Ortho Tri-Cyclen Lo for Birth Control

In This Article

Ortho Tri-Cyclen Lo is a brand of combination birth control pills. This is a triphasic birth control pill—this means that Ortho Tri-Cyclen Lo has three different doses of hormones during the three weeks of active pills in each pack.

Triphasic pills are different from traditional monophasic pills, which are made up of the same dose of both estrogen and progestin.

What's In a Pack of Ortho Tri-Cyclen Lo?
Verywell / Cindy Chung

Dosage and Schedule

Each monthly pack of Ortho Tri-Cyclen Lo contains 28 pills. The active pills are made up of ethinyl estradiol and a progestin called norgestimate.

The amount of norgestimate in Ortho Tri-Cyclen Lo slowly increases over the first three weeks of the pill pack, from 0.180 milligrams (mg) to 0.215 mg and 0.250 mg. The amount of estrogen stays the same, at 0.025 mg.

Triphasic birth control pills like this are meant to more closely mimic the hormonal changes of your natural menstrual cycle. Ortho Tri-Cyclen Lo comes with a DIALPAK Tablet Dispenser which is preset for a Sunday Start. However, you can also use it with a Day 1 Start.

Side Effects

As with any type of hormonal contraceptive, you may experience some side effects from Ortho Tri-Cyclen Lo, but they usually go away after the first 3 months. The most common reported side effects of the Ortho Tri-Cyclen Lo birth control pill are:

  • Nausea and/or vomiting
  • Spotting or irregular bleeding
  • Difficulty wearing contact lenses
  • Fluid retention 
  • Weight gain and/or change in appetite
  • Spotty darkening of the skin (usually the face)
  • Elevated blood pressure
  • Breast tenderness
  • Headache and/or dizziness
  • Depression and/or nervousness
  • Hair loss

According to the U.S. National Library of Medicine, research shows that the hormone combination in Ortho Tri-Cyclen Lo tends to be well-tolerated by most users. In a study of 1,723 women using this birth control pill, only 4% (69 women) stopped using it because of side effects. 

Another study, published in 2009, looked at the bleeding rates of healthy, sexually active Ortho Tri-Cyclen Lo users from across North America. The results showed that women using Ortho Tri-Cyclen Lo had less unscheduled bleeding/spotting for the first six cycles of use.

Noncontraceptive Benefits

In general, combination birth control pills have been found to help regulate cycles, decrease painful menstrual cramps, help with menorrhagia (heavy bleeding), and lower the risk of colon, ovarian, and endometrial cancer.

It is thought that Ortho Tri-Cyclen Lo can be especially helpful in decreasing disruptive spotting and breakthrough bleeding — which tends to be a typical birth control pill side effect during the first three months of use.

A nationwide study published in 2003 compared women who used Ortho Tri-Cyclen Lo for 13 cycles to women who used Loestrin Fe (a birth control pill with lower hormone levels). The participants using Ortho Tri-Cyclen Lo reported:

  • Less breakthrough bleeding per cycle
  • Less spotting/breakthrough bleeding during the first 3 months
  • Lower rate of discontinuation due to irregular bleeding

Some combination birth control pills can also help treat acne. In 1997, Ortho Tri-Cyclen (NOT Ortho Tri-Cyclen Lo) received FDA approval to help treat moderate acne in biological females who are at least 15 years old.

Ortho Tri-Cyclen Lo isn't FDA approved to help fight acne, but research published in 2017 suggests that lower estrogen pills (like Ortho Tri-Cyclen Lo) are effective for acne treatment.

Effectiveness

Combination birth control pills are a highly effective and convenient form of contraception. Ortho Tri-Cyclen Lo birth control pills are between 91% and 99.7% effective.

This means that with typical use, nine out of every 100 users will become pregnant during their first year on Ortho Tri-Cyclen Lo. With perfect use, less than one will become pregnant.

The type and amount of hormones in combination birth control pills don't change how effective the pill is. All combination pills prevent pregnancy the same way.

Research confirms Ortho Tri-Cyclen Lo is still an extremely effective contraceptive method despite having lower hormone levels than some pills.

Costs

The price of Ortho Tri-Cyclen Lo ranges between $45 and $140 for one pack of pills. A generic alternative called Tri-Lo Sprintec is available, as well. Under the Affordable Care Act, you should be able to get the generic version of these birth control pills for free.

