Have safer sex with Tri-Sprintec birth control pills on prescription

Tri-Sprintec is a tri-phasic combined pill that is designed to imitate the hormonal ups and downs of the menstrual cycle. It also is used to treat acne, endometriosis and period pain.

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Reviewed by Dr Yasmin Aghajan, MD

Information last reviewed 07/07/19


What is Tri-Sprintec?

Tri-Sprintec is a type of birth control pill known as a combined oral contraceptive - this means that it contains synthetic versions of both estrogen and progesterone. Tri-Sprintec is also a tri-phasic pill, meaning that the levels of the active ingredients vary between different pills in the pack. Tri-Sprintec is used primarily to prevent pregnancy, however it has a number of other applications including:

  • Reducing acne
  • Helping Endometriosis
  • Avoiding period pain
  • Alleviating PMS (premenstrual syndrome)
  • Preventing iron-deficiency anemia
  • Reducing chances of developing cysts on breasts or ovaries
  • Reducing the chance of endometrial and ovarian cancer.

How does Tri-Sprintec work?

Tri-Sprintec works in three ways:

  1. The progesterone helps to prevent ovulation from occurring, meaning that the ovaries will not release an egg.
  2. The mucus around the ovaries and the vagina becomes thicker and less hospitable to sperm, so sperm cannot reach an egg if an egg is released. 
  3. The estrogen alters the endometrium (lining of the womb/uterus) so that if an egg was fertilized, it would not be able to implant and develop. Instead, it would naturally pass out of the body. 

How effective is Tri-Sprintec?

Tri-Sprintec and other hormonal contraceptives are 99% effective in preventing pregnancy. A more accurate success rate, which takes into account women who occasionally miss one or more pills, or who are late taking their pill, is approximately 97%.


Active ingredients

Tri-Sprintec has three different phases of pills and a set of placebo pills. The differences are indicated by their color. The dose of  ethinyl estradiol (EE) - the synthetic estrogen - remains the same across all the active pills (35mcg), however the dose of norgestimate - the synthetic progesterone - varies across the pack, so the active ingredients are as follows:

  • Gray tablets - 35mcg EE and 0.18mg norgestimate (7 days)
  • Light blue tablets - 35mcg EE and 0.215mg norgestimate (7 days)
  • Blue tablets - 35mcg EE and 0.25mg norgestimate (7 days)
  • White tablets - These are placebos so do not contain any active ingredients. Instead, they are used to help you keep track of when to take your pills.

Inactive ingredients

The inactive ingredients vary slightly between the different colors of Tri-Sprintec pills. They are as follows:

  • Gray tablets - anhydrous lactose, lactose monohydrate, lake blend black LB 636 (ingredients include aluminum sulfate solution, aluminum-chloride solution, FD&C blue no. 2, FD&C red no. 40, FD&C yellow no. 6, sodium bicarbonate and sodium carbonate), magnesium stearate, and pregelatinized corn starch.
  • Light blue tablets - anhydrous lactose, FD&C blue no. 2 aluminum lake (ingredients include aluminum sulfate solution, aluminum-chloride solution, FD&C blue no. 2, sodium bicarbonate and sodium carbonate), lactose monohydrate, magnesium stearate, and pregelatinized corn starch
  • Blue tablets - anhydrous lactose, FD&C blue no. 2 aluminum lake (ingredients include aluminum sulfate solution, aluminum-chloride solution, FD&C blue no. 2, sodium bicarbonate and sodium carbonate), lactose monohydrate, magnesium stearate, and pregelatinized corn starch.
  • White tablets - anhydrous lactose, hypromellose, magnesium stearate, and microcrystalline cellulose.

Which ingredients can cause an allergic reaction?

Tri-Sprintec contains multiple ingredients that have been linked to allergic reactions in people. These include Blue 2, Red 40, and Yellow 6. While it is not known exactly who is at an increased risk of an allergic reaction, it is important to look out for the signs of a severe allergic reaction. These include dizziness, lip swelling, difficulty breathing, and hives. Seek immediate medical attention if you notice these symptoms. 


Tri-Sprintec Dosage

The usual dosage of Tri-Sprintec is as follows:

  • 1 x gray pills, containing 35 mcg EE and 0.18 mg norgestimate, per day for the first 7 days  of your cycle (week 1).
  • 1 x light blue pills, containing 35 mcg EE and 0.215 mg norgestimate, per day for the following 7 days (week 2).
  • 1 x blue pills, containing 35 mcg EE and 0.25 mg norgestimate, per day for the following 7 days (week 3).
  • 1 x white, inert pills per day for the final 7 days of your cycle (week 4).

How to start Tri-Sprintec

Never start taking Tri-Sprintec without first obtaining a personal prescription from a doctor, and make sure to read the package instructions carefully before use. When starting Tri-Sprintec, you have 2 options:

  • Sunday start: Take the first active pill (gray), marked as ‘Sunday’, on the first Sunday after the start of your menstruation, even if you are still bleeding. Make sure you use additional contraception such as condoms for the next 7 days if you opt for a Sunday start. 
  • Day-1 start: Take the first active pill (gray) marked with the day of the week on which your period starts, on the first day of your period. You will not need to use an additional method of contraception if you choose this method.

