tilia FE
Tilia Fe is a type of combined oral contraceptive (COC), or birth control, that's taken by mouth every day to prevent pregnancy. It's a triphasic birth control, meaning it has three different phases of hormones that try to mimic (are similar to) the rise and fall of hormones in the menstrual cycle. Some people find triphasic birth controls, like Tilia Fe, more complicated to take, especially if they need to make up for a missed dose.
What is Tilia Fe?
What is Tilia Fe used for?
- To prevent pregnancy
- Moderate acne in females age 15 years and older
How Tilia Fe works
Tilia Fe is a combination medication that contains two hormones, norethindrone (a progestin) and ethinyl estradiol (an estrogen). Both hormones work together to prevent pregnancy by:
- Suppressing ovulation (release of an egg from the ovary)
- Changing cervical mucus to block sperm movement
- Creating an unfriendly environment for the fertilized egg by changing the lining in the uterus (womb)
Tilia 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.
Drug facts
Side effects of Tilia 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
- Vomiting
- Stomach cramps and bloating
- Bleeding between periods
- Spotting
- Change in the flow of period
- Missing periods
Less Common Side Effects
- Unable to have a baby temporarily after stopping the medication
- Swelling
- Skin condition that causes brown spots or patches
- Breast changes (tenderness, enlargement)
- Weight changes
- Headache
- Allergic rash
- Mood changes
- Vaginal yeast infection
- Discomfort with contact lenses
Tilia Fe serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- 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
- Liver problems: yellowing of the skin or the whites of the eyes, tiredness, stomach pain
The following Tilia Fe 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, 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 cycles or spotting
- Nausea
- Weight gain
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Pros and cons of Tilia Fe
Pros
- Taken once daily
- Hormones provided by the pill every week are similar to your body's natural hormone production
- Placebo pills contain an iron supplement to help prevent anemia
- Works better to prevent pregnancy compared to some other birth control methods
- Can take with or without food
Cons
- Different colored pills might be confusing
- Dosing is complicated if you're trying to make up for missed pills
- Can't be used by females age 35 years and older who smoke cigarettes because of high risk of blood clots
- Doesn't protect against sexually transmitted diseases (STDs)
- Must take it at the same time every day for it to work well
Pharmacist tips for Tilia Fe
- Tilia Fe tablets are arranged in four rows of seven tablets, with the days of the week printed above the first row of tablets. Take the pills in the order directed on the pack. To remove a tablet, press down on it with your thumb or finger. The tablet will drop through the back of the tablet dispenser. Don't press with your fingernail, or any other sharp object, because this could damage the pill.
- Take Tilia Fe at the same time every day. You can set an alarm to help you remember to take it. 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.
- Tilia 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.
- If you have vomiting or diarrhea, Tilia Fe might not work as well for you. Always use a back-up birth control method until you're able to check with your healthcare provider.
- Let your provider or pharmacist know all of your current medications. Certain medications, such as rifampin (Rifadin), can interact with Tilia 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).
- If you want to start Tilia 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.
Common questions about Tilia Fe
Tilia Fe is called a triphasic birth control because it contains three different phases of hormone levels throughout the first three weeks. It tries to mimic your natural hormone levels more closely. Your provider can help you determine if this is the right medication for you based on the amount of hormones that your body might need.
As mentioned above, Tilia Fe has three different combinations of hormone levels. The first three weeks are "active" pills, which means that they contain hormones. The fourth week is made up of "inactive" pills, which don't have hormones. Tilia Fe is made up of four different sets of colored pills, each with different dosages of hormones (or no hormones in the case of the inactive, placebo pills). It's important for you to take the tablets in the correct order so your body can follow the appropriate hormone levels.
Yes, Tilia Fe is FDA-approved to treat moderate acne in certain people. If you're at least 15 years old, you're already planning on using a COC for birth control, you plan to stay on it for at least 6 months, and topical acne medications haven't helped, then your provider might consider prescribing Tilia Fe to treat your acne. Tilia Fe helps with acne by lowering the amount of testosterone in your body. This leads to less oil production and clogging of the pores of the skin, which can prevent acne.
It's important for you to take Tilia Fe every day to prevent pregnancy. But if you missed a dose, your next steps depend on when you missed it and how many pills you missed. If you only missed 1 pill, you can take the missed pill as soon as you remember and continue taking the next pill at your regular time. If you missed pills multiple days in a row, you might have to take 1 or 2 pills on the same day to make up for it. Or you might have to throw away your current pack and start a new pack. Since Tilia Fe is a triphasic birth control, it can be more complicated to make up for missed pills. Make sure to follow the instructions on the patient information sheet that was provided with your medication, or contact your provider or pharmacist. Also, ask them if you need to use another method of birth control to prevent pregnancy during this time.
Small amounts of Tilia Fe can pass into your breast milk and affect your baby. This can lead to side effects in your baby, such as yellowing of the skin and eyes (jaundice) 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. It's best to speak to your provider to see which form of birth control is safe for you and your baby while you're breastfeeding.
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Risks and warnings for Tilia Fe
Tilia 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 Tilia 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. 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 Tilia Fe less than a month after childbirth | High blood pressure | People identified as obese | High cholesterol | Diabetes | Higher dose of estrogen
Tilia 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 Tilia 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 Tilia Fe until 4 weeks after delivery if you're not breastfeeding your child.
Irregular bleeding
People who take Tilia 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
Tilia 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. Tilia Fe can't be taken by females who have high blood pressure that's not under control. 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
Tilia Fe can raise your blood sugar and cholesterol levels. Speak with your provider before starting Tilia Fe if you have diabetes, prediabetes, or high cholesterol. If you choose to take Tilia Fe with those health conditions, your provider will monitor you regularly.
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 Tilia Fe and other COCs can raise your risk for breast and cervical cancer.
Don't take Tilia 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 Tilia 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, Tilia Fe can raise your risk of benign liver tumors. If you experience signs of liver problems, you should stop taking Tilia 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 Tilia 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 Tilia Fe and discuss other birth control options with your provider if you need to start your treatment for hepatitis C. You can restart Tilia 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 Tilia 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 Tilia Fe. In cases of serious depression, your provider might have you stop taking it.
Tilia Fe dosage
Package| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 28 tablets | 3 packages | $53.62 | $17.87 |
Typical dosage for Tilia Fe
Tilia Fe (and its branded generics) comes in a 28-day pack. Your medication might look different depending on which branded generic your provider prescribes. Please take the medication as instructed by your provider or follow the directions on the package. In general:
The typical dose is 1 tablet by mouth at the same time every day for 28 days, following the order as instructed on the package.
Tilia Fe contains three different phases of hormone levels throughout the first three weeks:
- Day 1 through 5: 1 mg norethindrone acetate and 20 mcg ethinyl estradiol
- Day 6 through 12: 1 mg norethindrone acetate and 30 mcg ethinyl estradiol
- Day 13 through 21: 1 mg norethindrone acetate and 35 mcg ethinyl estradiol.
- Day 22 through 28: Placebo tablets (hormone-free) containing 75 mg of ferrous fumarate
How much does Tilia Fe cost?
Tilia 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 Tilia Fe will not be safe for you to take.
- Females age 35 years and older 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 Tilia Fe?
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