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Norgestimate-Ethinyl Estradiol

Common Brand Names: Ortho-Cyclen, Ortho Tri-Cyclen, Ortho Tri-Cyclen Lo, Previfem, Sprintec, Tri-Lo-Sprintec, TriNessa, TriNessa 28, Tri-Previfem, and Tri-Sprintec

Drug Information

Medically reviewed by Jessica Swirble, PharmD Last updated on April 21, 2025

Drug Information | Side Effects | Use & Dosage | Request an Online Prescription

Quick Facts:

  • Brand Name: Ortho-Cyclen, Ortho Tri-Cyclen, Ortho Tri-Cyclen Lo, Previfem, Sprintec, Tri-Lo-Sprintec, TriNessa, TriNessa 28, Tri-Previfem, and Tri-Sprintec
  • Generic Name: Norgestimate and Ethinyl Estradiol
  • Uses: Contraception
  • Drug Class: Combined oral contraceptive
  • Availability: Prescription only
  • Generic Status: Yes
  • Controlled Substance: No

What is norgestimate-ethinyl estradiol?

Norgestimate-ethinyl estradiol is a prescription combination birth control pill used to prevent pregnancy. It contains the hormones estrogen (ethinyl estradiol) and progestin (norgestimate), which work together to prevent ovulation and change the lining of the uterus. It also thickens the cervical mucus. While the primary effect of combination birth control pills is to prevent ovulation, these changes in the uterus and cervix make it more difficult for sperm to enter the uterus and also make it harder for a fertilized egg to attach itself and develop.

What is norgestimate-ethinyl estradiol used to treat?

Norgestimate-ethinyl estradiol is a prescription combination birth control medication that is used to prevent pregnancy. It is also sometimes used to treat acne in females who are at least 15 years of age and who have started their menstrual periods and also to regulate periods.

Oral contraceptives are not effective at preventing the spread of sexually transmitted diseases (STDs), so it is important to use additional forms of contraception to avoid their transmission.

How does norgestimate-ethinyl estradiol work?

Norgestimate-ethinyl estradiol prevents pregnancy in several ways. It prevents ovulation, which stops the ovaries from releasing eggs to be fertilized. It also thickens cervical mucus, which helps to prevent sperm from entering the uterus. It also thins the lining of the uterus to prevent implantation.

How do I take norgestimate-ethinyl estradiol?

Norgestimate-ethinyl estradiol is available as an oral tablet. It should be taken at the same time each day to maintain consistent hormone levels.

Norgestimate-ethinyl estradiol is typically taken once daily for 21 consecutive days, followed by seven days of no pills or placebo pills before beginning another cycle.

Follow your healthcare provider's instructions regarding dosage and schedule. Do not exceed the prescribed dose or frequency of use without consulting your provider.

How long until I see results?

Norgestimate-ethinyl estradiol is used for contraception (birth control). For contraception, the effects are immediate if taken on the first day of your menstrual cycle. Back-up contraception should be used for the first 7 days. See package instructions for specific information.

Continue using norgestimate-ethinyl estradiol as prescribed, even if you start feeling better. Regular use according to your prescription is crucial for effective contraception and acne management.

Are there any other uses for norgestimate-ethinyl estradiol?

While norgestimate-ethinyl estradiol is primarily used for contraception and acne treatment, healthcare providers may prescribe it off-label for other conditions such as regulating menstrual cycles, endometriosis, or managing the symptoms of polycystic ovary syndrome (PCOS).

Discuss any alternative uses of norgestimate-ethinyl estradiol with your healthcare provider.

Dosage forms of norgestimate-ethinyl estradiol

Norgestimate-ethinyl estradiol is available in the following dosage forms:

  • Oral tablets

Norgestimate-ethinyl estradiol is a prescription medication. You must have a valid prescription from a licensed healthcare provider to obtain it.

Side Effects and Precautions for Norgestimate-Ethinyl Estradiol


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What are the side effects of norgestimate-ethinyl estradiol?

The use of norgestimate-ethinyl estradiol can lead to various side effects in some individuals.

Common mild side effects of norgestimate-ethinyl estradiol use include:

  • Nausea
  • Vomiting
  • Stomach pain
  • Bloating and gas
  • Diarrhea
  • Constipation
  • Acne
  • Headache
  • Fatigue
  • Darkening of skin on the face
  • Changes in appetite
  • Weight gain or weight loss
  • Abnormal hair growth
  • Spotting or breakthrough bleeding
  • Changes in menstrual flow
  • Painful or missed periods
  • Breast tenderness
  • Vaginal irritation
  • Abnormal vaginal discharge

More severe side effects include:

  • Stroke symptoms (like weakness or numbness, severe headache, difficulty with speech, loss of vision)
  • Blood clot symptoms (like loss of vision, chest pain or chest heaviness, coughing up blood, shortness of breath, leg pain)
  • Double vision
  • Bulging eyes
  • Signs of a liver problem (like yellowing of the skin or eyes, loss of appetite, fatigue, fever, dark-colored urine, clay-colored stool)
  • Depression
  • Signs of an allergic reaction (like swelling in the hands, face, feet, ankles, or legs, skin rash, or difficulty breathing)
  • Migraine headaches

If you experience any severe or concerning side effects while taking norgestimate-ethinyl estradiol, contact your healthcare provider right away.

