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Norethindrone is progestin-only pill (POP), also known as the "mini-pill". It prevents pregnancy by blocking ovulation and making it hard for a fertilized egg to implant in the uterus. Norethindrone is an estrogen-free birth control for people ages 16 years and older. Norethindrone is taken by mouth daily at the same time each day. Some side effects of this medication include irregular bleeding, headaches, and nausea. There are many brand names of norethindrone, including Errin, Jencycla, and Heather.
What is Norethindrone?
What is Norethindrone used for?
- To prevent pregnancy
How Norethindrone works
Norethindrone is a progestin, which is a man-made form of progesterone (a natural female hormone). It prevents pregnancy by blocking sperm movement by thickening cervical mucus. It also prevents pregnancy by creating an unfavorable environment for the fertilized egg by changing the lining of the uterus. In some people, norethindrone also blocks ovulation.
Drug facts
More on Norethindrone essentials
Side effects of Norethindrone
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Irregular periods
- Spotting
Less Common Side Effects
- Headaches
- Tender breasts
- Nausea
- Dizziness
Norethindrone serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Ectopic pregnancy: stomach pain, spotting
The following Norethindrone side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Blood clot—pain, swelling, or warmth in the leg, shortness of breath, chest pain
- Gallbladder problems—severe stomach pain, nausea, vomiting, fever
- Increase in blood pressure
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- New or worsening migraines or headaches
- Stroke—sudden numbness or weakness of the face, arm, or leg, trouble speaking, confusion, trouble walking, loss of balance or coordination, dizziness, severe headache, change in vision
- Unusual vaginal discharge, itching, or odor
- Worsening mood, feelings of depression
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Breast pain or tenderness
- Dark patches of skin on the face or other sun-exposed areas
- Irregular menstrual cycles or spotting
- Nausea
- Weight gain
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Pros and cons of Norethindrone
Pros
- Can take right after childbirth
- Unlikely to affect milk supply of breastfeeding mothers
- Lower risk of blood clots compared to estrogen-containing pills
Cons
- Need to take at the same time each day, within a 3-hour window
- Can cause more headache, breast tenderness, and nausea compared to other birth control options
- Commonly causes irregular menstrual cycles or spotting
Pharmacist tips for Norethindrone
- If you're taking norethindrone for the first time, there are 2 options for when you can take your first dose: 1) It's best to start taking norethindrone on the first day of your menstrual period. 2) If you choose to start norethindrone on another day, make sure to use a backup method (e.g., condom or spermicide) each time you have sex for the next 48 hours.
- You can take norethindrone with or without food. Studies haven't looked at how food affects the absorption of the medication; what's more important is that you take it at the same time every day.
- Take your norethindrone pills every day. When you're done with your pack, start a new one the next day. All the pills in your birth control backs contain active norethindrone pills; there aren't any placebo pills.
- Hormonal contraceptives like norethindrone don't protect against sexually transmitted diseases (STDs), such as chlamydia, gonorrhea, genital warts, or herpes. Using a latex or polyurethane condom during sex can help lower your risk of an STD.
- If you've had a miscarriage or an abortion, you can start taking norethindrone the next day.
- If you're only breastfeeding your newborn (and not giving your baby any food or formula), you can start norethindrone 6 weeks after giving birth. If you're both breastfeeding and giving your baby some food or formula, you can start norethindrone 3 weeks after giving birth. Discuss when you should start birth control after birth with your provider.
- If you think you might have become pregnant while taking norethindrone, stop taking it and talk with your provider. There doesn't seem to be any evidence that norethindrone can harm your unborn baby, but you should still stop taking it since you don't need it anymore.
- You can stop taking norethindrone at any time, but if you don't want to become pregnant, speak with your provider about other birth control options.
Common questions about Norethindrone
Yes, taking norethindrone can cause you to stop having menstrual periods. Or, you might experience lighter bleeding during menstrual periods.
Taking norethindrone as prescribed by your provider might cause you to stop having menstrual periods. This is because norethindrone (as well as most other POPs) birth control packs only contain active norethindrone pills; there aren't any placebo pills. As a result, many people who take norethindrone as directed (one tablet by mouth daily) stop having periods, or have much lighter bleeding during their periods.
One of the most common side effects of taking norethindrone is changes to your menstrual bleeding patterns. This means that it might be hard to predict how soon you'll get your period after starting norethindrone. Some people might experience spotting or breakthrough bleeding (bleeding in between periods) after starting this medications. Other people might experience lighter periods or their periods stopping altogether. In some cases, people might even have heavier bleeding. Usually, irregular bleeding becomes less common after the first 3 to 6 months of starting norethindrone.
