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Tri-Estarylla Review

Tri-Estarylla is an oral contraceptive, containing a combination of hormones, ethinyl estradiol and norgestimate. The drug is used to prevent ovulation and pregnancy.


Indications for use

Tri-Estarylla is used for the following indications:

  • hormonal contraception;
  • menstrual disorders;
  • infertility;
  • hypoplasia;
  • treatment of some gynecological diseases during menopause.

Mechanism of action

The components of the drug, ethinyl estradiol and norgestimate, inhibit the secretion of the gonadotropic hormones of the pituitary gland, control the process of maturation of the egg, prepare the uterine mucosa for implantation of a fertilized egg. As a result, the process of ovulation is inhibited and the egg does not mature. Also, Tri-Estarylla changes the properties of the cervical canal, therefore, the permeability of this genital tract for spermatozoa is reduced, and the inner uterine membrane is also affected.

Dosage and mode of application

Each pack contains 28 pills:

  • 7 pills each containing norgestimate/ethinyl estradiol 0.18 mg/35 mcg;
  • 7 pills each containing norgestimate/ethinyl estradiol 0.215 mg/35 mcg;
  • 7 pills each containing norgestimate/ethinyl estradiol 0.25 mg/35 mcg;
  • 7 placebo pills (used as remonders).

Birth control pills should be started on the 1st day of the period. Take 1 pill per day for 28 days in a row, preferably at the same time. After you have taken the last pill from the pack, start a new pack without interruption. Menstrual-like bleeding usually occurs 2-3 days after you have taken the last active pill in the pack. you can take this drug as long as there is a need for contraception. If you follow the instructions for use, the contraceptive effect is valid during 7 no-hormones days.


In case of an accidental overdose, you can experience vaginal bleeding, nausea, vomiting. A gastric lavage and symptomatic therapy are recommended.

Side effects

  • Cardiovascular system: deep vein thrombosis, myocardial infarction, thromboembolism, edema, atrial hypertension;
  • Hepatobiliary system: Badda-Chiari syndrome, cholestatic jaundice, cholelithiasis, intrahepatic cholestasis;
  • Gastrointestinal tract: nausea, flatulence, abdominal pain, colitis, vomiting;
  • Thoracic glands: galactorrhea, feeling of tension and soreness, increase in size, engorgement of the mammary glands;
  • Genital organs: amenorrhea, intermenstrual bleeding, vaginal candidiasis, decreased libido, cervical erosion, increased cervical secretion;
  • Skin: erythema nodosum, chloasma, skin rash, exudative erythema, seborrhea, hirsutism, alopecia, acne, age spots on the face, pemphigoid, hypertrichosis, melasma;
  • Organ vision: discomfort when wearing contact lenses, lesions of the optic nerve, cataracts;
  • CNS: headache, irritability, mood changes, chorea, depression, migraine, dizziness.
  • Urinary system: hemolytic-uremic syndrome, reduced kidney function;
  • Metabolism: change in body weight, reduced glucose tolerance, fluid retention, change in appetite.


Tri-Estarylla should not be used in the presence of any of the conditions listed below. If any of these conditions occur while taking the pills, they should be immediately canceled.

  • Thrombosis (venous and arterial) and thromboembolism, including a history;
  • Conditions preceding thrombosis (transient ischemic attacks, angina), including a history;
  • Migraine with focal neurological symptoms, including a history;
  • Diabetes with vascular complications;
  • Multiple or expressed risk factors for venous or arterial thrombosis;
  • Pancreatitis with severe hypertriglyceridemia, including a history;
  • Liver failure and severe liver disease (until liver tests return to normal);
  • Liver tumors (benign or malignant), including a history;
  • Identified hormone-dependent malignant diseases;
  • Vaginal bleeding of unknown origin;
  • Pregnancy;
  • Lactation period;
  • Hypersensitivity to ethinyl estradiol and norgestimate;
  • Prolonged immobilization, serious surgery, surgery on the legs, extensive injuries.

