Sprintec (Ethinyl Estradiol/Norgestimate) - Oral

Generic Name: Ethinyl Estradiol and Norgestimate (ETH-i-nil es-tra-DYE-ol, nor-JES-ti-mate)
Common Brand Names: Estarylla, MonoNessa, Ortho-Cyclen, Ortho Tri-Cyclen, Ortho Tri-Cyclen Lo, Previfem, Sprintec, Tri-Lo-Sprintec, TriNessa, TriNessa 28, Tri-Previfem, Tri-Sprintec
By Carrie Yuan, PharmD
Carrie Yuan head shot
Carrie Yuan, PharmD

Carrie Yuan PharmD is a board-certified ambulatory care pharmacist. She is a clinical pharmacist in the Family Medicine Clinic at Harborview Medical Center in Seattle and a clinical associate professor at the University of Washington School of Pharmacy.

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Published on November 16, 2022
Medically reviewed by Lindsay Cook, PharmD
Lindsay Cook, PharmD
Medically reviewed by Lindsay Cook, PharmD

Lindsay Cook, PharmD is a board-certified consultant pharmacist.

Learn about our Medical Expert Board
Additional Content by IBM Micromedex®
Warning:

The Food and Drug Administration (FDA) has issued a boxed warning for Sprintec. Boxed warnings are the agency’s strongest warnings for serious and potentially life-threatening risks.

The boxed warning:

Sprintec is discouraged in females over 35 who smoke. Cigarette smoking increases the risk of serious cardiovascular (heart) failure from combination oral contraceptives (COC) use.
…

What Is Sprintec?

Sprintec (ethinyl estradiol/norgestimate) is an orally administered combinational birth control pill containing two primary hormones—estrogen (ethinyl estradiol) and progestin (norgestimate)—that is classified as a combination oral contraceptive (COC).

Sprintec is prescribed for females of childbearing age who wish to avoid pregnancy.

Estrogen and progestin are two female sex hormones. The combination of estrogen and progestin hormones works by stopping ovulation (the process where eggs are released from the ovaries) from occurring. This combination of hormones also works to change the lining of the uterus (womb).

Additionally, Sprintec changes the mucus at the cervix (opening of the uterus) to prevent sperm from entering, thus inhibiting fertilization.

While no generic version exists, Sprintec is available as a tablet to be taken orally (by mouth).

Drug Facts

Generic Name: Ethinyl estradiol/norgestimate
Brand Name: Sprintec, Tri Lo Sprintec, Tri-Sprintec
Drug Availability: Prescription
Administration Route: Oral
Therapeutic Classification: Triphasic contraceptive combination
Available Generically: No
Controlled Substance: N/A
Active Ingredient: Ethinyl estradiol/norgestimate
Dosage Form(s): Tablet

What Is Sprintec Used For?

The Food and Drug Administration (FDA) has approved Sprintec as a COC for females of reproductive potential. The effectiveness of Sprintec is expected to be the same for postpubertal people under 18 as it is for those over 18.

While used as a drug to avoid unwanted pregnancy, Sprintec is also commonly used to treat acne. Oral contraceptives, such as Sprintec, treat acne by decreasing the amounts of certain natural substances, such as sweat, that can cause acne to appear on the skin.

A combinational drug, Sprintec contains ethinyl estradiol, an estrogen hormone, and norgestimate, a progestin hormone.

For context, estrogen hormones are important for sexual and reproductive development. They are referred to as female sex hormones. What's more, "estrogen" refers to all of the chemically similar hormones in this group, which includes estrone, estradiol, and estriol.

In comparison, progestin is a type of medication that produces effects similar to the female sex hormone, progesterone, in the body. Progesterone is a naturally occurring hormone involved in pregnancy that is produced primarily in the ovaries and used as a part of hormone replacement therapy in people who have passed menopause.

Overall, COCs are an effective method of birth control, but they do not prevent the spread of human immunodeficiency virus (HIV; a virus that leads to acquired immunodeficiency syndrome [AIDS]) and other potentially life-threatening sexually transmitted diseases (STDs).

How to Take Sprintec

The following guidelines will help you safely consume Sprintec over the duration of your prescription:

  • Take one tablet daily by mouth at the same time every day.
  • Take the tablets in the order directed on the blister pack.
  • Do not skip or delay tablet consumption.

As a 28-tablet packet, take one tablet daily for 28 days in a row in the order specified in your packet. Start a new packet the day after you take your 28th tablet.

