Norethindrone (Oral)

The contraceptive medication known as norethindrone is also an effective treatment for female patients that suffer from secondary amenorrhea, irregular menstrual periods that are caused by hormonal imbalances, and endometriosis.

Overview

Norethindrone is a contraceptive that utilizes progesterone in the prevention of pregnancy. When taken as directed this medication is an effective birth control method. This prescription drug is also used to effectively treat secondary amenorrhea, irregular menstrual periods that are caused by hormonal imbalances, and endometriosis.

Patients are reminded that no method of contraception is fully reliable, and some patients may wish to use a complementary method, such as the use of condoms, in addition to the birth control pill. If you are looking for 100% pregnancy prevention, surgery may be an option to discuss with your doctor.

Birth control medication does not protect against the contraction of any sexually transmitted diseases, including HIV/AIDS. Norethindrone is not an effective method of emergency birth control and should not be used for that purpose. If you have had unprotected sex it is best to speak with your doctor or pharmacist to learn more about the options that are available in such a situation.

This medication should not be taken by women who are pregnant. If your menstrual cycle does not start as expected, it is important to inform your doctor as you may need a pregnancy test. Patients who discover that they are pregnant while taking norethindrone should stop taking it immediately and contact their physician for further medical guidance.

Women who are taking norethindrone should not smoke as this can increase their risk of heart attack and stroke. If you do smoke it is important to inform your doctor prior to starting the norethindrone course of treatment.

Norethindrone is available in the following dosage delivery method:

  • Tablet

Conditions Treated

  • Birth control
  • Secondary amenorrhea
  • Irregular menstrual periods that are caused by hormonal imbalances
  • Endometriosis

Type Of Medicine

  • Progesterone

Side Effects

Patients who use norethindrone may experience unwanted side effects that may require further medical attention. If you become concerned with any reaction that you experience, whether it is listed here or not, it is always best practice to consult with your doctor for further guidance.

Let your physician know as soon as possible if you experience any of the following symptoms as they may be a sign of a more serious problem:

More likely:

  • Menstrual changes
  • Bleeding that is irregular and frequent

An unknown incidence of occurrence:

  • Stomach or abdominal pain
  • Upper right abdominal or stomach pain
  • Color blindness in blue-yellow hues
  • Unpleasant breath odor
  • Breast pain
  • Trouble concentrating
  • Vision changes, especially blurriness
  • Swelling
  • Clay-colored stools
  • Pain, redness, or swelling of the extremities
  • Coughing
  • Nausea and vomiting
  • Decreased vision
  • Loss of interest or pleasure
  • Difficulty swallowing
  • Light-colored stools
  • Dizziness
  • Irritability
  • Eye pain
  • Heavy non-menstrual vaginal bleeding
  • Feeling sad or empty
  • Blindness
  • Headaches
  • Fever
  • Hives, itching, or rash
  • Increased heartbeat
  • Lack of appetite
  • Double vision
  • Light vaginal bleeding outside of the expected menstrual cycle
  • Discouragement
  • Migraine headaches
  • Diarrhea
  • Hand numbness
  • Dark urine
  • Eyelid swelling
  • Swelling in the area near the eyes
  • Swelling of the tongue, lips, or face
  • Confusion
  • Tightness in the chest
  • Chills
  • Difficulty sleeping
  • Changes in menstrual cycle
  • Unexplained tiredness or weakness
  • Blurred vision
  • Vomiting of blood
  • Yellowish tint to the skin and eyes
  • General weakness or feeling tired

As your body adjusts to the introduction of norethindrone you may experience one or more of the following side effects that will likely go away on their own. If you experience any of these symptoms and they do not begin to dissipate after a few days, or if they become worse, it is advised that you consult with your doctor for further medical advice.

More likely:

  • Pimples
  • Breast tenderness
  • Weight gain
  • Increased hair growth, particularly facial hair

An unknown incidence of occurrence:

  • Mood swings
  • Blotchy and discolored spots on exposed areas of the skin
  • Feeling nervous
  • Enlarged breasts
  • Changes in the weight of the patient
  • Hair loss or thinning hair

If you experience other unwanted side effects that are not listed, it is always best practice to inform your doctor of the symptoms in cases where they last for longer than a few days, worsen, or are of concern to you.

Dosage

Norethindrone comes in a 28-day blister pack that dispenses the tablets. It is important for patients to take this medication at the same time each day in order to maintain the proper amount of medication in their systems at all times. Do not take any days off between packets, it is important that you take a pill every day without skipping in-between. Your doctor will advise you when to begin your medication, whether it be on the first day of your cycle or another day. For the first two days that you are taking this medication be sure to use an alternative method of birth control. If you are uncertain about when to begin taking this medication, it is advisable to double check with your prescribing physician for clarification.

