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Pirmella 1/35 Coupon - Pirmella 1/35 28 tablets package

pirmella 1/35

Generic Ortho-Novum 1/35
Used for Birth Control
Used for Birth Control

Pirmella 1/35 is a type of combined oral contraceptive (COC), or birth control, that contains both estrogen and progesterone hormones. This medication works well to prevent pregnancy if it's taken at the same time every day. Depending on which day you start this medication, you might need to use a back-up birth control method, such as a condom, for the first 7 days of taking Pirmella 1/35.

Last reviewed on August 22, 2022
basics-icon

What is Pirmella 1/35?

What is Pirmella 1/35 used for?

  • To prevent pregnancy

How Pirmella 1/35 works

Pirmella 1/35 is a combination of two hormones, norethindrone (a progestin) and ethinyl estradiol (an estrogen). These two hormones work together to help prevent pregnancy by:

  • Stopping ovulation (release of an egg from the ovary) by blocking luteinizing hormone (LH) and follicle stimulating hormone (FSH)

  • Thickening cervical mucus (fluid from the cervix), which makes it hard for sperm to move and fertilize an egg

  • Thins the lining of the uterus (womb) so a fertilized egg cannot grow

Drug Facts

Common BrandsPirmella 1/35, Dasetta 1/35, Nortrel 1/35, Alyacen 1/35, Cyclafem 1/35 (brand no longer available)
Drug ClassEstrogen / Progestin combined contraceptive
Controlled Substance ClassificationNot a controlled medication
Generic StatusLower-cost generic available
AvailabilityPrescription only
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Avg retail price
$82.80(save 63.81%)
GoodRx discount
$29.97
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What are the side effects of Pirmella 1/35?

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
  • Vomiting
  • Belly cramps and bloating
  • Bleeding or spotting
  • Change in the flow of periods
  • Missing periods
  • Swelling
  • Brown patches on the face
  • Tender or swollen breasts
  • Changes in weight
  • Migraine

Other Side Effects

  • Vaginal yeast infection
  • Contact lens discomfort
  • Changes in mood
  • Feeling tired
  • Rash

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Heart attack: chest pain, belly 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
  • Liver problems: yellowing of the skin or the whites of the eyes, tiredness, belly pain

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 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
pros-and-cons

Pros and cons of Pirmella 1/35

thumbs-up

Pros

Taken by mouth once daily, so it's convenient for people with a busy schedule

Available as a lower-cost generic medication

Active pills are all one color so they're easy to identify

thumbs-down

Cons

Can raise risk of heart attacks, blood clots, and stroke

Must take it at the same time every day for the medication to work well

Interacts with many medications, such as atorvastatin (Lipitor), levothyroxine (Synthroid), and lamotrigine (Lamictal)

pharmacist-tips

Pharmacist tips for Pirmella 1/35

pharmacist
  • Try to take Pirmella 1/35 around the same time every day. Consider setting an alarm to remind yourself to take your doses at the scheduled time.

    • If you missed one tablet, take your missed dose as soon as possible and take your next scheduled dose at the regular time. You might need to take two tablets in one day. If you've missed more than one tablet in a blister pack, refer to the instructions that came with your pack or call your provider or pharmacist for further instructions.

      • Make sure to get your yearly physical exam done while you’re taking Pirmella 1/35 so your provider can make sure this medication is safe for you. During your appointment, your provider might check your blood pressure, do a breast or cervical exam, as well as other relevant blood works.

        • It's normal to have irregular bleeding (a small amount of vaginal bleeding) while using Pirmella 1/35. This doesn't mean that your medication isn't working. Continue to take Pirmella 1/35 every day as directed by your provider. Speak with your provider if your bleeding doesn't stop or you miss your period.

          • Tell your provider if you notice any swelling or sudden weight gain while taking Pirmella 1/35. Talk with a provider about your medical history before taking this medication.

            • Let your provider know if you experience symptoms of depression or worsening mood while taking Pirmella 1/35. In cases of serious depression, your provider might ask you to stop taking this medication.

              • If you wear contact lens, let your provider or an eye specialist know if you have changes in vision or discomfort with your lenses after starting Pirmella 1/35.