Stopping norethindrone can make it more likely for you to become pregnant. And if you have side effects from taking norethindrone, you might experience some of those side effects going away after you stop the medication. For examples, you might notice your menstrual bleeding returning or becoming heavier, or you might notice headaches or nausea going away. Let your provider know if you have any specific concerns about what might happen after stopping norethindrone.
Take norethindrone only as directed by your provider. The typical directions for norethindrone is to take one tablet by mouth daily at the same time each day. But if you miss a dose of norethindrone by 3 hours or more, take the missed dose as soon as you remember. Then, go back to your regular schedule the next day. But make sure to use a backup birth control (e.g., condom or spermicide) if you have sex in the next 48 hours. If you're unclear what to do after missing pills, continue taking norethindrone and use a backup method until you can speak with your pharmacist or provider.
Your provider might recommend norethindrone over estrogen-containing combination pills if you have certain health conditions or based on your preferences. For example, norethindrone might be a better choice for people who are at higher risk for blood clots because it has a lower risk of clots compared to estrogen-containing pills. Another example is that norethindrone might be a better choice for breastfeeding mothers because this medication is less likely to affect milk supply compared to combination pills. Talk with your provider if you have questions about what type of birth control pills might be best for you.
In order for norethindrone to be effective, you must take it at the same time everyday. Missing this medication by as little as 3 hours can raise your risk of becoming pregnant. If taken "perfectly", meaning taking it every day on time, norethindrone works well to prevent pregnancy about 99% of the time. But based on data from "typical use", meaning taking it late or missing doses here and there, norethindrone prevents pregnancy about 91% of the time.
Yes, you can still take norethindrone if you're on your period or if you have spotting (breakthrough vaginal bleeding) between your periods. This birth control is meant to be taken continuously. All the pills in the pack are active norethindrone pills; there aren't any placebo pills. Stopping norethindrone can make it more likely for you to become pregnant.
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Risks and warnings for Norethindrone
Norethindrone can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Medication interactions
Tell your provider or pharmacist about all the medications and supplements you're taking before starting norethindrone. They can check for interactions between your medications.
Certain medications can cause norethindrone to not work as well at preventing pregnancy and also raise the risk of breakthrough bleeding. Examples of these medications include certain seizure medications (i.e., phenytoin (Dilantin) and carbamazepine (Tegretol)), tuberculosis (TB) medications (i.e., rifampin), human immunodeficiency virus (HIV) medications, and St. John's wort. If you're taking medications that can cause norethindrone to not work as well, your provider will likely recommend that you use an additional non-hormonal birth control, such as condoms, during and after treatment.
Talk with your provider if you have more questions about norethindrone and medication interactions.
Ectopic pregnancy or ovarian cyst
If you happen to get pregnant while taking norethindrone, there's a small chance that the pregnancy might be ectopic (outside of the womb). While rare, having an ectopic pregnancy can be serious. Get medical help right away if you notice symptoms of an ectopic pregnancy, such as cramping or pain in the lower belly area or shoulder.
In addition, taking norethindrone can raise the risk of ovarian cysts (small sacs of fluid in the ovary). Most of the time, the cysts don't cause much symptoms and tend to go away without any treatment. But rarely, they can cause serious problems, so contact your provider if you suddenly have nausea, vomiting, or serious pain in the stomach area.
Irregular vaginal bleeding
Irregular vaginal bleeding is a common side effect of POPs, like norethindrone. Rarely, it can be a sign of a more serious condition, such as an infection or cancer. If you're concerned about irregular vaginal bleeding, talk with your healthcare provider. If you don't have any vaginal bleeding, check with your provider to test whether or not you're pregnant.
Possible risk of cancer
Some studies suggest that taking combination birth control pills might raise the risk of breast cancer or ovarian cancer. There's not enough information to know whether norethindrone or other POPs carry the same risk. If you're concerned about the possible risk of cancer, talk with your provider.
Norethindrone dosage
Package| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 28 tablets of 0.35mg | 3 packages | $18.51 | $6.17 |
Typical dosage for Norethindrone
Each tablet contains 0.35 mg of norethindrone.
The typical dose is one tablet by mouth every day, at the same time every day.
How much does Norethindrone cost?
$11.60
Norethindrone contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Norethindrone will not be safe for you to take.
- Pregnancy
- Breast cancer, either confirmed or suspected
- Bleeding between your periods that hasn't been diagnosed by your provider
- Liver tumor, either benign or cancerous
- Acute (sudden) liver disease
What are alternatives to Norethindrone?
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