norgestimate / ethinyl estradiol
Tri-Lo-Sprintec (norgestimate / ethinyl estradiol) is a combined oral contraceptive (COC) that's taken by mouth every day prevent pregnancy. It contains 2 medications: norgestimate (a progestin) and ethinyl estradiol (an estrogen). It's a triphasic birth control, meaning the doses of hormones in the active pills change three times in the 28-day pack. The "Lo" in its name means that it contains a lower dose of estrogen than many other similar birth controls. Potential side effects include headache, nausea, and mood changes.
Tri-Lo-Sprintec (norgestimate / ethinyl estradiol) is a generic of the discontinued brand name Ortho-Tri-Cyclen Lo. Other generics include Tri-Lo-Estarylla, Tri-Lo-Mili, and Tri-Vylibra Lo (norgestimate / ethinyl estradiol).
What is Tri-Lo-Sprintec (norgestimate / ethinyl estradiol)?
What is Tri-Lo-Sprintec (norgestimate / ethinyl estradiol) used for?
To prevent pregnancy
How Tri-Lo-Sprintec (norgestimate / ethinyl estradiol) works
Tri-Lo-Sprintec (norgestimate / ethinyl estradiol) is a combination oral contraceptive (COC) that contains two hormones: ethinyl estradiol (an estrogen) and norgestimate (a progestin). These hormones work together to prevent pregnancy by:
Stopping 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)
Drug Facts
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What are the side effects of Tri-Lo-Sprintec (norgestimate / ethinyl estradiol)?
Common Side Effects
- Headache or migraine (31%)
- Nausea or vomiting (16%)
- Breast changes (10%)
- Stomach pain (9%)
- Period pain or changes to period bleeds (9%)
- Mood changes (8%)
Other Side Effects
- Acne
- Vaginal infection
- Stomach bloating
- Weight gain
- Feeling tired
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
- Serious liver problems: yellowing of the skin or the whites of the eyes, tiredness, stomach pain
Source: DailyMed
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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, 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
Pros and cons of Tri-Lo-Sprintec (norgestimate / ethinyl estradiol)
Pros
Once-daily dosing
Works better to prevent pregnancy compared to some other birth control methods
Comes in a convenient blister pack to help you keep track of your doses
Cons
Need to take your pill at the same time every day for it to work well
Doesn't protect against sexually transmitted diseases (STDs)
Can't be used by females over 35 who smoke cigarettes because of risk for blood clots
Pharmacist tips for Tri-Lo-Sprintec (norgestimate / ethinyl estradiol)
Before starting Tri-Lo-Sprintec (norgestimate / ethinyl estradiol), discuss your full medical history with your prescriber. This medication can worsen certain conditions. Some examples are chloasma (a condition that causes dark skin patches) and hereditary angioedema (episodes of severe swelling in your body). If you have a history of chloasma, avoid sun exposure while taking Tri-Lo-Sprintec (norgestimate / ethinyl estradiol).
Set an alarm to help you remember to take Tri-Lo-Sprintec (norgestimate / ethinyl estradiol) 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 or call your prescriber.
Any time you vomit or have diarrhea within 3 to 4 hours of taking Tri-Lo-Sprintec (norgestimate / ethinyl estradiol), you should consider it a missed dose and take another pill of the same color to make up for it. If you don't have another pill that's the same color, use one from your extra pack and ask your pharmacist for a refill if needed.
It's normal to have spotting (light vaginal bleeding outside of your period) for the first few packs of Tri-Lo-Sprintec (norgestimate / ethinyl estradiol). This should get better over time, but contact your prescriber if it doesn't.
If you've been taking Tri-Lo-Sprintec (norgestimate / ethinyl estradiol) as instructed and have missed two periods in a row or feel like you might be pregnant, call your prescriber. Studies haven't shown a risk of birth defects in females who've used birth control pills before pregnancy or during early pregnancy, but it's no longer necessary to take them once you're pregnant.
Oral contraceptives like Tri-Lo-Sprintec (norgestimate / ethinyl estradiol) can lower the amount of breast milk you're able to produce while breastfeeding. If you're breastfeeding, ask your prescriber about alternative birth control options.
Tri-Lo-Sprintec (norgestimate / ethinyl estradiol) can interact with other medications. Before starting Tri-Lo-Sprintec (norgestimate / ethinyl estradiol), talk to your healthcare team if you’re taking levothyroxine (Euthyrox) or steroids like prednisone. They might need to adjust your medication dose.
Frequently asked questions about Tri-Lo-Sprintec (norgestimate / ethinyl estradiol)
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What are the risks and warnings for Tri-Lo-Sprintec (norgestimate / ethinyl estradiol)?
