Approximately 65% of women in America between 15 and 49 years of age use some form of contraception, and oral contraceptive pills (also referred to as “the pill”) are the preferred hormonal method in our country. Trivora belongs to the category of combined pills, which characterizes itself for a very high success rate.
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Trivora is a hormonal contraceptive method, which belongs to the large family of combined oral contraceptive (COC) pills. That means it uses two kinds of hormones (called progestogens and estrogens) to prevent pregnancy. The specific names of these hormones are Levonorgestrel and Ethinylestradiol, respectively. It is important to mention that Trivora is a triphasic oral contraceptive.
The hormones contained in Trivora produce an internal environment in the female reproductive system in which achieving pregnancy is extremely hard. When a woman gets pregnant, progestogen and estrogen levels rise, blocking the normal biochemical processes that would allow another pregnancy to occur (that’s why women can’t get pregnant again when they’re already carrying a baby). Due to the high progestogen and estrogen levels that it induces, Trivora simulates this state, so we could say that it tricks the body into believing that the woman is already pregnant, thereby, preventing the possibility of “another” pregnancy. This effect is common to all other combined contraceptive pills.
Triphasic basically means “having 3 phases”, so a triphasic contraceptive method has 3 different doses of hormones for 3 different periods of the month. On the other hand, normal (monophasic) contraceptive pills use the same dose of hormones during the whole month. Because of this, triphasic oral contraceptives simulate the changing hormone levels in the body during the normal menstrual cycle more accurately. Trivora is a classic example of a triphasic contraceptive pill. Methods with 2 phases also exist and they’re called biphasic.
When used properly, Trivora is extremely effective, having a 99% success rate. That is why you should try not to miss any days.
Trivora contains two different hormones as active ingredients: a progestogen (specifically called Levonorgestrel) and an estrogen (specifically called Ethinylestradiol), which play a key role in the hormonal cycle of women. Essentially, they block other hormones responsible for allowing eggs to mature and be released (ovulation). Since they prevent ovulation, even if a sperm cell was available, there would be no egg to be fertilized and pregnancy wouldn’t be possible. They also thicken the cervical mucus, making it hard for sperm to even get into the womb. In addition, they change the lining of the uterus, so that, even if an egg was matured and released, and a sperm cell managed to get into the uterus to fertilize it, it would be very hard for the fertilized egg to stick to the uterine wall to survive. Since all three lines of defense would have to fail at the same time in order for pregnancy to take place, Trivora is an extremely effective contraceptive method.
The peach tablets are essentially inactive. They contain anhydrous lactose, lactose monohydrate, magnesium stearate, and microcrystalline cellulose. The inactive ingredients in the blue, white and pink tablets are: lactose monohydrate, magnesium stearate, povidone, and starch. The blue, pink and peach tables also contain color additives: FD&C Blue #1, FD&C Red #40 and FD&C Yellow #6 respectively.
Trivora, like any other triphasic contraceptive method, is used just as normal monophasic methods: you’ll take 1 pill per day, always at the same time of the day. Therefore, it is not more complicated to take properly than monophasic pills. The groups are separated by colors, so you’ll find a set of 6 blue tablets for the first 6 days (phase 1), 5 white tablets for the next 5 days (phase 2), and 10 pink tablets for the last 10 days (phase 3) of the hormonally active period (21 days). You will also see 7 peach tablets at the end, which do not contain any hormones (inert or placebo tablets), for a total of 28 pills. After you finish the last placebo tablet, you should start over again with the first blue tablet of the next package.
Combined oral contraceptives can be started at any time of your menstrual cycle without causing any damage, but it is recommended that you start them on the first day of your period to assure their immediate efficacy. That means the first pill should be taken on the same day that your bleeding starts.
It is also widely accepted that if you start combined oral contraceptives within the first 5 days since your menstrual bleeding started, protection should be expected immediately, but we recommend that you stick to the first-day-rule. Always ask for your doctor’s opinion on when it is convenient for you to start.