                • Pirmella 1/35 can interact with many medications. Let your provider or pharmacist know what medications you're taking, including over-the-counter products and supplements, before you start Pirmella 1/35. Talk with your provider or pharmacist if you have any questions about interactions with this medication.

                  faqs

                  Frequently asked questions about Pirmella 1/35

                  What's the difference between the 21-day pack and the 28-day pack?
                  Pirmella 1/35 comes in a 28-day pack, but some of it's branded generics come in a 21-day pack. They all contain 21 days of active tablets that all have the same dose of norethindrone and ethinyl estradiol. The biggest difference between the 21-day pack and 28-day pack is whether or not they contain placebo (hormone-free) tablets. For a 21-day pack, you take one active tablet every day for 21 days, follow by no tablet for the next 7 days. For a 28-day pack, you take an active tablet every day for 21 days, followed by a placebo tablet every day for the next 7 days. These placebo tablets don't prevent pregnancy, but serve as reminders to help you stay on track until your next pack starts.
                  What's the difference between Pirmella 1/35 and Tilia Fe?
                  Pirmella 1/35 and Tilia Fe are both COCs that contain norethindrone and ethinyl estradiol, but they're not the same. 1) One difference between Pirmella 1/35 and Tilia Fe is the dose of each active tablet. Pirmella 1/35 is considered a monophasic birth control because all of the active tablets contain the same amount of estrogen and progesterone. Tilia Fe is considered a triphasic birth control because it contains three different doses of estrogen throughout the first three weeks. Triphasic birth controls more closely copy the natural changes in your body's hormone levels throughout your menstrual cycle. 2) Another difference between the two birth controls is what they're used for. Both birth controls are used to prevent pregnancy, but Tilia Fe is also used to treat moderate acne in females aged 15 years and older. If you have other questions about the difference between Pirmella 1/35 and Tilia Fe (or between Pirmella 1/35 and any other birth control), talk with your provider or pharmacist.
                  Can Pirmella 1/35 cause harm if I take it while unknowingly pregnant?
                  Studies show that taking Pirmella 1/35 during early pregnancy shouldn't cause birth defect in unborn babies. If you took Pirmella 1/35 during early pregnancy when you didn't know you were pregnant, let your provider know. You shouldn't take Pirmella 1/35 if you know you're pregnant.
                  Can I take Pirmella 1/35 if I am breastfeeding?
                  You're recommended to not take Pirmella 1/35 if you're breastfeeding since small amounts of this medication can pass into your breast milk and affect your baby. This can lead to side effects in your baby, such as jaundice (yellowing of the skin and whites of the eyes) and large breasts. This medication can also lower the amount and quality of your breast milk, so it's not recommended to use until after you've stopped breastfeeding. Talk to your provider to see which type of birth control is safe for you and your baby while you're breastfeeding.
                  Can I skip my period while taking Pirmella 1/35?
                  Maybe. You might be able to skip your period while taking Pirmella 1/35, but don't do this without discussing with your provider first. Your provider might ask you to skip the placebo tablets if you're taking a 28-day pack. Or they might have you take your 21-day packs continuously, without a week break in-between. Keep in mind that while this can help you postpone your period, it can also sometimes lead to irregular bleeding throughout the month. Something else to think about is that certain insurances might not cover a new pack of birth control sooner than 28 days. Your provider can help you choose a birth control that allows you to skip your period. Talk with your provider so you can discuss the benefits and risks of taking birth control pills continuously.
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                  What are the risks and warnings for Pirmella 1/35?

                  Pirmella 1/35 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.

                  risk-warning

                  Cigarette smoking and serious heart problems

                  • Risk factors: Females over 35 years old who smoke cigarettes

                    Smoking cigarettes while taking COCs, like Pirmella 1/35, can significantly raise the risk of serious heart problems, including heart attack and stroke. The risk is greater if you're over 35 years old and have a history of smoking cigarettes. If you smoke, talk with your provider about safer birth control alternatives.

                    risk-warning

                    Risk of blood clot

                    • 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 COCs less than a month after childbirth | High blood pressure | People identified as obese | High cholesterol | Diabetes | Higher dose of estrogen | First year of using COCs | Restarting COCs after a month

                      Pirmella 1/35 can cause serious blood clots because it contains ethinyl estradiol (an estrogen). More estrogen can lead to more blood proteins that stimulate clot formation. These blood clots can be life-threatening and can happen anywhere in your body. Get medical attention right away if you have any signs or symptoms of a blood clot:

