• Ethinylestradiol/Norethisterone

TriNovum is a form of combined birth control manufactured by Janssen, which works by overriding the process of ovulation in the body.

TriNovum is no longer available. Talk to your doctor to find out which is the most suitable alternative.

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35mcg/500mcg; 35mcg/750mcg; 35mcg/1mg

One pack contains three different types of pill. They all have the same active ingredients, but in varying doses. The white coloured pills, of which there are seven, contain 500 micrograms norethisterone and 35 micrograms of ethinylestradiol; each of the seven pale peach-coloured pills contains 750 micrograms norethisterone and 35 micrograms ethinylestradiol; and the seven peach-coloured pills each contain 1mg norethisterone and 35 micrograms ethinylestradiol.

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TriNovum has been discontinued by its manufacturers. If you are currently taking this pill and want to know which option is the most suitable replacement, we recommend that you see your doctor or family planning nurse in person.

TriNovum is a pill made by Janssen, which prevents pregnancy. It consists of two active ingredients, which are artificial hormones called norethisterone and ethinylestradiol. These agents simulate the function of progesterone and oestrogen, which govern when the female body is ready to become pregnant.

Each month, the female reproductive system undergoes a series of phases in order to prepare itself for pregnancy. Ovulation is one, and this involves the release of an egg from the ovary, ready for fertilisation by male sperm. When fertilisation has occurred, this egg travels to the uterus, where it attaches to the uterine wall (or endometrium) and starts to develop into an embryo.

This process, as well as the building up of the lining of the uterine wall, which makes egg implantation possible, is managed by hormones. When these hormones rise and fall, these sequences are triggered. The ingredients in TriNovum subvert these actions, by tricking the body into thinking that hormone levels are still high. This then stops an egg from being produced by the ovary, and alters the consistency of the uterine wall lining; thus making pregnancy less likely.

The hormones perform another function as well, which is to increase the density of vaginal fluid, thereby making it more difficult for sperm to travel through the cervix and reach an egg.

Care should be taken to follow the directional arrows provided on the packaging when using this medication, as it is a triphasic pill. This means that the tablets contain varying doses of the active ingredients, and need to be taken in a certain order to be effective.

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How to use TriNovum

Before using this pill, make sure you read the instructions provided in the patient information leaflet fully, and follow the directions of your prescriber. This will help to make the contraceptive as efficient as possible while also reducing the risk of side effects.

  1. Administer as prescribed.
  2. This will usually be one pill per day for the first 21 days of your menstrual cycle, starting on the first day of your period.
  3. Start by taking a white pill corresponding with the correct day of the week, then take one pill a day according to the directional arrows on the strip.
  4. Once you have finished these, move onto the light peach coloured pills, again following the days and arrows as marked.
  5. Then move onto the peach coloured pills, until you have taken all the pills in your strip.
  6. Follow this with seven pill-free days.
  7. Start the next strip by taking the white pill again the following week and repeat the above process.
  8. Take the pill at the same time each day.
  9. Follow the direction arrows provided on the strip. As TriNovum is a triphasic pill, you will need to make sure you take the pills in the right sequence for the treatment to be effective.
  10. In the event that you miss a dose, consult the leaflet supplied for guidance on what to do next. If you need further assistance, speak to your doctor or family planning nurse.

These directions are intended only as a guide. For more detailed instructions, refer to the patient information leaflet.

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TriNovum side effects

Contact your doctor immediately if you experience any serious side effects. These include signs of a blood clot, such as: painful swelling in the legs; sudden chest pain and difficult breathing; sudden loss of or blurred vision; signs of a heart attack or stroke, including: a migraine for the first time, or one which is worse than normal; sudden weakness or numbness in one side or part of your body; slurred speech; sudden crushing pains in your chest which may spread to your left arm; signs of breast cancer, which may be: dimpling of the skin; changes in the nipple; or any lumps you can see or feel; or signs of severe liver problems, such as: severe pain in your upper abdomen; or jaundice; or an increase in blood pressure; or signs of an allergic reaction, which may appear in the form of: hives; swelling of the face, lips, mouth, tongue or throat; difficulty in swallowing or breathing.

Very common (1 in 10 women or more):
Headache, nausea and vomiting, painful or unusual periods, breakthrough bleeding or spotting between periods or premenstrual syndrome.

Common (1 in 10 women or less):
Dizziness, stomach ache, bloating, depression, acne, diarrhoea, tender or painful breasts, increased vaginal secretions or discharge, itchiness, heavy or missing periods, withdrawal bleed when product is stopped, muscle spasms, or back or pelvic pain.

Uncommon (1 in 100 women or less):
Skin rash, migraine, mood swings, changes in skin colour, hair loss, reduced appetite, weight gain, swollen hands, ankles or feet, reduced sex drive, thrush, drowsiness, or weakness.

Rare (1 in 1,000 women or less):
Increased appetite, difficulty losing weight, gallstones, excess hair growth, inability to tolerate contact lenses.

This is not a complete list of the side effects this product may cause. A more detailed account can be located in the patient information leaflet.

Taking it with other medicines

Inform your prescriber of any other treatments you are currently using as these may make this product less effective, or vice versa. TriNovum may interact with the following: treatments for epilepsy, such as topiramate, carbamazepine, phenytoin, oxcarbazepine, felbamate, eslicarbazepine acetate, or rufinamide; bosentan; rifampicin and rifabutin; anti-HIV medicines; boceprevir and telaprevir; aprepitant and fosaprepitant; griseofulvin; modafinil; barbiturates; St. John’s Wort; colesevelam; etoricoxib; ciclosporin; lamotrigine; prednisolone; selegiline; theophylline; or tizanidine.

Conditions to look out for

This product is not suitable for some users. If you have or have ever had any of the following conditions, you should not use it: breast or liver cancer; irregular heartbeat; problems with blood circulation; blood clot, heart attack or stroke, or any condition which puts you at increased risk of these; very high blood pressure; migraines with visual disturbance; diabetes for more than 20 years or have diabetes with secondary problems; severe liver disease; or Systemic Lupus Erythematosus.

Q&A: our TriNovum discussion forum

Can I still drink alcohol?

Yes. It is not thought that alcohol will affect the function of this product.

Will I still be able to drive?

Yes. Your capacity to drive should not be reduced by this pill, but if you experience any side effects which may make driving dangerous or unsafe, do not drive and contact your doctor as soon as possible.

Can I take the medicine while pregnant?

No. Those who are pregnant, or think they might be should not use this treatment.

Generally, this treatment is not recommended for use during breastfeeding. Tell our prescriber when filling in our medical assessment if you are, as they may elect to suggest a different type of pill.

How should I store it?

Do not store above 30°C.

Am I allergic to anything in the medicine?

Trinovum contains: norethisterone, ethinylestradiol, anhydrous lactose, magnesium stearate, pregelatinised starch, a dye called FD&C yellow No 6 (E110). If you are allergic to any of these ingredients, do not use it.

Is it available over-the-counter?

Because it was a prescription only medicine, you could only buy TriNovum in the UK with a prescription from a registered practitioner. However, it has now been discontinued.

Is it right for me?

TriNovum is not being manufactured or sold any more. Speak to your doctor to find out which pill is the most appropriate replacement.

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