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Generess Fe is a type of combined oral contraceptive (COC), or birth control. It differs from similar COCs because it comes as a chewable tablet. Generess Fe is a monophasic birth control, which means that it contains the same amount of hormones in all active tablets. It has 24 active tablets, which is more compared to other traditional COCs that typically have 21 active tablets.
What is Generess Fe?
What is Generess Fe used for?
To prevent pregnancy
How Generess Fe works
Generess Fe (along with its branded generics) is a combination medication that contains 2 hormones: norethindrone (a progestin) and ethinyl estradiol (an estrogen). These 2 hormones work together to prevent pregnancy by:
Preventing your ovaries from releasing eggs
Changing the mucus in your cervix to make it harder for the sperm to enter the uterus (womb)
Changing the lining of the uterus so it's more difficult for a fertilized egg to implant
Generess Fe also contains placebo (hormone-free or inactive) tablets with ferrous fumarate. This is an iron supplement which helps to lower your risk for low iron levels or anemia during the days when you're taking the placebo tablets. The days you're taking the placebo tablets are the days you're most likely to have your period, so supplementing iron during this time can be helpful.
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What are the side effects of Generess Fe?
Common Side Effects
- Nausea or vomiting (9%)
- Headaches or migraines (8%)
- Depression or mood changes (4%)
- Painful periods (4%)
Other Side Effects
- Acne
- Anxiety
- Breast pain and tenderness
- Weight gain
Serious Side Effects
- Heart attack: chest pain, stomach discomfort, sweating, nausea, dizziness
- Stroke: sudden numbness or weakness in the arm, leg, or face, confusion, trouble seeing, headache, difficulty walking
- Deep vein thrombosis (blood clot in the leg): leg cramp, swelling, pain, muscle tightness
- Pulmonary embolism (blood clot in the lung): cough, chest pain, trouble breathing, racing heart
Source: DailyMed
The following 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 these 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 cycle or spotting
- Nausea
- Weight gain
Pros and cons of Generess Fe
Pros
Taken once daily
Chewable tablet can be taken without water
Contains iron, which might be helpful in preventing low iron levels during periods
Can take with or without food
Works better to prevent pregnancy compared to some other birth control methods
Cons
Not the best option for females over 35 years old who smoke
Can cause mood swings
Can cause or worsen certain health problems, such as high blood pressure, high blood sugar, and high cholesterol
Vomiting or diarrhea after taking Generess Fe can raise the risk of getting pregnant
Must take it at the same time every day for it to work well
Pharmacist tips for Generess Fe
Take Generess Fe at the same time every day in the order directed on the pack. The tablets should be chewed and swallowed without water.
Set an alarm to help you remember to take Generess Fe at the same time every day. Forgetting to take your pill raises the chance of getting pregnant. If you miss a dose, refer to the instructions that came with your blister pack or call your provider or pharmacist for further instructions.
Generess Fe can prevent pregnancy, but it can't protect against human immunodeficiency virus (HIV) infections (AIDS) or other sexually transmitted diseases (STDs). One way to prevent STDs is to use condoms.
Let your provider or pharmacist know all of your current medications. Certain medications, such as rifampin (Rifadin), can interact with Generess Fe and make it work less well to prevent pregnancy. Some medications can raise the risk of breakthrough bleeding (bleeding outside of the scheduled withdrawal bleeding).
Any time you vomit within 3 to 4 hours after taking Generess Fe, it's considered a missed dose and you should refer to the instructions for missed doses that came with your prescription or ask your pharmacist or provider.
If you want to start Generess Fe after having a baby, check with your provider first. You need to wait at least 4 weeks after delivering your baby before you can start your birth control. Starting any earlier raises your risk of blood clots.
If you're breastfeeding, small amounts of Generess Fe can pass into your breast milk and might affect your baby. It can also lower the amount of breast milk you're able to make. Discuss with your provider safe birth control options while breastfeeding your baby.
Frequently asked questions about Generess Fe
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What are the risks and warnings for Generess Fe?
Generess Fe 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.
Cigarette smoking and serious heart problems
Risk factors: Females over 35 years old who smoke cigarettes
If you smoke cigarettes, using combined oral contraceptives (COCs), like Generess Fe, raises your risk for serious health problems, such as strokes, heart attacks, and blood clots. Females age 35 years and older who smoke are at even higher risk for these problems and shouldn't use COCs. If you smoke, talk with your provider about safer birth control alternatives.
Blood clots and strokes
Risk factors: Females over 35 years old who smoke | Females over 40 years old who don't smoke | Recent surgery with a long period of bed rest | Starting Generess Fe less than a month after childbirth | High blood pressure | People identified as obese | High cholesterol | Diabetes | Higher dose of estrogen
Generess Fe raises your risk of blood clots. These clots can occur anywhere in your body, including your lungs (pulmonary embolism or PE), legs (deep vein thrombosis or DVT), brain (stroke), and heart (heart attack). Get emergency help right away if you have any signs of a blood clot:
Brain: weakness or numbness in your arms, legs, or face on one side of the body, trouble speaking, blurred vision, dizziness, loss of balance, trouble walking, or confusion
Eyes: trouble seeing, bulging eye, double vision
Heart: chest pain, sweating, nausea, or dizziness
Lungs: trouble breathing, chest pain, or cough
Legs: cramps, swelling, pain, or muscle tightness
If you need to have surgery, tell your provider you're taking Generess Fe. They might have you stop taking it 4 weeks before until 2 weeks after your surgery to lower your risk of blood clots. If you recently delivered a baby, you shouldn't start Generess Fe until 4 weeks after delivery if you're not breastfeeding your child.