Tri-Lo-Sprintec (norgestimate / ethinyl estradiol) 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 Tri-Lo-Sprintec (norgestimate / ethinyl estradiol) raises your risk for serious health problems, such as strokes, heart attacks, and blood clots. Females aged 35 years and older who smoke are at even higher risk for these problems. If you smoke, talk with your healthcare professional 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 Tri-Lo-Sprintec (norgestimate / ethinyl estradiol) less than a month after childbirth | High blood pressure | People identified as obese | High cholesterol | Diabetes | Higher dose of estrogen
Tri-Lo-Sprintec (norgestimate / ethinyl estradiol) 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 healthcare professional you're taking Tri-Lo-Sprintec (norgestimate / ethinyl estradiol). They might have you stop taking it 4 weeks before the surgery up until 2 weeks after your surgery to lower your risk of blood clots.
Risk of breast and cervical cancer
Risk factors: History of breast cancer | Taking COCs for a long time
Study results are mixed, but there's a possibility that Tri-Lo-Sprintec (norgestimate / ethinyl estradiol) and other COCs can raise your risk for breast and cervical cancer.
Don't use Tri-Lo-Sprintec (norgestimate / ethinyl estradiol) if you have breast cancer because some types of breast cancer grow faster in the presence of estrogen, an ingredient in this birth control pill. To help with early breast cancer detection, you can do monthly breast self-checks at home and yearly breast exams with your healthcare professional. Call your HCP if you notice any abnormal changes or feel lumps, pain, or swelling in your breasts.
Get medical help right away if you experience abnormal vaginal bleeding, discharge, or pain during sex, since these could be signs of cervical cancer.
Liver problems
Risk factors: Liver problems or infection in the liver | Taking COCs with 50 mcg of estrogen or higher
Though rare, Tri-Lo-Sprintec (norgestimate / ethinyl estradiol) can cause liver problems, such as liver damage and liver tumors. These problems are linked more with earlier formulations of COCs that contained higher levels of estrogen (50 mcg or higher), and less so with Tri-Lo-Sprintec (norgestimate / ethinyl estradiol) since it only contains 25 mcg of estrogen. Don't use this medication if you already have liver problems. Call your prescriber right away if you experience symptoms of liver problems, such as tiredness, stomach pain, or yellowing of the skin or whites of the eyes.
Gallbladder problems
Some studies suggest that Tri-Lo-Sprintec (norgestimate / ethinyl estradiol) 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 gynecologist if you a history of gallbladder disease before starting Tri-Lo-Sprintec (norgestimate / ethinyl estradiol).
High blood sugar and triglycerides
Risk factors: Pre-diabetes or diabetes | High triglycerides
Tri-Lo-Sprintec (norgestimate / ethinyl estradiol) can raise your levels of blood sugar and triglycerides (a type of fat). If you've been diagnosed with prediabetes or diabetes, your risk of having your blood sugar rise is much higher. This is because Tri-Lo-Sprintec (norgestimate / ethinyl estradiol) 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 prescriber before starting Tri-Lo-Sprintec (norgestimate / ethinyl estradiol) if you have a history of high blood sugar or triglycerides. They might help you choose another birth control or monitor your blood work more closely if you take this medication.
High blood pressure
Risk factors: High blood pressure | Older age | Using COCs for a long time | Kidney problems
Tri-Lo-Sprintec (norgestimate / ethinyl estradiol) and other COCs can raise your blood pressure. Your prescriber might ask you to check your blood pressure regularly. If you notice your blood pressure is higher while you're taking this medication, contact your prescriber. If you have uncontrolled high blood pressure, Tri-Lo-Sprintec (norgestimate / ethinyl estradiol) might not be the best option for you.
Headache
Headaches are a common side effect of COCs like Tri-Lo-Sprintec (norgestimate / ethinyl estradiol). But, if you experience a new migraine, a migraine that's worse than normal, or a new headache that keeps coming back or is severe, call your prescriber so you can be checked out.
Irregular bleeding
Breakthrough bleeding and spotting are common side effects of hormonal birth control pills. This is more common during the first 3 months of using Tri-Lo-Sprintec (norgestimate / ethinyl estradiol). Let your prescriber know if you experience any vaginal bleeding outside of your period, or if your period has stopped completely. There are other causes besides your birth control pills for irregular bleeding that your healthcare professional will evaluate.
Depression
Risk factors: History of depression
Let your care team know if you experience symptoms of depression or worsening depression while taking Tri-Lo-Sprintec (norgestimate / ethinyl estradiol). In cases of serious depression, your prescriber might have you stop taking it.
Interactions with other medications
Certain medications can make Tri-Lo-Sprintec (norgestimate / ethinyl estradiol) get broken down faster in your body, making it work less well to prevent pregnancy. Some examples include carbamazepine (Tegretol) and phenytoin (Dilantin). Use a back-up method or other form of birth control for at least 28 days after stopping any of these medications. Other medications can raise the amount of Tri-Lo-Sprintec (norgestimate / ethinyl estradiol) in your body, which can lead to more side effects. Make sure to tell your prescriber or pharmacist all of your medications so they can make sure they don't interact with Tri-Lo-Sprintec (norgestimate / ethinyl estradiol).
