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Ortho Tri-Cyclen is one of the most popular birth control options. The medication is more than 92% effective when taken daily.

What is Ortho Tri-Cyclen?

Ortho Tri-Cyclen is a combination birth control pills which contains 2 female hormones (norgestimate, ethinyl estradiol) used to prevent pregnancy. The drug is also used to treat severe acne. Each pack contains 28 tablets: 21 active tablets each containing norgestimate and ethinyl estradiol and 7 placebo tablets containing only inert ingredients.

Mechanism of action

This is a combined oral contraceptive which works by suppressing the secretion of gonadotropins,. The drug prevents the maturation of the eggs in the ovaries and ovulation. In addition, it increases the viscosity of the cervical mucus, which makes it difficult for sperm to reach the uterus, and affects the endometrial epithelium, reducing the likelihood of implantation.

How to use Ortho Tri-Cyclen?

Take the first tablet on the first day of your period or on the first Sunday after your period begins. After this, you need to take 1 tablet daily for 28 days. Do not take breaks in taking medication. Menstrual bleeding usually begins a few days after taking the last active pill. The next pack should be started without interruption. The first tablet of the new pack should be taken regardless of whether menstruation has stopped or still continues. Birth control pills are most effective if taken at the same time of day, for example in the morning or in the evening.

Side effects

Ortho Tri-Cyclen is usually well-tolerated. In very rare cases, the contraceptive can cause the following side effects: arterial hypertension, myocardial infarction, cerebrovascular accident, deep vein thrombosis, arterial thromboembolism, pulmonary or other thromboembolism, edema, benign and malignant tumors of the liver, cervical cancer, breast cancer, cholestatic jaundice, Bintrahepatic cholestasis, cholelithiasis, nausea, vomiting, abdominal pain, flatulence, colitis intermenstrual bleeding, spotting, amenorrhea, changes in the menstrual cycle, increase in the size of uterine fibroids, vaginal candidiasis, increase in cervical secretion, cervical erosion, decreased libido, premenstrual syndrome, temporary infertility after the drug withdrawal, pain and sensation of tension, galactorrhea, engorgement, increase in size, skin rash, chloasma, exudative erythema, acne, seborrhea, alopecia, hirsutism, pigment spots on the face, hypertrichosis, gestational herpes, melasma with a tendency to persist, cataract, lesions of the optic nerve, changes in the curvature of the cornea, discomfort when wearing contact lenses, headache, mood changes, irritability, depression, chorea, fluid retention, changes in body weight (decrease or increase), decrease in glucose tolerance, changes in appetite, reduced renal function, hemolytic uremic syndrome, dizziness, migraine.

If you have menstrual-like bleeding in the middle of the cycle, continue taking tablets. If the bleeding does not stop, you need to consult a doctor to eliminate organic causes.


Do not take Ortho Tri-Cyclen if you have any of the following conditions: thrombophlebitis (inflammation of the walls of the veins with their blockage), thromboembolism (vascular impairment), deficiency of antithrombin 3 (one of the factors that prevent blood clotting), cerebrovascular disorders (changes in the blood vessels of the brain), carcinoma of the mammary gland and endometrium (inner layer of the uterus), other estrogen-dependent neoplasms, bleeding from the urogenital tract of unknown etiology, pregnancy, breastfeeding, hepatic impairment, liver tumor.

With caution: ulcerative colitis, violations of the menstrual cycle, venous or arterial embolism in siblings or parents at a relatively young age, thrombophlebitis of the superficial veins and varicose veins, uterine fibroids, depression, prolonged immobilization or extensive surgery, risk factors for coronary heart disease (smoking, hyperlipidemia, hypertension, or obesity), arterial hypertension, mastopathy, diseases of the liver and gallbladder, epilepsy, mitral stenosis with atrial fibrillation, hypertriglyceridemia (including family history), systemic lupus erythematosus, kidney disease, adolescence, tuberculosis, Crohn’s disease, acute liver dysfunction during a previous pregnancy or prior use of hormonal contraceptives.


It’s not recommended to combine Ortho Tri-Cyclen with any of the following drugs and products: barbiturates, bosentan, carbamazepine, griseofulvin, modafinil, oxcarbazepine, phenytoin, rifampin, preparations on the basis of Hypericum, topiramate, HIV protease inhibitors, grapefruit juice, acetaminophen, ascorbic acid, inhibitors of CYP3A4 enzymes (itraconazole, ketoconazole, voriconazole, fluconazole), HMG-CoA reductase inhibitors (atorvastatin, rosuvastatin), cyclosporine, omeprazole, prednisone, theophylline, voriconazole, acetaminophen, clofibride acid, lamotrigine, morphine, salicylic acid, temazepam.

Before taking birth control pills, tell your doctor about all medications, substances and vitamins you are currently using.

What if I miss a pill?

Try not to miss tablets because it increases the chance of becoming pregnant. If you miss an active pill, take it as soon as possible. If the delay does not exceed 12 hours, the drug provides a reliable contraceptive effect. The effectiveness of the drug decreases with a delay for more than 12 hours. In this case, the tablet should be taken as soon as possible and use additional means of contraception (a condom or vaginal contraceptive suppositories) until you have your period. In such situations, you cannot rely on the “safe days” method or “temperature” method of contraception.

Safety precautions

Ortho Tri-Cyclen is contraindicated to pregnant women. The drug can affect lactation, i.e. reduce the amount and change the composition of breast milk. In addition, a small portion of norgestimate and ethinyl estradiol can penetrate into breast milk. In this regard, the contraceptive is contraindicated during breastfeeding. An overdose of hormones can cause nausea, vomiting and vaginal bleeding. If vomiting or diarrhea occurs, the medication may lose its effectiveness. In this case, it is recommended to use additional birth control methods until you have your next period. A woman can start using oral contraceptives no earlier than 4 weeks after delivery, provided that the woman is not breastfeeding. After an abortion or miscarriage for a period of up to 20 weeks of pregnancy, the drug can be started immediately, in these cases the use of additional methods of contraception is not required. After induced or spontaneous abortion at a gestational age of more than 20 weeks, oral contraceptives can be started on the 21st day after the abortion or on the first day of the period (whichever comes first). Before taking tablets, it is recommended to undergo a thorough physical examination. Examinations should be repeated every 6 months or as directed by a gynecologist. Efficiency decreases with regular consumption of alcohol. Impact on the ability to drive vehicles and control mechanisms have not been identified. The medication is discontinued 6 weeks before the scheduled surgeries. The risk of thrombosis increases with high blood pressure. Birth control pills do not protect against HIV infection (AIDS) and other sexually transmitted diseases.