Ortho Tri-Cyclen

Item	Count		Retail	Price	Order
Ortho Tricyclen 0.035 mg	1	tablets	$117.30	$97.75
Ortho Tricyclen 0.035 mg	3	tablets	$255.30	$212.75

Tablets
Chemical Name: NORGESTIMATE (nor-JES-ti-mate) and ETHINYL ESTRADIOL (ETH-in-il ess-tra-DYE-ole)

Common uses
This medicine is an estrogen and progestin combination used to prevent pregnancy. It may also be used to regulate the menstrual cycle, treat symptoms of menopause, or treat other conditions as determined by your doctor.

Before using
WARNING: Smoking cigarettes while using this medicine increases your chance of having heart problems. Do not smoke while using this medicine. The risk of heart problems increases with age (in women greater than 35 years of age) and with frequent smoking (15 cigarettes per day or greater). Some medicines or medical conditions may interact with this medicine. INFORM YOUR DOCTOR OR PHARMACIST of all prescription and over-the-counter medicine that you are taking. DO NOT TAKE THIS MEDICINE if you are also taking nevirapine or rifampin. ADDITIONAL MONITORING OF YOUR DOSE OR CONDITION may be needed if you are taking barbiturates, carvedilol, corticosteroids, felbamate, griseofulvin, HIV protease inhibitors, modafinil, metoprolol, pioglitazone, penicillin or tetracycline antibiotics, theophylline, topiramate, troglitazone, troleandomycin, or medicine for seizures. Inform your doctor of any other medical conditions, allergies, pregnancy, or breast-feeding. USE OF THIS MEDICINE IS NOT RECOMMENDED if you have a history of cancer, heart or liver conditions, pulmonary embolism, blood clots, stroke, cerebrovascular disease, or smoking. Contact your doctor or pharmacist if you have any questions or concerns about taking this medicine.

Directions
Follow the directions for using this medicine provided by your doctor. THIS MEDICINE COMES with a patient information leaflet. Read it carefully. Ask your doctor, nurse, or pharmacist any questions that you may have before using this medicine. TRY TO TAKE THIS MEDICINE at the same time every day, not more than 24 hours apart. STORE THIS MEDICINE at room temperature, away from heat and light. IF YOU MISS A DOSE OF THIS MEDICINE, take it as soon as you remember. Take your next dose at the regular time. This means you may take 2 doses on the same day. IF YOU MISS MORE THAN 1 DOSE OF THIS MEDICINE, refer to the patient information that came with this medicine. If you have any questions, contact your doctor, nurse, or pharmacist.

Cautions
SMOKING CIGARETTES while using this medicine may increase your risk of stroke, heart attack, blood clots, high blood pressure, or other diseases of the heart and blood vessels. IF YOU HAVE VOMITING OR DIARRHEA for any reason, your medicine may not work as well. TAKING CERTAIN ANTIBIOTICS or anticonvulsants while you are using this medicine may decrease the effectiveness of this medicine. To prevent pregnancy, use an additional form of birth control until your next period. If you have any questions, contact your doctor, nurse, or pharmacist. BEFORE YOU HAVE ANY MEDICAL OR DENTAL TREATMENTS, EMERGENCY CARE, OR SURGERY, tell the doctor or dentist that you are using this medicine. IF YOU WEAR CONTACT LENSES and you develop problems with them, contact your doctor. BEFORE YOU BEGIN TAKING ANY NEW MEDICINE, either prescription or over-the-counter, check with your doctor or pharmacist. THIS MEDICINE MAY CAUSE dark skin patches on your face. Exposure to the sun may make these patches darker. If patches develop, use a sunscreen or protective clothing when exposed to the sun, sunlamps, or tanning booths. USE OF THIS MEDICINE WILL NOT PREVENT the spread of sexually transmitted diseases (STDs). Do Not Use THIS MEDICINE if you are pregnant. IF YOU SUSPECT THAT YOU COULD BE PREGNANT, contact your doctor immediately. THIS MEDICINE IS EXCRETED IN BREAST MILK. IF YOU ARE OR WILL BE BREAST-FEEDING while you are using this medicine, check with your doctor or pharmacist to discuss the risks to your baby.

