Classifications: hormone; progestin; Therapeutic: hormone; progestin
Pregnancy Category: X
0.075 mg tablets
Potent progestational hormone with androgenic, antiestrogenic, and anabolic properties. Induces and maintains endometrium,
preventing uterine bleeding; inhibits production of pituitary gonadotropin, preventing ovulation; produces thick cervical
mucus resistant to passage of sperm.
Effective progestin contraceptive that prevents ovulation.
A progestin-only contraceptive (minipill).
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; cerebrovascular disease; depression, migraine, seizure disorders.
Route & Dosage
Adult: PO 0.075 mg/d starting on day 1 of menstrual flow, then continuing indefinitely
- Use a barrier method of contraception, when starting the minipill regimen, for the first cycle or for 3 wk to insure full
- The minipill can be started right after delivery in the nonlactating mother; however, she should be aware of an increased
risk of thromboembolic disease during the postpartum period.
- Take the minipill at same time each day, even if menstruating.
- Store at 15°30° C (59°86° F) in a tightly closed container.
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. Endocrine: Weight changes; breast tenderness,
enlargement, or secretion.
No clinically significant interactions established.
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
- Be aware that amount and duration of flow, cycle length, breakthrough bleeding, spotting, and amenorrhea vary greatly with
use of the progestin-only contraceptive.
- Wait at least 3 mo before becoming pregnant after stopping the minipill to prevent birth defects. Use a barrier 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 norgestrel.
- Learn and do breast self-examination.