Ovral 28 (norethindrone + ethinyl estradiol) is a progestin/estrogen combined oral contraceptive indicated for use by women to prevent pregnancy.
Indications for use
Tarina 24 Fe is indicated for use by females to prevent unwanted pregnancy.
Mechanism of action
This medication contains 2 hormones: norethindrone (a progestin) and ethinyl estradiol (an estrogen). It works mainly by preventing ovulation during your menstrual cycle. It also makes vaginal fluid thicker to help prevent sperm from reaching an egg and changes the lining of the womb to prevent attachment of a fertilized egg.
Each of the 4 inactive pills taken during the week 4 contains a small amount of iron (ferrous fumarate). They do not contain any hormones and are designed to keep you in the habit of taking 1 pill daily. They not contains enough iron to treat iron deficiency.
Besides, Tarina 24 Fe may make your periods more regular, less painful and less abundant, it can also decrease your risk of ovarian cysts and treat acne.
Dosage and mode of application
Each pack contains 28 tablets in the following order:
- 24 active tablets each containing 1 mg of norethindrone and 20 mcg of ethinyl estradiol;
- 4 non-hormonal placebo tablets each containing 75 mg ferrous fumarate.
Take this medicine orally at the same time each day and in the order directed on the package To reduce nausea, you can take this medicine with food. Do not take more tablets than directed.
This contraceptive is indicated for use in females who have started having menstrual periods.
If you think you have taken too much of this contraceptive, contact a poison control center or emergency room immediately.
If you have any severe side effects listed below, contact your doctor as soon as possible:
- allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue;
- breast tissue changes or discharge;
- chest pain;
- changes in vaginal bleeding during your period or between your periods;
- changes in vision;
- trouble speaking or understanding;
- headaches or migraines;
- severe or sudden headaches;
- stomach pain (severe);
- sudden shortness of breath;
- sudden numbness or weakness of the face, arm or leg;
- feeling faint or lightheaded;
- symptoms of vaginal infection like itching, irritation or unusual discharge;
- tenderness in the upper abdomen;
- leg, arm or groin pain;
- loss of balance or coordination;
- coughing up blood;
- yellowing of the eyes or skin.
This is a list of side effects that usually do not require medical attention and go away quickly:
- weight gain;
- mood changes, anxiety, depression, frustration, anger, or emotional outbursts;
- breakthrough bleeding and spotting that continues beyond the 3 initial cycles of pill;
- skin rash, acne, or brown spots on the ski;
- breast tenderness;
- increased sensitivity to sun or ultraviolet light.
Do not take Tarina 24 Fe to women who have the following conditions:
- Pregnancy, because there is no reason to use COCs during pregnancy;
- Smoke, if over age 35;
- Have uncontrolled hypertension;
- Have inherited or acquired hypercoagulopathies;
- Have coronary artery disease;
- Use of Hepatitis C drug combinations containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir, due to the potential for ALT elevations;
- Have thrombogenic valvular or thrombogenic rhythm diseases of the heart (for example, subacute bacterial endocarditis with valvular disease, or atrial fibrillation);
- Have diabetes mellitus with vascular disease;
- Women over age 35 with any migraine headaches;
- Liver tumors, benign or malignant, or liver disease;
- Undiagnosed abnormal uterine bleeding;
- Breast cancer or other estrogen- or progestin-sensitive cancer, now or in the past;
- Have headaches with focal neurological symptoms or have migraine headaches with aura;
- Have cerebrovascular disease.
Do not take Tarina 24 Fe with the following medication:
- ombitasvir; paritaprevir; ritonavir;
- dasabuvir; ombitasvir; paritaprevir; ritonavir.
This cotraceptive may also interact with the following drugs and foods:
- barbiturate medicines, such as phenobarbital;
- grapefruit juice;
- antibiotics or medicines for infections, especially rifampin, rifabutin, rifapentine, and griseofulvin, and possibly penicillins or tetracyclines;
- medicines for anxiety or sleeping problems, such as diazepam or temazepam;
- medicines for diabetes, including pioglitazone;
- mineral oil;
- ascorbic acid (vitamin C);
- thyroid hormones;
- ritonavir or other medicines for HIV infection or AIDS;
- tamoxifen or raloxifene;
- soy isoflavones supplements;
- St. John’s wort.
This list may not describe all possible interactions.
Pregnancy and breastfeeding
Do not use this product during pregnancy, because there is no reason to use birth control pills during pregnancy.
You can start these pills no earlier than 4 weeks after delivery provided that you are not breastfeeding.
What if I miss a pill?
If you missed one active tablet in Weeks 1, 2 or 3, take the missed tablet as soon as you remember. Then return to your usual schedule. Additional contraception is not needed;
If you missed two consecutive tablets in Week 1 or Week 2, take the two missed tablets as soon as you remember and the next two tablets the next day. Then return to your usual schedule. Use additional back-up contraception within 7 days after missing tablets.
If you missed two consecutive tablets in Week 3 or Week 4 or you missed three or more consecutive active tablets at any time:
- Day 1 Start: Discard the remaining pills and start a new pack the same day;
- Sunday Start: Keep on taking one tablet each day until Sunday, then discard the remaining pills and start a new pack the same day. Use additional back-up contraception within 7 days after missing tablets.
If you missed any of the 4 inert tablets, just throw them away as they serve purely as reminders.
Stop Tarina 24 Fe if you get jaundice, severe headaches, or thrombotic disorders.
Stop using this product at least 4 weeks before and 2 weeks after major surgery.
If you have well-controlled hypertension, monitor blood pressure when on these pills. Stop using the product if your blood pressure rises significantly.
This medicine does not protect against HIV infection (AIDS) and other sexually transmitted diseases.