norgestrel / ethinyl estradiol
Cryselle is a combined oral contraceptive (COC) that's taken by mouth every day to prevent pregnancy. Cryselle contains 2 medications: norgestrel (a progestin) and ethinyl estradiol (an estrogen). Each 28-day pack of Cryselle contains 21 active (hormone) pills and 7 placebo pills. It's a monophasic birth control, meaning each active pill contains the same amount of hormones. Some of the more common side effects of Cryselle include changes in body weight, acne, and menstrual cramps.
Cryselle is a generic of the discontinued brand name Lo-Ovral. Other generics that are like Cryselle include Elinest, Low-Ogesterel, and Turqoz.
What is Cryselle?
What is Cryselle used for?
- To prevent pregnancy
How Cryselle works
Cryselle is a combination oral contraceptive (COC) that contains two hormones: ethinyl estradiol (an estrogen) and norgestrel (a progestin). These two hormones work together to help 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
Side effects of Cryselle
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
- Weight gain (11%)
- Back pain, vaginal discharge, and other symptoms of cervical erosion (9%)
- Weight loss (6%)
- Acne (4%)
- Pain during your period (4%)
- Vaginal discharge (4%)
- Stomach pain, cramps, and bloating (3%)
- Larger appetite (3%)
- Depression (3%)
- Nervousness (3%)
Less Common Side Effects
- Darker skin patches (chloasma/melasma)
- Fatigue
- Aggravated varicose veins
Cryselle 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
- Serious liver problems: yellowing of the skin or the whites of the eyes, tiredness, stomach pain
The following Cryselle 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
- Nausea
- Weight gain
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Pros and cons of Cryselle
Pros
- Once-daily dosing
- Works better to prevent pregnancy compared to some other birth control methods
- Pills are in an easy-to-follow blister pack
Cons
- Doesn't protect against sexually transmitted diseases (STDs)
- Need to take your pill at the same time every day for it to work well
- Not a good option for females over 35 who smoke
Pharmacist tips for Cryselle
- Before starting Cryselle, 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 Cryselle.
- Set an alarm to help you remember to take Cryselle 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 HCP.
- It's normal to have spotting (light vaginal bleeding outside of your period) or feel sick to your stomach for the first few packs of Cryselle. This should get better over time, but if it doesn't contact your OB-GYN provider or HCP.
- You'll typically get your period within 3 days after you finish the 21 active tablets in your Cryselle pack. During this time, you'll be taking the 7 placebo tablets. Make sure to start a new Cryselle pack on the day after you finish your placebo tablets, even if you're still bleeding.
- If you have vomiting or diarrhea, or take certain medications, Cryselle might not work as well for you. Always use a back-up birth control method until you're able to check with your HCP.
- Any time you vomit within 3-4 hours of taking Cryselle, 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 HCP.
- If you've been taking Cryselle as instructed and have missed two periods in a row or feel like you might be pregnant, call your HCP. 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 Cryselle can lower the amount of breast milk you're able to produce while breastfeeding. If you're breastfeeding, ask your HCP about alternative birth control options.
Common questions about Cryselle
Based on clinical studies, about 1 in 100 females might get pregnant during the first year of using Cryselle. This means that this birth control is about 99% effective at preventing pregnancy if you take it daily around the same time each day. But your chance of getting pregnant while taking Cryselle is higher if you don't take it as directed. If you're having trouble remembering to take your pill and want to consider other birth control options, talk to your healthcare professional (HCP).
If you're starting birth control for the first time, your healthcare team will recommend that you use a hormone-free back-up birth control, such as condom, for 7 days when you begin taking Cryselle. It might take about a week before Cryselle can work well to protect you from becoming pregnant.
No, Cryselle isn't a low-dose birth control. Low-dose birth control is a COC that contains 20 mcg of ethinyl estradiol (estrogen) or less. Because Cryselle contains 30 mcg of ethinyl estradiol, it isn't considered low-dose. If you're concerned about side effects from estrogen, ask your healthcare team whether a a low-dose birth control with less estrogen might be better-suited for you.
You might experience weight gain when taking Cryselle. In clinical studies, 11% of females reported weight gain after taking at least one dose of Cryselle. But the cause of weight gain wasn't clear. In general, people who take COCs are more likely to have weight gain from water retention, rather than from an increase in body fat. But not everyone will experience weight gain; some people reported weight loss after taking Cryselle. If weight changes concern you, speak with your healthcare professional (HCP).
