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Trivora-28 Review

Trivora is a combination contraceptive which contains 3 different doses of progestin and estrogen (levonorgestrel and ethinyl estradiol).


Indications for use

  • Oral contraception.

Mechanism of action

Levonorgestrel and ethinyl estradiol are active synthetic gestagen and estrogen (respectively). Trivora is a drug of three-phase action for ingestion with different doses of progestogen and estrogen. Inhibiting the production of follicle-stimulating and luteonizing hormones, the drug prevents the maturation of the ovule in the follicle and ovulation, as well as cyclic changes in the endometrium; breaking its implantation ability. The medication practically does not interfere with periodic menstrual-like bleedings.

Dosage and mode of application

Each Trivora pack contains 21 active pills of three different drug doses:

  • Phase 1: 6 blue tablets, each containing 0.050 mg of levonorgestrel and 0.030 mg of ethinyl estradiol;
  • Phase 2: 5 white tablets, each containing 0.075 mg levonorgestrel and 0.040 mg ethinyl estradiol;
  • Phase 3: 10 pink tablets, each containing 0.125 mg levonorgestrel and 0.030 mg ethinyl estradiol.

The pack also contains 7 peach inert tablets (with no hormones).

Take 1 tablet once a day with a small amount of water starting from the 1st or the 5th day of your menstrual period for 28 days in a row.

The time of intake does not play a role, but the subsequent intake should be performed at the same selected hour, preferably in the evening.

If the drug was first taken during the second half of the week, the first menstrual period may be shorter than 4 weeks.

Regardless of the occurrence and duration of menstrual bleeding, the next 28-day course of taking Trivora drug should be started immediately after the end of the previous package.

Side effects

Trivora tablets can cause side effects:

  • nausea, vomiting;
  • headache;
  • breast engorgement;
  • weight gain;
  • decreased libido and mood;
  • coarsening of the voice;
  • intermenstrual bloody discharge;
  • eyelid edema, conjunctivitis, visual impairment;
  • discomfort when wearing contact lenses.

These adverse reactions and mild and temporary.

With long-term use, the drug can cause chloasma, hearing loss, generalized pruritus, jaundice, calf muscle cramps, increased frequency of epileptic seizures, hypertriglyceridemia, hyperglycemia, decreased glucose tolerance, increased blood pressure, thrombosis and venous thromboembolism, skin rashes, a change in the nature of vaginal secretion, vaginal candidiasis, increased fatigue, diarrhea (very rarely).


Do not use Trivora-28 if you have any of the following conditions:

  • hypersensitivity to ethinyl estradiol or levonorgestrel;
  • liver failure;
  • congenital hyperbilirubinemia (syndromes Gilbert, Dubin-Johnson and Rotor);
  • liver tumors (hemangioma, liver cancer);
  • malignant tumors (primarily breast cancer or endometrium);
  • severe cardiovascular and cerebrovascular diseases;
  • diabetes mellitus of severe course (accompanied by retinopathy and microangiopathy);
  • sickle cell anemia;
  • chronic hemolytic anemia;
  • vaginal bleeding of unknown etiology;
  • migraine;
  • otosclerosis;
  • bladder skidding;
  • otosclerosis with a deterioration of hearing;
  • idiopathic jaundice or pruritus during the previous pregnancy;
  • congenital hyperlipidemia;
  • age over 40 years

With caution: liver and gallbladder disease, epilepsy, depression, ulcerative colitis, uterine fibroids, mastopathy, tuberculosis, kidney disease, adolescence (prior to the menarche).


  • Barbiturates, some antiepileptic medicines (carbamazepine, phenytoin), sulfonamides, pyrazolone derivatives are able to enhance the metabolism of ethinyl estradiol and levonorgestrel included in the preparation;
  • The contraceptive effectiveness of Trivora contraceptive can be reduced by some antimicrobial drugs (ampicillin, rifampicin, chloramphenicol, neomycin, polymyxin B, sulfonamides, tetracyclines), that are able to change the microflora in the intestine;
  • When taking gestagen-estrogenic medicines, you may need to adjust the dosage regimen for hypoglycemic agents and indirect anticoagulants.

Breastfeeding and pregnancy

Trivora birth control pills are not used during pregnancy. If during the course of treatment the pregnancy is detected, it is necessary to immediately cancel the contraceptive. However, there was no increased risk of developmental defects in children born to women who took sex hormones before pregnancy or during for early pregnancy.

Ethinyl estradiol and levonorgestrel can reduce the amount of breast milk and change its composition, therefore, Trivora-28 is not recommended during a breastfeeding period. A small amount of sex steroids can be excreted in milk but there is no evidence of their negative impact on the health of the baby.

What if I miss a pill?

  • If you miss an active tablet of Trivora, you need to take it within the next 12 hours. If the interval exceeds 36 hours, a contraceptive effect is not guaranteed (however, the contraception should be continued in order to prevent premature menstruation associated with discontinuation of the drug). During this period it is recommended to use other non-hormonal methods of contraception (except a calendar method, as well as the temperature measurement method).
  • If you miss an inert tablet, just throw it away and continue taking the drug according to your usual scheme.


Fertility is restored within 1-3 menstrual periods after the drug withdrawal.

The use of Trivora pills after childbirth or abortion is recommended after the first normal menstrual period.

Before using the medication and every 6 months during treatment, you need to undergo a general medical and gynecological examination (breast and liver examination, blood pressure control and cholesterol concentration in the blood, urinalysis).

Smoking women who take Trivora hormonal contraceptive have an increased risk of developing serious vascular diseases (myocardial infarction, stroke). The risk increases with age and depends on the number of cigarettes smoked each day (especially in women over 35).

If diarrhea or vomiting occurs within 3-4 hours after taking a tablet, the contraceptive effect may be reduced, You need to continue taking the drug and use additional non-hormonal methods of contraception until you have the next menstruation.

The contraceptive should be canceled immediately if the following conditions occur or aggravate:

  • pregnancy;
  • migraine headaches;
  • unusual pain or bloating of the veins on the legs;
  • jaundice;
  • visual impairment;
  • cerebrovascular disorders;
  • stitching pains of unclear etiology when breathing or coughing;
  • pain and feelings of tightness in the chest;
  • an increase in blood pressure;
  • 3 months before the planned conception;
  • 6 weeks before the planned surgery;
  • prolonged immobilization.

Moderate spotting during the course does not require discontinuation of the contraceptive.

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