Lo Loestrin Fe
Lo Loestrin Fe is a prescription birth control pill used to help prevent pregnancy. It contains two hormones — ethinyl estradiol (an estrogen) and norethindrone (a progestin) — along with ferrous fumarate, which is an iron supplement. This low-dose combined oral contraceptive (COC) is taken once a day by mouth in a 28-day cycle: 26 days of active pills and 2 days of placebo pills. Some common side effects include spotting, nausea, and breast tenderness.
What is Lo Loestrin Fe?
What is Lo Loestrin Fe used for?
- To prevent pregnancy
How Lo Loestrin Fe works
Lo Loestrin Fe is a combination medication that contains two hormones: norethindrone (a progestin) and ethinyl estradiol (an estrogen). These hormones work together to prevent pregnancy by:
- Stopping ovulation (release of an egg from the ovary)
- Changing cervical mucus to block sperm movement
- Changing the lining of the uterus so it's less likely for a fertilized egg to implant
Lo Loestrin Fe also includes inactive (hormone-free) tablets that contain ferrous fumarate. This iron supplement is added to lower your risk of anemia during the days you might have your period while taking the inactive pills.
Drug facts
Side effects of Lo Loestrin Fe
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
- Nausea or vomiting (7%)
- Headache (7%)
- Irregular bleeding (5%)
- Menstrual cramps (4%)
- Changes in weight (4%)
- Breast tenderness (4%)
Less Common Side Effects
- Acne
- Stomach pain
- Anxiety
- Depression
Lo Loestrin Fe serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Heart attack: chest pain, arm pain, shortness of breath, stomach discomfort, sweating, nausea, dizziness
- Stroke: sudden numbness or weakness on one side of the body, drooping 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
- Serious liver problems: yellowing of the skin or the whites of the eyes, tiredness, stomach pain
More on Lo Loestrin Fe side effects
The following Lo Loestrin Fe side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common
Breast tenderness
heavy non-menstrual vaginal bleeding
irregular menstrual periods
longer or heavier menstrual periods
normal menstrual bleeding occurring earlier, possibly lasting longer than expected
Incidence not known
chills
clay-colored stools
confusion
dark urine
difficulty with speaking
dizziness
double vision
fast or irregular heartbeat
headache
inability to move the arms, legs, or facial muscles
inability to speak
indigestion
itching or rash
loss of appetite
pain, redness, or swelling in the arm or leg
pains in the chest, groin, or legs, especially in the calves
severe headaches of sudden onset
severe nausea or vomiting
slurred speech
stomach pain
sudden loss of coordination
sudden onset of slurred speech
sudden vision changes
tightness in the chest
unpleasant breath odor
unusual tiredness or weakness
unusual warmth or flushing of the skin
unusually heavy or unexpected menstrual bleeding
vaginal bleeding or spotting
vomiting of blood
yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Vomiting
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Lo Loestrin Fe
Pros
- Contains a very low estrogen dose
- Shorter, lighter periods compared to other birth control pills
- Placebo pills have an iron supplement, which might reduce the risk of anemia
Cons
- Must be taken at the same time every day
- More breakthrough bleeding or spotting compared to other birth control pills
- Can raise risk of heart attacks, blood clots, and stroke
Pharmacist tips for Lo Loestrin Fe
- Set an alarm to help you remember to take Lo Loestrin Fe at the same time every day. If you miss pills, your risk of getting pregnant goes up if you’re sexually active.
- Lo Loestrin Fe helps prevent pregnancy but doesn’t protect you from human immunodeficiency virus (HIV), hepatitis, or other sexually transmitted infections (STI). Using a condom with your birth control can help protect against infections.
- If you're starting Lo Loestrin Fe for the first time, take the first blue tablet within 24 hours of when your period starts. If you start later, use a non-hormonal backup method for the first 7 days.
- Know what to do if you miss a dose of Lo Loestrin Fe. Follow the instructions in your pill pack or ask your gynecologist — what you should do depends on which pill you missed, when you missed it, and how many pills you missed.
- Spotting or light bleeding while taking Lo Loestrin Fe is normal. It doesn’t mean the pill isn’t working. Keep taking a dose every day and talk to your gynecologist if the bleeding is heavy or doesn’t stop.