Possible side effects
SIDE EFFECTS, that may go away during treatment, include nausea, vomiting, bleeding between menstrual periods, breast tenderness, or weight change. If they continue or are bothersome, check with your doctor. CHECK WITH YOUR DOCTOR AS SOON AS POSSIBLE if you experience persistent or recurrent abnormal vaginal bleeding, a missed menstrual period, dizziness or fainting, swelling of fingers or ankles, headache, or difficulty wearing contact lenses. CONTACT YOUR DOCTOR IMMEDIATELY if you experience calf/leg pain or swelling, trouble breathing or shortness of breath, chest pain, one-sided weakness, slurred speech, lumps in the breast, sudden severe headache, sharp or crushing chest pain, sudden shortness of breath, yellowing skin or eyes, changes in vision, numbness of an arm or leg, or severe stomach pain. If you notice other effects not listed above, contact your doctor, nurse, or pharmacist.

Drug interactions
Drug interactions can result in unwanted side effects or prevent a medicine from doing its job. Use our drug interaction checker to find out if your medicines interact with each other. Check drug interactions

If you take too much
If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include nausea and vomiting. Females may experience vaginal bleeding.

Additional information
Do Not Share THIS MEDICINE with others for whom it was not prescribed. Do Not Use THIS MEDICINE for other health conditions. KEEP THIS MEDICINE out of the reach of children. If using THIS MEDICINE for an extended period of time, obtain refills before your supply runs out.

OrthoTriCyclen

Possible uses of Ortho TriCyclen
Ortho TriCyclen is an estrogen and progestin combination used to prevent pregnancy. Ortho TriCyclen may also be used to regulate the menstrual cycle, treat symptoms of menopause, or treat other conditions as determined by your doctor.

How to take Ortho TriCyclen
Follow the directions for using Ortho TriCyclen provided by your doctor. Ortho TriCyclen comes with a patient information leaflet. Read it carefully. Ask your doctor, nurse, or pharmacist any questions that you may have before using Ortho TriCyclen. Try to take Ortho TriCyclen at the same time every day, not more than 24 hours apart. Store Ortho TriCyclen at room temperature, away from heat and light. If you miss a dose of this medicine, take it as soon as you remember. Take your next dose at the regular time. This means you may take 2 doses on the same day. If you miss more than 1 dose of Ortho TriCyclen, refer to the patient information that came with this medicine. If you have any questions about Ortho TriCyclen, contact your doctor, nurse, or pharmacist.

Side Effects of Ortho TriCyclen
Side effects, that may go away during treatment with Ortho TriCyclen, include nausea, vomiting, bleeding between menstrual periods, breast tenderness, or weight change. If they continue or are bothersome, as you continue with Ortho TriCyclen check with your doctor. Check with your doctor as soon as possible if you experience persistent or recurrent abnormal vaginal bleeding, a missed menstrual period, dizziness or fainting, swelling of fingers or ankles, headache, or difficulty wearing contact lenses. Contact your doctor immediately if you experience sharp or crushing chest pain, sudden shortness of breath, sudden severe headache or leg pain, yellow skin or eyes, changes in vision, numbness of an arm or leg, or severe stomach pain while taking Ortho TriCyclen. If you notice other effects not listed above, contact your doctor, nurse, or pharmacist.

Precautions With Ortho TriCyclen
Smoking cigarettes while using Ortho TriCyclen may increase your risk of stroke, heart attack, blood clots, high blood pressure, or other diseases of the heart and blood vessels. If you have vomiting or diarrhea for any reason, Ortho TriCyclen may not work as well. Taking certain antibiotics or anticonvulsants while you are using Ortho TriCyclen may decrease the effectiveness of this medicine. To prevent pregnancy, use an additional form of birth control until your next period. If you have any questions, contact your doctor, nurse, or pharmacist. Before you have any medical or dental treatments, emergency care, or surgery, tell the doctor or dentist that you are using Ortho TriCyclen. If you wear contact lenses and you develop problems with them, contact your doctor. Before you begin taking any new medicine, either prescription or over-the-counter, check with your doctor or pharmacist. Ortho TriCyclen may cause dark skin patches on your face. Exposure to the sun may make these patches darker. If patches develop, use a sunscreen or protective clothing when exposed to the sun, sunlamps, or tanning booths. Use of Ortho TriCyclen will not prevent the spread of sexually transmitted diseases (STDs). Do Not Use Ortho TriCyclen if you are pregnant. If you suspect that you could be pregnant, contact your doctor immediately. Ortho TriCyclen is excreted in breast milk. If you are or will be breast-feeding while you are using Ortho TriCyclen, check with your doctor or pharmacist to discuss the risks to your baby.

Drug Interactions With Ortho TriCyclen
Tell your doctor of all nonprescription and prescription medication you may use, especially any nitrate medications (e.g., nitroglycerin, isosorbide dinitrate), nitroprusside (any "nitric oxide donor" medicines), cimetidine, erythromycin, azole antifungals (e.g., itraconazole, ketoconazole), mibefradil, rifamycins (e.g., rifampin) or high blood pressure medicines.