Cryselle is only FDA-approved to prevent pregnancy, not help with acne. But in general, COC pills like Cryselle can help with acne. In fact, there are a few COCs that are FDA-approved treat acne, including Yaz (drospirenone / ethinyl estradiol) But keep in mind that in clinical studies, some people who took Cryselle did experience acne breakouts, since different people's bodies respond differently to the pill. If you're concerned about acne, speak with your healthcare team about the best birth control option for you.
Some people (about 9%) who took Cryselle in clinical studies did have missed periods. But this medication isn't intended to stop your periods altogether. If this happens, speak with your prescriber and they'll check to see if you're pregnant.
Low Ogestrol is a branded generic version of Cryselle, meaning that it works just as well as Cryselle but it's essentially a lower-cost generic version. It contains the same hormones that are in Cryselle, and at the same doses.
It's important for you to take Cryselle every day for the medication 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. This means you might take 2 pills on the same day. If you missed pills multiple days in a row, check the instructions that came with your pack or ask your prescriber or pharmacist what to do. Also, ask them if you need to use another method of birth control to prevent pregnancy during this time.
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Risks and warnings for Cryselle
Cryselle 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, taking combined oral contraceptives (COCs) like Cryselle raises your risk for serious health problems, such as stroke, heart attack, and blood clots. Females ages 35 years and older who smoke are at even higher risk for these problems. If you smoke, talk with your OB-GYN provider or healthcare professional (HCP) 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 Cryselle less than a month after childbirth | High blood pressure | People identified as obese | High cholesterol | Diabetes | Higher dose of estrogen
Cryselle 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 team you're taking Cryselle. They might have you stop taking it 4 weeks before 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 Cryselle and other COCs can raise your risk for breast and cervical cancer.
Don't use Cryselle 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, Cryselle can cause liver problems, such as liver damage and liver tumors. These problems are linked more with earlier formulations of COCs that contained higher doses of estrogen (50 mcg or higher), and less so with Cryselle since it only contains 30 mcg of estrogen. Don't use this medication if you already have liver problems. Call your HCP right away if you experience symptoms of liver problems, such as tiredness, stomach pain, or yellowing of the skin or whites of the eyes.
High blood sugar and triglycerides
- Risk factors: Prediabetes or diabetes | Personal or family history of high triglycerides | High dose
COCs like Cryselle might raise your blood sugar and triglyceride (fat) levels. If you have diabetes, let your HCP know if you experience any changes in your blood sugar. Make sure to go to all of your check-ups so your healthcare team can monitor any changes.
High blood pressure
- Risk factors: High blood pressure | Older age | Using COCs for a long time | Kidney problems
Cryselle and other COCs can raise your blood pressure. Your HCP 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 HCP. If you have uncontrolled high blood pressure, Cryselle might not be the best option for you.
Headache
Headaches are a common side effect of COCs like Cryselle. 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 HCP 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 Cryselle. Let your HCP 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 HCP will evaluate.
Depression
- Risk factors: History of depression
Let your HCP know if you experience symptoms of depression or worsening depression while taking Cryselle. In cases of serious depression, your OB-GYN provider or HCP might have you stop taking it.
Gallbladder problems
Some studies suggest that Cryselle 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 Cryselle.
Interactions with other medications
Certain medications can make Cryselle get broken down faster in your body, making it less effective. And this can lead to 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 Cryselle in your body, which can lead to more side effects. Make sure to tell your HCP or pharmacist all of your medications so they can make sure they don't interact with Cryselle.
If you're taking medications to treat hepatitis C, immediately let your HCP know that you're taking a COC. Certain hepatitis C medications can affect the level of Cryselle in your body, either making it work not as well in preventing pregnancy or raising your risk of side effects. Your healthcare team can give you instructions about what to do if you're taking a hepatitis C medication that can interact with Cryselle.
Cryselle dosage
Package| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 28 tablets of 0.03mg/0.3mg | 3 packages | $30.22 | $10.07 |
Typical dosage for Cryselle
Cryselle comes in a 28-day pack. There are 21 active tablets and they each contain 0.3 mg of norgestrel and 30 mcg of ethinyl estradiol. There are 7 placebo tablets and they don't contain any active medications.
- 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.
How much does Cryselle cost?
$12.27
Cryselle 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 Cryselle will not be safe for you to take.
- 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 headaches with aura and over 35 years old
- Uncontrolled high blood pressure
- Currently have or have a history of breast cancer that might be hormone-sensitive
- Undiagnosed abnormal vaginal bleeding
- Liver tumors
- Liver disease
- Pregnancy
- Taking hepatitis C medication containing ombitasvir / paritaprevir / ritonavir, with or without dasabuvir