- Lo Loestrin Fe can interact with other medications. Let your gynecologist or pharmacist know about everything you're taking, including over-the-counter medications and supplements.
- It’s not recommended to breastfeed while taking Lo Loestrin Fe because it might lower your milk supply. If you’re nursing or planning to breastfeed, talk to your prescriber about your options. They can help you decide what’s best for you and your baby.
- If you haven’t had a period yet after giving birth and start Lo Loestrin Fe, use a non-hormonal birth control for the first 7 days. You need to take 7 blue pills in a row before relying on it for pregnancy prevention.
- You might not get your period while using Lo Loestrin Fe, and that can be normal. But if you miss two periods in a row, talk to your prescriber to rule out pregnancy.
- Get a yearly check-up while taking Lo Loestrin Fe so your gynecologist can make sure it’s still safe for you. They might check your blood pressure, do a breast or cervical exam, and order blood tests if needed.
Common questions about Lo Loestrin Fe
It can. Some people who took Lo Loestrin Fe noticed changes in their weight. But this is often due to bloating or holding extra water, not actual fat gain. If you’re worried about weight changes while taking this medication, talk to your gynecologist.
In clinical studies, Lo Loestrin Fe prevented pregnancy about 97% of the time. The medication works best when you take it every day at the same time. But if you miss doses or take it at different times each day, it might not work as well in preventing pregnancy. Talk with your gynecologist to determine the best birth control option for you.
Yes, Lo Loestrin Fe is a combination oral contraceptive (COC) that contains two hormones: a progestin called norethindrone and an estrogen called ethinyl estradiol. It's a type of biphasic birth control, meaning the hormone levels change during the month. Each pack has 24 blue tablets with 1 mg norethindrone and 10 mcg ethinyl estradiol, followed by 2 white tablets with only 10 mcg ethinyl estradiol. The final 2 brown tablets are placebo pills that contain ferrous fumarate, an iron supplement.
It's recommended that you start taking Lo Loestrin Fe on Day 1 of your period — this means the first day you start bleeding. Take one blue tablet every day for 24 days, then one white tablet each day for the next 2 days, and finally one brown tablet each day for the last 2 days of the pack. If you don’t start the pills on the first day of your period, make sure to use a hormone-free birth control method for the first 7 days to help prevent pregnancy.
Although rare, birth control pills like Lo Loestrin Fe can sometimes lead to long-term side effects like blood clots, stroke, heart attack, or certain types of cancers. If you're worried about these risks, it's a good idea to talk to your gynecologist. They can help you understand your options and choose what’s best for you.
You'll usually get your period while taking the brown pills in Lo Loestrin Fe. These are the last 2 pills in the 28-day pack and contain iron (not hormones). In studies, most people on average had their period for less than 2 days each month.
Yes, it's possible for you to have no periods while taking Lo Loestrin Fe. In a clinical study, some people had no period by the 1st month, and nearly half had no period by the 13th month. If you miss your period and didn't take your pills as directed, talk to your gynecologist to check for pregnancy.
While most other combination birth control pills contain 30 to 50 mcg of ethinyl estradiol, Lo Loestrin Fe has only 10 mcg of ethinyl estradiol. This makes it one of the lowest-dose options available, which might be helpful if you're sensitive to estrogen-related side effects.
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Risks and warnings for Lo Loestrin Fe
Lo Loestrin 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 risk for blood clots
- Risk factors: Over 35 years old who smoke cigarettes
If you smoke cigarettes, using combined oral contraceptives (COCs), like Lo Loestrin Fe, raises your risk for blood clots. These blood clots can lead to more serious problems, such as heart attack and stroke. People aged 35 years and older who smoke are at even higher risk for these problems. If you smoke, talk with your gynecologist about safer birth control alternatives.
Blood clots and strokes
- Risk factors: Age 35 or older and smoke | Recent surgery with a long period of bed rest | Starting Lo Loestrin Fe less than a month after childbirth | High blood pressure | People identified as obese | High cholesterol | Diabetes | Higher dose of estrogen
Lo Loestrin 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 care team you're taking Lo Loestrin 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 Lo Loestrin Fe until 4 weeks after delivery if you're not breastfeeding your child.
