Nortrel is a type of birth control pill called a combined oral contraceptive. This means that it contains synthetic versions of both estrogen and progesterone hormones. Each pack of Nortrel also contains seven white placebo pills to help you keep track of when to start your next pack after your period.
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Reviewed by Dr Yasmin Aghajan, MD
Information last reviewed 07/17/19
Nortrel is a type of combined oral contraceptive pill. It is primarily used as a birth control pill, but it can also be used to alleviate period pain, reduce acne and to treat endometriosis and other conditions. A pack of Nortrel contains both the active birth control pills (light yellow tablets) and placebo pills (white tablets). The placebo pills can help you to keep track of when to restart the active pills after your period.
Nortrel contains synthetic versions of the female sex hormones, estrogen and progesterone. This means that Nortrel helps to prevent pregnancy in the following ways:
Nortrel is 99% effective in preventing pregnancy. A more accurate success rate of Nortrel takes into account women who occasionally miss one or more pills, and is about 95%. Nortrel will NOT prevent you from contracting STIs, nor will any other form of hormonal contraception. The only contraceptive to offer protection from STIs is condoms.
Only the light yellow pills contain active ingredients. The active ingredients in Nortrel are 35mcg ethinyl estradiol (EE) and 0.5mg Norethindrone
The active pills, which are coloured light yellow, contain the following inactive ingredients: D&C yellow no. 10 aluminum lake, lactose monohydrate, magnesium stearate and pregelatinized corn starch.
The white placebo pills contain only the following inactive ingredients: lactose monohydrate, magnesium stearate, and pregelatinized corn starch.
The usual dosage of Nortrel is 1 x active tablet, containing 35 mcg ethinyl estradiol (EE) and 0.5 mg Norethindrone) per day for the first 21 days, and 1 x inactive tablets for the following 7 days. However, your doctor may choose to prescribe a stronger dose of Nortrel, in which the active tablets contain 35 mcg ethinyl estradiol and 1 mg Norethindrone.
Always read the package instructions carefully before use, and never start taking Nortrel without first consulting a doctor. Nortrel comes in a 28-day blister pack, containing 21 active pills and 7 inert pills, marked with the days of the week. You have 2 options of how to start Nortrel:
Take 1 pill per day at the same time each day. To help you remember, try and make this a part of your daily routine: for example, take your pill in the morning after you brush your teeth. When you finish the 21 active pills, move onto the inert pills the following day without leaving a break. During these 7 days, you will experience a bleed similar to your regular period. This is known as a withdrawal bleed, which is caused by the drop in progesterone and will not necessarily last for 7 days. When you reach the end of the 28-day pack, start a new pack the very next day regardless of whether you are still bleeding or not. Always make sure you have a new pack ready.
If you forget to take one of your active pills, take it as soon as you remember and continue with your next dose at the normal time. If you miss 2 active pills, take 2 as soon as you remember and 2 the next day, before carrying on as normal. In this instance, you should you use an additional method of contraception, such as condoms, for the following days, as missing pills can reduce the effectiveness of Nortrel. You may also experience some breakthrough bleeding or spotting, but this is completely normal. If you miss one of your inert pills, dispose of the missed pill and carry on as normal. If you are unsure about what to do in the event of a missed pill or pills, contact your doctor or health worker for advice.
Generally, you can stop taking Nortrel at any point during your pack. You do not usually have to wait until the end of the pack but, if you wait until you finish your pack, you will get your period at the normal time. When you finish taking the pill, it can take a few months for your menstrual cycle to return to normal. You should be aware that this could have an effect upon how likely you are to conceive during this time, however, it is possible to conceive as soon as you stop taking the pill. If you are switching from Nortrel to another combined pill, you can stop taking Nortrel and start taking the new pill straight away. You do not need to finish the pack. However, it is a good idea to check the instructions in the patient information leaflet before switching, just in case there are special requirements for different pills. If you are switching to a progesterone-only pill (mini pill), it is generally recommended that you finish your current pack and start the new pack on the first day of your period.
Common side effects of Nortrel include:
It is also possible to experience a range of less common side effects. You should always ensure that you read the patient information leaflet before taking any medication. You should also re-read the leaflet when you are prescribed medication again, in case there have been any updates.
If you experience any of the following symptoms you should seek emergency medical attention:
Do NOT take Nortrel if you:
In addition, you should let your doctor know if you have any of the following:
You are also strongly advised not to smoke while using hormonal contraceptives.
Before taking Nortrel, tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including those purchased over the counter without a prescription. The following drugs may interfere with the effectiveness of Nortrel:
Nortrel may interfere with the activity of the following medications:
There are many types of hormonal contraceptives available, and it is not uncommon for women to try a few different ones before finding the right fit for them. Different brands contain different types of synthetic hormones, and you may find that you are more sensitive to some than others. Women who are particularly sensitive to estrogen will be better suited to a low-estrogen combined oral contraceptive, which contains a lower dose of estrogen and therefore is associated with less estrogen-related side effects. Alternatively, your doctor may recommend the progestogen-only pill, also known as the mini pill, which contains progestogen only and is taken continuously without a gap for a monthly bleed.
If you struggle to remember to take your pill each day, you can try a form of hormonal contraceptive that is not taken orally. These include the implants (Implanon, Nexplanon), injections (Depo-Provera), and intrauterine devices (IUD, Mirena, ParaGard, Skyla, Liletta, Kyleena). The IUD in particular is suited to women with certain existing health conditions, such as diabetes or hypertension, as it works locally on the reproductive system. For advice on which type of contraceptive might be best for you, speak to your doctor or health worker.
Some women opt out of using hormonal contraceptives altogether and rely instead on barrier methods of contraception, including the cervical cap (FemCap), and male and female condoms. Remember, male condoms are the only form of contraception to offer protection against STIs when used correctly.
Nortrel is overall considered to be a safe and effective form of contraception. Hormonal contraceptives in general have been linked to an increased risk of developing blood clots, heart disease, gallbladder disease, liver tumours, and estrogen-sensitive cancers, such as breast cancer, ovarian cancer and endometrial cancer. Though most women will not experience these conditions, if you have a personal or family history of any of the above conditions, make sure you inform your doctor before starting an oral contraceptive, as it may not be suitable for you. See ‘Contraindications’ above or more information.
Nortrel will NOT protect you from contracting STIs, nor will any other form of hormonal contraceptive. Male condoms are the only form of contraception to offer protection against STIs when used correctly.
Yes, when taking Nortrel you will experience what is known as a monthly withdrawal bleed, a simulation of a natural period triggered by the drop in progestogen when you stop taking the active pills. When you first start taking Nortrel you may experience some breakthrough bleeding (bleeding between menstrual periods) or spotting; this is normal and often stops in time. However, if you are worried that you are bleeding particularly heavily or often, speak to your doctor for advice.
Oral contraceptives are designed primarily to prevent pregnancy, but in some cases are also prescribed to treat other hormone-related conditions such as acne and painful, irregular, or heavy periods. In addition, they are thought to have other health benefits, such as decreasing the incidence of ovarian cysts, lowering the risk of ovarian and uterine cancers, and preventing ectopic pregnancies (a type of abnormal pregnancy in which the fertilized egg attaches outside of the womb).
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.
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