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Ethinyl Estradiol-Norethindrone and Ferrous Fumarate (21/7) (Birth Control)

Generic name: ethinyl estradiol and norethindrone (birth control) [ETH-in-il-ess-tra-DYE-ole-and-nor-ETH-in-drone]

Brand names: Alyacen 1/35, Alyacen 7/7/7, Aranelle, Aurovela 1.5/30, Aurovela 1/20,… show all 74 brands
Drug classes: contraceptives, sex hormone combinations

What is Ethinyl Estradiol-Norethindrone and Ferrous Fumarate (21/7)?

Ethinyl Estradiol-Norethindrone and Ferrous Fumarate (21/7) is a combination birth control pill containing female hormones to inhibit ovulation (the release of an egg from an ovary).The medication can also cause changes to your cervical mucus or uterine lining. This makes it more difficult for fertilized eggs to adhere to the uterus and for sperm to reachEthinyl Estradiol-Norethindrone and Ferrous Fumarate (21/7) are used as contraceptives to prevent pregnancy. Ethinyl Estradiol-Norethindrone and Ferrous Fumarate (21/7) are also used to treat moderate acne in women who are at least 15 years old, have started having menstrual periods, and wish to use birth control pills. Many brands are available for norethindrone and ethinyl estradiol. This leaflet does not list all available brands.Ethinyl Estradiol-Norethindrone and Ferrous Fumarate (21/7) may also be used for other reasons that aren't mentioned here.

Side effects of Ethinyl Estradiol-Norethindrone and Ferrous Fumarate (21/7)

If you experience any of the following symptoms of an allergy reaction, seek immediate medical attention: difficulty breathing, hives, swelling in your lips, face, throat, or tongue.

The side effects of this medicine can be serious. If you experience:

  • Signs of a Stroke: sudden numbness, weakness, or severe headache; slurred or shaky speech.
  • Signs of a pulmonary blood clot: chest pain, sudden cough and shortness of breath; dizziness.
  • Signs of a deep blood clot—pain or swelling in one leg
  • Heart attack symptoms: chest pain, pressure or pain in your shoulder or jaw, nausea, and sweating.
  • Liver problems: swelling around the midsection of your body; upper right stomach pain; lack of appetite; dark colored urine; clay colored stools; jaundice (yellowing skin or eyes);
  • Increased blood pressure—severe head pain, blurred or distorted vision, and a pounding sensation in the neck, ears, or shoulders;
  • Depression: mood changes, low self-worth feelings, lack of interest in activities you used to enjoy, sleep disturbances, thoughts of harming yourself
  • A breast lump or swelling of the hands, feet, or ankles;
  • A change in migraine headache pattern or intensity

Common side effects of ethinyl estradiol-norethindrone and ferrous fumarate (21/7) may include:

  • Nausea, vomiting;
  • Breast tenderness or bleeding.
  • Headache or contact lens problems

There may be other side effects. For medical advice on side effects, call your doctor.Please report side effects by contacting the FDA at 1-800-FDA-1088.

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Doxycycline, alendronate, Clindamycin Topical, Estradiol, Topical Erythromycin, Fosamax, and Tetracycline


Avoid using birth control pills while pregnant or after having a recent baby.Birth control pills should be avoided if: you are suffering from uncontrolled hypertension, heart problems, circulatory issues (especially in diabetes), liver diseases or cancers of the liver, migraine headaches that last for days, if your surgery is going to take place soon, if you are smoking and you're over 35 years old, if a previous heart attack or stroke has occurred, if there was a blood clot or jaundice due to pregnancy, birth control pills or cancers of the breast, uterus, or cerviSmoking or using birth control pills, particularly if you're older than 35 years, can increase the risk of blood clots or strokes.

Before you take this drug

Birth control pills may increase the risk of stroke or heart attack. If you suffer from high blood pressure, diabetes, high cholesterol, or are overweight, you're at even greater risk. The risk of stroke and blood clots is greatest during the first year you take birth control pills. You are at high risk when you start taking birth control pills again after a break of 4 weeks.If you're older than 35, smoking can raise your chances of blood clots or stroke.

Do not use it if you are pregnant. Stop using Ethinyl Estradiol-Norethindrone and Ferrous Fumarate (21/7) and tell your doctor right away if you become pregnant or if you miss two menstrual periods in a row. Wait at least four weeks after giving birth if you've just had your baby.

