Norgestrel and Ethinylestradiol are combined in this medicine.
Norgestrel + Ethinylestradiol is a combination oral contraceptive (birth control pill). This medicine is used to prevent pregnancy in women of reproductive age.
Take Norgestrel + Ethinylestradiol exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
Try to take it at the same time each day.
Take the missed dose as soon as you remember and take the next one at your normal dosing schedule.
If you miss more than 1 dose, you may discuss with your doctor or pharmacist on how to properly manage your missed doses.
If you often forget to take your medicine, let your doctor and pharmacist know.
Alert your doctor if you have the following conditions:
- presence or risk factors of blood clot formation e.g. deep vein thrombosis (blood clots in your leg veins), pulmonary embolism (blood clots in a lung artery), recent heart attack or stroke, uncontrolled high blood pressure, diabetes with kidney, eye, nerve, or blood vessel damage, certain kinds of severe migraine, smoking (especially if you are more than 35 years old), certain heart valve problems or irregular heartbeat that may increase the risk of blood clots
- unexplained vaginal bleeding
- current or history of breast cancer or other cancer that is sensitive to hormones e.g. cancer of the lining of the uterus
- liver disease e.g. hepatitis, liver tumours
- yellowing of the whites of the eyes or the skin during pregnancy or previous use of birth control pills
as Norgestrel + Ethinylestradiol may not be suitable for you.
Do not take this medicine if you are pregnant or if you think that you are pregnant. If you become pregnant while being treated with this medicine, alert your doctor immediately. Norgestrel + Ethinylestradiol may cause harm to your unborn child.
Do not take this medicine with medicines used to treat hepatitis C infection, such as combination drugs containing ombitasvir, paritaprevir, and ritonavir, with or without dasabuvir.
Inform your doctor if you have the following conditions:
- history of chloasma (discolouration of the skin especially on the face or neck during pregnancy)
- risk factors for heart disease or blood vessel problem e.g. high blood pressure, high cholesterol levels
- current or family history of high triglyceride (fat) levels
- diseases that may be worsened by fluid retention
- diabetes or prediabetes (a condition in which the blood sugar levels are higher than usual but not high enough to be diagnosed as diabetes)
- history of depression
- hereditary angioedema (a rare inherited disorder characterised by severe swelling of the limbs, face, bowel, and airways)
- systemic lupus erythematosus (an autoimmune disease that causes inflammation)
- kidney disease
Let your doctor know if you are breastfeeding.
If you have a tendency to develop chloasma, you should avoid exposure to the sun or UV rays while taking Norgestrel + Ethinylestradiol. Apply sunscreen and wear protective clothing and eyewear when going outdoors.
This medicine does not lower the risk of getting HIV infection or any other sexually transmitted diseases. Ensure that you use proper precautions to avoid getting these diseases.
It is strongly advised not to smoke while taking Norgestrel + Ethinylestradiol. Smoking cigarettes while taking this medicine may increase the risk of severe heart and blood-related side effects. Smoking is also harmful to your overall health. If you have a smoking habit, speak to your doctor or pharmacist about ways to stop your habit.
If you are going to have an operation, including minor surgery and dental work, inform your doctor or dentist that you are taking this medicine.
If you are going for certain laboratory tests (e.g. tests for cholesterol, sugar, or clotting factors), inform your doctor that you are taking this medicine.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Pregnancy tests must be done before treatment or before starting a new dosing cycle when you miss 2 consecutive menstrual periods to know if this medicine is suited for you to take.
- Routine tests (e.g. cholesterol or sugar levels, liver function) may be done while you are being treated with this medicine.
- Your blood pressure may rise to unsafe levels without you noticing it. Monitor your blood pressure before and during treatment.
- Regular monitoring of signs and symptoms of depression, unusual bleeding, and changes in vision may also be needed.
Your doctor will advise you about how often you need to have these tests.
Norgestrel + Ethinylestradiol may cause any of the following side effects: headache, nausea, vomiting, stomach pain or cramps, bloating, tiredness, pimples, rash, nervousness, weight gain or loss, increased appetite, worsening of varicose veins, dark, discoloured patches on the skin (usually in the face), menstrual cramps, infrequent menstrual period, spotting or bleeding between menstrual cycles, vaginal discharge or infection, and tender or enlarged breasts.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- pain, swelling, and tenderness in your leg accompanied by redness and warmth
- breathlessness, chest pain, irregular heartbeat
- weakness on one side of the body, difficulty speaking or thinking, changes in balance
- sudden, severe headache
- changes in the nipple, lumps in the breast or underarm, dimpling of the breast skin
- sudden changes in or loss of vision
- yellowing of the skin or eyes, stomach pain, dark coloured urine
- pain in the upper right area of the stomach, right shoulder area, or between the shoulder blades; fever with chills, very upset stomach or vomiting
- swelling of the ankles, feet, or hands
- unusual changes in mood or behaviour (being too depressed)
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Do not take Norgestrel + Ethinylestradiol with medicines used to treat hepatitis C infection, such as combination drugs containing ombitasvir, paritaprevir, and ritonavir, with or without dasabuvir.
Inform your doctor or pharmacist if you are taking or using any of these medicines:
- medicines for epilepsy (fits or seizures) e.g. topiramate, felbamate, phenytoin, phenobarbital, carbamazepine, oxcarbazepine, rufinamide, lamotrigine
- medicines to treat TB (a lung infection known as tuberculosis) e.g. rifampicin, rifabutin
- bosentan (medicine to treat high blood pressure in the blood vessels leading to the lungs)
- medicines for HIV infection e.g. etravirine
- aprepitant (medicine used to prevent nausea and vomiting caused by chemotherapy)
- medicines to treat fungal infection e.g. griseofulvin, itraconazole, ketoconazole
- ciclosporin (medicine used in organ transplant or certain immune diseases)
- tizanidine (muscle relaxant)
- theophylline (asthma medicine)
- colesevelam (cholesterol-lowering medicine)
- vitamin C supplements
- medicines for thyroid disease
- St. John's wort (herbal medicine)
This list does not include all medicines that may interact with Norgestrel + Ethinylestradiol.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
Avoid alcohol.
Avoid excessive consumption of grapefruit or grapefruit juice (more than 1 litre a day).
Store in a cool, dry place away from the reach of children.
Medicines must not be used past the expiry date.
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