Generic name: ethinyl estradiol and norethindrone, and ferrous fumarate (ETH in il ess tra DYE ole and nor ETH in drone)
Brand name: Blisovi 24 FE, Brevicon, Estrostep Fe, Femcon FE, Kaitlib FE, Lo Minastrin Fe, Loestrin 24 Fe, Microgestin 24 FE, Norinyl 1+35, Ortho-Novum 7/7/7, Taytulla, Tri-Norinyl, Zenchent
Drug class: Contraceptives, Sex hormone combinations
Loestrin 24 Fe (ethinyl estradiol and norethindrone, and ferrous fumarate) is a combination birth control pill containing female hormones that prevent ovulation (the release of an egg from an ovary). This medication also causes changes in your cervical mucus and uterine lining, making it harder for sperm to reach the uterus and harder for a fertilized egg to attach to the uterus.
Loestrin 24 Fe is used as contraception to prevent pregnancy.
Loestrin 24 Fe may also be used for purposes not listed in this medication guide.
Warnings
Do not use Loestrin 24 Fe if you are pregnant or if you have recently had a baby.
You should not use Loestrin 24 Fe if you have: uncontrolled high blood pressure, heart disease, coronary artery disease, circulation problems (especially with diabetes), undiagnosed vaginal bleeding, liver disease or liver cancer, severe migraine headaches, if you also take certain hepatitis C medication, if you have major surgery, if you smoke and are over 35, or if you have ever had a heart attack, a stroke, a blood clot, jaundice caused by pregnancy or birth control pills, or cancer of the breast, uterus/cervix, or vagina.
Taking Loestrin 24 Fe can increase your risk of blood clots, stroke, or heart attack.
Smoking can greatly increase your risk of blood clots, stroke, or heart attack. You should not take Loestrin 24 Fe if you smoke and are over 35 years old.
Loestrin 24 Fe side effects
Get emergency medical help if you have signs of an allergic reaction to Loestrin 24 Fe: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Stop using this medicine and call your doctor at once if you have:
- signs of a stroke - sudden numbness or weakness (especially on one side of the body), sudden severe headache, slurred speech, problems with vision or balance;
- signs of a blood clot - sudden vision loss, stabbing chest pain, feeling short of breath, coughing up blood, pain or warmth in one or both legs;
- heart attack symptoms - chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating;
- liver problems - loss of appetite, upper stomach pain, tiredness, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
- increased blood pressure - severe headache, blurred vision, pounding in your neck or ears;
- swelling in your hands, ankles, or feet;
- a change in the pattern or severity of migraine headaches;
- a breast lump; or
- symptoms of depression - sleep problems, weakness, tired feeling, mood changes.
Common Loestrin 24 Fe side effects may include:
- nausea, vomiting;
- breast tenderness;
- breakthrough bleeding;
- headache; or
- problems with contact lenses.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Before taking this medicine
Taking Loestrin 24 Fe can increase your risk of blood clots, stroke, or heart attack. You are even more at risk if you have high blood pressure, diabetes, high cholesterol, or if you are overweight. Your risk of stroke or blood clot is highest during your first year of taking birth control pills. Your risk is also high when you restart birth control pills after not taking them for 4 weeks or longer.
Smoking can greatly increase your risk of blood clots, stroke, or heart attack. Your risk increases the older you are and the more you smoke. You should not take Loestrin 24 Fe if you smoke and are over 35 years old.
Do not use if you are pregnant. Stop using Loestrin 24 Fe and tell your doctor right away if you become pregnant, or if you miss 2 menstrual periods in a row. If you have recently had a baby, wait at least 4 weeks before taking Loestrin 24 Fe.
