Ortho Tri-Cyclen

Avoid pregnacy with Ortho Tri-Cyclen birth control pills on prescription

Ortho Tri-Cyclen is a multiphasic birth control pill that aims to better mimic the body’s natural menstrual cycle by varying the hormone dosage over time.

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Written by Patrick Moser, FNP-BC

Information last reviewed 06/21/19


What is Ortho Tri-Cyclen?

Ortho Tri-Cyclen is a triphasic combined oral contraceptive and contains an estrogen component (ethinyl estradiol) and a progesterone component (norgestimate). Triphasic means that there are three phases, each of which contains a different amount of norgestimate. This is further explained in the “dosage” section below. Ortho Tri-Cyclen, when taken daily, is used to prevent pregnancy. It is also indicated for acne treatment. 

How does Ortho Tri-Cyclen work?

Ortho Tri-Cyclen contains estrogen and progesterone. These hormones suppress ovulation, thicken the cervical mucus lining and alter the lining of the womb. These three actions prevent the fertilization or implantation of an egg.

How effective is Ortho Tri-Cyclen?

When taken correctly, Ortho Tri-Cyclen is more than 99% effective at preventing pregnancy. This means that fewer than one woman out of 100 women who use Ortho Tri-Cyclen for contraception will get pregnant in one year. Other forms of birth control, such as the IUD and implant, may be more effective than Ortho Tri-Cyclen because they do not require you to remember to take a pill every day. These might be better for people who have problems remembering to take medication daily. 


Active ingredients

The active ingredients in Ortho Tri-Cyclen are ethinyl estradiol (estrogen component) and norgestimatel (progesterone component).

Inactive ingredients

The inactive ingredients in Ortho Tri-Cyclen are carnauba wax, croscarmellose sodium, hypromelloses, lactose, magnesium stearate, microcrystalline cellulose, polyethylene glycol, titanium dioxide, and water. The colored tablets also contain artificial coloring.

Which ingredients can cause an allergic reaction?

Other than the small amount of lactose present in the pill, which should not cause any uncomfortable symptoms unless you have a severe lactose intolerance, Ortho Tri-Cyclen is not known to cause severe allergic reactions in users. 


How to start Ortho Tri-Cyclen

Ortho Tri-Cyclen is packaged in a Veridate tablet dispenser. Each dispenser contains 28 tablets. The 7 white tablets, for days 1-7, contain 0.035 mg of ethinyl estradiol and 0.180 mg of norgestimate. There are 7 light blue tablets, days containing 0.035 mg of ethinyl estradiol and 0.215 mg of norgestimate, 7 blue tablets which contain 0.035 mg of ethinyl estradiol and 0.250 mg of norgestimate. The remaining 7 tablets are dark green and do not contain hormones; these are the inactive pills. There are two ways to start taking Ortho Tri-Cyclen: Day 1 start or the Sunday start.

  • Day 1 start: This is a popular option whereby patients take the first active (white) tablet on the first day of their menstrual cycle and then continue to take the pills in the order of the packaging.
  • Sunday start: Alternatively, you can start taking the first active (white) tablet on the Sunday after the start of your menstruation. Continue to take the pills in the order they are packaged in.

How to take Ortho Tri-Cyclen

Ortho Tri-Cyclen should be taken daily around the same time and patients should follow the order in the packaging. You should get your period during the seven days when you are taking the inactive tablets. Period length can vary during this time. Try to find a suitable time each day to take the pill – one that you can remember easily to avoid missing a pill.  

Side Effects

Ortho Tri-Cyclen side effects

Possible side effects of Ortho Tri-Cyclen include:

  • Nausea or vomiting

  • Gastrointestinal symptoms (such as abdominal cramps and bloating)

  • Breakthrough bleeding

  • Spotting

  • Change in menstrual flow

  • Amenorrhea (cessation of menstrual periods)

  • Temporary infertility after discontinuation of treatment

  • Edema

  • Melasma which may persist

  • Breast changes, which may include tenderness, enlargement, secretion

  • Change in weight (increase or decrease)

  • Interference with lactation if given immediately postpartum

  • Cholestatic jaundice

  • Migraine headaches

  • Allergic reaction, including rash, urticaria, angioedema

  • Mental depression

  • Reduced tolerance to carbohydrates

  • Vaginal candidiasis (yeast infection)

  • Change in corneal curvature (steepening)

  • Intolerance to contact lenses

Ortho Tri-Cyclen and other oral contraceptives do not protect against sexually transmitted infections.


Do NOT take Ortho Tri-Cyclen if you have any of the following conditions:

  •  Abnormal vaginal bleeding

Take extra care if you have any of the following:

  • Have a family history of blood clots

  • Smoke

  • Are diabetic

  • Have a history of migraine headaches

  • Have a history of gallbladder disease

  • Have a history of hepatic adenomas

  • Have a history of liver disease, to include hepatitis

  • Have a history of hereditary angioedema

  • Have a history of depression

Should you experience any of the following, find medical help immediately:

  • 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

Below are known medications that can decrease Ortho Tri-Cyclen’s effectiveness. They include:

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

If you are taking antibiotics at the same time as Ortho Tri-Cyclen, make sure you use a backup birth control method such as condoms.

Treatment Options

Alternatives to Ortho Tri-Cyclen

When it comes to choosing the best birth control pill, you have many different choices. To find the one that works for you, you may want to try different ones. If you are sensitive to estrogen or are currently breastfeeding, you can opt for the progesterone-only or ‘mini-pill'. Other hormonal contraceptives include the intrauterine device (IUD), injections and the contraceptive patch. They are advantageous if you worry that you may forget to take a pill. It’s best to consult your doctor when considering alternatives as their side effects may be different from those of the birth control pill.  


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 - ORTHO TRI CYCLEN- Norgestimate and Ethinyl Estradiol ORTHO CYCLEN- Norgestimate and Ethinyl Estradiol” (U.S. National Library of Medicine) https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=384e7a40-dcbd-4908-bf5e-65abc9932973, accessed June 20, 2019 
  2. James WD, “Acne” (2005) 352 The New England Journal of Medicine 1463 
  3. Moskowitz D, “A Comprehensive Review of the Safety and Efficacy of Bioidentical Hormones for the Management of Menopause and Related Health Risks ”(2006) 11 Alternative Medicine Review 208 
  4. Trussell J, Schwarz EB and Guthrie K, “Obesity and Oral Contraceptive Pill Failure” (2009) 79 Contraception 334

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