The doses for each phase of the Trivora cycle are already defined and should not be changed or mixed. During the first 6 days (phase 1), each blue tablet contains 0.05 mg of Levonorgestrel and 0.03 mg of Ethinylestradiol. During the next 5 days (phase 2), the white tablets will have 0.075 mg of Levonorgestrel and 0.040 mg of Ethinylestradiol. Finally, during phase 3, comprised of the 10 pink tablets, you will be taking 0.125 mg of Levonorgestrel and 0.030 mg of Ethinylestradiol every day. After finishing this 21-day period, only the 7 placebo tablets will be left in the package.
Conventionally, it is recommended to take combined oral contraceptive pills after the evening meal or just before bedtime. However, if used properly, Trivora can be taken at any time of the day. The most important thing to keep in mind is that you have to take the pill at the same time every single day. If you vary the time in which you use it, you are putting yourself at risk of getting pregnant.
If you forget to take Trivora at your specified time, you should take it as soon as you realize that you missed it. After that, you only have to take the pill the next day at the usual time. Even if you miss it for several hours, you will still be protected against pregnancy. Just make sure you don’t do it too often.
If you forget to take Trivora for a whole day, the instructions are the same as if you forget to take it at the right time. You should take the pill immediately and then take the next one at the specified time. In this scenario, you will take two pills the same day or even at the same time. Anyhow, you will still be protected against pregnancy and no other contraceptive method needs to be used.
If you miss 2 active pills in a row, your response should vary depending on which week of the cycle you are on. If it happens during week 1 or week 2 of your package, you will have to take 2 pills as soon as you remember and then 2 pills the day after. Then, you continue taking one pill every day until you finish the package. In this case, you will have to use another form of protection (for example condoms, spermicide, or sponge) for the next 7 days; otherwise, you’ll be putting yourself at risk of getting pregnant.
If this happens during week 3, you should throw out the whole package and start a new one the same day. In this case, you will also need to use another form of protection (condoms, spermicide, or sponge) for the next 7 days or you won’t be protected against pregnancy.
If you forget to take Trivora for 3 days in a row (or more), you should throw out the whole package and start a new one the same day. In this case, you will also need to use another form of protection (condoms, spermicide, or sponge) for the next 7 days. Always ask your doctor when you are not sure about what to do if you missed some of your pills.
If you start the pill during the first day of your period, Trivora will start protecting you right away. On the other hand, If you decide to start at a different moment, it will be necessary to also use another non-hormonal method for up to 7 days (for example condoms or a spermicide) to keep you totally protected. After these 7 days have passed, you can continue with Trivora alone.
Trivora, like any other combined contraceptive pill, could produce a range of mild and moderate side effects, among which are:
Abdominal pain, cramps and bloating
Changes in menstrual flow (increased or decreased).
Temporary infertility after discontinuation of treatment.
Melasma (skin patches)
Breast tenderness, pain, enlargement or secretion.
Changes in weight or appetite (increased or decreased).
Decreased milk production
Mild mood changes/irritability.
If any of these situations persist, contact your health-care provider.
There are other more severe but infrequent events that are associated with the usage of combined oral contraceptives:
Blood clots (thromboembolism)
Loss of vision
Exacerbation of systemic lupus erythematosus.
Aggravation of varicose veins.
Anaphylactic (severe allergic) reactions, including urticaria, angioedema, and severe respiratory and circulatory symptoms.
Some indications that you might be suffering from a serious adverse event include: severe chest or abdominal pain, sudden loss of vision, stabbing pain in the legs or arms, itching/swelling (especially of the face/tongue/throat), sudden shortness of breath/rapid breathing, yellowing of the skin/eyes, coughing up blood or blood-streaked phlegm, among others. If you experience any of these, seek immediate medical attention.
There are certain situations in which Trivora or any other combined oral contraceptives should never be used:
Blood clots in your legs, lungs or eyes or current general blood clotting disorders
A past history of blood clotting disorders.
Heart valve or heart rhythm disorders that may be associated with the formation of blood clots
Diabetes affecting your circulatory system.