If you are pregnant, or if:

  • Untreated or uncontrolled hypertension or heart disease
  • An increased risk for blood clots as a result of a blood disorder or heart disease;
  • Circulatory problems, especially if they are caused by diabetes
  • A history of cancers of the breast, uterus, or cervix, or of vaginal or ovarian origin;
  • Unusual vaginal bleeding not checked by your doctor
  • Liver disease, or cancer of the liver;
  • Severe migraine headaches, especially in older people over 35.
  • Jaundice can occur as the result of pregnancy or birth control pills, leading to symptoms like jaundice.
  • If you are older than 35 and smoke,
  • If you take any hepatitis C medication containing ombitasvir, paritaprevir, or ritonavir with or without dasabuvir.

If you've ever:

  • If you have heart disease, blood clots, or high blood pressure,
  • If you have high triglycerides or cholesterol or are overweight,
  • Depression;
  • A seizure or migraine headache;
  • Gallbladder disease; underactive thyroid
  • Liver or kidney disease
  • Uneven menstrual cycle, or fibrocystic breast disease Lumps, nodules, or abnormal mammograms

A doctor can tell you if breastfeeding is possible while taking this medication.

How to take Ethinyl Estradiol-Norethindrone and Ferrous Fumarate (21/7)?

Read all the instructions or guides that come with your medication and follow all the directions. Follow the directions on your prescription label.When you start taking this drug, it is possible that you will need to use a backup birth control method, like condoms with spermicide. You should follow your doctor's advice.One pill per day is recommended, but no more than one every 24 hours. Start a fresh pack of pills the next day when the old ones run out. If you don't take one daily pill, it is possible to become pregnant.Several birth control packages contain "reminder pills" to help you maintain your normal cycle. Usually, your period begins when you use these pills.If you have severe nausea or diarrhea, use backup birth control.It is possible that you are bleeding through the skin. If it persists or becomes very heavy, tell your doctor.You may have to temporarily stop taking this medication if you are going to be undergoing major surgery or if you will need long-term rest. Any doctor or surgeon who treats you should know that you are using ethyl estradiol-norethindrone and ferrous fumarate (21/7).You will have to see your doctor frequently if you are taking birth-control pills.Keep away from heat and moisture at room temperature.

What happens if I miss the dose?

Read all the instructions or guides that come with your medication. You are more likely to become pregnant if you miss a pill.Take two active pills the next day if you forget. Take 1 pill a day until the remainder of the package.Take two pills a day for two consecutive days if you missed two active pills back-to-back in the first or second week. Take 1 pill per dose for the remainder of your pack. After missing a pill, use a backup birth control method for at least seven days.You can start fresh the next day if your Day 1 starter pack is empty. You can continue to take a pill each day up until Sunday if you started on Sunday. Throw out the remaining pills on Sunday and begin a brand new package that same day.You can start over if you missed three pills consecutively in the first, second, or third week. You can continue taking the pill until Sunday if you started on Sunday. Throw out the remaining pills on Sunday and begin a brand new package that same day.You may miss your period if you don't take two active pills or more. Call your doctor if you have missed a period in two consecutive months. You might be pregnant.You can throw away the missed pill and continue taking one reminder per day until you run out of pills.

What happens if I overdose?

Call the Poison Help Line at 1-800-222-1222 or seek emergency medical care. An overdose can cause vomiting or bleeding.

What should be avoided?

Don't smoke when taking birth-control pills, particularly if you are more than 35 years old.The birth control pill will not shield you against sexually transmissible diseases, including HIV and AIDS. The only way to prevent these diseases is by using a condom.

Interaction with other drug

Inform your doctor of any other medications you are taking, such as:

  • Rifampin;
  • Troglitazone;
  • Atorvastatin;
  • Glecaprevir/pibrentasvir;
  • Anticonvulsants such as carbamazepine, phenytoin, and phenobarbital

The list below is not exhaustive. Other drugs may affect Ethinyl Estradiol-Norethindrone and Ferrous Fumarate (21/7), including prescription and over-the-counter medicines, vitamins, and herbal products. This list does not include all possible drug interactions.



Prescription only

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