Low in estrogen but effective in preventing unplanned pregnancies

Chateal is a combination pill with only a small dose of estrogen, making the drug an optimal birth control choice for women who are susceptible to estrogen side effects.

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Written by Patrick Moser, FNP-BC

Information last reviewed 06/21/19


What is Chateal?

Chateal is an oral contraceptive that contains both progesterone and estrogen. It is considered a low-dose oral contraceptive because it contains a lower dose of progesterone compared to some other birth control pills. Chateal is taken daily to prevent pregnancy; it can also be used as emergency contraception.

How does Chateal work?

The hormones - estrogen and progesterone - in Chateal act to suppress ovulation, thicken the cervical mucus lining – the entrance to the womb – and cause changes to the lining of the womb. These three actions prevent an egg from being fertilized.  


Active ingredients

The active ingredients in Chateal are ethinyl estradiol (estrogen component) and levonorgestrel (progesterone component).

Inactive ingredients

The inactive ingredients in Chateal are lactose monohydrate, magnesium stearate, and polacrilin potassium. The inactive pills also contain artificial colors.

Which ingredients can cause an allergic reaction?

Oral birth control rarely causes a severe allergic reaction that requires medical attention. Chateal does however contain lactose monohydrate. This additive is safe and usually does not cause any uncomfortable symptoms for those who are lactose intolerant. However, if you have a severe lactose allergy, you might want to try another form of birth control that does not contain lactose. 


How to start Chateal

Chateal comes in small plastic packs with 28 tablets each. The 21 active tablets are colored white. They are the ones that contain active hormones. The 7 green tablets are inactive pills; they do not contain hormones. Chateal can be started on day 1 or on a Sunday.

  • Day 1 start: If you’re starting Chateal on Day 1 it means you are taking your first active tablet (white) on the first day of your menstrual cycle. Most patients prefer this option.
  • Sunday start: If you prefer a Sunday start, you should take your first white tablet on Sunday after your menstruation has started. Continue to take the pills in the order they are in.

How to take Chateal

It’s important that you take Chateal at the same time each day and in the order the pills are packaged in. You should get your menstruation during the seven days when you are taking the inactive (green) tablets. That is not to say your menstrual cycle will be exactly seven days long, but it could be. Try and pick a suitable time during the day to take the pill. This will make it easier to remember when you should take Chateal and avoid missing any doses.

Side Effects

Chateal side effects

Possible side effects of Chateal include:

  • Nausea or vomiting
  • Headache
  • Abdominal pain, cramping, or bloating
  • Edema, or fluid retention
  • Amenorrhea (menstrual periods stop)
  • Breast tenderness, enlargement, or secretion
  • Swelling of the ankles or feet
  • Change in weight or appetite
  • Decreased serum folate levels
  • Aggravation of varicose veins
  • Irregular periods, especially in the first few months of use
  • Vaginal bleeding or spotting between periods
  • Decreased libido
  • Mood changes, to include depression
  • Increased blood pressure
  • Contact lens intolerance
  • Pancreatitis
  • Gallbladder disease
  • Liver problems

Chateal and other oral contraceptives do not protect against sexually transmitted infections.


Do NOT take Chateal if you:

  • Have been diagnosed with adrenal insufficiency
  • Are pregnant or think you might be pregnant
  • Are breastfeeding
  • Experience undiagnosed abnormal vaginal bleeding
  • Have or had breast cancer or other estrogen- or progestin-sensitive cancer
  • Have had a stroke or heart attack in the past
  • Have high blood pressure
  • Have or have had a blood clot
  • Are over the age of 35
  • You smoke
  • Have been diagnosed with diabetes with vascular disease
  • Are being treated for Hepatitis C
  • Are sensitive to ethinyl estradiol, levonorgestrel, or another component of Chateal

Extra care should be taken if you:

  • Have a family history of blood clots
  • Smoke
  • Are diabetic
  • Have a history of migraine headaches
  • Have a history of hepatic adenomas
  • Have a history of gallbladder disease
  • Have a history of liver disease, to include hepatitis
  • Have a history of hereditary angioedema
  • Have a history of depression

Seek immediate medical attention if you experience any of the following:

  • Severe abdominal pain
  • Severe headache, especially if you do not have a history of a headache disorder
  • Chest pain
  • Vision changes or eye pain
  • Severe leg pain or swelling

Drug interactions

Some medications can decrease the effectiveness of Chateal. These include:

  • Barbiturates
  • Bosentan
  • Carbamazepine
  • Felbamate
  • Griseofulvin
  • Oxcarbazepine
  • Phenytoin
  • Rifampin
  • St. John's wort
  • Topiramate

If you are taking antibiotics at the same time as Chateal, it is advisable to use another contraceptive method such as condoms.

Treatment Options

How effective is Chateal?

When taken correctly, Chateal is more than 99% effective at preventing pregnancy. This means that fewer than one woman out of 100 women who use Chateal for contraception will get pregnant in one year. Other forms of birth control, such as the IUD and implant, may be more effective than Chateal.

Chateal for emergency contraception

Chateal is indicated for emergency contraception. The dosage for emergency contraception is 4 white (active) pills as soon as possible after unprotected or inadequately protected sexual intercourse, followed by 4 white pills 12 hours after the first dose. Although it can be used for emergency contraception, it is not as effective compared to progesterone (Levonorgestrel or mifepristone) only. The progesterone-only pills, commonly known as plan B, are the preferred medication for emergency contraception.

Alternatives to Chateal

Chateal is one of many different types of contraceptive pills and it may take you a while to find the right one for you. If you have a sensitivity toward estrogen, you can try the progesterone-only or ‘mini pill’. The mini pill is also a better choice for women who are breastfeeding. If you’d prefer not to have to take a pill every day or you find it difficult to remember, your options include implants, the intrauterine device (IUD) and hormonal injections. Make sure you speak to your doctor about the side effects of these alternatives. They can help you find the right contraceptive method.


Disclaimer: This is not medical advice. You and your physician will determine if and how you should take any medication prescribed to you following a medical consultation.

  1. “DailyMed - CHATEAL - Levonorgestrel and Ethinyl Estradiol” (U.S. National Library of Medicine) <> accessed June 11, 2019 
  2. “Ectopic Pregnancy Directory: Find News, Features, and Pictures Related to Ectopic Pregnancy” (WebMD) <> accessed June 11, 2019 
  3. “Emergency Contraception: Pill Brands, Doses, and Instructions” (Princeton University) <> accessed June 11, 2019 
  4. Shen J and others, “Interventions for Emergency Contraception” [2017] Cochrane Database of Systematic Reviews

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