Ovral 28 (norgestrel + ethinyl estradiol) is an oral contraceptive used by females of reproductive potential to prevent pregnancy. The product combines two types of female hormones, an estrogen and a progestin.
Indications for use
Ovral 28 is indicated for fertility control in females and for the control of some menstrual irregularities.
Mechanism of action
This is a combined oral contraceptive pill. It works by preventing the release of egg and affecting sperm movement in the uterus to prevent fertilization. It also changes the lining of the uterus and renders it unsuitable for pregnancy.
Dosage and mode of application
Each pack contains 28 tablets (21 active and 7 inert tablets).
Take this contraceptive in the dose and duration as advised by your doctor and directed on the package. Take 1 tablet daily at the same time of the day. Do not chew, crush or break the tablet. Tablets may be taken with water, with or without food.
There must be no interval between finishing one pack and starting the next.
Most side effects caused by Ovral 28 do not require any medical attention and go away as your body adjusts to the hormones. Consult your doctor if they are severe and/or lasting.
Common side effects:
- breast pain;
- irregular uterine bleeding;
Ovral 28 is contraindicated in patients with the following conditions/diseases:
- cholestatic jaundice;
- undiagnosed vaginal bleeding;
- impaired liver function;
- carcinoma of the breast;
- previous or active thromboembolic disorders;
- hormone dependent neoplasms;
- severe migraine or cerebrovascular insufficiency;
- coronary artery disease.
Stop using the drug right away if migraine becomes focal, or if you lose vision, or if you get unexplained chest pain.
Relative contraindications for use include a history of asthma, diabetes mellitus, hypertension, epilepsy, porphyria or states that provoke fluid retention.
This product should be avoided in pregnancy and in females who are breast feeding.
Antibiotics may reduce the contraceptive effect of Ovral 28. For maximal protection during antibiotic therapy, use additional non-hormonal methods of birth control; and also for seven days afterwards.
The efficacy of the birth control pill may be decreased when it is combined with anti-epileptic agents (phenytoin and phenobarbital), phenylbutazone, rifampicin, and ampicillin.
Pregnancy and breastfeeding
Ovral 28 is unsafe to use during pregnancy. Consult your doctor on the use of this product during pregnancy.
The drug is probably unsafe to use during breastfeeding. The hormones may pass into the breast milk and harm the baby.
What if I miss a pill?
Try not to skip doses. Missing an active pill increases your risk of getting pregnant.
- If you miss one active pill, take two pills on the day that realize your mistake. Then continue your usual schedule until the pack is over;
- If you miss two active pills in a row in Week 1 or 2, take two pills per day for two next days. Then return to your usual schedule. Use additional back-up method of contraception for at least 1 week following the missed pills;
- If you miss two active pills in a row in Week 3, discard the remaining pills and start a new pack the same day if you are a Day 1 starter. If you are a Sunday starter, continue to take one pill daily until Sunday. On Sunday, discard the remaining pills and start a new pack that day;
- If you miss three active pills in a row in Week 1, 2, or 3, discard the remaining pills and start a new pack the same day if you are a Day 1 starter. If you are a Sunday starter, continue to take one pill daily until Sunday. On Sunday, discard the remaining pills and start a new pack that day;
- If you miss two or more active pills, you may not get your period during the month. If you get no period for two months in a row, contact your doctor because you might be pregnant;
- If you miss an inert pill, discard it and continue your usual schedule until the pack is over. You do not need additional back-up method of contraception if you miss an inert pill.
The product does not protect you and your partner against sexually transmitted diseases.
Caution is advised when combining Ovral 28 with alcohol. Doctor’s advice is required.
It is not known whether these pills alter the ability to drive. Do not drive if you have any symptoms that worsen your ability to concentrate.
There is limited information available on the use of this drug in patients with kidney disease and liver disease. Doctor’s advice is required.
If you have vomiting and diarrhea that lasts over 24 hours, the contraceptive effect of Ovral 28 may be reduced and women should use additional methods of birth control at a time of such disorders.
Treatment of overdose is symptomatic and supportive. Possible overdose symptoms are nausea and withdrawal bleeding.