It is typical to experience spotting or light bleeding when you first begin to take norethindrone. If this condition lasts for more than a few days, becomes heavier, or is of concern to you it is always best practice to consult with your doctor for further medical advice.

Patients may be prescribed different dosages due to the reason that they are taking norethindrone and the severity of their condition, or their tolerance of the hormone progesterone.

The guidelines outlined below are the most typical dosages that are prescribed. If your prescription is for a different dosage or you have been instructed to take this medication differently, it is important to always follow the directions provided by your doctor.

It is important to consult with your doctor prior to making any changes to how you take norethindrone. Do not stop taking this medication without first consulting with your physician.

For patients that are taking norethindrone tablets as contraception:

Take one tablet, with or without food, at the same time each day, every day

For patients that are taking norethindrone to treat abnormal vaginal bleeding or secondary amenorrhea:

Take 2.5 to 10 milligrams one time each day for five to ten days, as directed

For patients that are taking norethindrone to treat endometriosis:

Your doctor will start your course of treatment at five milligrams taken one time each day for a period of two weeks. After that initial dosage, they might increase your dosage level every two weeks by 2.5 milligrams each day. The maximum dosage of norethindrone, when taken for endometriosis, is 15 milligrams per day for a six to nine-month-long period. Patients that are not experiencing relief from their endometriosis symptoms should consult with their doctor before making any changes to the way that they take this medication. Do not start taking more norethindrone without first consulting with your physician.

Patients who miss a dosage of norethindrone should take it as soon as they remember. If however, if it is close to the time of their next scheduled dose, it should be skipped entirely. Patients that are unsure of what to do after missing a dose of norethindrone should speak with their pharmacist for further clarification. Do not ever take a double dose of this medication.

In circumstances where norethindrone is taken as a contraceptive, an alternative birth control method should be used if a pill is taken three or more hours after the regularly scheduled time.

Major Drug Interactions

Norethindrone is not recommended for use with tranexamic acid and your doctor may opt to treat you with an alternative medication. If you are taking tranexamic acid it is important to make sure that your doctor is aware that you are taking it. Do not begin taking norethindrone if you have taken tranexamic acid in the recent past without first speaking to your doctor.

It is important that your doctor is informed of all medications that you are currently taking, both prescription and non-prescription. When informing your medical team of your current medications you must also include any herbal remedies that you take, all over the counter medications such as cold and allergy pills, as well as all vitamin and mineral supplements.

Inform your doctor and medical team of all allergies that you currently have. Include any issues that you have with other medications, foods, cleaning solutions and other substances, and pets and other animals prior to starting your norethindrone course of treatment.

The following medications are not recommended for concurrent use with norethindrone, however, your doctor may feel that the combination is the most effective. Because of this, it is important to inform your doctor of any significant reactions that you experience while taking norethindrone. If you are prescribed norethindrone along with one of the other medications listed below, your doctor may alter your dosage or how you take one or both of the medications:

  • Carbamazepine
  • Theophylline
  • Darunavir
  • Pitolisant
  • Isotretinoin
  • Ulipristal
  • Lumacaftor
  • Lesinurad
  • Sugammadex
  • Eliglustat
  • Tizanidine
  • Dabrafenib
  • Lixisenatide

The use of this drug with any of the medications on the following list may increase the likelihood of experiencing certain unwanted side effects. Patients who are currently taking one of the following can confer with their doctor or another healthcare provider on strategies that can help to minimize the likelihood of certain side effects. If you have any negative reactions or significant symptoms when taking norethindrone be sure to notify your doctor as they may be able to alter your medications or how you take them:

  • Alprazolam
  • Valdecoxib
  • Aprepitant
  • Troglitazone
  • Bacampicillin
  • Telaprevir
  • Bexarotene
  • Selegiline
  • Colesevelam
  • Rosuvastatin
  • Delavirdine
  • Rifapentine
  • Fosamprenavir
  • Rifabutin
  • Fosphenytoin
  • Prednisolone
  • Lamotrigine
  • Phenobarbital
  • Modafinil
  • Oxcarbazepine
  • Mycophenolic Acid
  • Amprenavir
  • Parecoxib
  • Mycophenolate Mofetil
  • Phenytoin
  • Licorice
  • Primidone
  • Griseofulvin
  • Rifampin
  • Fosaprepitant
  • Ritonavir
  • Etravirine
  • Rufinamide
  • Cyclosporine
  • St John's Wort
  • Bosentan
  • Topiramate
  • Betamethasone
  • Troleandomycin
  • Atazanavir
  • Voriconazole
  • Nelfinavir
  • Warfarin

It is important to take this medication at the same time each day, with or without food as dictated by the patient's preference. In order to be an effective form of birth control, a certain level of progesterone must be maintained at all times; if a dosage is taken three or more hours after it is scheduled, an alternative method of contraception should be used for the next 48 hours.

