TRICIRA LO (Norgestimate/ Ethinyl Estradiol)
TRICIRA LO (Norgestimate/ Ethinyl Estradiol)
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TRICIRA LO (Norgestimate/ Ethinyl Estradiol)

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What is this medication? 

Ethinyl Estradiol+Norgestimate
Contraceptive, estrogen and progestin combination

Brand Name US: Estarylla, Femynor, Mili, Mono-Linyah, Nymyo, Previfem, Sprintec 28, Tri Femynor, Tri-Estarylla, Tri-Linyah, Tri-Lo-Estarylla, Tri-Lo-Marzia, Tri-Lo-Mili, Tri-Lo-Sprintec, Tri-Mili, Tri-Nymyo, Tri-Previfem, Tri-Sprintec, Tri-VyLibra, Tri-VyLibra Lo, VyLibra
Brand Name Canada: Tri-Cira 21, Tri-Cira 28, Tri-Cira Lo 21, Tri-Cira Lo 28, TRI-Jordyna 21, TRI-Jordyna 28

“Alert: US Warning

Cigarette smoking increases the risk of serious cardiovascular events from hormonal contraceptive use. This risk increases with age, particularly in women over 35 years of age, and with the number of cigarettes smoked.”

How does this medication work? 

Ethinyl Estradiol+Norgestimate is a combination hormonal contraceptive that inhibits ovulation via a negative feedback mechanism on the hypothalamus, which alters the normal pattern of gonadotropin secretion of a follicle-stimulating hormone (FSH) and luteinizing hormone by the anterior pituitary. The follicular phase FSH and midcycle surge of gonadotropins are inhibited. In addition, Ethinyl Estradiol+Norgestimate produce alterations in the genital tract, including changes in the cervical mucus, rendering it unfavorable for sperm penetration even if ovulation occurs. Changes in the endometrium may also occur, producing an unfavorable environment for nidation. Ethinyl Estradiol+Norgestimate may alter the tubal transport of the ova through the fallopian tubes. Progestational agents may also alter sperm fertility.

How should I take this medication? 

Strength: 0.180mg/0.025mg - 0.215mg/0.025mg - 0.250mg/0.025mg

Usual (Oral): 1 tablet once daily

Schedule 1 (Sunday starter): Dose begins on first Sunday after onset of menstruation, if the menstrual period starts on Sunday, take first tablet that very same day. With a Sunday start, an additional method of contraception should be used until after the first 7 days of consecutive administration.

Schedule 2 (Day 1 starter): Dose starts on first day of menstrual cycle taking 1 tablet daily.

How to Take: Administer at the same time each day at intervals no >24 hours. Ethinyl Estradiol+Norgestimate may be initiated at any time during the menstrual cycle if it is reasonably sure the woman is not pregnant. Back-up contraception should be used for 7 days unless contraception is initiated within the first 5 days of menstrual bleeding or the woman abstains from sexual intercourse. Ethinyl Estradiol+Norgestimate may be started immediately following or within 7 days of a first or second trimester abortion; backup contraception is needed for 7 days unless contraception is started at the time of surgical abortion. 

What should I watch for while using this medication? 

When starting Ethinyl Estradiol+Norgestimate make sure your physician is aware of any allergies or medications you currently take, and prior medical history.  The use of Ethinyl Estradiol+Norgestimate has been associated with an increased risk of cervical cancer, chloasma, cholestasis, hypertriglyceridemia, dyslipidemia, thromboembolic disorders including venous thromboembolism.  Breakthrough or intracyclic bleeding and spotting may occur, especially during the first 3 months of therapy. In addition, occasional missed periods may occur.  Ethinyl Estradiol+Norgestimate should be used with caution in patients with risk factors for cardiovascular disease such as hypertension, low HDL, high LDL, high triglycerides, older age, diabetes, women who smoke.  Use with caution in patients with a history of depression, discontinue if serious depression recurs.  Glucose tolerance may be impaired, use with caution in women with diabetes or prediabetes. Do not use Ethinyl Estradiol+Norgestimate in patients with pre-existing hepatic tumors, liver cirrhosis, uncontrolled hypertension, headaches with focal neurological symptoms, or migraine headaches with or without aura if >35 years of age, complicated organ transplants, and systemic lupus erythematosus (SLE).

What if I miss a dose?

Take the pill as soon as you remember. Then take the rest of the pills like you normally would. To stay on schedule, this might mean that you have to take two pills in one day.

If severe diarrhea or vomiting occur within 3 to 4 hours after taking an active tablet, it should be considered a missed dose; additional contraceptive measures are recommended.

Note: If all doses have not been taken on schedule and one menstrual period is missed, the possibility of pregnancy should be considered. If two consecutive menstrual periods are missed, pregnancy test is required before new dosing cycle is started.

How should I store this medication?

Keep out of the reach of children at all times. Store at room temperature, 59 to 86° F (15 to 30° C). Protect from light. Keep the container tightly closed. Properly dispose of any unused medication after the expiration date.

What are the possible side effects of using this medication?

Headache, breast tenderness and engorgement, nausea, application site reaction, increased blood pressure, anxiety, mood disorder, dizziness, fatigue, migraine, insomnia, malaise, acne vulgaris, pruritis, chloasma, contact dermatitis, erythema, skin irritation, menstrual disease, weight gain, change in libido, dyslipidemia, fluid retention, galactorrhea, premenstrual syndrome, abdominal pain, vomiting, diarrhea, abdominal distention, cholecystitis, dysmenorrhea, vaginal hemorrhage, vulvovaginal candidiasis, genital discharge, uterine spasm, vaginal dryness.

Note this is not a complete list of side effects, only the most common.