Estrostep Tablet: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Estrostep Tablet (norethindrone acetate and ethinyl estradiol) is a combination estrogen/progestin oral contraceptive given in a graduated dose pattern over 21 days. Estrostep Fe adds seven hormone-free brown iron tablets to complete a 28-day pack and help maintain the daily pill-taking habit. It is used to prevent pregnancy and, in some women, to treat moderate acne. It works mainly by preventing ovulation and thickening cervical mucus.

What is Estrostep Tablet

Estrostep is a combination birth control pill containing two hormones, norethindrone acetate and ethinyl estradiol, given in a graduated dose pattern over 21 days. Estrostep Fe also includes seven brown iron tablets with no hormones, used only to help keep the daily pill-taking habit going during the 28-day pack. It is used to prevent pregnancy and, in some women, to treat moderate acne.

Estrostep Tablet uses

• Prevention of pregnancy in women who choose to use oral contraceptives
• Treatment of moderate acne in females 15 years and older who have started their periods, have no reason they can't use birth control pills, want to use the pill for birth control, plan to stay on it for at least 6 months, and have not improved with acne creams or gels

Benefits of Estrostep Tablet

• Helps prevent pregnancy when taken correctly.
• Helps thicken cervical mucus, making it harder for sperm to reach an egg.
• Can help make menstrual cycles more regular and predictable.
• Is also FDA-approved to help treat moderate acne in certain females aged 15 years and older who also want oral contraception.

How Estrostep Tablet works

Estrostep works mainly by stopping the ovaries from releasing an egg each month. It also thickens the mucus at the entrance to the uterus, making it harder for sperm to get through, and changes the lining of the uterus so that it is less likely to support a pregnancy.

Estrostep Tablet dosage

Take one tablet every day at about the same time, in the order shown in the pill dispenser. Tablets can be taken without regard to meals. Take pills in the exact order printed on the dispenser, following the arrows. Do not skip pills even if you have spotting, bleeding between periods, or feel sick to your stomach.

For the 21-day pack, take one tablet daily for 21 days, then take no tablets for 7 days before starting a new pack. For the 28-day pack (Estrostep Fe), take the hormone tablets for 21 days followed immediately by the brown reminder tablets for 7 days, with no break between packs.

If you start on the first day of your period (Day-1 Start), no back-up birth control method is needed. If you start on the first Sunday after your period begins (Sunday Start), use a back-up birth control method for the first 7 days. If you vomit, have diarrhea, or take certain other medicines, the pill may not work as well, so use a back-up method until you check with your doctor. If you miss pills, follow the specific missed-pill instructions from your doctor or the package insert, and use a back-up birth control method as directed.

This product is intended for women of reproductive age; it has not been studied in women over 65 and is not meant to be used before a girl's first period.

Available forms and strengths

• Tablet (21-day dispenser with white tablets)
• Tablet (28-day dispenser with white tablets and brown iron tablets)

Side effects of Estrostep Tablet

Common

• Nausea and vomiting
• Bleeding between periods or spotting
• Breast tenderness or enlargement
• Weight change (increase or decrease)
• Difficulty wearing contact lenses
• Headache
• Fluid retention (swelling of fingers or ankles)
• Darkening of skin patches (melasma), especially on the face
• Change in appetite
• Nervousness
• Depression or mood changes
• Dizziness
• Loss of scalp hair
• Rash
• Vaginal yeast infections
• Abdominal cramps and bloating

Serious

• Blood clots in the legs (thrombophlebitis)
• Blood clots in the lungs (pulmonary embolism)
• Stroke (blood clot or bleeding in the brain)
• Heart attack or chest pain (angina)
• Blood clots in the eye that can cause vision loss
• Liver tumors, which may rupture and cause severe internal bleeding
• Gallbladder disease
• High blood pressure
• Severe depression
• Jaundice (yellowing of skin or eyes) with liver problems
• Breast lumps possibly indicating breast cancer or fibrocystic disease
• Severe abdominal pain that could indicate a ruptured liver tumor

Warnings and precautions

• Smoking while taking this medicine greatly raises the risk of serious heart and blood vessel problems, and this risk is higher in women over 35 and in heavy smokers. Women taking this medicine should not smoke.
• This medicine does not protect against HIV or other sexually transmitted infections.
• Using this medicine raises the risk of serious blood clot-related problems such as clots in the legs, lungs, heart, or brain, which can cause disability or death.
• This medicine should not be used by women with a history of blood clots, stroke, heart attack, certain cancers, unexplained vaginal bleeding, liver tumors, or jaundice related to pregnancy or previous pill use.
• If surgery is planned or you must stay in bed for a long time, this medicine may need to be stopped several weeks beforehand because of a higher risk of blood clots.
• Breast cancer has been found slightly more often in women who use the pill, though this extra risk goes away over the 10 years after stopping. Women who currently have or have had breast cancer should not use this medicine.
• This medicine should not be used during pregnancy. It will not work as a pregnancy test and should not be used to try to bring on a period if you might be pregnant. If you become pregnant while taking it, stop taking it and contact your doctor.
• If possible, avoid using this medicine while breastfeeding. Small amounts pass into breast milk and have been linked to jaundice and breast enlargement in nursing babies. It can also reduce the amount and quality of breast milk.
• The effect of kidney disease on how this medicine is processed by the body has not been studied.
• This medicine may not be broken down properly by a liver that isn't working well, and it should be stopped if yellowing of the skin or eyes (jaundice) develops. It should not be used by anyone with liver tumors or significant liver disease.

Storage

• Store at 20–25°C (68–77°F) at controlled room temperature.
• Keep tablets in their original blister packaging until ready to take.
• Protect from excessive heat, moisture, and direct sunlight.
• Avoid storing in bathrooms or other hot and humid locations.
• Keep out of reach and sight of children and pets.

When to see a doctor

• Get medical help right away for sharp chest pain, coughing up blood, or sudden shortness of breath, which could mean a clot in the lung.
• Get medical help right away for calf pain, which could mean a clot in the leg.
• Get medical help right away for crushing chest pain or heaviness in the chest, which could mean a heart attack.
• Get medical help right away for a sudden severe headache, vomiting, dizziness, fainting, trouble with vision or speech, or weakness or numbness in an arm or leg, which could mean a stroke.
• Get medical help right away for sudden partial or complete loss of vision, which could mean a blood clot in the eye.
• Get medical help right away if you find a breast lump.
• Get medical help right away for severe pain or tenderness in the stomach area, which could mean a ruptured liver tumor.
• Get medical help right away for trouble sleeping, weakness, lack of energy, fatigue, or a change in mood, which could mean serious depression.
• Get medical help right away for yellowing of the skin or eyes, often with fever, tiredness, loss of appetite, dark urine, or light-colored stools, which could mean a liver problem.
• Call your doctor if you miss two periods in a row, since this could mean you are pregnant.

Alternatives

• Tri-Sprintec
• Sprintec
• Ortho-Novum
• Junel Fe
• Loestrin Fe