Lo Loestrin Fe (ethinyl estradiol, norethindrone and ferrous fumarate) is a combination medicine that contains female hormones that prevent ovulation (the release of an egg from an ovary). This medication also causes changes in your cervical mucus and uterine lining, making it harder for sperm to reach the uterus and harder for a fertilized egg to attach to the uterus.
Lo Loestrin Fe is used as contraception to prevent pregnancy.
Lo Loestrin Fe may also be used for purposes not listed in this medication guide.
Important information
Do not use Lo Loestrin Fe if you are pregnant or if you have recently had a baby. You should not take Lo Loestrin Fe if you have any of the following conditions: uncontrolled high blood pressure, heart disease, a blood-clotting disorder, circulation problems, diabetic problems with your eyes or kidneys, unusual vaginal bleeding, liver disease or liver cancer, severe migraine headaches, if you smoke and are over 35, or if you have ever had breast or uterine cancer, jaundice caused by birth control pills, a heart attack, a stroke, or a blood clot.
You may need to use back up birth control, such as condoms or a spermicide, when you first start using Lo Loestrin Fe or if you miss a dose. Follow your doctor"s instructions.
Missing a pill increases your risk of becoming pregnant. Carefully follow the "missed dose" instructions if you forget to take your Lo Loestrin Fe tablets.
Some drugs can make Lo Loestrin Fe less effective in preventing pregnancy, including antibiotics, hepatitis C medications, HIV/AIDS medications, seizure medications, or barbiturate sedatives. Tell your doctor about all other medications you use.
Before taking this medicine
Lo Loestrin Fe can cause birth defects. Do not use if you are pregnant. Tell your doctor right away if you become pregnant, or if you miss two menstrual periods in a row. If you have recently had a baby, wait at least 4 weeks before taking Lo Loestrin Fe. You should not take Lo Loestrin Fe if you have:
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untreated or uncontrolled high blood pressure;
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heart disease (coronary artery disease, uncontrolled heart valve disorder, history of heart attack, stroke, or blood clot);
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a blood-clotting disorder or circulation problems;
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problems with your eyes, kidneys or circulation caused by diabetes;
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a history of hormone-related cancer such as breast or uterine cancer;
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unusual vaginal bleeding that has not been checked by a doctor;
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liver disease or liver cancer;
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severe migraine headaches (with aura, numbness, weakness, or vision changes), especially if you are older than 35;
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a history of jaundice caused by pregnancy or birth control pills; or
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if you smoke and are over 35 years old.
To make sure you can safely take Lo Loestrin Fe, tell your doctor if you have any of these other conditions:
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high blood pressure, varicose veins;
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high cholesterol or triglycerides, or if you are overweight;
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a history of depression;
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underactive thyroid;
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gallbladder disease;
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diabetes;
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seizures or epilepsy;
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a history of irregular menstrual cycles;
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tuberculosis; or
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a history of fibrocystic breast disease, lumps, nodules, or an abnormal mammogram.
The hormones in Lo Loestrin Fe (ethinyl estradiol and norethindrone) can pass into breast milk and may harm a nursing baby. This medication may also slow breast milk production. Do not use Lo Loestrin Fe if you are breast feeding a baby.
How should I take Lo Loestrin Fe?
Take Lo Loestrin Fe as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.
You will take your first pill on the first day of your period or on the first Sunday after your period begins. You may need to use back-up birth control, such as condoms or a spermicide, when you first start using Lo Loestrin Fe. Follow your doctor"s instructions.
Take one pill every day, no more than 24 hours apart. When the pills run out, start a new pack the following day. You may get pregnant if you do not take one pill daily. Get your prescription refilled before you run out of pills completely.
The 28 day birth control pack contains 4 ferrous fumarate "reminder" pills to keep you on your regular cycle. Your period will usually begin while you are using these reminder pills.
You may have breakthrough bleeding, especially during the first 3 months. Tell your doctor if this bleeding continues or is very heavy.
Use a back-up birth control if you are sick with severe vomiting or diarrhea.
If you need surgery or medical tests or if you will be on bed rest, you may need to stop using Lo Loestrin Fe for a short time. Any doctor or surgeon who treats you should know that you are using Lo Loestrin Fe.
While taking Lo Loestrin Fe, you will need to visit your doctor regularly.
Store Lo Loestrin Fe at room temperature away from moisture and heat.
