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Tri-Mili
Tri-Mili is a combination oral contraceptive that contains two hormones: norgestimate (a progestin) and ethinyl estradiol (an estrogen). It is primarily used to prevent pregnancy by inhibiting ovulation, thickening cervical mucus, and altering the uterine lining, making it difficult for sperm to reach the uterus and for a fertilized egg to implant. Additionally, Tri-Mili may be used to regulate menstrual cycles, treat moderate acne, and manage other hormonal imbalances in women who desire contraception.
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Frequently Asked Questions
How long does it take for Tri-Mili to become effective?
If you start taking Tri-Mili on the first day of your period, it is effective immediately. If you start on any other day, use backup contraception for the first 7 days.
Can Tri-Mili help with acne?
Yes, Tri-Mili is FDA-approved to treat moderate acne in women at least 15 years old who also seek contraception.
What should I do if I miss a pill?
If you miss one pill, take it as soon as you remember and continue with your regular schedule. If you miss two or more pills, consult the package insert for instructions and use backup contraception for 7 days.
Can I take Tri-Mili if I smoke?
Smoking while taking Tri-Mili increases the risk of serious cardiovascular events, especially in women over 35. It is strongly recommended to quit smoking while using this medication.
Can Tri-Mili cause weight gain?
Some women may experience weight gain due to fluid retention or changes in appetite while taking Tri-Mili. Regular exercise and a healthy diet can help manage weight changes.
Comprehensive Drug Guide
How Does Tri-Mili Work?
- Inhibiting ovulation: Preventing the release of an egg from the ovaries.
- Thickening cervical mucus: Making it harder for sperm to reach the egg.
- Changing the uterine lining: Making it less suitable for a fertilized egg to implant.
Common Dosages
- 21 active tablets with varying hormone levels:
- Days 1–7: 0.18 mg norgestimate / 0.025 mg ethinyl estradiol
- Days 8–14: 0.215 mg norgestimate / 0.025 mg ethinyl estradiol
- Days 15–21: 0.25 mg norgestimate / 0.025 mg ethinyl estradiol
- 7 placebo tablets (inactive) for the last 7 days of the cycle.
Typical Dosing
- Take one tablet daily at the same time each day. Start on the first day of your menstrual cycle or the first Sunday after your period begins.
- Continue taking one pill daily for 28 days, including the 7 placebo pills.
- Use backup contraception (such as condoms) for the first 7 days if starting on any day other than the first day of your period.
Typical Dosing
FDA Approved Indications
- Prevention of pregnancy.
- Treatment of moderate acne in women at least 15 years old who desire contraception.
Who Shouldn't Take Tri-Mili?
- A history of blood clots, deep vein thrombosis (DVT), or pulmonary embolism.
- A history of stroke or heart attack.
- Uncontrolled hypertension.
- Certain cancers (breast, uterine, or liver cancer).
- Liver disease.
- Known hypersensitivity to norgestimate, ethinyl estradiol, or any of the ingredients.
- Smoking in women over 35, due to the increased risk of cardiovascular events.
Advice From The Pharmacist
- Take Tri-Mili at the same time every day for maximum effectiveness. If you miss a pill, follow the instructions in the package insert and use backup contraception if needed.
- Do not skip doses, as this can increase the risk of pregnancy. If you miss two or more pills, use a backup method for the next 7 days.
- Tri-Mili does not protect against sexually transmitted infections (STIs). Use condoms to protect against STIs.
- Inform your healthcare provider if you experience symptoms such as severe leg pain, shortness of breath, or chest pain, as these could be signs of a serious blood clot.
Side Effects of Tri-Mili
Common Side Effects
- Nausea
- Headaches
- Breast tenderness
- Weight changes
- Mood changes
- Spotting or breakthrough bleeding between periods
Uncommon/Severe Side Effects
- Blood clots (deep vein thrombosis, pulmonary embolism)
- Stroke or heart attack
- Liver problems
- Severe migraine headaches
Risks and Warnings of Tri-Mili
- Blood Clots: Women over 35 who smoke are at an increased risk of developing blood clots, stroke, or heart attack while taking Tri-Mili. Quitting smoking is highly recommended if using this medication.
- Cardiovascular Events: Women with a history of hypertension, diabetes, or high cholesterol have a higher risk of cardiovascular problems while using combination oral contraceptives. Discuss your risks with your doctor before starting this medication.
- Liver Tumors: Rarely, hormonal contraceptives can cause benign liver tumors. Contact your healthcare provider immediately if you experience symptoms such as severe abdominal pain, yellowing of the skin or eyes, or dark urine.
- Vision Problems: Tri-Mili may increase the risk of retinal vein thrombosis. Report any sudden vision changes to your healthcare provider.
Interactions with Tri-Mili
Common Drug Interactions
- Antibiotics: Some antibiotics, such as rifampin, may reduce the effectiveness of Tri-Mili. Use a backup method of contraception while taking these medications.
- Anticonvulsants: Medications such as phenytoin or carbamazepine may reduce the effectiveness of hormonal birth control.
- St. John's Wort: This herbal supplement can decrease the effectiveness of Tri-Mili, increasing the risk of pregnancy.
Alternatives to Tri-Mili
- Ortho Tri-Cyclen Lo: A similar triphasic oral contraceptive with varying hormone levels.
- Lo Loestrin Fe: A lower-dose oral contraceptive.
- Depo-Provera: An injectable contraceptive given every three months.
- NuvaRing: A vaginal ring that releases hormones to prevent pregnancy.