Irregular bleeding
People who take Generess Fe can sometimes experience irregular bleeding and spotting, especially during the first 3 months of taking this medication. Irregular bleeding can vary from slight staining to bleeding similar to a regular period. This problem might be temporary, so continue taking your medication as directed. Let your provider know if the bleeding is a problem for you and they can change your birth control. If you missed your period(s), contact your provider or get a pregnancy test to make sure you're not pregnant.
High blood pressure
Risk factors: Older age | Using COCs for a long time | High blood pressure | Kidney problems
Generess Fe can raise your blood pressure, so make sure you check your blood pressure while you're taking this medication. The risk is higher in females who are older and have been taking birth control for a long period of time. Females who have high blood pressure that's not under control shouldn't take Generess Fe. Speak to your provider if this medication raises your blood pressure and they can help you pick a different method of birth control that's safer for you.
High blood sugar and cholesterol
Risk factors: Prediabetes or diabetes | High triglycerides
Generess Fe can raise your levels of blood sugar and triglycerides (a type of fat). If you're prediabetic or diabetic, your risk of having your blood sugar rise is much higher. This is because Generess Fe can prevent your body from breaking down sugar efficiently. Additionally, this medication can also affect your level of triglycerides. High triglycerides might lead to a higher risk of pancreatitis (pancreas inflammation). Speak with your provider before starting Generess Fe if you have a history of high blood sugar or triglycerides. Your provider might help you choose another birth control or monitor your blood works more closely if you take this medication.
Breast and cervical cancer
Risk factors: History of breast or cervical cancer | Taking COCs for a long time
Study results are mixed, but there's a possibility that Generess Fe and other COCs can raise your risk for breast and cervical cancer.
Don't take Generess Fe if you currently have or have had breast cancer because some types of breast cancer grow faster in the presence of estrogen, a hormone in this medication. The risk of developing breast cancer might be slightly higher in females who currently take COCs, have taken them within the past 6 months, or are taking them for a long time (8 years or more). You can examine your breasts regularly at home or get yearly breast exams with your healthcare provider to help with early breast cancer detection. Let your provider know if you notice any new or abnormal lumps, pain, or swelling in your breasts.
Make sure you follow up with your provider to get proper screenings for cervical cancer. Report any signs of vaginal bleeding or discharge that's not normal.
Liver problems
Risk factors: Taking COCs for a long time | Hepatitis C treatment
Don't take Generess Fe if you have liver problems, such as sudden liver infection caused by a virus, severe (decompensated) scarring of the liver, or liver tumors. Although rare, Generess Fe can raise your risk of benign liver tumors. If you experience signs of liver problems, you should stop taking Generess Fe and ask your provider for a different type of birth control. Signs of liver problems can include jaundice (yellowing of the skin or eyes), along with fever, tiredness, loss of appetite, or dark colored urine. People with liver problems might have trouble breaking down hormones.
Talk to your provider before starting Generess Fe if you are taking Viekira Pak (dasabuvir / ombitasvir / paritaprevir / ritonavir) to treat hepatitis C. This medication can cause liver problems if you are taking it together with a COC. Stop taking Generess Fe and discuss other birth control options with your provider if you need to start your treatment for hepatitis C. You can restart Generess Fe 2 weeks after your Viekira Pak treatment is complete.
Headache
Let your provider know if you experience new or worsening migraines or headaches while taking Generess Fe. You will have to stop your medication if your migraine or headache doesn't go away or becomes severe.
Depression
Risk factors: History of depression
Let your provider know if you experience symptoms of depression or worsening depression while taking Generess Fe. In cases of serious depression, your provider might have you stop taking this medication
Generess Fe dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 28 chewable tablets of 0.8mg/25mcg | 1 package | $167.50 | $167.50 |
Typical dosing for Generess Fe
Your medication might look different and have slightly different directions depending on which branded generic your provider prescribes. Please take the medication as instructed by your provider. In general:
Generess Fe comes in a 28-day pack. There are 24 active tablets and they each contain 0.8 mg norethindrone acetate and 25 mcg ethinyl estradiol. There are 4 placebo tablets and they each contain 75 mg of ferrous fumarate.
The typical dose is to chew and swallow 1 active tablet by mouth daily for 24 days, followed by 1 placebo tablet daily for the remaining 4 days.
How much does Generess Fe cost?
Generess Fe contraindications
Females over 35 years old who smoke
Current or history of blood clots
Health condition that makes it more likely for your blood to clot
A history of heart attack or stroke
Heart valve problems or irregular heart beat that raies the risk of having blood clots
High blood pressure that's not under control
Diabetes with kidney, eye, nerve, or blood vessel problems
Certain kinds of severe migraine headaches with aura, numbness, weakness, or vision changes
Any migraine headaches for women over 35 years old
Liver problems, including liver tumors or cancer
Unexplained vaginal bleeding that hasn't been diagnosed
Current or history of breast cancer
Taking hepatitis C medication with ombitasvir, paritaprevir, and ritonavir, with or without dasabuvir
What are alternatives to Generess Fe?
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