Ortho Tri-Cyclen Lo seems to be covered by over 80% of most health insurance plans. But, if you want to buy Ortho Tri-Cyclen Lo (and not its generic alternative), you are probably going to have a co-pay when buying this birth control pill brand.

What to Do When You Miss a Pill

Because the hormone levels are different in each week of an Ortho Tri-Cyclen Lo pill pack, the directions for forgetting a pill or two depend on which week it's in.

The following is a good rule of thumb to follow (but you should always check the pill prescribing information that comes with each monthly pack.)

One Missed Pill—Weeks 1, 2, or 3

If you missed ONE pill that was white, light blue, or dark blue:

  • Take the missed pill as soon as you remember
  • Take the next pill at your regular time
  • You may take two pills in one day
  • No backup contraception should be needed

Two Missed Pills—Weeks 1 or 2

If you missed TWO pills in a row that were white or light blue:

  • Take two pills on the day you remember
  • Take two pills the next day
  • Then resume one pill each day until you finish the pack
  • Use backup birth control for the following seven days or you could become pregnant

Two Missed Pills—Week 3

If you missed TWO pills in a row that are dark blue AND you're a Sunday starter:

  • Continue taking one pill every day until Sunday
  • On Sunday, throw out the remainder of the pack
  • Start a new pack of pills that same day
  • You may not have a withdrawal period that month
  • Use backup birth control for the following seven days or you could become pregnant

If you missed TWO pills in a row that are dark blue AND you're a Day 1 starter:

  • Throw out your current Ortho Tri-Cyclen Lo pill pack
  • Begin a new pack that same day
  • You may not have a withdrawal period that month
  • Use backup birth control for the following seven days or you could become pregnant

Three Missed Pills—Weeks 1, 2, and 3

If you missed THREE or more consecutive white, light blue, or dark blue pills AND are a Sunday starter:

  • Continue taking one pill every day until Sunday
  • On Sunday, throw out the rest of the pack
  • Start a new one
  • You may not have a withdrawal period that month
  • Use backup birth control for the following seven days or you could become pregnant

If you missed THREE or more consecutive white, light blue, or dark blue pills AND are a Day 1 starter:

  • Throw out the remainder of the pill pack
  • Start a new pack that same day
  • You may not have a withdrawal period that month
  • Use backup birth control for the following seven days or you could become pregnant

Any Missed Pills—Week 4

If you missed any of the seven dark green "reminder pills":

  • Throw away the pill(s) you missed
  • Continue taking the green pills every day until the pack is finished
  • You should not need a backup birth control method
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Article Sources
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  1. U.S. National Library of Medicine DailyMed. Ortho Tri Cyclen Lo. Updated April 25, 2019.

  2. Hampton RM, Fisher AC, Pagano S, Laguardia KD. Scheduled and unscheduled bleeding patterns with two combined hormonal contraceptives: application of new recommendations for standardization. Fertil Steril. 2009;92(2):434-40. doi:10.1016/j.fertnstert.2008.07.010

  3. Poindexter AN, Burkman R, Fisher AC, Laguardia KD. Cycle control, tolerability, and satisfaction among women switching from 30-35 microg ethinyl estradiol-containing oral contraceptives to the triphasic norgestimate/25 microg ethinyl estradiol-containing oral contraceptive Ortho Tri-Cyclen LO. Int J Fertil Womens Med. 2003;48(4):163-72.

  4. Trivedi MK, Shinkai K, Murase JE. A Review of hormone-based therapies to treat adult acne vulgaris in womenInt J Womens Dermatol. 2017;3(1):44–52. doi:10.1016/j.ijwd.2017.02.018

  5. Trivedi MK, Shinkai K, Murase JE. A Review of hormone-based therapies to treat adult acne vulgaris in womenInt J Womens Dermatol. 2017;3(1):44-52. Published 2017 Mar 30. doi:10.1016/j.ijwd.2017.02.018

  6. Hampton RM, Short M, Bieber E, et al. Comparison of a novel norgestimate/ethinyl estradiol oral contraceptive (Ortho Tri-Cyclen Lo) with the oral contraceptive Loestrin Fe 1/20Contraception. 2001;63(6):289-295. doi:10.1016/s0010-7824(01)00214-1