Lo Loestrin Fe (norethindrone acetate/ethinyl estradiol/ferrous fumarate) is a prescription drug that’s used to help prevent pregnancy. Lo Loestrin Fe comes as an oral tablet that’s typically taken once per day.

Lo Loestrin Fe basics

Lo Loestrin Fe contains the active ingredients norethindrone acetate and ethinyl estradiol. (An active ingredient is what makes a drug work.) Lo Loestrin Fe also contains ferrous fumarate (iron).

Lo Loestrin Fe is a brand-name birth control pill. A generic version of the drug isn’t currently available.

Find answers to some commonly asked questions about Lo Loestrin Fe.

Will Lo Loestrin Fe cause me to not have a period?

It’s possible. In studies of Lo Loestrin Fe, amenorrhea (not having a menstrual period) and unexpected spotting or bleeding were reported side effects.

However, most people still have a period while taking Lo Loestrin Fe. If you’re sexually active and miss a period while taking Lo Loestrin Fe, you may be pregnant. Consider taking a pregnancy test.

If you think you’re pregnant or have questions about menstrual cycle changes while taking Lo Loestrin Fe, talk with your doctor.

Is Lo Loestrin Fe used for hormonal imbalance?

In some cases, yes. Lo Loestrin Fe is not FDA-approved for hormonal imbalance, but your doctor may prescribe it off-label for this use. (With off-label use, doctors prescribe a drug for a purpose other than what it’s approved for.)

To learn more about possible treatment options for balancing hormones, including Lo Loestrin Fe, talk with your doctor.

Does Lo Loestrin Fe cause long-term side effects?

It’s possible. Examples of long-term side effects reported in Lo Loestrin Fe’s studies include:

Long-term side effects include those that may start at any time during your treatment, even if you’ve taken a drug for a long time. It also includes side effects that may continue to affect you even after you stop taking a drug.

Talk with your doctor to learn more about possible side effects of Lo Loestrin Fe and how long they may affect you.

Lo Loestrin Fe is used to help prevent pregnancy in females* of any age who can become pregnant.

Lo Loestrin Fe is a hormonal birth control pill. It works by changing the levels of certain hormones that regulate the menstrual cycle. By doing so, the drug stops ovulation (the release of an egg from an ovary), which prevents fertilization and pregnancy.

It’s not known whether Lo Loestrin Fe is effective for preventing pregnancy in females with a body mass index (BMI) of 35 or higher.

Other factors can also lower the effectiveness of birth control pills, including Lo Loestrin Fe. For example, skipping doses or taking certain other medications can make birth control pills less effective. If you have questions about this, talk with your doctor or pharmacist.

* In this article, we use the term “female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

Like most drugs, Lo Loestrin Fe may cause mild or serious side effects. The lists below describe some of the more common side effects that Lo Loestrin Fe may cause. These lists don’t include all possible side effects.

Keep in mind that side effects of a drug can depend on:

  • your age
  • other health conditions you have
  • other medications you take

Your doctor or pharmacist can tell you more about the potential side effects of Lo Loestrin Fe. They can also suggest ways to help reduce side effects.

Mild side effects

Here’s a list of some of the mild side effects that Lo Loestrin Fe can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Lo Loestrin Fe’s prescribing information.

Mild side effects of Lo Loestrin Fe that have been reported include:

  • nausea and vomiting
  • headache
  • weight changes
  • low libido (sex drive)
  • acne
  • diarrhea
  • mood changes, which may include anxiety or depression
  • breast tenderness
  • abdominal pain or bloating
  • eye dryness, which may cause discomfort while wearing contact lenses
  • blotches of darkened skin, especially on the face
  • menstrual pain
  • spotting or irregular vaginal bleeding
  • mild allergic reaction*

Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

* To learn more about this side effect, see the “Allergic reaction” section below.

Serious side effects

Serious side effects from Lo Loestrin Fe can occur, but they aren’t common. If you have serious side effects from Lo Loestrin Fe, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects of Lo Loestrin Fe that have been reported include:

* For more information, see the “What should be considered before taking Lo Loestrin Fe?” section.
† To learn more about this side effect, see the “Allergic reaction” section below.

Allergic reaction

Some people may have an allergic reaction to Lo Loestrin Fe. While allergic reaction wasn’t reported in studies of this medication, it can still occur.

Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, usually in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.

Call your doctor right away if you have an allergic reaction to Lo Loestrin Fe. But if you think you’re having a medical emergency, call 911 or your local emergency number.

