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Nortrel 0.5/35 Review

Nortrel 0.5/35 is an oral contraceptive containing two hormones (levonorgestrel and norethindrone), which is used to prevent pregnancy.


Indications for use

The pills are indicated for the prevention of pregnancy in women who choose to use this product as a method of every day contraception.

Mechanism of action

The drug works mainly by preventing the release of an egg during your menstrual cycle. It also makes vaginal fluid thicker, which makes it hard to sperm to reach an egg. It also changes the lining of the uterus to prevent attachment of a fertilized egg.

Dosage and mode of application

Each Nortrel 0.5/35 pack contains 28 pills: 21 active pills (0.5 mg of norethindrone and 0.035 mg of ethinyl estradiol) and 7 inert pills with no hormones.

1 tablet orally once a day, at the same time each day. Dot not miss any pills. Once the pack is empty, start a new one without interruption.

You may need barrier contraception if you start taking pills on Sun-day (first pack only) or if you start taking pills after the birth of a child .

Side effects

In some cases, Nortrel 0.5/35 can cause some side effects, including:

  • absent, missed, or irregular menstrual periods;
  • anxiety;
  • change in vision;
  • changes in skin color;
  • pounding in the ears;
  • unusual tiredness or weakness;
  • vomiting;
  • vomiting of blood;
  • rash;
  • redness of the skin;
  • severe headaches of sudden onset;
  • slow or fast heartbeat;
  • bloating;
  • blotchy spots on the exposed skin;
  • breast enlargement or tenderness;
  • discouragement;
  • chills;
  • clay-colored stools;
  • constipation;
  • medium to heavy, irregular vaginal bleedingbetween regular monthly periods, which may require the use of a pad or a tampon;
  • nausea;
  • feeling sad or empty;
  • irritability;
  • itching of the vagina or outside genitals;
  • loss of interest or pleasure;
  • pain during sexual intercourse;
  • cough;
  • dark urine;
  • diarrhea;
  • dizziness or lightheadedness;
  • fainting;
  • fast heartbeat;
  • fever;
  • stomach pain;
  • sudden loss of coordination or slurred speech;
  • sweating;
  • troubled breathing;
  • stomach cramps;
  • thick, white curd-like vaginal discharge without odor or with mild odor;
  • tiredness;
  • pain or discomfort in the arms, jaw, back, or neck;
  • pain, tenderness, or swelling of the foot or leg;
  • pains in the chest, groin, or legs, especially in the calves of the legs;
  • headache;
  • hives or welts;
  • itching skin;
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs;
  • loss of appetite;
  • trouble concentrating;
  • trouble sleeping;
  • trouble wearing contact lenses;
  • chest pain or discomfort.


Do not use Nortrel 0.5/35 if you have any of the following conditions:

  • abnormal genital bleeding;
  • liver disease;
  • thromboembolism;
  • abnormal vaginal bleeding;
  • carcinomas (estrogenic);
  • hepatic neoplasms;
  • breast malignancy;
  • hypercalcemia in breast cancer;
  • hypertension;
  • thromboembolism/cardiovascular.


Some drugs and herbal products may reduce the effectiveness of these birth control pills.

Tell your doctor about all drugs that you take, especially about:

  • colesevelam;
  • certain seizure medicines (carbamazepine, felbamate, oxcarbazepine, phenytoin, rufinamide, and topiramate);
  • certain non nucleoside reverse transcriptase inhibitors (nevirapine);
  • rifampin and rifabutin;
  • barbiturates;
  • bosentan;
  • griseofulvin;
  • certain combinations of HIV medicines (nelfinavir, ritonavir, ritonavir-boosted protease inhibitors);
  • St. John’s wort;
  • medicines that affect how your liver breaks down other medicines (itraconazole, ketoconazole, voriconazole, and fluconazole);
  • certain HIV medicines (atazanavir, indinavir);
  • atorvastatin;
  • rosuvastatin;
  • aprepitant;
  • acetaminophen;
  • ascorbic acid;
  • etravirine.

Pregnancy and breastfeeding

Use of Nortrel 0.5/35 during pregnancy is contraindicated. Interrupt use if you get pregnant when on the pills.

If you are breastfeeding, consult your doctor before using oral birth control pills. Ethinyl estradiol and norethindrone may penetrate into the milk. This may cause ad-verse effects on the child, such as jaundice and breast enlargement. In addition, this contraceptive may decrease the amount and quality of your milk. If possible, avoid taking these pills use while breastfeeding. It’s recommended to use a non-hormonal method of contraception.

What if I miss a pill?

Try not to miss pills. Missing a pill increases your risk of getting pregnant.

If you miss 1 active pill, take 2 pills on the day that you realize your mistake. Then take 1 pill per day as usual.

If you miss 2 active pills in a row in Week 1 or 2, take 2 pills per day for 2 days in a row. Then take 1 pill per day as usual. Use an additional barrier birth control for a week following the missed pills.

If you miss 2 active pills in a row in Week 3, discard the rest of the remaining pills and start a new pack the same day if you are a Day 1 starter. If you are a Sunday starter, keep taking a pill every day until Sunday. On Sunday, throw out the rest of the pack and start a new pack that day.

If you miss 3 active pills in a row in Week 1, 2, or 3, throw out the rest of the pack and start a new pack on the same day if you are a Day 1 starter. If you are a Sunday starter, continue to take 1 pill daily until Sunday. On Sunday, discard the remaining pills and start a new pack that day.

If you miss 2 or more pills in a row, your may not get your period during the month. If you have no period for 2 months in a row, take a pregnancy test and contact your doctor because you might be pregnant.

If you miss any of the inert reminder pills, throw the missed pill away and continue to take the remaining pills as usual until you finish the pack. DO not use a back-up birth control if you miss an inactive pill.


This product does not protect against transmission of HIV (AIDS) and other sexual-ly transmitted diseases such as chlamydia, genital warts, syphilis, gonorrhea, genital herpes, and hepatitis B.

Cigarette smoking increases the risk of serious cardiovascular event, especially in cigarette smokers over 35 years of age. Stop taking the pills if you have thrombotic disorders, unusual visual changes, jaun-dice, severe headache, migraine, and at least a month before through 2 weeks after surgery.

When on the pills, you need to monitor your blood pressure. Moreover, it is recommended to do regular complete physical exams.

If you overdose, seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Use the drug with caution in the presence of the following conditions:

  • angioedema;
  • hypercalcemia;
  • liver disease;
  • fluid retention;
  • glucose intolerance;
  • retinal thrombosis;
  • melasma;
  • depression;
  • hyperlipidemia;
  • thyroid function tests;
  • hyperlipidemia;
  • weight gain;
  • gallbladder disease.

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