Ortho Tri-Cyclen

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 treatment of acne. 

How does Ortho Tri-Cyclen work?

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.   

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.

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 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.

• Sunday start: 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.

How to take Ortho Tri-Cyclen

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. 

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.

Contraindications

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

• Liver cancer

• 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

• 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

 

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 Ortho Tri-Cyclen. These include:

• Barbiturates

• Bosentan

• Carbamazepine

• Felbamate

• Griseofulvin

• Oxcarbazepine

• Phenytoin

• Rifampin

• St. John's wort

• Topiramate

If you are prescribed antibiotics while taking Ortho Tri-Cyclen, you should use a backup birth control method while taking the antibiotics.

Alternatives to Ortho Tri-Cyclen

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.