How to take Tri-Sprintec

Take your pill 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 when you brush your teeth. Follow the 28-day carefully, taking 1 gray pill for the first 7 days, then 1 light blue pill per day for 7 days, then 1 blue pill per day for the next 7 days, and finally, 1 white, inert pill for the last 7 days. While you are taking the white pills, you will experience a withdrawal bleed, a simulation of a natural period caused by the drop in your progestogen dose. This bleed will not necessarily last for 7 days, but it is important that you continue to take the inert pills for the full 7 days before starting a new pack. Always make sure you have  new pack ready, as you will need to start it the day after finishing the old pack without leaving a break. 

What to do if you miss a pill

In case you miss an active pill (grey, light blue or blue), make sure you take it immediately after you remember. Then you can continue as normal. This may mean that you have to take 2 pills in one day. Should you miss 2 active pills consecutively, take 2 once you remember and follow up by taking another 2 the next day. Then continue as normal. If you miss more than 1 pill, make sure to use an additional method of contraception as Tri-Sprintec’s effectiveness can be reduced if doses are missed. It is normal to experience some breakthrough bleeding. If you are worried about having missed a pill consult a health worker or doctor.

Side Effects

Tri-Sprintec side effects

Common side effects of Tri-Sprintec are:

  • Nausea
  • Breast tenderness
  • Headache
  • Irregular bleeding i.e. spotting, bleeding between periods, irregular periods

There are a number of other less common side effects that you could experience, so it is recommended that you always read the patient information leaflet before taking any medication. 

Combined contraceptive pills have a recognized risk of causing blood clots. Blood clots can lead to a number of conditions, including strokes and heart attacks. Therefore, if you experience any of the following symptoms, you should seek immediate medical attention:

  • Breathing difficulties
  • Fainting or Dizziness
  • Chest pain - especially pain that spreads into your jaw or left arm
  • Confusion
  • Slurred speech
  • Severe headaches or migraines
  • Changes in vision, including double vision and partial or full blindness
  • Lack of coordination
  • Excessive sweating

You should also be aware that it is possible to experience an allergic reaction in response to Tri-Sprintec. If you experience hives, breathing difficulties, or swelling of the face, mouth, lips, tongue or throat, you should seek emergency medical attention. 


Do NOT take Tri-Sprintec if:

  • You have an allergy to any of its active or inactive ingredients
  • You are or think you may be pregnant, or are planning on becoming pregnant
  • You have a history of stroke or heart attack
  • You have blood clots in the legs (thrombophlebitis), lungs (pulmonary embolism), brain (stroke) or eyes
  • You have previously had blood clots in the deep veins of your legs
  • You have chest pain (angina pectoris)
  • You have or suspect you have breast cancer or cancer of the cervix, uterus lining or vagina
  • You experience unexplained vaginal bleeding
  • You have had jaundice (yellowing of the skin or whites of the eyes) during pregnancy or during the use of other contraceptive medication
  • You have a liver tumor (benign or cancerous)
  • You will be undergoing major surgery
  • You have headaches with focal neurological symptoms
  • You have high blood pressure

In addition, tell your doctor and take care with Tri-Sprintec if:

  • You have breast nodules, fibrocystic disease of the breast, an abnormal mammogram or breast x-ray
  • You have diabetes
  • You have high cholesterol or triglycerides
  • You have elevated blood pressure
  • You have migraines or other headaches
  • You have epilepsy
  • You have depression
  • You have heart, gallbladder or kidney disease
  • You have a history of irregular menstrual periods
  • You smoke. You are strongly advised not to smoke while using hormonal contraceptives.

Drug interactions

Before taking Tri-Sprintec, inform your doctor if you are taking or have recently taken any other medicines, including those purchased over the counter without a prescription. The following medications may interfere with the effectiveness of Tri-Sprintec:

  • Rifampin
  • Barbiturates such as phenobarbital
  • Anticonvulsants such as carbamazepine (Tegretol)
  • Phenytoin (Dilitan/Dilantin)
  • Phenylbutazone (Butazolidin)
  • Certain antibiotics

Treatment Options

Alternatives to Tri-Sprintec

There are many different types and brands of hormonal contraceptives and it is not uncommon for women to try a few different ones before finding the right fit for them. Different types contain different types of progesterone and estrogen supplements, and you may find that you are more sensitive to some than others. Women who are particularly sensitive to estrogen may be better suited to low-estrogen oral contraceptives, which help to reduce estrogen-related side effects such as breast tenderness and headaches. Alternatively, your doctor may recommend the progesterone-only pill, or the mini pill, which contains no estrogen and is taken continuously without a monthly break for a bleed.

Non-oral forms of hormonal contraceptive are also available, and are useful if you struggle to remember to take your pills each day. Non-oral hormonal contraceptives include the implant (Implanon, Nexplanon), the shot (Depo-Provera), and the intrauterine device (IUD, Mirena, ParaGard, Skyla, Liletta, Kyleena). The IUD in particular is suited to women with certain other health conditions, such as diabetes or hypertension, as it works locally to the reproductive system. For advice on which type of contraceptive might be best for you, speak to your doctor or health worker.

If you don’t want to use hormonal contraceptives, or have a contradictory health condition or medication, you can rely on barrier methods instead. These include cervical cap (FemCap) and condoms, which are the only form of contraception to offer partial protection from STIs.


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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