Hesperian Health Guides
Oral Contraceptives (The "Pill", Birth control pills)
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Interactions of oral contraceptives with other medicines: Some medicines make combined birth control pills (ones that contain both estrogen and progestin) work poorly or not at all. Do not use combined birth control pills if you regularly take:
- carbamazepine (Tegretol)
- phenobarbital (phenobarbitone, Luminal)
- phenytoin (diphenylhydantoin, Dilantin)
- valproic acid (Depakene)
See other information about which oral contraceptives (and other hormonal methods of family planning) should be avoided by women with certain disabilities. Birth control pills come in different strengths of each hormone and are sold under many different brand names. We list only a few brands in the chart below.
Usually, brands that contain a smaller amount of both hormones are the safest and
work best for most women. These ‘low-dose’ pills are found in Groups 1, 2, and 3.
|Group 1 - Triphasic pills|
|These contain low amounts of both estrogen and progestin in a mix that changes throughout the month. Since the amounts change, it is important to take the pills in order.|
|Group 2 - Low dose pills|
|These contain low amounts of estrogen (35 micrograms of the estrogen ‘ethinyl estradiol’ or 50 micrograms of the estrogen ‘mestranol’) and progestin in a mix that stays the same throughout the month.|
|Brevicon 1 + 35||Norinyl 1 + 35, 1 + 50||Ovysmen 1/35||Norimin|
|Noriday 1 + 50||Ortho-Novum 1/35, 1/50||Neocon||Perle|
|Group 3 - Low dose pills|
|These pills are high in progestin and low in estrogen (30 or 35 micrograms of the estrogen ‘ethinyl estradiol’).|
To assure effectiveness and minimize spotting (small amounts of bleeding at other times than your normal monthly bleeding), take the pill at the same time each day, especially with pills that have low amounts of hormones. If spotting continues after 3 or 4 months, try one of the brands in Group 3. If there is still spotting after 3 months, try a brand from Group 4.
But if a woman misses her monthly bleeding for months or is disturbed by the very
light monthly bleeding, she can change to a brand with more estrogen from Group 4.
For a woman who has very heavy monthly bleeding or whose breasts become painful before her monthly bleeding begins, a brand low in estrogen but high in progestin may be better. These pills are found in Group 3.
Women who continue to have spotting or miss their monthly bleeding when using a brand from Group 3, or who became pregnant before while using another type of pill, can change to a pill that has a little more estrogen. These ‘high dose’ pills are found in Group 4.
|Group 4 - High dose pills|
|These pills are higher in estrogen (50 micrograms of the estrogen ‘ethinyl estradiol’) and most are also higher in progestin.|
Women who are breastfeeding, or who should not use regular pills because of headaches or mild high blood pressure, may want to use a pill with only progestin. These pills in Group 5 are also called ‘mini-pills.’
|Group 5 - Progestin-only pills|
|These pills, also known as ‘mini-pills,’ contain only progestin.|
|Femulen||Microlut||Neogeston||these brands can
also be used for
Emergency Family Planning
Progestin-only pills should be taken at the same time every day, even during the monthly bleeding. Menstrual bleeding is often irregular.