Ortho Tri-Cyclen (Norgestimate and Ethinyl Estradiol)

Ortho Tri-Cyclen is a medication prescribed to prevent pregnancy and plan childbearing. It contains 0.180 mg of norgestimate and 0.035 mg of ethinyl estradiol.

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Table of Contents


What is it?

Ortho Tri-Cyclen belongs to a group of a combined oral contraceptive preparation. It has an effect on the hypothalamic-pituitary system, inhibits the production of gonadotropic hormones. It leads to the suppression of ovulation. Influencing cervical mucus, these substances increase its viscosity, reduce the transport function of the fallopian tubes, change the endometrial implantation ability.

What does this pill do?

This drug is prescribed for contraception purposes only.

How to take pills for the first time?

The time of the first dose does not matter, but the subsequent reception should be made at the same time, preferably after breakfast or dinner to ensure a constant concentration of hormones in the plasma. The interval between doses should not exceed 36 hours, it should be maintained at the level of 22–26 hours.

How long for Ortho Tri-Cyclen to start working?

Ortho-Tri-Cyclen contains norgestimate and ethinyl estradiol.

Norgestimate: when taken orally, it is absorbed for 2 hours, metabolized to 17-deactyl norgestimate. The half-life is about 4 hours. Metabolites are slowly excreted from the body. After 2 weeks, about 50% of the active substance is excreted in the urine and about 40% in the feces.

Ethinyl estradiol: quickly and almost completely absorbed by oral administration. The maximum plasma concentration is reached in 1-2 hours. Ethinyl estradiol is only partially metabolized in the body. The half-life is 4.5 hours. Over 17% of the active substance is excreted unchanged in the urine and more than 10% is excreted in the feces. The metabolites are estradiol, estriol, and mainly 2-hydroxy- and 16β-hydroxyethyl phenyl estradiol.
Ortho-Tri-Cyclen_ Combined Oral Contraceptve


For oral administration, the first tablet is taken on the first day of menstruation. Then daily – 1 tablet per day for 27 days, followed by 7-days’ placebo pills. Menstrual bleeding occurs a few days after taking the last pill. The next cycle begins after 7 placebo pills.

Side effects

  • Cardiovascular system: arterial hypertension, myocardial infarction, cerebrovascular accident, deep vein thrombosis, arterial thromboembolism, pulmonary or other thromboembolism, edema.
  • Tumors: benign and malignant tumors of the liver, cervical and breast cancer.
  • Hepatobiliary system: cholestatic jaundice, Budd-Chiari syndrome, intrahepatic cholestasis, cholelithiasis.
  • Gastrointestinal tract: nausea, vomiting, abdominal pain, flatulence, colitis, anorexia.
  • Genital organs: intermenstrual bleeding, spotting, amenorrhea, changes in the menstrual cycle, increase in the size of uterine fibroids, vaginal candidiasis, increase in cervical secretion, cervical erosion, decrease in libido, premenstrual syndrome, temporary infertility after the withdrawal of the drug.
  • Breast glands: sensations of tension, galactorrhea, tenderness, increase in size, decrease in lactation when taken immediately after birth.
  • Skin: erythema nodosum, skin rash, chloasma, exudative erythema, acne, seborrhea, alopecia, hirsutism, pigment spots on the face, hypertrichosis, pemphigoid (gestational herpes), melasma with a tendency to persist.
  • Organs of vision: cataract, lesion of the optic nerve, change in the corneal curvature, discomfort when wearing contact lenses.
  • Central nervous system: headache, mood changes, irritability, depression, chorea, dizziness, migraine.
  • Metabolism: fluid retention, changes in body weight (decrease or increase), decrease in glucose tolerance, changes in appetite.
  • Kidneys: decreased kidney function, hemolytic-uremic syndrome.
  • Others: kidney disease, decreased libido.


Missed pills

In the case of missing the common time of administration, Ortho-Tri-Cyclen pill should be taken immediately. The delay in the usual administration time to 12 hours provides a reliable contraceptive effect. The effectiveness of the drug decreases with a delay for more than 12 hours. If more than 12 hours have passed from the moment of taking the latest pill or if more than one tablet is missed, the drug should be resumed immediately, leaving the missed tablet in the package. However, before the end of this cycle, you should use additional means of protection from pregnancy, such as a condom or vaginal contraceptive suppositories.

Drug interactions

Barbiturates, some antiepileptic drugs (carbamazepine, phenytoin), sulfonamides, pyrazolone derivatives are able to increase the steroid hormones’ metabolism. A decrease in the concentrative reliability can also be observed in the case of the simultaneous use with some antibiotics (ampicillin, rifampicin), which is associated with a change in the microflora in the intestine. When taking gestagen-estrogen drugs, hypoglycemic drugs may require the correction of the dosage regimen.

Effect for acne

There are no definite data in relation to the effect to treat acne. Sometimes, it is prescribed as an alternative treatment but the US FDA has not approved Orth-Tri-Cyclen as an effective and safe means to treat acne vulgaris.


Yasmin Allan: “I take Ortho-Tri-Cyclen for 3 months. Disadvantages: there was nausea for the first 1.5 months, sometimes pimples appear, my breast hurts. Benefits: breast increases becoming like before childbirth, no delays in menstruation and less abundant. Weight has not changed.”

Alexandra Knight: “I have been taking this birth control intermittently for 4 years already. Very satisfied. There are no changes in the weight associated with the drug. The cycle has become regular, day to day. The doctor prescribed me this drug after a detailed examination.”

Isobel Ward: “I started taking this medication on the recommendations of a gynecologist because my boyfriend did not like to use condoms. I have been taking for a year, I have to discontinue it within a month, but I do not want! Pros: acne on my face disappeared (it was a pleasant shock for me, in general, my face became clean and smooth, I cannot enjoy this idea), my breast increased. This is also a pleasant moment, depilation began to be done less frequently (hair grows very slowly), hair began to look healthier and more obedient, grow quickly), nails became stronger, painful feelings decreased during menstruation, and no unplanned pregnancy. It works 100%.”