Your doctor will recommend the dosage of Lo Loestrin Fe that’s right for you. Below are commonly used dosages, but always take the dosage your doctor prescribes.

Form and strengths

Lo Loestrin Fe is available as an oral tablet. It comes in a blister pack of 28 tablets in the following order:

  • 24 blue tablets containing 1 milligram (mg) of norethindrone acetate and 10 micrograms (mcg) of ethinyl estradiol
  • two white tablets containing 10 mcg of ethinyl estradiol
  • two brown tablets containing 75 mg of ferrous fumarate (iron)

Recommended dosage

Your doctor will explain how you should take Lo Loestrin Fe. Be sure to follow their instructions.

The recommended dosage of Lo Loestrin Fe is one tablet taken once per day. You should take the tablets in order, as shown in the blister pack.

When you first start Lo Loestrin Fe treatment, you’ll likely take your first dose on day 1 of your period (the first day of menstrual bleeding). If you start Lo Loestrin Fe on a different day, you should use a backup birth control method (such as condoms) for the first week of treatment.

If you have questions about how or when to take Lo Loestrin Fe, talk with your doctor or pharmacist.

Questions about taking Lo Loestrin Fe

Below are some common questions about taking Lo Loestrin Fe.

  • Can Lo Loestrin Fe be chewed, crushed, or split? No, you should not chew, crush, or split Lo Loestrin Fe tablets. You should swallow them whole. If you have trouble swallowing pills, you can ask your doctor or pharmacist for advice.
  • Should I take Lo Loestrin Fe with food? Lo Loestrin Fe may be taken with or without food. The drug isn’t affected by food.
  • Is there a best time of day to take Lo Loestrin Fe? Lo Loestrin Fe can be taken at any time of day, but it’s important to take it at the same time each day. This helps keep a consistent level of the drug in your body, which helps Lo Loestrin Fe work effectively to prevent pregnancy.
  • What if I miss a dose of Lo Loestrin Fe? Missing doses can make the drug less effective at preventing pregnancy. If you miss a dose of Lo Loestrin Fe, your next steps depend on when your missed dose was due and how many doses you’ve missed. You can always talk with your doctor or pharmacist if you’re not sure what to do, but the recommendations from the drug manufacturer are:
    • If you miss one dose, take it as soon as possible and continue taking one tablet per day until you finish the pack.
    • If you miss two doses in a row during week 1 or 2, take two tablets on the day you remember. The following day, take the next two tablets. Then, starting the next day, take one tablet per day until you finish the pack. You’ll need to use a backup form of birth control (such as condoms) for at least 7 days.
    • If you miss two doses in a row during weeks 3 or 4, discard the rest of the pack and start a new one, using backup birth control for at least 7 days.
    • If you miss three or more doses in a row in any week, discard the pack and start a new one, using backup birth control for at least 7 days.
    • If you miss taking one or both brown tablets in week 4, discard the missed tablets and start a new pack on the usual day. There’s no need for backup birth control if you miss one or both brown tablets.

Overdose

Do not take more Lo Loestrin Fe than your doctor prescribes. Using more than this can lead to harmful effects.

Symptoms of overdose

Symptoms caused by an overdose can include:

  • vaginal bleeding
  • nausea

What to do in case you take too much Lo Loestrin Fe

Call your doctor if you think you’ve taken too much Lo Loestrin Fe. You can also call 800-222-1222 to reach America’s Poison Centers or use its online resource. But if you have severe symptoms, immediately call 911 or your local emergency number. Or go to the nearest emergency room.

Whether you have health insurance or not, cost may be a factor when you’re considering Lo Loestrin Fe. What you’ll pay for Lo Loestrin Fe may depend on several things, such as your treatment plan and the pharmacy you use.

Here are a few things to consider regarding cost:

  • Cost information and savings coupons: You can visit Optum Perks to get price estimates of what you’d pay for Lo Loestrin Fe when using coupons from the site. See the coupon options below. (Note: Optum Perks coupons cannot be used with insurance copays or benefits.)
  • Generic form: Lo Loestrin Fe is not currently available as a generic drug. Generics usually cost less than brand-name drugs. Talk with your doctor if you’d like to know more about alternative birth control pills that have generic versions available.
  • Savings program: If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. A Lo Loestrin Fe savings program may be available.

You can also check out this article to learn more about saving money on prescriptions.

