Micronor, Norlutin, Nor-Q.D.
Aygestin , Norlutate
Classifications: hormone; progestin; Therapeutic: hormone; progestin
Pregnancy Category: X
0.35 mg, 5 mg tablets
Synthetic progestational hormone with androgenic, anabolic, and estrogenic properties. Progestin-only contraceptives alter
cervical mucus, exert progestational effect on endometrium, interfere with implantation, and, in some cases, suppress ovulation.
May produce excess estrogenic effect.
Contraceptive that suppresses the midcycle surge of luteinizing hormone (LH).
Amenorrhea, abnormal uterine bleeding due to hormonal imbalance in absence of organic pathology; endometriosis. Also alone
or in combination with an estrogen for birth control.
Thromboembolic disorders, cerebral vascular or coronary vascular disease; carcinoma of breast, endometrium, or liver; abnormal
vaginal bleeding; known or suspected pregnancy (category X); children <16 y.
Cardiac disease; history of depression, seizure disorders, migraine; diabetes mellitus; CHF; history of thrombophlebitis
or thromboembolic disease.
Route & Dosage
Adult: PO Norethindrone 520 mg on day 5 through day 25 of menstrual cycle; Acetate 2.510 mg on day 5 through day 25 of menstrual cycle
Adult: PO Norethindrone 10 mg/d for 2 wk; increase by 5 mg/d q2wk up to 30 mg/d, dose may remain at this level for 69 mo or until breakthrough
bleeding; Acetate 5 mg/d for 2 wk, increase by 2.5 mg/d q2wk up to 15 mg/d, dose may remain at this level for 69 mo or until breakthrough
Adult: PO Norethindrone 0.35 mg/d starting on day 1 of menstrual flow, then continuing indefinitely
- Note: Dosing schedule is based on a 28-d menstrual cycle.
- Use or add a barrier contraceptive when starting the minipill regimen (progestin-only contraception) for the first cycle
or for 3 wk to ensure full protection.
- Protect drug from light and from freezing.
Adverse Effects (≥1%)CNS: Cerebral thrombosis or hemorrhage, depression
Hypertension, pulmonary embolism,
Nausea, vomiting, cholestatic jaundice
, abdominal cramps. Urogenital: Breakthrough bleeding,
cervical erosion, changes in menstrual flow, dysmenorrhea, vaginal candidiasis. Other: Weight changes; breast tenderness,
enlargement or secretion.
, carbamazepine, fosphenytoin, modafinil, phenytoin, primidone, pioglitazone, rifampin rifabutin, rifapentine, topiramate, troglitazone
can decrease contraceptive effectiveness.
Readily absorbed from GI tract. Metabolism:
In liver. Elimination:
In urine and feces as metabolites.
Assessment & Drug Effects
- Monitor for S&S of thrombophlebitis (see Appendix F).
- Withhold drug and notify physician if any of the following occur: Sudden, complete, or partial loss of vision, proptosis,
diplopia, or migraine headache.
Patient & Family Education
- Wait at least 3 mo before becoming pregnant after stopping the minipill to prevent birth defects. Use a barrier or nonhormonal
method of contraception until pregnancy is desired.
- If you have not taken all your pills and you miss a period, consider the possibility of pregnancy after 45 d from the last
menstrual period; stop using progestin-only contraceptive until pregnancy is ruled out.
- If you have taken all your pills and you miss 2 consecutive periods, rule out pregnancy and use a barrier or nonhormonal
method of contraception before continuing the regimen.
- Review package insert to ensure you understand how to use norethindrone.
- Promptly report prolonged vaginal bleeding or amenorrhea.
- Learn and do breast self-examination.
- Keep appointments for physical checkups (q612mo) while you are taking hormonal birth control.