Why is this medication prescribed?

Progestin-only oral contraceptives, also known as the mini-pill, are prescribed primarily for birth control. Unlike combination birth control pills, which contain both estrogen and progestin, progestin-only pills only contain a progestin hormone (in this case, norethindrone). They are commonly recommended for women who may have contraindications to estrogen-containing contraceptives, such as those who are breastfeeding or have a history of blood clots.

How should this medicine be used?

Here’s how progestin-only oral contraceptives are typically used:

• Timing: Unlike combination pills, which are taken every day for three weeks followed by a week of inactive pills (or no pills), progestin-only pills are taken every day without a break.
• Consistency: It’s crucial to take the pill at the same time every day. This consistency helps maintain its effectiveness.
• Start Date: You can start taking progestin-only pills at any time during your menstrual cycle. However, if you start more than five days after the start of your period, it’s recommended to use backup contraception, such as condoms, for the first 48 hours of pill-taking.
• Missed Doses: If you miss a dose of the progestin-only pill, take it as soon as you remember, even if it means taking two pills in one day. If you miss more than one dose, consult your healthcare provider for guidance. It might be necessary to use backup contraception until you’re back on track.
• Efficacy: While progestin-only pills are effective in preventing pregnancy when taken correctly, they require a higher level of consistency in timing compared to combination pills.
• Other Considerations: Some medications and conditions can affect the effectiveness of progestin-only pills. It’s essential to discuss any other medications you’re taking and your medical history with your healthcare provider before starting this form of contraception.

Other uses for this medicine

Aside from contraception, progestin-only oral contraceptives may have other uses, such as:

• Management of Menstrual Disorders: They can help regulate irregular menstrual cycles and reduce menstrual cramps.
• Treatment of Endometriosis: Progestin-only pills may alleviate symptoms associated with endometriosis, such as pelvic pain and abnormal bleeding.
• Breastfeeding: Progestin-only pills are considered safe for use during breastfeeding since they don’t affect milk production or quality.

What special precautions should I follow?

Special precautions for using progestin-only oral contraceptives include:

• Consistency in Timing: As mentioned earlier, it’s crucial to take progestin-only pills at the same time every day to maintain their effectiveness.
• Backup Contraception: If you miss a dose or take a pill more than three hours later than usual (for some brands), backup contraception may be necessary to prevent pregnancy.
• Interactions with Other Medications: Some medications, such as certain antibiotics and anticonvulsants, can reduce the effectiveness of progestin-only pills. Consult your healthcare provider about potential interactions with any medications you are taking.
• Health Conditions: Inform your healthcare provider about any medical conditions you have, such as liver disease or a history of blood clots, as they may affect whether progestin-only pills are suitable for you.
• Smoking: Smoking while taking progestin-only contraceptives, especially if you are over 35 years old, increases the risk of blood clots and other cardiovascular complications. It’s generally advised to avoid smoking while using any form of hormonal contraception.

Always follow your healthcare provider’s instructions and recommendations regarding the use of progestin-only oral contraceptives, and don’t hesitate to ask any questions or voice concerns you may have.

What special dietary instructions should I follow?

Regarding dietary instructions, there are no specific dietary restrictions associated with progestin-only oral contraceptives. However, maintaining a healthy diet can contribute to overall well-being and may complement the effectiveness of the contraceptive. If you have any concerns about diet and medication interactions, consult your healthcare provider or a registered dietitian.

What should I do if I forget a dose?

• Take the missed pill as soon as you remember, even if it means taking two pills in one day.
• Continue taking the pills at your regular time.
• If you missed more than one pill or had unprotected sex in the past 48 hours, consult your healthcare provider for advice on backup contraception or emergency contraception.
• If you’re unsure about what to do, don’t hesitate to contact your healthcare provider or pharmacist for guidance.

What side effects can this medication cause?

Progestin-only oral contraceptives, like any medication, can potentially cause side effects in some individuals. While many women tolerate them well, others may experience side effects. Common side effects of progestin-only (norethindrone) oral contraceptives may include:

• Menstrual Changes: Irregular bleeding, spotting between periods, or changes in menstrual flow are common side effects, especially during the first few months of use.
• Headaches: Some women may experience headaches or migraines while taking progestin-only pills.
• Breast Tenderness: Breast tenderness or enlargement may occur in some individuals.
• Nausea: Nausea or stomach discomfort is another possible side effect, though it often improves with time.
• Mood Changes: Some women may experience mood swings, irritability, or changes in libido.
• Weight Changes: While weight changes are possible, they are generally minimal with progestin-only pills compared to combination pills containing estrogen.
• Acne: Progestin-only contraceptives may worsen or improve acne in some individuals.
• Other Side Effects: Less common side effects can include fatigue, dizziness, changes in appetite, and hair loss.

It’s important to note that while these side effects can occur, many women do not experience any significant adverse effects while taking progestin-only oral contraceptives. Additionally, side effects often improve over time as the body adjusts to the medication. If you experience persistent or severe side effects, it’s essential to consult your healthcare provider. They may recommend adjusting your dosage, switching to a different formulation, or exploring alternative contraceptive options.

What should I know about storage and disposal of this medication?

Storage and Disposal:

• Storage: Store progestin-only oral contraceptives at room temperature away from moisture and heat. Avoid storing them in the bathroom or in places where they may be exposed to direct sunlight or extreme temperatures.
• Keep Out of Reach of Children: Store the medication in a safe place out of reach of children and pets.
• Proper Disposal: Dispose of expired or unused medication properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so by your healthcare provider or pharmacist. Instead, check with your local pharmacy or healthcare facility for guidance on safe disposal methods.

In case of emergency/overdose

In case of emergency or suspected overdose of progestin-only oral contraceptives, seek immediate medical attention or contact a poison control center (in the United States, call 1-800-222-1222). Symptoms of overdose may include nausea, vomiting, and vaginal bleeding.

What other information should I know?

• Effectiveness: Progestin-only oral contraceptives are most effective when taken consistently and at the same time each day. Missing doses or taking them inconsistently can reduce their effectiveness in preventing pregnancy.
• Consultation with Healthcare Provider: Always consult your healthcare provider before starting or stopping any medication, including progestin-only oral contraceptives. They can provide personalized advice based on your medical history and individual needs.
• Regular Check-ups: It’s important to attend regular check-ups with your healthcare provider while taking progestin-only oral contraceptives to monitor for any potential side effects or complications.
• Interactions with Other Medications: Inform your healthcare provider about any other medications, supplements, or herbal remedies you are taking, as they may interact with progestin-only oral contraceptives.
• Follow Instructions: Follow the instructions provided by your healthcare provider or pharmacist regarding the use of progestin-only oral contraceptives, including dosing instructions, missed dose guidance, and any special precautions or considerations.

By following these guidelines and staying informed about your medication, you can use progestin-only oral contraceptives safely and effectively.