Follow the directions on your prescription label exactly, and ask your healthcare provider to explain any part you do not understand. Do not take more or less of it and do not take it more often nor take it for a longer time than prescribed.

Finally, do not chew, crush, or freeze the tablets.

Storage

Store Sprintec tablets at room temperature (between 67 to 78 degrees F) and protect the tablets from harsh light. Moreover, keep out of reach of children and pets.

Finally, do not store it in a bathroom or areas susceptible to high levels of moisture.

Off-Label Uses

Sprintec has uses beyond its original indication. Of note, Sprintec has been proven to be effective to treat the following:

How Long Does Sprintec Take to Work?

Oral contraceptives will work only as long as they are taken regularly. However, when traditional regimens of COCs are discontinued, ovulation usually returns within three menstrual cycles but can take up to six months in some people.

What Are the Side Effects of Sprintec?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

Common side effects include:

Severe Side Effects

The Food and Drug Administration (FDA) has issued a boxed warning for Sprintec. Boxed warnings are the agency’s strongest warnings for serious and potentially life-threatening risks.

The boxed warning: Sprintec is discouraged in females over 35 who smoke. Cigarette smoking increases the risk of serious cardiovascular (heart) failure from COC use.

Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you have a medical emergency. Serious side effects and their symptoms can include the following:

Long-Term Side Effects

COCs may lead to hypertension (high blood pressure) over time. People taking Sprintec should have their blood pressure checked at least once a year.

Sprintec and other COCs cause an increase in blood levels of proteins that bind certain drugs, so people taking thyroid hormone or cortisol therapy may need to have their doses increased.

Report Side Effects

Sprintec may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

(800) 332-1088

Dosage: How Much Sprintec Should I Take?

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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

Your doctor may ask you to begin your dose on the first day of your menstrual period (called Day 1 start) or on the first Sunday after your menstrual period starts (called Sunday start). When you begin on a certain day it is important that you follow that schedule, even if you miss a dose. Do not change your schedule on your own. If the schedule that you use is not convenient, talk with your doctor about changing it. For a Sunday start, you need to use another form of birth control (eg, condom, diaphragm, spermicide) for the first 7 days.

You should begin your next and all subsequent 28-day regimens of therapy on the same day of the week as the first regimen began and follow the same schedule.

Do not eat grapefruit or drink grapefruit juice while you are using this medicine. Grapefruit and grapefruit juice may change the amount of this medicine that is absorbed in the body.

  • For oral dosage form (tablets):
    • For contraception (to prevent pregnancy):
      • Adults and teenagers—
        • Ortho-Cyclen®: One blue tablet (active) taken at the same time each day for 21 consecutive days followed by one dark green (inert) tablet daily for 7 days per menstrual cycle.
        • Ortho Tri-Cyclen®: One white, light blue, or blue tablet (active) taken at the same time each day for 21 consecutive days followed by one dark green (inert) tablet daily for 7 days per menstrual cycle.
        • Ortho Tri-Cyclen® Lo: One white, light blue, or dark blue tablet (active) taken at the same time each day for 21 consecutive days followed by one dark green (inert) tablet daily for 7 days per menstrual cycle.
      • Children—Use and dose must be determined by your doctor.
    • For acne:
      • Adults and teenagers 15 years of age and older—One white, light blue, or blue tablet (active) taken at the same time each day for 21 consecutive days followed by one dark green (inert) tablet daily for 7 days per menstrual cycle.
      • Teenagers and children younger than 15 years of age—Use and dose must be determined by your doctor.

Modifications

Potential users should be aware of the following before beginning Sprintec:

Pregnancy: Sprintec should not be used once a person knows they are pregnant. However, there is no increased risk of birth defects in people who inadvertently take Sprintec in early pregnancy. 

Breastfeeding: Sprintec, like other combined COCs, can reduce the production of breast milk in those lactating. Many healthcare advisers recommend that lactating people use an alternative form of contraception until nursing is well established. Small amounts of COC hormones can and do pass into breast milk. 

Use in children: Sprintec is safe and effective in females of reproductive potential. Efficacy is expected to be the same for post-pubertal adolescents under age 18 and adults over age 18. Use of this drug is not indicated before menarche (first menstrual cycle) or after menopause.

Adults 65 and older: Sprintec has not been studied in postmenopausal people and is not approved in this population.

Missed Dose

Note the following if you have been inconsistent with taking Sprintec according to your prescription:

If one tablet was missed during weeks one, two, or three:

  • Take the missed tablet as soon as possible. This may mean taking two tablets at the same time. 
  • Continue taking one tablet daily until the pack is finished. 

