Marvelon 21 and Marvelon 28

Brand Name:Alesse 21 and Alesse 28, Brevicon 0.5/35 21 and Brevicon 0.5/35 28, Brevicon 1/35 21, and Brevicon 1/35 28, Cyclen 21 and Cyclen 28, Demulen 30 21 and Demulen 30 28, Diane-35 21, Evra, FemHRT 0.5/2.5, FemHRT 1/5, Linessa 21 and Linessa 28, Minovral 21 and Minovral 28, NuvaRing, Ortho-Cept 21 and Ortho-Cept 28, Ortho 0.5/35 21 and Ortho 0.5/35 28, Ortho 1/35 21 and Ortho 1/35 28, Ortho 7/7/7 21 and Ortho 7/7/7 28, Ovral 21 and Ovral 28, Select 1/35 21 and Select 1/35 28, Synphasic 21 and Synphasic 28, Tri-cyclen 21 and Tri-cyclen 28, Tri-cyclen LO 21 and Tri-cyclen LO 28, Triphasil 21 and Triphasil 28, Triquilar 21 and Triquilar 28, Yasmin 21 and Yasmin 28

Prescription needed: Yes

What is this drug used for?

Ethinyl estradiol (Alesse or Dianne-35) and other oral contraceptives are used to prevent pregnancy. Birth control pills are also sometimes used to treat acne. As well, many women who are “peri-menopausal” (experiencing menopause) have unpredictable periods and bleeding, and oral contraceptives help regulate this bleeding.

Is there any reason not to take this drug?

It is important to disclose your medical history, including any pre-existing conditions. You should not take this drug if you are allergic to estrogen or progestin, or any other medications.

Tell your doctor if you may be pregnant or have or have ever had jaundice during pregnancy or while you were using another type of birth control and if you have recently had surgery or have been unable to move around for any reason.

Also tell your doctor if you have or have ever had problems with your breasts such as lumps or an abnormal mammogram or:

  • high blood pressure
  • high blood cholesterol
  • diabetes
  • asthma
  • stroke or mini stroke
  • blood clots in your legs, lungs, or eyes
  • thrombophilia (a condition in which the blood clots easily)
  • toxemia (high blood pressure during pregnancy)
  • heart attack
  • chest pain
  • coronary artery disease
  • seizures
  • migraine headaches
  • depression
  • liver disease
  • heart disease
  • gallbladder
  • kidney disease
  • adrenal insufficiency
  • jaundice (yellowing of the skin or eyes)
  • unexplained vaginal bleeding
  • excessive weight gain
  • fluid retention during the menstrual cycle

What about possible side effects?

Tell your doctor of any and all side effects that you experience while taking this drug, including:

  • upset stomach
  • vomiting
  • stomach cramps or bloating
  • diarrhea
  • constipation
  • gingivitis
  • increased or decreased appetite
  • weight gain or weight loss
  • brown or black skin patches
  • acne
  • hair growth in unusual places
  • bleeding or spotting between menstrual periods
  • changes in menstrual flow
  • painful or missed periods
  • breast tenderness, enlargement, or discharge
  • difficulty wearing contact lenses
  • swelling, redness, irritation, burning, or itching of the vagina
  • white vaginal discharge

Tell your doctor immediately if you experience any of these more serious side effects :

  • severe headache
  • severe vomiting
  • speech problems
  • dizziness or faintness
  • weakness or numbness of an arm or leg
  • crushing chest pain or chest heaviness
  • coughing up blood
  • shortness of breath
  • pain, warmth, or heaviness in the back of the lower leg
  • partial or complete loss of vision
  • double vision
  • bulging eyes
  • severe stomach pain
  • yellowing of the skin or eyes
  • loss of appetite
  • extreme tiredness, weakness, or lack of energy
  • fever
  • dark-coloured urine
  • light-coloured stool
  • swelling of the hands, feet, ankles or lower legs
  • depression, especially if you also have trouble sleeping, tiredness, loss of energy, or other mood changes
  • unusual bleeding
  • rash

This drug may cause other side effects. Talk to your doctor if you have any unusual symptoms while taking this medicine.

Oral contraceptives may also slightly increase the chance that you will develop breast, liver, or cervical cancer, or have a heart attack, a stroke, or a serious blood clot.

This is especially true if you are a smoker and over 35 years of age. They also raise the risk of gallbladder disease. On the other hand, oral contraceptives reduce the risk of endometrial and ovarian cancers and other diseases such as pelvic inflammatory disease and ectopic pregnancies.

What if I am taking other drugs?

Always provide your doctor with a list of all other drugs you are taking (including over-the-counter medications) as they may interact with another drug, increasing or decreasing effectiveness and safety of either or both. Tell your doctor specifically if you are taking any of the following:

  • acetaminophen
  • antibiotics
  • erythromycin
  • metronidazole
  • rifabutin
  • rifampin
  • tetracycline
  • troleandomycin
  • anticoagulants
  • antifungal
  • itraconazole
  • ketoconazole
  • atorvastatin
  • clofibrate
  • cyclosporine
  • danazol
  • delavirdine
  • diltiazem
  • fluoxetine
  • HIV protease inhibitors such as indinavir and ritonavir
  • medications for seizures
  • felbamate
  • oxcarbazepine
  • phenobarbital
  • phenytoin
  • primidone
  • topiramate
  • modafinil
  • morphine
  • nefazodone
  • oral steroids such as dexamethasone
  • methylprednisolone
  • prednisone
  • prednisolone
  •  temazepam
  • theophylline
  • thyroid medication such as levothyroxineverapamil
  • vitamin C
  • zafirlukast

Tell your doctor what herbal products you are taking, especially St. John's wort.

Other information:

Cigarette smoking increases the risk of serious side effects from birth control pills. These include heart attacks, blood clots, and strokes. The risk is higher for women over the age of 35 and for heavy smokers.

Children: Not usually prescribed

Seniors may take this drug as prescribed.

Pregnancy: Do not take oral contraceptives if you are pregnant or plan to become pregnant. If you become pregnant while on the pill, call your doctor immediately.

Women who are nursing: This drug passes into the breast milk and may reduce flow. Talk to your doctor. If you have recently given birth, wait until 4 weeks after giving birth before you go on the pill.

Alcohol: Always drink in moderation.

Overdose: if you experience any unusual reactions or if you seriously exceed the recommended dosage, call your doctor or 911.

Stopping the drug: Birth control pills will prevent pregnancy or treat acne only as long as they are taken regularly.

If you miss a dose: Every brand of oral contraceptives comes with specific directions to follow if you miss a dose. Carefully read the directions.

Storage conditions: closed container; cool, dry location away from excess moisture (not in the bathroom); always out of reach of children.

Dietary precautions: None.