Uncontrolled hypertension (high blood pressure).
Known or suspected breast cancer.
Cancer of the lining of the womb, vagina, or other known or hormone-dependent tumors.
Abnormal genital bleeding with no apparent cause
Yellowing of the skin during pregnancy
Yellowing of the skin with prior pill use.
Tumors or cancer in the liver
Active liver disease, as long as liver function has not returned to normal.
Known or suspected pregnancy.
During the first 4 weeks after giving birth
If you smoke and are over 35 years old
Hypersensitivity to any of the components of Trivora
If you are receiving Hepatitis C drug combinations containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir, due to the potential for ALT (liver enzymes) elevations
There might be further severe adverse events and contraindications to using Trivora. Always tell your health-care provider about any past or current health conditions you or your close family members have had, especially if they are listed above. Remember that the risk of cardiovascular adverse events increases if you are a smoker.
Aside from Hepatitis C medications, there are several other drugs that can interact with Trivora. Some of them are:
Lomitapide, some HIV drugs, Tranexamic Acid, Sodium Tetradecyl Sulfate, Rifampin, Rifabutin, Barbiturates, Phenylbutazone, Phenytoin sodium, Griseofulvin, Protease Inhibitors, Modafinil, Ampicillin and other Penicillins, Vitamin C, Acetaminophen, Fluconazole, Atorvastatin, among others.
Always tell your health-care provider about any medications you are currently using before starting Trivora.
Combined oral contraceptive pills, such as Trivora, are the most widely accepted hormonal method in America. However, there are many other options to take into account.
The mini-pill is another oral contraceptive method characterized for using only one active hormone (a progestogen) instead of two. Their success rate is very similar, but there are some key differences between them. For example, the mini-pill does not have an optional 7-day break between packages and it is more likely to make you skip your periods. Besides, you should not miss your pill for more than 3 hours after your scheduled time. Of course, there are some benefits to it too. It can be used by women who are sensitive to estrogens, women who are over 35 and smoke, or even during the first 4 weeks after giving birth.
There are many other hormonal options available such as extended-cycle combined pills, injections, patches, low-dose combined pills, implants, and non-hormonal options such as condoms, IUDs, sponges, diaphragms, among others. Your health-care provider can help you decide which one is the most convenient for you in your particular situation.
There are also several benefits of Trivora aside from its contraceptive effect:
Increased menstrual cycle regularity, decreased blood loss and decreased risk of iron-deficiency anemia, decreased intensity of menstrual pain, decreased risk of ovarian cysts, decreased risk of some breast diseases and decreased risk of some types of cancer.
Ask your physicians if it is convenient for you to use Trivora for any of these purposes before using it.
Yes, you are. As long as you took the first 21 pills correctly, you won’t be in risk of pregnancy even if you miss all 7 placebo pills. However, it is highly recommended that you take them to help you keep track of when the next Trivora package needs to be started.
Yes, withdrawal bleeding is expected when you take Trivora. It usually occurs within 3 days following the last pink tablet. Some months, it might be absent even if you’re not pregnant. If you miss two withdrawal bleeding periods in a row, consider taking a pregnancy test, especially if you have skipped pills that month.
Yes, you should always continue taking the pills even if you’re still bleeding. It could happen that the withdrawal bleeding is still there when you finish your 7th and last placebo tablet and the first blue tablet of the new package is due. That represents no problem at all. You should never interrupt the continuity of the pills because of this.
This will depend on which method you were previously using:
If you are switching from another oral contraceptive, Trivora Tablets should be started on the first day of bleeding following the last active tablet taken of the previous oral contraceptive.
If you were using a progestogen-only pill (mini-pill) you can switch any day and should begin Trivora the day after your last mini-pill.
If you want to switch from an implant, you should start Trivora on the same day that you remove your implant.
If you were using an injection, start Trivora on the same day the next injection would be due.
Notice that if you’re switching from a progestogen-only pill (mini-pill)l, injection, or implant, you’ll need to use a non-hormonal back-up method for 7 days after you start with Trivora.
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