Oral contraceptives, commonly known as birth control pills, are most frequently used to prevent pregnancy. Other uses for oral contraceptives include treatment for acne, regulate the menstrual cycle, and to help ease premenstrual symptoms. Oral contraceptives contain certain hormones which cause changes in the women’s reproductive system in order to prevent pregnancy.
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Written by Patrick Moser, FNP-BC
Information last reviewed 06/21/19
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 treatment of acne.
There are three actions caused by the hormones, estrogen and progesterone, in Ortho Tri-Cyclen. The first of these actions is to suppress ovulation. Ortho Tri-Cyclen also thickens the mucus lining of the cervix, or entrance to the womb, and changes the lining of the uterus, or womb. All of these actions work to prevent fertilization of an egg or implantation of a fertilized egg.
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.
The active ingredients in Ortho Tri-Cyclen are ethinyl estradiol (estrogen component) and norgestimatel (progesterone component).
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.
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 Ortho Tri-Cyclen, the Day 1 Start and the Sunday Start.
Day 1 start:
This is the most commonly used starting method for Ortho Tri-Cyclen. Start with the first active white tablet on the first day of menstruation, which is known as Day 1 of the menstrual cycle. Take the tablets in order according to the dispenser.
With the Sunday start, the first tablet should be taken on the Sunday after the onset of the menstrual period. Again, start with the first active white tablet and take them in order as packaged.
Ortho Tri-Cyclen should be taken at around the same time every day. The pills should be taken in order according to the packaging. Your menstrual period should occur during the seven days of inert, or inactive, tablets. This does not mean that your period will last seven days, although it can. Take Ortho Tri-Cyclen at a time of day when you are most likely to remember to avoid late or missed doses.
Possible side effects of Ortho Tri-Cyclen include:
Nausea or vomiting
Gastrointestinal symptoms (such as abdominal cramps and bloating)
Change in menstrual flow
Amenorrhea (Cessation of menstrual periods)
Temporary infertility after discontinuation of treatment
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
Allergic reaction, including rash, urticaria, angioedema
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.
You should not take Ortho Tri-Cyclen if you have any of the following conditions:
History of deep vein thrombosis (DVT), or blood clots in the veins
Coronary artery disease
Cerebral vascular disease
Severe hypertension (high blood pressure)
Diabetes with vascular disease
Headaches with focal neurological symptoms
Major surgery with prolonged immobilization
Abnormal vaginal bleeding for which you have not been evaluated
Known or suspected breast cancer or personal history of breast cancer
Endometrial cancer or other known or suspected estrogen-sensitive cancer
Cholestatic jaundice of pregnancy or jaundice (yellowing of the skin) with prior pill use
Acute or chronic liver disease with abnormal liver function
Known or suspected pregnancy
Hypersensitivity to any component of Ortho Tri-Cyclen
Extra care should be taken if you:
Have a family history of blood clots
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
Seek immediate medical attention if you experience any of the following:
Some medications can decrease the effectiveness of Ortho Tri-Cyclen. These include:
St. John's wort
If you are prescribed antibiotics while taking Ortho Tri-Cyclen, you should use a backup birth control method while taking the antibiotics.
There are several different types of birth control pills available. You may have to try a few different ones before you find the pill that works best for you. You may have heard of the mini pill, which contains progesterone only. The mini pill is a good alternative if you are sensitive to estrogen. Progesterone-only pills are also used for women who are breastfeeding. Other alternatives include the implant, IUD (intrauterine device), and injections. These options have the advantage that you do not need to remember to take a pill every day. However, there are some side effects with these methods which can make them undesirable. Make sure you talk to your doctor and get the information you need to make the best decision for you.
Ortho Tri-Cyclen is indicated for the treatment of moderate acne vulgaris. Ortho Tri-Cyclen can reduce inflammatory acne lesions by up to 60 percent after six to nine months of use. Roughly 50 to 90 percent of women have a positive response to oral contraceptives when used to treat acne.
Perimenopause is the 2-8 years before menstrual periods stop completely. During this time, the production of estrogen decreases, and the menstrual cycle fluctuates. Many women experience hot flashes and night sweats. Heavy periods and growth of fibroids are more likely to occur early in perimenopause. Taking oral contraceptives such as Ortho Tri-Cyclen can help to reduce the hot flashes and ease other symptoms which commonly occur during this time.
A comprehensive review of studies revealed that oral contraceptives, including Ortho Tri-Cyclen, are as effective in overweight and obese women compared to women who are not overweight. The evidence did suggest that overweight and obese women are less likely to use any type of contraception. However, the reason for this was not specified in the review.
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