Nordette is an oral contraceptive containing two hormones (levonorgestrel and ethinylestradiol), which helps prevent pregnancy if taken correctly.
Indications for use
Nordette 28 is an oral contraceptive that is used to prevent pregnancy in women who choose to use this product as a method of regular contraception.
Mechanism of action
It works by suppressing gonadotropins, inhibiting ovulation, changing the cervical mucus (which makes it difficult for sperm to get into the uterus) and the endometrium (which reduce the likelihood of implantation).
Dosage and mode of application
Read the product leaflet before using this medicine as it contains very important information. If you have any questions or concerns, consult your doctor or pharmacist.
Your pill pack contains 28 pills: 21 pills with hormones and 7 reminder pills with no hormones.
Take 1 pill orally at about the same hour each day, 24 hours apart, without breaks. Do not miss pills. You should have your period during the 4 week of the cycle.
Vomiting or diarrhea can reduce the effect of the contraceptive. If you have vomiting or diarrhea within 2 hours after taking the pill, use a back-up birth control method (for example, a condom).
After you have taken the last tablet in the pack, start a new pack the next day regardless of whether you have your period or not. If your period is missing, consult your doctor.
If you are using Nordette 28 for the first time, take the first tablet in the pack on the first day of your period or on the first Sunday following the start of your menstrual period. If your period begins on a Sunday, start taking this contraceptive on that day. For the first cycle of use, use an additional back-up birth control for the first week. If you start taking the pills on the first day of your period, you do not need to use any additional birth control methods during the first 7 days.
Ask your doctor about how to switch to Nordette from other forms of hormonal birth control.
In some cases, Nordette 28 may cause some side effects:
- absent, missed, or irregular menstrual periods;
- breast tenderness, enlargement, discharge;
- bloody stools;
- unpleasant breath odor;
- blurred vision;
- thick, white curd-like vaginal discharge without odor or with mild odor;
- troubled breathing;
- twitching, uncontrolled movements of the tongue, lips, face, arms, or legs;
- unusual tiredness or weakness;
- vomiting of blood;
- inability to speak;
- itching of the vagina or outside the genitals;
- yellow eyes or skin;
- changes in skin color, pain, tenderness, or swelling of the foot or leg;
- chest pain or discomfort;
- clay-colored stools;
- dark or cloudy urine;
- pain during sexual intercourse;
- light vaginal bleeding between regular menstrual periods;
- loss of appetite;
- fast heartbeat;
- swelling, pain, or tenderness in the upper abdominal area;
- pain or discomfort in the arms, jaw, back or neck;
- pelvic pain;
- pounding in the ears;
- sensitivity to the sun;
- skin thinness;
- slow or fast heartbeat;
- decrease in urine output or decrease in urine-concentrating ability;
- difficult, burning, or painful urination;
- difficulty in speaking;
- slow speech;
- stomach bloating and cramping;
- stomach pain and tenderness;
- dizziness or lightheadedness;
- double vision;
- stopping of menstrual bleeding;
- swollen feet and ankles;
- tenderness, pain, swelling, warmth, skin discoloration, and prominent superficial veins over the affected area;
- fluid-filled skin blisters;
- frequent urge to urinate;
- headache, severe and throbbing;
- inability to move the arms, legs, or facial muscles;
- itching skin near damaged veins;
- dull ache or feeling of pressure or heaviness in the legs;
If you have any lasting and/or severe unwanted reactions, consult your doctor right away.
Do not use Nordette birth control pills if you have any of the following conditions:
- Known or suspected pregnancy;
- Uncontrolled hypertension;
- Thrombophlebitis or thromboembolic disorders;
- A past history of deep-vein thrombophlebitis or thromboembolic disorders;
- Carcinoma of the endometrium or other known or suspected estrogen-dependent neoplasia;
- Undiagnosed abnormal genital bleeding;
- Hypersensitivity to any of the components of Nordette-28 (levonorgestrel and ethinyl estradiol tablets);
- Cerebral-vascular or coronary artery disease;
- Thrombogenic valvulopathies;
- Thrombogenic rhythm disorders;
- Diabetes with vascular involvement;
- Known or suspected carcinoma of the breast;
- Cholestatic jaundice of pregnancy or jaundice with prior pill use;
- Hepatic adenomas or carcinomas, or active liver disease, as long as liver function has not returned to normal;
- Use of Hepatitis C drugs containing ombitasvir/paritaprevir/ritonavir.