What should I tell my healthcare provider before using norgestimate-ethinyl estradiol?

Inform your healthcare provider about any existing medical conditions, allergies, or other medications you are taking before starting treatment with norgestimate-ethinyl estradiol. This includes prescription drugs, over-the-counter medications, and dietary supplements, as they may interact with norgestimate-ethinyl estradiol.

Tell your provider if you are taking these medications or supplements:

  • Antibiotics
  • Blood pressure medications
  • Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Diuretics ('water pills')
  • Aldosterone antagonists
  • Anticoagulants
  • Potassium supplements
  • Bile acid sequestrants
  • Folate supplements
  • Antimetabolites (cancer medications)
  • Antimalarials
  • Anticonvulsants
  • Antivirals

You should also mention medical conditions such as:

  • High blood pressure
  • High cholesterol or triglycerides
  • Heart disease
  • Stroke
  • Irregular heartbeat
  • Blood clots (or family history of blood clots)
  • Diabetes
  • Breast cancer
  • Cancer of the uterus or cervix
  • Unexplained vaginal bleeding
  • Liver disease or liver cancer
  • Kidney disease
  • Jaundice during pregnancy
  • Depression
  • Seizures
  • Migraines
  • Toxemia
  • Thyroid problems
  • Gallbladder disease
  • Irregular menstrual cycles
  • Obesity
  • Fibrocystic breast disease

This medication has been given a black box warning from the FDA due to the risks of smoking cigarettes while using norgestimate-ethinyl estradiol. Doing so increases your risk of heart attacks, strokes, blood clots, and other side effects from taking oral contraceptives, especially for heavy smokers over the age of 35. Do not smoke cigarettes if you are taking oral contraceptives such as norgestimate-ethinyl estradiol.

Oral contraceptives such as norgestimate-ethinyl estradiol may increase your long-term risk of developing liver tumors, breast, cervical, or liver cancer and your short-term risk of heart attack, stroke, and blood clots – while reducing your overall risk of ovarian, endometrial, and colorectal cancers, so be sure to talk with your healthcare provider about the risks and benefits of oral contraceptives.

If you are pregnant, planning to become pregnant, or breastfeeding, discuss the potential risks and benefits of using norgestimate-ethinyl estradiol with your healthcare provider.

Are there any other special instructions I should follow?

Take norgestimate-ethinyl estradiol exactly as prescribed by your healthcare provider. Do not exceed the recommended dose or duration of treatment.

Norgestimate-ethinyl estradiol can cause dizziness or nausea. Do not drive or operate machinery until you know how this medication affects you.

Complete the full course of treatment, even if you feel better, to ensure the medication's effectiveness in managing your condition.

What should I do in case of an overdose?

In case of a norgestimate-ethinyl estradiol overdose, seek medical attention immediately. Symptoms of overdose may include severe nausea, vomiting, and vaginal bleeding. If you suspect an overdose, contact the poison control helpline at 1-800-222-1222 or call emergency services.

Proper Use & Dosage Information for Norgestimate-Ethinyl Estradiol


Drug Information | Side Effects | Use & Dosage | Request an Online Prescription

What is the typical starting dose of norgestimate-ethinyl estradiol?

Norgestimate-ethinyl estradiol is available in the following form:

  • Oral tablets

The typical starting dose of norgestimate-ethinyl estradiol is one tablet orally once daily. It is crucial to follow your healthcare provider's instructions regarding dosage and administration.

For contraception:

  • Adults: The typical starting dose is one tablet taken once daily at the same time each day. Back-up contraception should be used initially when starting birth control. Refer to the package instructions for specific information.

The dosage should be taken as directed by your healthcare provider. Your healthcare provider will determine the most appropriate dose based on your medical history and your response to the medication.

Norgestimate-ethinyl estradiol should be taken as prescribed by your healthcare provider. Do not exceed the recommended dose or duration of treatment without consulting your provider.

If you have any questions about your dosage or need adjustments, contact your healthcare provider for guidance. If you want to talk to a provider right away, consider scheduling an online doctor appointment through a telehealth platform like Sesame.

What should I do if I miss a dose of norgestimate-ethinyl estradiol?

If you miss a dose of norgestimate-ethinyl estradiol, take it as soon as you remember and take the next pill at the regular time. It may be necessary to take 2 tablets in one day. Refer to the package instructions for specific information on missed doses.

Missed doses may cause spotting or light bleeding.

Take norgestimate-ethinyl estradiol around the same time every day to maintain a consistent amount of medication in your body.

What should I do if I'm feeling better while taking norgestimate-ethinyl estradiol?

Continue taking norgestimate-ethinyl estradiol as prescribed by your healthcare provider, even if you start feeling better. It's important to keep taking the medication as directed to manage your condition effectively.

Do not suddenly stop taking norgestimate-ethinyl estradiol; this can cause a return of your symptoms.

If you have any concerns or questions about your medication, discuss them with your healthcare provider for medical advice and recommendations.

How should I store norgestimate-ethinyl estradiol?

Store norgestimate-ethinyl estradiol according to the instructions provided by your healthcare provider or pharmacist. Keep it at room temperature, away from light and moisture. Ensure the container is tightly closed and out of reach of children.

Do not use expired medication or medications that appear damaged or discolored. If you have any questions about storage, consult your healthcare provider or pharmacist for guidance.

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