If two tablets were missed during weeks one or two:

  • Take two missed tablets as soon as possible. 
  • The next day, take two more active tablets. 
  • Continue taking one tablet daily until the pack is finished. 
  • Use additional nonhormonal contraception (e.g., condoms and spermicide) for the next seven days after missing pills. 

If three tablets in a row were missed in weeks one, two, or three, or if two tablets were missed in week three: 

  • Continue taking one active tablet daily.
  • Once all active tablets from that pack are finished, throw out the pack and begin a new pack, starting with active tablets. You will be skipping the hormone-free interval. 
  • Use additional nonhormonal contraception (e.g., condoms and spermicide) for the next seven days after missing pills. 

Overdose: What Happens If I Take Too Much Sprintec?

There have been no reports of serious negative reactions from overdosage of COCs, including ingestion by children.

Nonetheless, overdosage may cause nausea, and females may experience withdrawal bleeding.

What Happens If I Overdose on Sprintec?

If you think you or someone else may have overdosed on Sprintec, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Sprintec, call 911 immediately.

911

Precautions

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It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly and does not cause unwanted effects. These visits will usually be every 6 to 12 months, but some doctors require them more often. Your doctor may also want to check your blood pressure while taking this medicine.

Although you are using this medicine to prevent pregnancy, you should know that using this medicine while you are pregnant could harm your unborn baby. If you think you have become pregnant while using the medicine, tell your doctor right away. Make sure your doctor knows if you had given birth within 4 weeks before you start using this medicine.

Do not use this medicine together with medicine to treat hepatitis C virus infection, including ombitasvir/paritaprevir/ritonavir, with or without dasabuvir (Technivie®, Viekira Pak®).

This medicine will not protect you from getting HIV/AIDS, herpes, or other sexually transmitted diseases. Tell your doctor if you or your partner begin to have sexual intercourse with other people, or you or your partner tests positive for a sexually transmitted disease. If this is a concern for you, talk with your doctor.

Vaginal bleeding of various amounts may occur between your regular menstrual periods during the first 3 months of use. This is sometimes called spotting when slight, or breakthrough bleeding when heavier.

  • If this should occur, continue with your regular dosing schedule.
  • The bleeding usually stops within 1 week. Check with your doctor if the bleeding continues for more than 1 week.
  • If the bleeding continues after you have been taking hormonal contraceptives on schedule and for more than 3 months, check with your doctor.

Check with your doctor right away if you miss a menstrual period. Missed periods may occur if you skip one or more tablets and have not taken your pills exactly as directed. If you miss two periods in a row, talk to your doctor. You might need a pregnancy test.

If you suspect that you may be pregnant, stop taking this medicine immediately and check with your doctor.

Do not use this medicine if you smoke cigarettes or if you are over 35 years of age. If you smoke while using birth control pills, you increase your risk of having a blood clot, heart attack, or stroke. Your risk is even higher if you are over age 35, if you have diabetes, high blood pressure, high cholesterol, or if you are overweight. Talk with your doctor about ways to stop smoking. Keep your diabetes under control. Ask your doctor about diet and exercise to control your weight and blood cholesterol level.

Using this medicine may increase your risk of having blood clotting problems. Check with your doctor right away if you have pain in the chest, groin, or legs, especially the calves, difficulty with breathing, a sudden, severe headache, slurred speech, a sudden, unexplained shortness of breath, a sudden unexplained shortness of breath, a sudden loss of coordination, or vision changes while using this medicine.

Using this medicine may increase your risk of breast cancer or cervical cancer. Talk with your doctor about this risk. Check with your doctor immediately if your experience abnormal vaginal bleeding.

Check with your doctor immediately if you wear contact lenses or if blurred vision, difficulty in reading, or any other change in vision occurs during or after treatment. Your doctor may want an eye doctor (ophthalmologist) to check your eyes.

Check with your doctor right away if you have pain or tenderness in the upper stomach, dark urine or pale stools, or yellow eyes or skin. These could be symptoms of a serious liver problem.

Using this medicine may increase your risk for gallbladder surgery. Talk with your doctor about this risk.

This medicine may make your skin more sensitive to sunlight. Wear sunscreen. Do not use sunlamps or tanning beds. Tell your doctor if you have a history of dark patches of skin around the forehead, nose, cheeks, and around the mouth, especially during pregnancy.

Check with your doctor before refilling an old prescription, especially after a pregnancy. You will need another physical examination and your doctor may change your prescription.

