types of cancer. Talk to your doctor if you have concerns about this risk.
- This medicine will not protect you from getting HIV/AIDS or other sexually transmitted diseases. If this is a concern for you, talk with your doctor.
- You might have some light bleeding or spotting when you first start using this medicine. 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.
- If you miss two periods in a row, call your doctor for a pregnancy test before you take any more pills.
- If you wear contact lenses and you have vision problems or eye discomfort, check with your eye doctor.
- 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 medical tests.
- Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain medical tests.
- Your doctor will need to check your progress at regular visits while you are using this medicine. Be sure to keep all appointments.
Possible Side Effects While Using This Medicine
Call your doctor right away if you notice any of these side effects:
- Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
- Breast changes or lumps.
- Chest pain, shortness of breath, or coughing up blood.
- Dark-colored urine or pale stools.
- Decrease in how much or how often you urinate.
- Heavy vaginal bleeding.
- Irregular, late, or missed menstrual periods.
- Numbness or weakness in your arm or leg, or on one side of your body.
- Pain in your lower leg (calf).
- Rapid weight gain.
- Sudden and severe stomach pain, nausea, vomiting, and lightheadedness.
- Sudden or severe headache, problems with vision, speech, or walking.
- Swelling in your hands, ankles, or feet.
- Yellowing of your skin or the whites of your eyes.
If you notice these less serious side effects, talk with your doctor:
- Acne, mild skin rash, or darkened skin on your face.
- Breast tenderness, pain, swelling, or discharge.
- Changes in appetite.
- Contact lens discomfort, or changes in vision.
- Hair loss or increased hair growth in areas other than the head.
- Mild headache or dizziness.
- Mild nausea, vomiting, diarrhea, stomach cramps, or bloated feeling.
- Mood changes, depression, nervousness, or trouble sleeping.
- Problems having sex.
- Vaginal spotting or light bleeding, itching, or discharge.
- Weight changes.
If you notice other side effects that you think are caused by this medicine, tell your doctor