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Tulana
Tulana (generic name: norethindrone) is a progestin-only oral contraceptive pill (often referred to as the “mini-pill”) used for the prevention of pregnancy. Unlike combination oral contraceptives, which contain both estrogen and progestin, Tulana contains only progestin. This makes it an option for women who cannot take estrogen, such as those with a history of blood clots or certain other health conditions. Tulana works by preventing ovulation, thickening cervical mucus to block sperm, and altering the uterine lining to prevent fertilized eggs from implanting.
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Frequently Asked Questions
Can I use Tulana while breastfeeding?
Yes, Tulana is often recommended for women who are breastfeeding because it does not contain estrogen, which can reduce milk supply.
What should I do if I miss a dose of Tulana?
If you miss a dose or take it more than 3 hours late, take the pill as soon as you remember and use a backup form of contraception (like condoms) for the next 48 hours.
Can Tulana affect my menstrual cycle?
Yes, Tulana may cause irregular periods, spotting between periods, or missed periods, which are common side effects of progestin-only pills.
Does Tulana protect against STIs?
No, Tulana does not provide protection against sexually transmitted infections. Condoms should be used to reduce the risk of STIs.
How effective is Tulana?
When taken perfectly (at the same time every day), Tulana is over 99% effective at preventing pregnancy. However, typical use, which includes missed or late pills, reduces its effectiveness to about 91%.
Comprehensive Drug Guide
How Does Tulana Work?
- Inhibiting ovulation: Though progestin-only pills do not always suppress ovulation as consistently as combination pills, they can still inhibit the release of an egg from the ovary in some cases.
- Thickening cervical mucus: This makes it more difficult for sperm to enter the uterus.
- Altering the uterine lining: This reduces the likelihood of implantation if fertilization occurs.
Common Dosages
- 0.35 mg norethindrone oral tablets, taken once daily.
Typical Dosing
- Take one tablet daily, at the same time each day, without a break between packs. There are no placebo pills in progestin-only pill packs, so each pill is active.
- It is important to take Tulana at the same time every day to maintain its effectiveness. Delaying a dose by more than 3 hours can reduce contraceptive protection.
Typical Dosing
FDA Approved Indications
- Contraception (prevention of pregnancy).
Who Shouldn't Take Tulana?
- Known or suspected pregnancy.
- Current or history of breast cancer or other progestin-sensitive cancers.
- Liver disease or liver tumors.
- Undiagnosed abnormal vaginal bleeding.
Advice From The Pharmacist
- Take Tulana at the same time every day, as missing or delaying a dose by more than 3 hours increases the risk of pregnancy.
- If you miss a dose or take it late, use a backup method of contraception (such as condoms) for the next 48 hours.
- Tulana does not protect against sexually transmitted infections (STIs), so consider using condoms to reduce your risk of STIs.
- Store the medication at room temperature, away from heat and moisture.
Side Effects of Tulana
Common Side Effects
- Irregular menstrual periods or spotting
- Breast tenderness
- Headache
- Nausea
- Weight changes
Uncommon/Severe Side Effects
- Blood clots (though the risk is lower compared to estrogen-containing contraceptives)
- Severe abdominal pain, which could indicate a potential ectopic pregnancy
- Severe allergic reactions (swelling, rash, difficulty breathing)
Risks and Warnings of Tulana
- Ectopic Pregnancy: Progestin-only pills like Tulana may slightly increase the risk of ectopic pregnancy (a pregnancy that occurs outside the uterus), so seek immediate medical attention if you experience severe abdominal pain or unusual bleeding.
- Missed Doses: If you miss a pill or take it late, your risk of pregnancy increases. Use a backup form of contraception for the next 48 hours if this occurs.
- Bone Density: Long-term use of progestin-only contraceptives may affect bone density, particularly in young women and adolescents.
Interactions with Tulana
Common Drug Interactions
- Antibiotics: Some antibiotics (such as rifampin) may reduce the effectiveness of Tulana, increasing the risk of pregnancy.
- Anticonvulsants: Certain medications used to treat seizures (such as carbamazepine or phenytoin) may also reduce the effectiveness of Tulana.
- HIV medications: Some antiretroviral drugs can interact with Tulana and reduce its effectiveness.
Alternatives to Tulana
- Micronor: Another brand of norethindrone, a progestin-only contraceptive pill.
- Depo-Provera: A progestin-only injectable contraceptive given every 3 months.
- Implanon/Nexplanon: A progestin-only contraceptive implant placed under the skin that lasts up to 3 years.
- Mirena IUD: A progestin-releasing intrauterine device that provides contraception for up to 5 years.