Liver problems
- Risk factors: History of liver problems | Taking Lo Loestrin Fe long term | Taking certain hepatitis C combination medications
Don't take Lo Loestrin Fe if you have liver problems. Although rare, COCs like Lo Loestrin Fe can raise your risk of benign liver tumors. Signs of liver problems can include jaundice (yellowing of the skin or eyes), along with fever, tiredness, loss of appetite, or dark colored urine.
High blood pressure
- Risk factors: Older age | Taking COCs for a long time
Lo Loestrin Fe can raise your blood pressure, so you might want to check your blood pressure while you're taking this medication. The risk is higher in older adults that have taken birth control for a long time. Stop taking Lo Loestrin Fe and let your care team know if your blood pressure is unusually high.
High blood sugar and triglycerides
- Risk factors: Prediabetes or diabetes | History of high triglycerides
Lo Loestrin Fe can raise your blood sugar and triglyceride (fat) levels. If you have diabetes or prediabetes, let your prescriber know if you experience any changes in your blood sugar. A rise in triglycerides can lead to serious conditions like inflammation of the pancreas (pancreatitis). Get emergency medical help if you notice symptoms of pancreatitis, which can include stomach pain, nausea, or vomiting.
Headache
Let your prescriber know if you experience new or worsening migraines or headaches while taking Lo Loestrin Fe. You'll have to stop this medication if your migraine or headache doesn't go away or becomes severe.
Irregular bleeding
People who take Lo Loestrin Fe can sometimes experience breakthrough bleeding and spotting, especially in the first 3 months. This bleeding can be light or feel like a regular period. Keep taking your pills as directed, and let your gynecologist know if the bleeding bothers you.
You might also stop getting your period while using Lo Loestrin Fe. If you missed doses or started your pack late and don’t get your period, there’s a chance you could be pregnant. If you’ve taken your pills correctly and miss two periods in a row, talk to your gynecologist or take a pregnancy test to be safe.
Depression
Talk to your gynecologist if you experience symptoms of depression or worsening depression while taking Lo Loestrin Fe. They might consider stopping this medication if you have serious depression.
Risk for 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 Lo Loestrin Fe and other COCs can raise your risk for breast and cervical cancer.
Don't take Lo Loestrin Fe if you currently have or have had breast cancer because some types of breast cancer grow faster in the presence of estrogen, an ingredient in this medication. You can perform breast self-checks regularly at home and get yearly breast exams with your gynecologist to help with early breast cancer detection. Let them know if you notice any new or abnormal lumps, pain, or swelling in your breasts.
Make sure you follow up with your gynecologist to get proper screenings for cervical cancer. Report any signs of vaginal bleeding or discharge that's not normal.
Worsening of other health conditions
- Risk factors: History of hereditary angioedema | History of chloasma gravidarum
If you have certain conditions, such as hereditary angioedema or chloasma (a skin condition that causes dark patches on the face), talk to your gynecologist before taking Lo Loestrin Fe because it might worsen your symptoms. If you have a history of chloasma, limit exposure to the sun or UV light while taking birth control pills like Lo Loestrin Fe.
More on Lo Loestrin Fe warnings
Lo Loestrin Fe dosage
Package| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 28 tablets of 1mg/10mcg/10mcg | 1 package | $99.00 | $99.00 |
Typical dosage for Lo Loestrin Fe
Lo Loestrin Fe comes in a 28-day pack with 26 active tablets and 2 placebo tablets.
In general, the typical dose is 1 active tablet by mouth a day for 26 days, followed by 1 placebo tablet a day for the last 2 days of the pack.