If you have hepatitis C and need to be treated with Viekira Pak (dasabuvir / ombitasvir / paritaprevir / ritonavir), immediately let your prescriber know that you're taking a COC. You'll need to stop Tri-Lo-Sprintec (norgestimate / ethinyl estradiol) before starting Viekira Pak because taking them together can cause liver problems. You can start Tri-Lo-Sprintec (norgestimate / ethinyl estradiol) again 2 weeks after you stop Viekira Pak.
Allergic reactions
Risk factors: History of allergy to FD&C Yellow No. 5 (tartrazine)
Tri-Lo-Sprintec (norgestimate / ethinyl estradiol) and other generics might contain a dye called FD&C Yellow No. 5 (tartrazine). Although rare, some people can have an allergic reaction to this ingredient. If you have hives, itching, or other signs of an allergic reaction, seek medical attention.
More on Tri-Lo-Sprintec (norgestimate / ethinyl estradiol) warnings
Tri-Lo-Sprintec (norgestimate / ethinyl estradiol) dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 28 tablets | 3 packages | $22.20 | $7.40 |
Typical dosing for Tri-Lo-Sprintec (norgestimate / ethinyl estradiol)
Tri-Lo-Sprintec (norgestimate / ethinyl estradiol) (and other branded generics) comes in a 28-day pack. Your medication might look different depending on which branded generic your healthcare professional (HCP) prescribes. Please take the medication as instructed by your HCP or follow the directions on the package.
There are 21 active tablets and they contain different dosages of norgestimate and ethinyl estradiol. In general:
Day 1 through 7: 0.18 mg norgestimate and 25 mcg ethinyl estradiol
Day 8 through 14: 0.215 mg norgestimate and 25 mcg ethinyl estradiol
Day 15 through 21: 0.25 mg norgestimate and 25 mcg ethinyl estradiol
Day 22 through 28: Placebo tablets (hormone-free)
The typical dose is 1 active tablet by mouth daily for 21 days, followed by 1 placebo tablet daily for the remaining 7 days.
Tri-Lo-Sprintec (norgestimate / ethinyl estradiol) contraindications
Currently have or history of DVT, PE, or other blood clotting problems
Smoke and over age 35 years old
Cerebrovascular disease (problems with blood flow in the brain)
Coronary artery disease (problems with blood flow in the heart)
Certain heart valve or heart rhythm problems
Diabetes with blood vessel problems
Certain types of headaches with neurological symptoms
Migraine with aura or if you're over 35 years old
Uncontrolled high blood pressure
Currently have or have a history of breast cancer
Unusual vaginal bleeding where your healthcare professional hasn't yet determined the cause
Liver tumors
Liver disease
Pregnancy
Taking hepatitis C medication containing ombitasvir / paritaprevir / ritonavir, with or without dasabuvir
What are alternatives to Tri-Lo-Sprintec (norgestimate / ethinyl estradiol)?
To prevent pregnancy
To prevent pregnancy
Treatment of moderate acne
What is the latest news about Tri-Lo-Sprintec (norgestimate / ethinyl estradiol)?
Tri-Lo-Sprintec (norgestimate / ethinyl estradiol) images
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References
Best studies we foundAllais, G., et al. (2009). Headache induced by the use of combined oral contraceptives. Neurological Sciences.
Etminan, M., et al (2011). Oral contraceptives and the risk of gallbladder disease: A comparative safety study. Canadian Medical Association Journal.
Hannaford, P. C., et al. (1997). Combined oral contraceptives and liver disease. Contraception
International Agency for Research on Cancer. (2012). Combined estrogen-progestogen contraceptives. Pharmaceuticals.
Latwal, B., et al. (2020). Authorized generics vs. branded generics: A perspective. Journal of Generic Medicines.
MedlinePlus. (2024). Hereditary angioedema.
National Institute of Diabetes and Digestive and Kidney Diseases. (2020). Estrogens and oral contraceptives. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury.
Ojha, N., et al. (2023). Myocardial infarction. StatPearls.
Teva Pharmaceutical Industries Ltd. (2016). Teva announces launch of generic Ortho Tri-Cyclen® Lo in the United States.
Teva Pharmaceuticals USA, Inc. (2021). Tri-Lo-Sprintec- norgestimate and ethinyl estradiol kit [package insert]. DailyMed.
U.S. Food and Drug Administration. (2023). How safe are color additives?
Xiromed, LLC. (2023). Tri-Lo- Estarylla- norgestimate and ethinyl estradiol kit [package insert]. DailyMed.
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