What happens if I miss a dose?
Follow the patient instructions provided with your Lo Loestrin Fe tablets. Ask your doctor or pharmacist if you do not understand these instructions. Missing a pill increases your risk of becoming pregnant.
If you miss ONE blue pill, follow these steps:
Take it as soon as you remember. Take the next pill at your regular time. This means you may take two pills in 1 day. You do not need to use a back-up birth control method if you have sex.
If you miss TWO blue pills in a row in Week 1 or Week 2 of your pack, follow these steps:
Take
1. Two pills on the day you remember and two pills the next day.
2. One pill a day until you finish the pack.
You could become pregnant if you have sex during the first 7 days after you restart your Lo Loestrin Fe pills. You MUST use a non-hormonal birth control method (such as a condom and spermicide) as a back-up for those 7 days.
If you miss TWO pills (blue or white) in a row in Week 3 or Week 4 of your pack, follow these steps:
Throw out the rest of the pill pack and start a new pack that same day. You may not have your period this month but this is expected. However, if you miss your period 2 months in a row, call your healthcare provider because you might be pregnant.
You could become pregnant if you have sex during the first 7 days after you restart your Lo Loestrin Fe pills. You MUST use a non-hormonal birth control method (such as a condom and spermicide) as a back-up for those 7 days after you restart your Lo Loestrin Fe pills.
If you miss THREE OR MORE pills (blue or white) in a row at any time, follow these steps:
Throw out the rest of the pill pack and start a new pack that same day.
You may not have your period this month but this is expected. However, if you miss your period 2 months in a row, call your healthcare provider because you might be pregnant.
You could become pregnant if you have sex on the days when you missed pills or during the first 7 days after restarting your Lo Loestrin Fe pills. You MUST use a non-hormonal birth control method (such as a condom and spermicide) as a back-up the next time you have sex and for the first 7 days after you restart your pills.
If you forget either of the 2 brown "reminder" pills in Week 4, follow these steps:
Throw away the pills you missed. Keep taking one pill each day until the pack is empty. You do not need to use a back-up method of birth control.
If you are still not sure what to do about the pills you have missed:
Use a back-up method of birth control anytime you have sex.
Keep taking one pill each day until you can reach your healthcare provider.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include nausea, vomiting, and vaginal bleeding.
What should I avoid?
Smoking can increase your risk of blood clots, stroke, or heart attack caused by Lo Loestrin Fe, especially if you are older than 35.
Lo Loestrin Fe will not protect you from sexually transmitted diseases--including HIV and AIDS. Using a condom is the only way to protect yourself from these diseases.
Lo Loestrin Fe side effects
Get emergency medical help if you have any of these signs of an allergic reaction to Lo Loestrin Fe: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Stop using Lo Loestrin Fe and call your doctor at once if you have a serious side effect such as:
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sudden numbness or weakness, especially on one side of the body;
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sudden and severe headache, confusion, problems with vision, speech, or balance;
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chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;
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sudden cough, wheezing, rapid breathing, coughing up blood;
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pain, swelling, warmth, or redness in one or both legs;
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a change in the pattern or severity of migraine headaches;
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nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
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swelling in your hands, ankles, or feet;
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a breast lump; or
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symptoms of depression (sleep problems, weakness, tired feeling, mood changes).
Less serious Lo Loestrin Fe side effects may include:
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mild nausea (especially when you first start taking this medicine), vomiting, bloating, stomach cramps;
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breast tenderness or swelling, nipple discharge;
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freckles or darkening of facial skin, increased hair growth, loss of scalp hair;
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changes in weight or appetite;
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problems with contact lenses;
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vaginal itching or discharge; or
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changes in your menstrual periods, decreased sex drive.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
What other drugs will affect Lo Loestrin Fe?
Some drugs can make Lo Loestrin Fe less effective, which may result in pregnancy. Before using Lo Loestrin Fe, tell your doctor if you are using any of the following drugs:
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bosentan (Tracleer);
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an antibiotic or tuberculosis medication;
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drugs to treat hepatitis C, HIV, or AIDS;
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phenobarbital (Solfoton) and other barbiturates;
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St. John"s wort; or
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seizure medications.
Tell your doctor about all other medicines you use, especially:
This list is not complete and other drugs may interact with Lo Loestrin Fe. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.