Missed Doses Of Ortho TriCyclen
If you miss a dose of Ortho TriCyclen, do not double the next dose. Instead, skip the missed dose and resume your usual Ortho TriCyclen dosing schedule.

Storage
Store Ortho TriCyclen at room temperature away from light and moisture. Keep Ortho TriCyclen and all medications out of the reach of children.

Notes
Do Not Share Ortho TriCyclen with others for whom it was not prescribed. Do Not Use Ortho TriCyclen for other health conditions. Keep Ortho TriCyclen out of the reach of children. If using Ortho TriCyclen for an extended period of time, obtain refills before your supply runs out.

ADDITIONAL INFORMATION REGARDING ORTHO TRICYCLEN
How long until I am protected against pregnancy?

If you use a Sunday Ortho TriCyclen Start and you are taking the Pill for the first time, you must use a back-up method of birth control (such as condoms or spermicide) for the first seven days. If you use a Day 1 Ortho TriCyclen Start, you are protected from becoming pregnant as soon as you take your first pill.

Am I protected from getting pregnant during "inactive" pills?
Yes. As long as you have taken Ortho TriCyclen correctly (at the same time, every day), you are still protected from unplanned pregnancies even when you are taking the placebo pillsor the green "inactive" pillsin the fourth week of your Ortho TriCyclen pack.

How do I switch from another birth control pill?
Switching to Ortho TriCyclen from another birth control pill is easyand you can do so while maintaining a continuous level of protection from pregnancy. Simply start your new pack of Ortho TriCyclen pills the next day after you take your last "inactive" pill of your previous brand of birth control pills. If you follow these instructions carefully, you should not have to use a back-up method of birth control.

How does Ortho TriCyclen work?
Ortho TriCyclen inhibits ovulationthe most fertile stage in a woman's cycle. Once a month, usually in mid-cycle, a mature egg is released from a woman's ovary into the fallopian tube. Once in the tube, the egg is ready to be fertilized by a man's sperm. While ovulation is occurring, the lining of the uterus begins to thicken in preparation to receive and nourish a fertilized egg.

If ovulation does not occur, your egg is not released, it can't be fertilized by sperm, and you can't get pregnant. By delivering an adequate amount of progestin and estrogen throughout your body, Ortho TriCyclen stops ovulation from occurring. Ortho TriCyclen also thickens the cervical mucus, making it difficult for sperm to enter the uterus, and changes the lining of the uterus to reduce the likelihood of implantation.

Is Ortho TriCyclen effective?
Birth control pills are one of the most effective methods for preventing pregnancy. When used correctly, Ortho TriCyclen is more than 99 percent effective. A clinical study of more than 6,000 women in the United States and Canada showed that Ortho TriCyclen is safe and highly effective. Ortho TriCyclen delivers just the right amount of hormones throughout your cycle to keep you from getting pregnant, with few side effects.

Should I take Ortho TriCyclen at a particular time of day?
The correct way to take Ortho TriCyclen is to take one pill each day, at the same time. Select a time that's easy for you to remember. If there is something you do at the same time each dayfor instance, brushing your teethtake your Ortho TriCyclen then. Missed Ortho TriCyclen pills may not only increase the risk of pregnancy but may also increase your chance of experiencing some side effects, such as bleeding between periods.

What should I do if I miss Ortho TriCyclen pills?
Sometimes schedules get hectic and women forget to take their Ortho TriCyclen pills. While it's very important that you take your Ortho TriCyclen at the same time every day for Ortho TriCyclen to be effective, don't panic if you forget to take one on time.

Can I get pregnant if I miss one Ortho TriCyclen pill?
Probably nothowever, the more Ortho TriCyclen pills you miss, the more likely you are to get pregnant. It's important to take your pill as scheduled.

If I miss a period, does it mean that I am pregnant?
A missed period does not necessarily mean you are pregnant. Although it is unlikely, you may miss a period when you first start taking Ortho TriCyclen . As long as you've taken your Ortho TriCyclen pills exactly as instructed, a missed period is probably not a problem. Continue as usual with the next cycle of pills, but inform your doctor or healthcare professional. If you miss two consecutive periods, you may be pregnant. Stop taking your Ortho TriCyclen pills and check with your doctor or healthcare professional immediately. Until you know whether you are pregnant it is very important to use another form of birth control consistently.