- Days 1 to 24: 1 mg norethindrone / 10 mcg ethinyl estradiol (blue tablets)
- Days 25 and 26: 10 mcg ethinyl estradiol (white tablets)
- Days 27 and 28: 75 mg placebo with ferrous fumarate (brown tablets)
Interactions between Lo Loestrin Fe and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Dasabuvir
- Ombitasvir
- Paritaprevir
- Ritonavir
- Tranexamic Acid
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Amifampridine
- Amoxicillin
- Ampicillin
- Amprenavir
- Anagrelide
- Apalutamide
- Aprepitant
- Armodafinil
- Artemether
- Bacampicillin
- Baloxavir Marboxil
- Betamethasone
- Bexarotene
- Bictegravir
- Boceprevir
- Bosentan
- Brigatinib
- Bupropion
- Carbamazepine
- Carbenicillin
- Cefaclor
- Cefadroxil
- Cefdinir
- Cefditoren
- Cefixime
- Cefpodoxime
- Cefprozil
- Ceftazidime
- Ceftibuten
- Cefuroxime
- Cenobamate
- Ceritinib
- Clavulanic Acid
- Clobazam
- Cloxacillin
- Colesevelam
- Cyclacillin
- Cyclosporine
- Dabrafenib
- Darunavir
- Dexamethasone
- Dicloxacillin
- Dimercaprol
- Dolutegravir
- Donepezil
- Doxycycline
- Efavirenz
- Elagolix
- Eltrombopag
- Elvitegravir
- Encorafenib
- Enzalutamide
- Erdafitinib
- Eslicarbazepine Acetate
- Etravirine
- Fosamprenavir
- Fosaprepitant
- Fosphenytoin
- Fostemsavir
- Glecaprevir
- Griseofulvin
- Guar Gum
- Isotretinoin
- Ivosidenib
- Lesinurad
- Lixisenatide
- Lorlatinib
- Lumacaftor
- Minocycline
- Mitotane
- Modafinil
- Mycophenolate Mofetil
- Mycophenolic Acid
- Nafcillin
- Nelfinavir
- Nevirapine
- Octreotide
- Oxacillin
- Oxcarbazepine
- Oxytetracycline
- Paclitaxel
- Paclitaxel Protein-Bound
- Penicillin G
- Penicillin G Procaine
- Penicillin V
- Phenobarbital
- Phenylbutazone
- Phenytoin
- Pibrentasvir
- Piperaquine
- Pitolisant
- Prednisone
- Primidone
- Raltegravir
- Red Clover
- Rifabutin
- Rifampin
- Rifapentine
- Ritonavir
- Rufinamide
- Secobarbital
- St John's Wort
- Sugammadex
- Sultamicillin
- Tazemetostat
- Telaprevir
- Tetracycline
- Theophylline
- Ticarcillin
- Tigecycline
- Tizanidine
- Topiramate
- Troglitazone
- Ulipristal
- Valproic Acid
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Amitriptyline
- Atazanavir
- Carbidopa
- Cefdinir
- Clomipramine
- Delafloxacin
- Demeclocycline
- Diazepam
- Doxepin
- Doxycycline
- Eslicarbazepine Acetate
- Etoricoxib
- Gatifloxacin
- Ginseng
- Grepafloxacin
- Imipramine
- Lamotrigine
- Levodopa
- Levofloxacin
- Levothyroxine
- Licorice
- Lomefloxacin
- Lorazepam
- Methyldopa
- Minocycline
- Moxifloxacin
- Mycophenolic Acid
- Norfloxacin
- Ofloxacin
- Omadacycline
- Omeprazole
- Parecoxib
- Penicillamine
- Prednisolone
- Roflumilast
- Selegiline
- Temafloxacin
- Temazepam
- Tetracycline
- Tipranavir
- Triazolam
- Troleandomycin
- Trovafloxacin Mesylate
- Valdecoxib
- Voriconazole
- Warfarin
- Zinc
How much does Lo Loestrin Fe cost?
$99.00
Lo Loestrin Fe 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 Lo Loestrin Fe will not be safe for you to take.
- Over 35 years old who smoke
- Currently have or have had a blood clot
- Blood clotting condition
- Stroke
- Coronary artery disease (CAD)
- Certain heart rhythm problems, like atrial fibrillation (AFib)
- High blood pressure that's not under control
- Diabetes with high blood pressure or organ damage
- Migraine headaches with aura
- Any migraine headaches for those over 35 years old
- Liver problems or liver disease
- Unexplained vaginal bleeding that hasn't been diagnosed
- Currently have or have had breast cancer
- Take hepatitis C combination medications containing ombitasvir/paritaprevir/ritonavir
What are alternatives to Lo Loestrin Fe?
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