You should not take Loestrin 24 Fe if you have:
- untreated or uncontrolled high blood pressure;
- heart disease (chest pain, coronary artery disease, history of heart attack, stroke, or blood clot);
- an increased risk of having blood clots due to a heart problem or a hereditary blood disorder;
- circulation problems (especially if caused by diabetes);
- a history of hormone-related cancer, or cancer of the breast, uterus/cervix, or vagina;
- unusual vaginal bleeding that has not been checked by a doctor;
- liver disease or liver cancer;
- severe migraine headaches (with aura, numbness, weakness, or vision changes), especially if you are older than 35;
- a history of jaundice caused by pregnancy or birth control pills;
- if you smoke and are over 35 years old; or
- if you take any hepatitis C medication containing ombitasvir/paritaprevir/ritonavir (Technivie).
To make sure Loestrin 24 Fe are safe for you, tell your doctor if you have ever had:
- heart problems, high blood pressure, or if you are prone to having blood clots;
- high cholesterol or triglycerides, or if you are overweight;
- depression;
- a seizure or migraine headache;
- diabetes, gallbladder disease, underactive thyroid;
- liver or kidney disease;
- irregular menstrual cycles; or
- fibrocystic breast disease, lumps, nodules, or an abnormal mammogram.
The hormones in Loestrin 24 Fe can pass into breast milk and may harm a nursing baby. Birth control pills may also slow breast milk production. Do not use if you are breast feeding a baby.
How should I take Loestrin 24 Fe?
Take Loestrin 24 Fe exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.
Each blister card (28 tablets) of Loestrin 24 Fe contains 24 white, round (active) tablets with 1 mg norethindrone acetate and 20 mcg ethinyl estradiol and 4 brown (placebo) tablets containing 75 mg ferrous fumarate. The ferrous fumarate tablets do not serve any therapeutic purpose.
Take your first pill on the first day of your period or on the first Sunday after your period begins. You may need to use back-up birth control, such as condoms with spermicide, when you first start using this medication. Follow your doctor's instructions.
Take one pill every day, no more than 24 hours apart. When the pills run out, start a new pack the following day. You may get pregnant if you do not take one pill daily. Get your prescription refilled before you run out of pills completely.
Use a back-up birth control if you are sick with severe vomiting or diarrhea.
You may have breakthrough bleeding, especially during the first 3 months. Tell your doctor if this bleeding continues or is very heavy.
If you need major surgery with long-term bed rest, you may need to stop using Loestrin 24 Fe for a short time. Any doctor or surgeon who treats you should know that you are using birth control pills.
While taking Loestrin 24 Fe, you will need to visit your doctor regularly.
Store Loestrin 24 Fe at room temperature away from moisture and heat.
What happens if I miss a dose?
Follow the patient instructions provided with your medicine. Missing a pill increases your risk of becoming pregnant.
If you miss 1 active pill, take 2 pills on the day you remember. Then take 1 pill per day for the rest of the pack.
If you miss 2 active pills in a row in Week 1 or 2, take 2 pills per day for 2 days in a row. Then take 1 pill per day for the rest of the pack. Use back-up birth control for at least 7 days following the missed pills.
If you miss 2 active pills in a row in Week 3, throw out the rest of the pack and start a new pack the same day if you are a Day 1 starter. If you are a Sunday starter, keep taking a pill every day until Sunday. On Sunday, throw out the rest of the pack and start a new pack that day.
If you miss 3 active pills in a row in Week 1, 2, or 3, throw out the rest of the pack and start a new pack on the same day if you are a Day 1 starter. If you are a Sunday starter, keep taking a pill every day until Sunday. On Sunday, throw out the rest of the pack and start a new pack that day.
If you miss 2 or more active pills, you may not have a period during the month. If you miss a period for 2 months in a row, call your doctor because you might be pregnant.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose may cause nausea or vaginal bleeding.
What to avoid
Do not smoke while taking Loestrin 24 Fe, especially if you are older than 35 years of age.
Loestrin 24 Fe will not protect you from sexually transmitted diseases--including HIV and AIDS. Using a condom is the only way to protect yourself from these diseases.
What other drugs will affect Loestrin 24 Fe?
Other drugs may interact with ethinyl estradiol and norethindrone, including prescription and over-the-counter medicines, vitamins, and herbal products. Some drugs can make Loestrin 24 Fe less effective, which may result in pregnancy. Tell your doctor about all your current medicines and any medicine you start or stop using.