Make sure any doctor or dentist who treats you knows that you are using this medicine. The results of some medical tests may be affected by this medicine. You may also need to stop using this medicine at least 4 weeks before and 2 weeks after having major surgery.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (eg, St. John's wort) or vitamin supplements.

What Are Reasons I Shouldn’t Take Sprintec?

You should not take Sprintec in certain situations.

If you're allergic to Sprintec or any of its ingredients, do not take it. Ask your healthcare provider for a complete list of the ingredients if you're unsure.

If any of the following applies to you, do not take Sprintec:

What Other Medications Interact With Sprintec?

The following drugs or herbal products (not a complete list) may decrease blood levels of COCs, thereby reducing the effectiveness of COCs:

These medications increase the plasma concentrations of COCs:

COCs have been shown to decrease blood levels of Lamictal (lamotrigine) which may reduce seizure control. If you take this drug, a dosage adjustment of lamotrigine may be needed.

Persons taking thyroid hormone replacement therapy (e.g., Synthroid [levothyroxine]) may need an increase in thyroid hormone dose due to an increase in blood concentrations of thyroid-binding globulin associated with taking COCs.  

What Medications Are Similar?

Sprintec belongs to a large family of drugs known as combined oral contraceptive (COC) pills. COCs act similarly to prevent pregnancy, as non-oral combined hormonal forms of contraception do, including:

People should use only one hormonal contraceptive at a time. If you experience side effects from one COC, your healthcare provider may try you on a different COC to see if you tolerate it with fewer side effects.

Frequently Asked Questions

  • How effective are COCs at preventing pregnancy?

    With typical use, meaning the pills are not always taken consistently or correctly, 91% of persons using this method will not become pregnant during the first year of use. With perfect use, meaning the pills are used consistently and correctly each time, effectiveness is over 99% at preventing pregnancy.

  • What side effects can I expect while taking Sprintec?

    The most common side effects of Sprintec include headaches, GI issues, vaginal infections or discharge, breast changes (pain, enlargement, discharge), and mood disorders.

  • I’m experiencing some minor side effects from Sprintec. How long should I continue it before deciding to switch to another pill or method?

    Many side effects that COC users experience initially will improve over time, notably headaches, nausea, breast changes, and irregular vaginal bleeding/spotting. Most healthcare providers suggest giving a pill at least a three-month trial before deciding to change methods.

  • Can I use Sprintec to skip my period occasionally for vacation or when it’s inconvenient to bleed?

    Monophasic COCs (constant dose of estrogen and progestin in all active pills) can be taken continuously (e.g., taking active pills only) without a hormone-free interval to produce amenorrhea (absence of withdrawal bleed).

    Discuss this with your healthcare provider to see if this is a good option for you, as your prescription will need to be written to reflect how you will be taking the pills to ensure proper insurance coverage.

How Can I Stay Healthy While Taking Sprintec?

Smoking increases the risk of blood clots while taking COCs; in fact, this medication is not recommended for smokers over the age of 35. If you are under 35, decreasing the number of cigarettes smoked per day can decrease your risk of a blood clot.

Sprintec’s effectiveness at preventing pregnancy is affected by the pill takers' consistency in taking the medication. In order to achieve maximum effectiveness, take the medication at around the same time each day without missing doses.

Many people use some kind of reminder system to help them improve medication adherence. Common reminder systems include a cell phone alarm or taking at the same time you do something else habitually (e.g., right before you brush your teeth at bedtime).

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. DailyMed. Label: Sprintec- norgestimate and ethinyl estradiol kit.

  2. Bastianelli C, Farris M, Rosato E, Brosens I, Benagiano G. Pharmacodynamics of combined estrogen-progestin oral contraceptives: 1. Effects on metabolism. Expert Rev Clin Pharmacol. 2017;10(3):315-326. doi:10.1080/17512433.2017.1271708

  3. MedlinePlus. Estrogen and progestin (oral contraceptives).

  4. LiveScience. What is estrogen?

  5. MedlinePlus. Progesterone.

  6. Prescribers' Digital Reference. Ethinyl estradiol/norgestimate - drug summary.

  7. Centers for Disease Control and Prevention. Classifications for combined hormonal contraceptives.

  8. Planned Parenthood. How effective is the birth control pill?

  9. Planned Parenthood. How do I use birth control pills?

  10. American Heart Association. Understand your risk for excessive blood clotting.

By Carrie Yuan, PharmD
Carrie Yuan PharmD is a clinical pharmacist with expertise in chronic disease medication management for conditions encountered in primary care. 

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