Save on your Lo Loestrin Fe prescription

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Retail price refers to the manufacturer’s published list price and is up to date as of 3/2023. Retail and discounted prices are U.S.-only and can vary based on region and pharmacy. We cannot guarantee that the discounted price listed here will exactly match the price at your pharmacy. Please contact your pharmacy for the exact price.

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Below is important information you should consider before taking Lo Loestrin Fe.

Interactions

Taking a drug with certain medications, vaccines, foods, and other things can affect how the drug works. These effects are called interactions.

Before starting Lo Loestrin Fe treatment, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also, tell them about any vitamins, herbs, and supplements you take. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.

Lo Loestrin Fe can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Drug interactions

Below is a list of medications that can interact with Lo Loestrin Fe. This list doesn’t contain all drugs that may interact with Lo Loestrin Fe. If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Drug group or drug nameDrug examples
certain seizure drugs • carbamazepine (Tegretol)
• topiramate (Topamax)
• phenytoin (Dilantin)
certain hepatitis C drugs• ombitasvir/paritaprevir/ritonavir
• ombitasvir/paritaprevir/ritonavir with dasabuvir
antibiotics• rifampin (Rifadin)
certain HIV drugs• efavirenz (Sustiva)
• atazanavir sulfate (Reyataz)

Lo Loestrin Fe and alcohol

Alcohol is not known to interact with Lo Loestrin Fe. If you drink alcohol, it’s likely safe to consume it while taking Lo Loestrin Fe.

Lo Loestrin Fe interaction with vitamins or supplements

Lo Loestrin Fe may interact with St John’s wort. This is an herbal supplement that some people use to ease symptoms of depression or other conditions. Your doctor will likely recommend that you avoid taking this supplement during your Lo Loestrin Fe treatment.

Pregnancy and breastfeeding

Lo Loestrin Fe is used to help prevent pregnancy. The drug isn’t meant to be taken during pregnancy. However, Lo Loestrin Fe shouldn’t cause harm if you become pregnant while taking it.

Although it’s considered safe to take Lo Loestrin Fe while breastfeeding, doctors typically don’t recommend doing so. This is because it could reduce your breast milk production if taken while breastfeeding.

If you’re breastfeeding or planning to do so, talk with your doctor before you start taking Lo Loestrin Fe.

Birth control

Lo Loestrin Fe is a birth control pill used to help prevent pregnancy. In certain situations, backup birth control methods (such as condoms) may be necessary to prevent pregnancy during your Lo Loestrin Fe treatment. Example situations include starting the pill late in your menstrual cycle or taking medications that decrease its effectiveness.

It’s also important to note that Lo Loestrin Fe does not protect against sexually transmitted infections, such as HIV. Talk with your doctor if you have questions about backup birth control methods.

Boxed warning

Lo Loestrin Fe has a boxed warning about the risk of serious cardiovascular (heart and blood vessel) problems in certain females* who smoke cigarettes. A boxed warning is the most serious warning from the Food and Drug Administration (FDA) about drug effects that may be dangerous.

Certain females who smoke cigarettes while taking hormonal birth control, such as Lo Loestrin Fe, have an increased risk of blood clots. The risk increases with age and with how much you smoke. To help prevent blood clots, doctors do not typically prescribe this medication to females over age 35 years who smoke cigarettes.

If you’re over age 35 years and smoke cigarettes, talk with your doctor about other birth control methods that may be safer for you. They can also help if you want to quit smoking.

* In this article, we use the term “female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

Other warnings

Lo Loestrin Fe can sometimes cause harmful effects in people who have certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether Lo Loestrin Fe is a good treatment option for you.

Talk with your doctor about your health history before you take Lo Loestrin Fe. Be sure to tell them if any of the following factors apply to you:

Other drugs are available that can help prevent pregnancy. If you’d like to explore an alternative to Lo Loestrin Fe, talk with your doctor. They can tell you about other medications that might work well for you.

The following drugs are similar to Lo Loestrin Fe:

  • drospirenone/ethinyl estradiol (Yaz, Yasmin)
  • norgestimate/ethinyl estradiol (Sprintec)
  • norethindrone acetate/ethinyl estradiol/ferrous fumarate (Junel Fe, Hailey Fe)

If you have questions about taking Lo Loestrin Fe, talk with your doctor or pharmacist. Questions you may want to ask include:

  • If I have acne, can Lo Loestrin Fe make it better or worse?
  • How does the cost of Lo Loestrin Fe compare with that of other birth control pills?
  • Do I need to take the brown iron tablets included with this drug for it to be effective?

To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.