What if I think I'm pregnant?
If you think you may be pregnant, stop taking your pills and check with your doctor or other healthcare professional immediately. Until you know that you are pregnant, it is very important to use another form of birth control, such as condoms.

What if I want to become pregnant?
If you want to become pregnant, talk to your healthcare professional about steps you should take to ensure a healthy pregnancy. After you have stopped taking Ortho TriCyclen , you may want to postpone conception until you start having regular periods again. Many healthcare professionals tell women to wait a few months to conceive, because a pregnancy can be dated more accurately if the woman has re-established her natural menstrual cycle after finishing Ortho TriCyclen .

What should I do if I take the Ortho TriCyclen pills out of sequence?
It depends on the day and week that you took the "active" or "inactive" pill out of sequence. Your doctor or healthcare professional is the best person to decide what your next steps should be.

Do I need to use a back-up form of birth control while on an antibiotic and for how long?
Some drugs, including certain antibiotics, can interact with Ortho TriCyclen pills and may make them less effective in preventing pregnancy, or cause an increase in breakthrough bleeding. Your doctor or other healthcare professional can best answer whether your antibiotic will interact with the effectiveness of Ortho TriCyclen .

Is it normal to spot or bleed between periods?
Some women experience spotting or bleeding between periods in their first two or three months of Ortho TriCyclen use as their bodies adjust to the hormones. The good news is
Ortho TriCyclen has demonstrated significantly low rates of breakthrough bleeding and spotting. In a clinical study, fewer than one in five Ortho TriCyclen users reported these potentially embarrassing side effects in their first month on the Pill.

About one-third to one-half of Ortho TriCyclen -users who bleed between periods during their first month on a birth control pill won't do so in their second. But if you're in your third cycle and still spotting or bleeding irregularly, you may want to consult your doctor.

In addition to preventing pregnancy, are there other benefits to taking Ortho TriCyclen ?
Yes. Taking Ortho TriCyclen may make your periods become more regular and your flow lighter. A lighter blood flow may mean that you'll lose less iron. Cramps and other menstrual symptoms are usually less severe when you're on Ortho TriCyclen . Women who use Ortho TriCyclen are also less likely to develop ovarian cysts or experience an ectopic (tubal) pregnancy. Your chances of developing acute pelvic inflammatory disease (a serious infection of the uterus, fallopian tubes, and/or ovaries) are also minimized when you're on Ortho TriCyclen .

How long can I stay on Ortho TriCyclen ?
Birth control pills are the most popular form of reversible contraception in the United States . In fact, 80 percent of women have used the Pill at some time during their lives. Products such as Ortho TriCyclen can be prescribed by a doctor to healthy nonsmoking women after age 40, provided that there are no risk factors that may make taking Ortho TriCyclen inappropriate. But how long you would like to stay on Ortho TriCyclen is something you should discuss with your doctor or healthcare professional.

Is it necessary to take a break from using Ortho TriCyclen ?
There is no medical reason to take a break from using Ortho TriCyclen . But how long you would like to stay on Ortho TriCyclen is something you should discuss with your doctor or healthcare professional.

What should I do if I take other medications?
Certain drugs may interact with Ortho TriCyclen and may make them less effective in preventing pregnancy or cause an increase in breakthrough bleeding. Such drugs include rifampin, drugs used for epilepsy such as barbiturates (for example, phenobarbital), anticonvulsants such as topiramate (Topamax), carbamazepine (Tegretol is one brand of this drug), phenytoin (Dilantin: is one brand of this drug), phenylbutazone (Butazolidin is one brand), certain drugs used in the treatment of HIV or AIDS, and possibly certain antibiotics. A possible interaction has been suggested with hormonal contraceptives and the herbal supplement St. John's Wort based on some reports of oral contraceptive users experiencing breakthrough bleeding shortly after starting St. John's Wort. Pregnancies have been reported by users of combined hormonal contraceptives who also used some form of St. John's wort. You may need to use additional contraception when you take drugs that can make oral contraceptives less effective. If you are taking any other medications or herbal medicines, be sure to tell your doctor or pharmacist.

Should my partner use a condom even though I'm taking Ortho TriCyclen ?
Ortho TriCyclen is one of the best non-surgical, reversible methods to prevent pregnancy, but if you are sexually active and have more than one partner, it is essential that your partners always use a condom. Ortho TriCyclen is intended to prevent pregnancy. It does not protect against transmission of HIV (AIDS) or other sexually transmitted diseases (STDs) such as chlamydia, genital herpes, genital warts, gonorrhea, hepatitis B, and syphilis. If you think you are at risk for contracting STDs, using a condom may give you some protection against these diseases.

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