                      1) Brain: weakness or numbness in your arms, legs, or face on one side of the body, trouble speaking, blurry vision, dizziness, loss of balance, trouble walking, or confusion
                      2) Eyes: trouble seeing, bulging eye, double vision
                      3) Heart: chest pain, sweating, nausea, or dizziness
                      4) Lungs: trouble breathing, chest pain, or cough
                      5) Legs: cramps, swelling, pain, or muscle tightness

                      Your risk of getting a blood clot is higher if you're older, smoke cigarettes, or have certain medical conditions. Your risk is also higher if you're on bedrest after surgery or if you've just given birth. Typically your provider will temporarily stop Pirmella 1/35 for 3-4 weeks before surgery, then restart it 2 weeks after. If you recently delivered a baby, you shouldn't start this medication until 4 weeks after delivery and if you're not breastfeeding. Talk with your provider if you have any questions regarding your risk of blood clots.

                      risk-warning

                      Breast and cervical cancer

                      • Risk factors: History of breast or cervical cancer | Taking COCs for a long time | Taken COCs in the last 6 months

                        It's not clear whether Pirmella 1/35 and other COCs can significantly raise your risk for breast and cervical cancer. In one study, people who used COCs for more than 5 years seemed to be at a greater risk for cervical cancer than those who never used these medications. Certain breast cancers also have tumor cells that spread faster in the presence of estrogen. Since there's a risk of serious harm, don't take Pirmella 1/35 if you currently have or have had breast cancer or cervical cancer. If you currently take this medication or have taken it in the last 6 months, make sure to get a yearly breast exam with your provider to check for early signs of breast cancer. Your provider can also make sure you get appropriate screenings for cervical cancer. Let your provider know if you notice any signs of breast cancer (e.g., new or abnormal lumps, pain, or swelling in your breasts) or cervical cancer (e.g., vaginal bleeding or discharge that's not normal).

                        risk-warning

                        Liver problems

                        • Risk factors: Taking COCs for more than 8 years | Certain hepatitis C medications

                          Don't take Pirmella 1/35 if you have liver problems, such as liver infection caused by a virus (e.g., hepatitis) or liver tumors. Although rare, this medication can raise your risk of getting benign liver tumors. If you experience signs of liver problems, you should stop taking Pirmella 1/35 and ask your provider for an alternative birth control. Signs of liver problems can include jaundice (yellowing of the skin or whites of the eyes), fever, tiredness, loss of appetite, or dark colored urine.

                          Additionally, Pirmella 1/35 shouldn’t be taken together with Viekira Pak (a medication to treat hepatitis C infection) because it might cause liver problems. You can restart Pirmella 1/35 two weeks after completing hepatitis C treatment.

                          risk-warning

                          Gallbladder problems

                          Some studies show that Pirmella 1/35 can raise the risk of gallbladder disease since more progestin and estrogen can lead to higher chance of gallstones. Although the risk is low, talk to your provider if you a history of gallbladder disease before starting Pirmella 1/35.

                          risk-warning

                          High blood sugar and triglycerides

                          • Risk factors: Prediabetes or diabetes | High triglycerides

                            Pirmella 1/35 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 Pirmella 1/35 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 Pirmella 1/35 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.

                            risk-warning

                            High blood pressure

                            • Risk factors: Older age | Using COCs for a long time | History of high blood pressure | Kidney problems

                              Pirmella 1/35 can raise your blood pressure, so make sure you check your blood pressure while you're taking this medication. The risk is higher if you're older and have been taking birth control for a long period of time. If you have a history of kidney problems or high blood pressure that's not controlled, don't use this medication. Talk with your provider so you can discuss the benefits and risks of taking Pirmella 1/35.

                              risk-warning

                              Headache

                              Let your provider know if you experience new or worsening migraines or headaches while taking Pirmella 1/35. You might need to stop your medication if your migraine or headache doesn't go away or becomes severe.

                              risk-warning

                              Irregular bleeding

                              • Risk factor: First 3 months of COCs

                                People who take Pirmella 1/35 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 is often temporary, so continue taking your medication as directed. If your bleeding doesn't stop, becomes heavier, or you miss a period after the initial bleeding, let your provider know. Your provider can perform blood tests to rule out other potential causes for bleeding.

                                risk-warning

                                Interaction with other medications

                                Some medications can interfere with how your body gets rid of Pirmella 1/35. This can affect the amount of Pirmella 1/35 in your body, how well it works, and the risk of side effects.