Inform your doctor of any tobacco use, regular intake of alcohol, or other lifestyle habits that may affect the way that your system might react to norethindrone. It is advisable to avoid the following substance while taking this medication:

  • Caffeine

If you are currently being treated for any of the following illnesses or conditions, these ailments may affect the way that your system reacts to norethindrone. You may also experience adverse effects from taking this medication if you suffer from:

Warnings

Due to the long period of time that many patients take norethindrone, it is likely that your doctor will order diagnostic tests and check-ups on a regular basis. These measures are taken to ensure that the norethindrone is an effective course of treatment and to detect and manage any unwanted side effects. Be sure to keep all scheduled follow-up appointments and go for all tests as directed.

Patients that experience vaginal bleeding when they begin taking this medication should see it dissipate within a period of one week or less. If you experience bleeding for a period of time longer than one week, check with your doctor for further medical advice as this may be a sign that the medication is not working effectively. You should not experience any bleeding of any type, outside of your regular menstrual period, after taking this medication for three months. If you do still have irregular bleeding after this amount of time, speak with your doctor as this may be a sign of a different problem. Patients may not react well to the first birth control medication that is prescribed to them and it may be necessary to try several different medications to find the one that works effectively and causes the fewest number of side effects.

If you miss your menstrual period while taking this medication speak with your doctor right away as you may need a pregnancy test. Patients who believe that it is possible that they may be pregnant should stop taking norethindrone right away.

Women who are pregnant should not take norethindrone. If you become pregnant while taking this medication, stop taking it right away and notify your doctor at once.

Patients that have taken this drug in the past and now want to start taking it again are advised to discuss this action with their doctor. Do not refill a prescription that was written long ago as you will need a physical exam before starting to take this medication again. Patients who take norethindrone will require regular medical check-ups and possibly diagnostic testing. This is also true in some cases for patients that are starting this medication. Speak with your doctor before you start taking this drug after a lapse in treatment.

Patients who experience severe or sudden stomach pain or pain in their lower abdominal region should seek medical attention right away as these can be signs of an ovarian cyst or an ectopic pregnancy.

Regular smokers should not use this medication as it can increase the risk of heart attack and stroke. Patients that are overweight or obese should also refrain from using norethindrone. If you suffer from diabetes, your doctor may instruct you to find an alternative method of birth control as this medication can worsen that condition. Inform your doctor of all medical conditions from which you suffer as well as any lifestyle habits that may affect how your system reacts to norethindrone.

Inform your doctor of any changes to your vision or eye health right away. If you experience blurred vision, difficulty with your contact lenses or problems reading they may order an eye exam right away. If your doctor advises you to see an ophthalmologist it is important to keep this appointment and undergo any diagnostic testing as ordered. Patients who are taking norethindrone for an extended period of time should undergo regular eye exams as your ophthalmologist may be able to discover complications before any signs and symptoms become noticeable.

Inform all of the doctors that you see for diagnostic testing or any other reason that you are taking this medication as it may alter the results of some tests.

Do not change the way that you take any of your medications while you are taking norethindrone without first checking with your doctor. Be sure to let them know of any changes to your overall health and well-being that you may experience while taking this medication.

Storage

It is always best practice to store all medications in its original packaging. Do not store norethindrone in an environment that has a high level of moisture; do not expose this medication to direct light, extreme heat or cold, and do not allow it to freeze.

Keep this and all medications out of the reach of pets and children.

Do not keep any unused, expired, or excess medication; be sure to consult with your pharmacist to learn the appropriate methods of disposal to follow.

Summary

Norethindrone is a contraceptive that utilizes progesterone in the prevention of pregnancy. When taken as directed this medication is an effective birth control method. This prescription drug is also used to effectively treat secondary amenorrhea, irregular menstrual periods that are caused by hormonal imbalances, and endometriosis.

Do not start taking this medication following a lengthy period when you did not take it. Patients that would like to start taking norethindrone again should check with their doctor for medical advice and should not refill any old prescriptions that they may have.

Birth control medication does not protect against the contraction of any sexually transmitted diseases, including HIV/AIDS. Patients are encouraged to utilize other methods of prevention for STIs.

This medication should not be taken by women who are pregnant. If you think that you may be pregnant stop taking norethindrone immediately and contact your doctor.

Due to the extended period of time over which this medication is typically taken, patients are advised to keep all follow-up appointments and undergo all diagnostic testing ordered by their physician.