Some drugs may reduce the contraceptive effect of Nordette. Avoid taking these birth control pills with any of the following drugs:
- Anti-viral hepatitis C virus (HCV) medicines such as ombitasvir, paritaprevir, ritonavir and dasabuvir;
- Atorvastatin used to treat high cholesterol;
- Antibiotics such as ampicillin, other penicillins and tetracyclines;
- Barbiturates (certain types of medicines prescribed for epilepsy, such as phenobarbitone);
- Lamotrigine used for seizures;
- Ritonavir for the treatment of HIV infection;
- Modafinil used to treat excessive daytime sleepiness;
- Medicines for epilepsy (such as phenytoin, primidone, carbamazepine and topiramate);
- Anti-fungal agents such as griseofulvin;
- Theophyllines used for asthma and other breathing difficulties;
- St. John’s Wort, an ingredient in many medicines you can buy without a prescription from a pharmacy, health food shop or supermarket;
- Rifampicin and rifabutin for the treatment of tuberculosis;
- Corticosteroids such as dexamethasone;
- Indinavir for the treatment of HIV infection;
- Anti-fungal agents such as itraconazole and fluconazole;
- Paracetamol and ascorbic acid (Vitamin C);
- Cyclosporin used to prevent organ rejection.
Pregnancy and breastfeeding
Use of Nordette during pregnancy is contraindicated. Make sure you are not pregnant prior to initiation. Stop taking the pills use if pregnancy is confirmed.
You should not take these birth control pills if you are breastfeeding. Its active ingredients ethinyl estradiol and levonorgestrel can get into breast milk and may affect a nursing baby. Also, the product can reduce the quantity and quality of milk you produce.
What if I miss a pill?
If you miss an active pill (1-21), take it as soon as you remember and then take the next dose at your regular time. This may mean that you take two pills in one day.
If you miss two pills of Nordette in a row within the first two weeks, take two pills as soon as you remember about your mistake, and take two pills the next day. Then return to your usual schedule of taking pills. Use an additional non-hormonal method of birth control for 7 days.
If you miss two pills in a row during week 3, do the following, throw out the rest of the pack and start a new one that same day. Use an additional non-hormonal method of birth control for 7 days.
If you miss three or more pills in a row during weeks 1-3, discard the rest of the pack and start a new one that same day. Use an additional non-hormonal method of birth control for 7 days.
If you miss any of the inactive pills in the week 4, discard the pill you missed. Continue to take one pill daily until the pack is empty.
If you are confused about what to do if you missed dose of Nordette, use an additional method of birth control each time you have sex, keep taking the pills a day and consult your doctor.
Prior to using Nordette 28, you must undergo a thorough medical check-up, including breast check, blood pressure check, a Pap smear and urine test.
Tell your doctor if you you have a hereditary predisposition to blood clots in the legs or lungs.
Tell your doctor if you have or ever had any of the following conditions:
- High cholesterol;
- Systemic lupus erythematosus;
- Haemolytic uraemic syndrome;
- Have had any recent surgery or trauma;
- Recently had a baby;
- Gallbladder disease;
- Hepatitis C;
- Crohn’s disease or ulcerative colitis;
- Sickle cell disease;
- Lost a baby in the second trimester;
- Heart disease including heart valve disorders or certain heart rhythm disorders;
- High blood pressure, a history of high blood pressure or high blood pressure during pregnancy;
- Migraine or other headaches;
- Breast lumps, abnormal breast X-ray or mammogram;
- Fluid retention or kidney disease;
- Yellowing of the whites of the eyes or skin (jaundice) during pregnancy or during previous oral contraceptive use;
- Hereditary angioedema. (swelling of the face, lips, mouth, tongue or throat);
- Had major surgery and have been immobilized for long periods of time;
- If over 35 years of age or are overweight;
- If you are planning a long plane flight (longer than 4 hours);
- If you plan to become pregnant or are breastfeeding;
- If you are allergic to any foods, preservatives, dyes, or any other drugs;
- If you are intolerant to some sugars;
- Smoking particularly if you are heavy smoker (15 or more cigarettes per day) and are aged over 35 years.