Select 21 day (Ethinyl estradiol/ norethindrone)

Indications

Select 21-day is an oral contraceptive medication used to prevent pregnancy. In addition to its contraceptive effects, birth control pills may also have other benefits such as regulating menstruation, reducing pain and blood loss during periods, lowering the risk of ovarian cysts, and treating acne.

Select 21-day consists of two hormones, namely an Ethinyl estradiol and Norethindrone. They work by preventing ovulation, thickening the cervical mucus to prevent sperm from reaching the egg, and thinning the lining of the uterus to make implantation of a fertilized egg less likely.

Use and Dosage

Select 21-day pills are designed to be taken for 21 days, followed by a 7-day break period. During this break period, you may experience withdrawal bleeding, which is similar to a menstrual period. Taking the pills after your evening meal or at bedtime may help if you have stomach upset or nausea with the medication. You may choose to take it at another time of day that is easier for you to remember.

To use Select 21-day contraceptive pills, take one pill every day at the same time, for 21 consecutive days. Try to take the pill at the same time every day to maintain consistency. After you have taken all the pills in the pack, take a 7-day break, during which you will not take any pills. You should start your next pack of pills on the eighth day, even if you are still experiencing withdrawal bleeding.

If you miss one pill, take it as soon as you remember, and take the next pill at the usual time. This means that you might take 2 pills in one day. If you miss 2 pills in a row during the first 2 weeks of your cycle, take 2 pills the day you remember and 2 pills the next day, then take one pill a day until you finish the pack. Use a second method of birth control if you have sex in the 7 days after you miss the pills.

If you miss 2 pills in a row during the third week of your cycle or 3 or more pills at any time during your cycle and you start your pills on Day 1, safely dispose of the rest of the pill pack and start a new pack that same day. Use another method of birth control if you have sex in the 7 days after you miss the pills. You may not have a period this month. If you miss 2 periods in a row, call your doctor or clinic.

Side Effects

Common Side Effects of Select 21-day (Ethinyl estradiol/Norethindrone):

• Nausea and vomiting
• Headache
• Breast tenderness or enlargement
• Mood changes
• Changes in menstrual bleeding patterns, such as breakthrough bleeding or spotting between periods
• Decreased libido
• Weight gain or fluid retention

Serious Side Effects of Select 21-day (Ethinyl estradiol/Norethindrone):

• Blood clots in the legs, lungs, heart, or brain
• Heart attack or stroke
• High blood pressure
• Liver disease
• Gallbladder disease
• Breast, cervical, or liver cancer
• Depression
• Jaundice (yellowing of the skin or eyes)
• Severe allergic reactions

Forms and Strength

Select 21-day (Ethinyl estradiol/Norethindrone) is available in the following forms and strength:

Select 21-day: Tablet

• 1/35mcg

Cautions

• Select 21-day may increase the risk of developing blood clots, especially in smokers over age 35 or individuals with a history of clots or certain medical conditions.
• Select 21-day may cause severe mood problems in some individuals, particularly with older versions of oral contraceptives that contain ethinylestradiol.
• Missing doses or taking the medication at different times of the day than usual may increase the risk of pregnancy.
• Select 21-day may interact with certain medications, including antibiotics, antifungals, and epilepsy drugs.
• Select 21-day may not be appropriate for individuals with certain medical conditions, including a history of heart attack, stroke, or breast cancer.
• These pills may cause high blood pressure or worsen existing high blood pressure, and therefore should be used with caution in individuals with a history of high blood pressure.
• These pills may increase the risk of gallbladder disease.
• It may cause abnormal vaginal bleeding or spotting, particularly during the first few months of use.
• These pills may interact with herbal supplements, such as St. John's Wort, which may reduce the effectiveness of the medication.
• Individuals with liver disease should be monitored closely while taking Select 21 day, as it may worsen liver function.
• These pills may increase the risk of certain types of cancer, such as breast and cervical cancer.
• These pills may cause serious allergic reactions in some individuals, including hives, difficulty breathing, and swelling of the face, lips, tongue, or throat.

Frequently Asked Questions (FAQ)

Who should not use select 21-day contraceptive pills?

Select 21-day contraceptive pills may not be appropriate for people who have a history of blood clots, certain cancers, or liver disease. They may also be contraindicated for people who smoke or are over 35.

What are 21-day contraceptive pills?

21-day contraceptive pills are a type of birth control pill that is taken daily for 21 days, followed by a seven-day break. During the seven-day break, you will typically experience a withdrawal bleed that is similar to a period.

How do I start taking 21-day contraceptive pills?

You should start taking 21-day contraceptive pills on the first day of your menstrual period for maximum effectiveness. Alternatively, you can start taking them on the Sunday following the start of your period. If you start in this way, you will need to use backup contraception for the first seven days.

Resources

• https://www.drugs.com/sfx/ethinyl-estradiol-norethindrone-side-effects.html
• https://www.pfizer.ca/files/Select_1-35_PI_228390_E_11July2019.pdf
• https://www.webmd.com/drugs/2/drug-16239-115/norethindrone-acetate-ethinyl-estradiol-oral/progestin-estrogen-contraceptive-oral/details
• https://medlineplus.gov/druginfo/meds/a601050.html
• https://www.medbroadcast.com/drug/getdrug/select