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Ethinyl estradiol and levonorgestrel


This combination oral contraceptive contains compounds similar to the female hormones estrogen and progestin.

It works primarily by preventing the release of eggs from the ovary. Each packet contains 28 pills with four different levels of hormones.

Oral contraceptives also offer some additional benefits beyond the prevention of pregnancy. They can make the menstrual cycle more regular and decrease the likelihood of painful menstruation and of ovarian cysts.

In addition, they reduce the risk of cancer of the uterus or the ovaries over the long term.

Side Effects and Interactions

Unexpected vaginal bleeding may occur during the first month or two on Triphasil. Notify your physician if you continue to experience bleeding between periods after the second month on this medication.

Serious side effects are rare, but they may include high blood pressure, heart attacks, stroke, blood clots, visual changes, problems with liver or gallbladder, and birth defects.

Do not continue taking Triphasil-28 if you become pregnant.

Less dangerous reactions include nausea, vomiting, fluid retention, headache, darkening of the skin across the face, changes in menstrual flow, depression, nervousness, breast tenderness, rash, inability to wear contact lenses and susceptibility to vaginal infections. Report any symptoms or suspected side effects promptly.

Some women become more susceptible to sunburn while taking Triphasil-28. Use a good sunscreen and sunglasses to protect yourself.

Triphasil interacts with many other medications.  Antibiotics such as penicillin, tetracycline, rifampin and related drugs may reduce contraceptive protection.

This is also a potential hazard with barbiturates like phenobarbital or Mysoline, the antifungal medicine griseofulvin, and seizure medications such as Dilantin.

Antianxiety drugs such as Halcion, Valium or Xanax, asthma drugs containing theophylline or aminophylline, the beta blocker Lopressor, oral corticosteroids like hydrocortisone or prednisone, and caffeine, an ingredient common in many beverages and over-the-counter drugs, may all have more serious adverse effects if they are taken together with birth control pills. So may antidepressants or the OCD medicine Anafranil.

Until the estrogenic activity of hops is further studied, taking this herb in combination with medicines such as oral contraceptives or hormone replacement therapy is an experiment best avoided.

St. John’s wort can speed elimination of birth control pills from the body, which could reduce their effectiveness.

In general, the herb chaste tree berry should not be combined with exogenous hormones such as oral contraceptives or menopausal hormone replacement therapies.

Saw palmetto berries, which have both estrogenic and antiestrogenic activity, are not recommended for women using female hormones for contraception.

Check with your doctor and pharmacist before taking any other medicine or herbs in combination with Triphasil-28.

Special Precautions

Triphasil-28, like other oral contraceptives, is quite effective. Some women are at greater risk of negative consequences, however.

Tell your doctor if you smoke cigarettes, have had phlebitis or other clotting problems, or if you or someone in your family has had uterine or breast cancer.

You will also be asked about asthma, diabetes, epilepsy, migraine, depression and certain other conditions that could be aggravated by oral contraceptives.

Tests for thyroid function and blood sugar may be altered by oral contraceptives.

Taking the Medicine

Each Triphasil-28 tablet should be swallowed at the same time every day to maintain consistent levels in the body. The manufacturer recommends it be taken after supper or at bedtime.

They should be taken in the order indicated on the package: first brown, then white, then yellow, and finally green.

The light green ones to be taken during the last week of the cycle contain no active ingredients, allowing for normal menstruation.

If you forget one dose, take it as soon as you remember it, and take the next one at the usual time.

If you miss two doses, take both as soon as you remember and take the next at the usual time.

If you have missed two or more pills, use additional contraceptive protection such as spermicidal foam or condoms for a week after getting back on schedule.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.”.
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