                                Taking medications like ketoconazole and atorvastatin (Lipitor) can raise the amount of Pirmella 1/35 in your body, which can cause a higher risk of side effects.

                                Taking certain medications like rifampin (Rifadin) can lower the amount of Pirmella 1/35 in your body. This can cause your birth control to not work as well and raise the risk of bleeding. Use a condom when you take these medications together and for 28 days after stopping rifampin (Rifadin).

                                Pirmella 1/35 also interferes with how your body gets rid of other medications. For example, it shouldn’t be taken with lamotrigine (Lamictal). Doing so can drop levels of lamotrigine (Lamictal) in your body and raise your risk for seizures or mood changes.

                                If you take Pirmella 1/35 and a medication to replace your thyroid hormone, such as levothyroxine (Synthroid), you might need to take a higher dose of your thyroid medication since Pirmella 1/35 can cause it to not work as well.

                                Let your provider or pharmacist know what other medications you’re taking before and while taking Pirmella 1/35.

                                dosage

                                Pirmella 1/35 dosage forms

                                The average cost for 3 packages of 28 tablets of Pirmella 1/35 is $29.97 with a free GoodRx coupon. This is 63.81% off the average retail price of $82.80.
                                package
                                Package
                                DosageQuantityPrice as low asPrice per unit
                                28 tablets3 packages$29.97$9.99

                                Typical dosing for Pirmella 1/35

                                Your medication might look different depending on which branded generic you've received from the pharmacy. You might be prescribed a 21-day pack (21 active tablets with norethindrone and ethinyl estradiol) or a 28-day pack (21 active tablets and 7 placebo tablets). Make sure to take your medication as instructed by your provider or follow the directions on the package. In general:

                                • For 21-day pack: The typical dose is to take 1 active tablet by mouth daily for 21 days, followed by 7 days without medication (three weeks on, one week off).

                                • For 28-day pack: The typical dose is to take 1 active tablet by mouth daily for 21 days, followed by 1 placebo tablet daily for the remaining 7 days.

                                drug-cost

                                How much does Pirmella 1/35 cost?

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                                contraindications-icon

                                Pirmella 1/35 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 Pirmella 1/35 will not be safe for you to take.
                                • Currently have or history of DVT, PE, or other blood clotting problems

                                • Cerebrovascular disease (problems with blood flow in the brain)

                                • Coronary artery disease (problems with blood flow in the heart)

                                • Certain heart valve problems

                                • Uncontrolled high blood pressure

                                • Diabetes with blood vessel problems

                                • Certain types of headaches with neurological symptoms

                                • Long-term bed rest after surgery

                                • Currently have or have a history of breast cancer

                                • Endometrial cancer or other estrogen-dependent tumor

                                • Undiagnosed abnormal vaginal bleeding

                                • Jaundice during pregnancy or birth control pill use

                                • Liver tumors

                                • Liver problems

                                • Pregnancy

                                • Taking hepatitis C medication containing ombitasvir / paritaprevir / ritonavir, with or without dasabuvir

                                alternatives

                                What are alternatives to Pirmella 1/35?

                                There are a number of medications that your doctor can prescribe in place of Pirmella 1/35. Compare a few possible alternatives below.
                                Pirmella 1/35
                                Used for:
                                • To prevent pregnancy

                                $29.97 Lowest GoodRx priceView Prices
                                Used for:
                                • To prevent pregnancy

                                • Moderate acne in females age 15 years and older

                                $53.32 Lowest GoodRx priceView Prices
                                Used for:
                                • To prevent pregnancy

                                $13.94 Lowest GoodRx priceView Prices
                                images

                                Pirmella 1/35 images

                                Green Round L27 And Lu - Pirmella 1 / 35 28-Day 1mg-0.035mg Tablet
                                This medicine is Green, Round Package Imprinted With "L27" And "Lu".Green Round L27 And Lu - Pirmella 1 / 35 28-Day 1mg-0.035mg Tablet
                                Green Round L27 And Lu - Pirmella 1 / 35 28-Day 1mg-0.035mg Tablet
                                This medicine is Green, Round Package Imprinted With "L27" And "Lu".Green Round L27 And Lu - Pirmella 1 / 35 28-Day 1mg-0.035mg Tablet

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