Lo-Ovral (ethinyl estradiol and norgestrel) is an oral birth control pill used to prevent pregnancy in women. The medicine combines two types of female hormones, an estrogen and a progestin. The pack may contains 21 or 28 pills.
Indications for use
This medication is used to prevent unwanted pregnancy.
Mechanism of action
The hormones work by preventing the release of an egg during your menstrual cycle. It also makes vaginal fluid thicker, which prevents fertilization and changes the lining of the womb.
In addition, this medicine may make your periods less painful and heavy, and more regular, reduce your risk of ovarian cysts, and also help you get rid of acne.
Dosage and mode of application
Each Lo-Ovral contains 21 active pills and 7 inert pills with no hormones.
Take 1 pill per day at intervals not exceeding 24 hours, in the row indicated on the blister. It is recommended that pills be taken at the same time each day. As soon as you finish the pack, start a new one. Your period should occur while you are taking inert pills (week 4).
The common side effects from Lo-Ovral are nausea, bloating, vomiting, headache, breast tenderness, weight change, or swelling of the ankles/feet. You may also experience missed/irregular periods, or vaginal bleeding between periods (spotting), especially during the first there months of use. If any of these reactions persist or get worse, consult your doctor right away. If you get no period in a row for 2 months, contact your doctor because you might be pregnant.
Contact your doctor immediately if you have any serious adverse reactions, including:
- yellowing eyes/skin;
- mental/mood changes ;
- lumps in the breast;
- continuous spotting, sudden heavy bleeding, missed periods;
- dark urine;
- severe stomach/abdominal pain.
In very rare cases, thie drug may cause serious problems, such as heart attack, deep vein thrombosis, pulmonary embolism, stroke. Seek urgent medical attention if you get any of these adverse effects:
- sudden shortness of breath/rapid breathing;
- chest/jaw/left arm pain;
- unusual headaches;
- pain/swelling/warmth in the groin/calf;
- slurred speech;
- unusual sweating;
- double vision, partial/complete blindness;
- sudden dizziness/fainting;
- weakness on one side of the body.
A severe allergic reaction to norgestrel + ethinyl estradiol is rare. However, seek urgent medical attention if you notice any signs of a severe allergic reaction, including:
- trouble breathing;
- severe dizziness;
This list is in complete. If you notice other side effects not listed above, contact your healthcare provider.
- Hypersensitivity to any of the components of the drug;
- Smoke, if over age 35;
- Deep vein thrombosis or pulmonary embolism, current or a history;
- Cerebrovascular disease;
- Thrombogenic valvular or thrombogenic rhythm diseases of the heart;
- Headaches with focal neurological symptoms or migraine headaches with aura;
- Uncontrolled hypertension;
- Diabetes mellitus with vascular disease;
- Undiagnosed abnormal uterine bleeding;
- Inherited or acquired coagulopathies;
- Liver tumors, benign or malignant, or liver disease;
- Breast cancer or other estrogen- or progestin-sensitive cancer, current or a history;
- Coronary artery disease.
Some medications, vitamins, herbal products, and foods that may interact with Lo-Ovral. These are:
- drugs for seizures (barbiturates, felbamate, phenytoin, primidone, carbamazepine, topiramate);
- aromatase inhibitors (anastrozole, exemestane);
- tranexamic acid;
- drugs for chronic hepatitis C (ombitasvir/paritaprevir/ritonavir with or without dasabuvir);
- rifamycins (rifampin, rifabutin);
- HIV drugs (nelfinavir, nevirapine, ritonavir);
- St. John’s wort.
The list is incomplete. Consult your healthcare provider.
Pregnancy and breastfeeding
Lo-Ovral should not be used during pregnancy. If you get pregnant or think you may be pregnant, stop taking these pills consult your doctor as soon as possible.
You can start using birth control pills no earlier than 4 weeks after delivery provided that you are not breastfeeding.
What if I miss a pill?
This contraceptive may become less effective if you miss active pills (1-21).
- If you miss 1 active pill: 1. Take it as soon as possible. Take the next pill at your scheduled time. This means you may need to take 2 pills at once. You MUST use a barrier birth control method for the next 7 days;
- If you miss active pills in a row in week 1 or week 2: Take 2 pills on the day you realize your mistake and 2 pills the next day. 2. Return to your usual schedule until you finish the pack. 3. You MUST use a barrier birth control method for the next 7 days;
- If you miss 2 active pills in a row in week 3: 1. Continue to take 1 pill each day until Sunday. On Sunday, discard the remaining pills and start a new pack that same day. 2. Your period may be absent this month. If you get no period 2 months in a row, contact your doctor for a pregnancy test. 3. You MUST use a barrier birth control method for the next 7 days;
- If you miss 3 or more active pills in a row (during the week 1,2, or 3): 1. Contunie to take 1 pill daily until Sunday. On Sunday, discard the remaining pills and start a new pack that same day. 2. Your period may be absent this month. If you get no period 2 months in a row, contact your doctor for a pregnancy test. 3. You MUST use a barrier birth control method for the next 7 days;
- If you miss any of the 7 inert pills in week 4: Discard the missed pills. Continue to take 1 pill every day until you finish the pack. You do not need a barrier birth control method for the next 7 days.
If you think you have an overdose, call 911 or a poison control center right away. Overdose symptoms may include sudden/unusual vaginal bleeding, passing out or trouble breathing, severe nausea, vomiting.
Before using this contraceptive, tell your doctor about all your medical conditions that you currently have or ever had, especially about:
- high blood pressure;
- unexplained vaginal bleeding;
- abnormal breast exam;
- high cholesterol or triglyceride levels;
- family or personal history of a certain swelling disorder;
- blood clots;
- blood clotting disorders;
- gallbladder problems;
- severe headaches/migraines;
- heart problems;
- history of yellowing eyes/skin during pregnancy or while using hormonal birth control;
- kidney disease;
- liver disease;
- thyroid problems;
- allergy to any estrogens or progestins.
Tell your doctor if you are planning any surgery or prolonged immobilization.
If you wear contact lenses, you may develop trouble wearing your contact lenses. Consult your healthcare provider if these adverse effects occur.
It may take longer for you to conceive after you stop taking Lo-Ovral. Consult your doctor.