Noret 28 Pill

Ethinylestradiol, Norgestrel & Ferrous Fumarate is indicatd for prevention of pregnancy.

Oral Contraceptive preparations

Combination of hormonal contraceptives (Norgestrel, Ethinylestradiol & Ferrous Fumarate) inhibits ovulation by modulating pituitary secretion of gonadotrophins, luteinising hormone and follicle stimulating hormone through a negative feedback system. They reduce sperm penetration if ovulation does occur by altering the cervical mucus; cause changes in the endometrium which reduce the risk of nidation and may change the tubal transport of the ova through the fallopian tubes.

Ferrous fumarate is an iron preparation that is used in the prevention and treatment of iron deficiency.

How to take Levonorgestrel, Ethinylestradiol & Ferrous Fumarate:

To achieve maximum contraceptive effectiveness, Levonorgestrel, Ethinylestradiol & Ferrous Fumarate must be taken in the order directed on the package and at intervals not exceeding 24 hours. Women should be instructed to take the pills at about the same time every day, preferably after the evening meal or at bedtime. One pill is to be taken daily for 28 consecutive days. Each subsequent pack is started on the day after the current pack is completed.

• If you have decided to take Levonorgestrel, Ethinylestradiol & Ferrous Fumarate for contraception, wait for your next menstruation begins.
• From the first day of your menstruation, start taking the first white pill from the left corner of the top row(with arrow mark) of your Levonorgestrel, Ethinylestradiol & Ferrous Fumarate pill pack.
• Continue taking one white pill each day along the arrow mark.
• After taking 21 white pills for 21 days, continue taking one brown iron pill every day from the last row in the foil for next 7 days.

It is most likely that your menstruation will start while taking the brown pills. Do not discontinue taking the brown pills. In addition to giving you iron supplementation regular taking of the brown tablets for 7 days will help you keep your pill taking routine. If your menstruation does not start during this time, check with your doctor to make sure you are not pregnant.
After completing the seven iron pills, start taking white pills from another Levonorgestrel, Ethinylestradiol & Ferrous Fumarate pack and continue taking the pill as long as you don’t want to be pregnant.

What to do after missing the pill?

How to delay a period: To delay a period you should continue with another new pack of Levonorgestrel, Ethinylestradiol & Ferrous Fumarate just after finishing the white active pill of the present pack(that is no need to take brownish inert tablet of present pack). The extension can be carried on for as long as wished until the end of the second pack. When you wish your period to begin, just stop tablet taking. While using the second pack woman may have some breakthrough bleeding or spotting. Start with your next pack after the usual 7 day red inactive pill interval.

Advice in case of Vomiting: If vomiting occurs within 4 hours after white active pill taking, absorption may not be complete. In such an event, the advice concerning Management of Missed Pills is applicable. The woman must take the extra active pill(s) needed from a back up pack after vomiting.

Interactions between ethinylestradiol and other drugs may lead to decreased or increased ethinylestradiol concentrations, respectively.Decreased ethinylestradiol serum concentrations may cause an increased incidence of breakthrough bleeding and menstrual irregularities and may possibly reduce efficacy of the oral contraceptive. Example of substances that may decrease serum ethinylestradiol concentrations include rifampicin, phenytoin, primidone, rifabutin, dexamethasone, griseofulvin, topiramate, some protease inhibitors, modafinil, ritonavir and barbiturates. Certain antibiotics including ampicillin, other penicillins and tetracyclines may reduce the efficacy of oral contraceptives. During concomitant use of Ethinylestradiol, Norgestrel & Ferrous Fumarate & other drugs that may lead to decreased ethinylestradiol serum concentrations, it is recommended that a non-hormonal back-up method of contraception to be used in addition to the regular intake of Ethinylestradiol, Norgestrel & Ferrous Fumarate.

Ethinylestradiol, Norgestrel & Ferrous Fumarate should not be used:

• If you are pregnant or think to become pregnant
• If you had stroke or thrombosis in blood vessels of heart, legs, lungs or other parts of body
• If you are a heavy smoker
• If you suffer from liver disease or jaundice
• If you are suffer from high blood pressure, migraine, feel something hard in your breast, diabetes with vascular involvement, experience excessive bleeding for which no reason has yet been ascertained
• If you have or had a benign or malignant liver tumor
• Hypersensitivity to any of the components of Ethinylestradiol, Norgestrel & Ferrous Fumarate.

At the initial stage some women may experience side-effects like dizziness, headache, nausea, diarrhea, abdominal pain, weight gain, fluid retension, depression, mood changes, breast pain, breast tenderness, rash, vaginal discharge, erythema etc. If taken regularly, such types of side-effects normally lessen with time. If she continues to have the side effects beyond 2-3 months, she could consult with a doctor.

Overdose Effects

Symptoms of oral contraceptive overdosage in adults and children may include nausea, vomiting, breast tenderness, dizziness, abdominal pain, drowsiness, fatigue; withdrawal bleeding may occur in females. There is no specific antidote and further treatment of overdose, if necessary, is directed to the symptoms.

Store in a cool, dry place. Keep away from light & out of reach of children.