With caution:

Pronounced disorders of fat metabolism (obesity, hyperlipidemia); thrombophlebitis of the superficial veins; otosclerosis with impaired hearing, idiopathic jaundice or itching during a previous pregnancy; migraine; congenital hyperbilirubinemia (Gilbert, Dubin-Johnson and Rotor syndromes); diabetes; systemic lupus erythematosus; hemolytic uremic syndrome; Crohn’s disease; sickle cell anemia; arterial hypertension


Drugs that induce estrogen metabolizing enzymes reduce the contraceptive effectiveness of Tri-Estarylla. The induction of these same isoenzymes can lead to a decrease in the blood concentration of norgestimate in the contraceptive. In this regard, you need to take with caution the following drugs: St. John’s wort, barbiturates, carbamazepine, phenytoin, sulfonamides, pyrazolone derivatives, rifampicin

Some protease inhibitors and some antiretroviral drugs (indinavir, ritonavir) can increase or decrease the concentration of ethinyl estradiol and norgestimate in the blood.

Some antibiotics (ampicillin or tetracycline) can violate the intrahepatic circulation of estrogen, which results in accelerated elimination and decreases the concentration of ethinyl estradiol.

Pregnancy and breastfeeding

The drug is contraindicated for use during pregnancy and lactation.

What if I miss a pill?

If you missed 1 active pill:

  • Take 2 pills on the day you remember. Then keep taking 1 pill per day until the pack is empty.

If you missed 2 active pills in a row in week 1 or week 2:

  • Take 2 pills per day for 2 days in a row. Then keep taking 1 pill per day until the pack is empty. Use an additional method of contraception for 7 days following the missed pills.

If you missed 2 active pills in a row in week 3:

  • Day-1 starter: Discard the rest of the pills from the current pack and start a new pack the same day;
  • Sunday-starter: Continue taking 1 pill per day until Sunday. On Sunday, discard the rest of pills from the current pack and start a new pack that same day.

If you missed 3 active pills in a row in weeks 1, 2, or 3:

  • Day-1 starter: Discard the rest of the pills from the current pack and start a new pack the same day;
  • Sunday-starter: Continue taking 1 pill every day until Sunday. On Sunday, discard the rest of the pills from the current pack and start a new pack that same day.

If you missed 2 or more pills, you might not have menstruation in the month.

If you have no menstruation for 2 months in a row, visit your doctor because you might be already pregnant.

If you missed a placebo pill, discard it and keep taking 1 pill daily until you finish the pack. You don’t need to use an additional method of contraception if you miss a placebo pill.


After cessation of hormonal contraception, the function of the female genital glands is quickly restored, which ensures a normal ability to conceive.

Use of Tri-Estarylla after childbirth or abortion (miscarriage) is recommended after the first normal period.

Smoking women who take COCs have an increased risk of developing vascular diseases with serious consequences (myocardial infarction, stroke). The risk increases with age and with the number of cigarettes smoked per day (especially in women over 35).

Before taking birth control pills and every 6 months, you are recommended to undergo general medical and gynecological examinations (examination of the mammary glands, liver function, blood pressure and cholesterol concentration in the blood, urinalysis).

The efficiency of the contraceptive decreases with regular use of ethanol.

Diarrhea and vomiting can reduce the contraceptive effect of the drug. If you have these gastrointestinal disorders, you should keep on taking the pills at your usual time and use additional non-hormonal methods of birth control).

Moderate bleeding during the course does not require discontinuation of the medication. If severe bleeding occurs, stop taking the tablets and consult a gynecologist.

Stop taking pills immediately in the following cases: unusual migraines/headaches, early signs of phlebitis or phlebothrombosis, jaundice, visual disturbances, cerebrovascular disorders stabbing pain of obscure etiology when breathing or coughing, pain and tightness in the chest, an increase in blood pressure, 3 months before the planned conception and 6 weeks before the planned surgical operation followed by prolonged immobilization.

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