Mestranol and Norethindrone

Mestranol and Norethindrone Brand Names

Necon 1/50 | Norinyl 1/50 | Ortho-Novum 1/50

What is Mestranol and Norethindrone

Mestranol and norethindrone are used together as an oral contraceptive agent for routine contraception.

Mestranol is the estrogen that was in the first marketed combination oral contraceptive pill, Enovid. Mestranol is metabolized to ethinyl estradiol, the active form in vivo.

Norethindrone is a first generation oral progestin with moderate androgenic and slight estrogenic activity relative to newer progestins.

Norethindrone is known as norethisterone outside of the United States. Combined hormonal contraceptives can be used in female patients from menarche to over the age of 40 years up until the time of menopause with proper selection of products.

The choice of a routine hormonal contraceptive for any given patient is based on the individual’s contraceptive needs, underlying medical conditions or risk factors for adverse effects, and individual preferences for use.

All combined oral contraceptives (COCs) have risks related to venous and arterial thromboembolism, particularly in women who smoke; all combined hormonal contraceptive labels contain a boxed warning about tobacco smoking.

The Centers for Disease Control’s U.S. medical Eligibility Criteria describe considerations for risk vs. benefits, including medical conditions or attributes that contraindicate use; these criteria can help prescribing practitioners in product selection for individual patients.

Mestranol and norethindrone oral contraceptive combinations were first approved by the FDA before 1982.

Indications

  1. acne vulgaris
  2. amenorrhea
  3. contraception
  4. dysfunctional uterine bleeding
  5. endometriosis
  6. gastrointestinal bleeding prophylaxis
  7. hirsutism
  8. polycystic ovary syndrome

Side Effects

  1. abdominal pain
  2. acne vulgaris
  3. alopecia
  4. amenorrhea
  5. anaphylactoid reactions
  6. angioedema
  7. anorexia
  8. anxiety
  9. appetite stimulation
  10. arthralgia
  11. asthenia
  12. back pain
  13. bowel ischemia
  14. breakthrough bleeding
  15. breast discharge
  16. breast enlargement
  17. candidiasis
  18. cataracts
  19. cervical dysplasia
  20. cholecystitis
  21. cholelithiasis
  22. cholestasis
  23. colitis
  24. cystitis
  25. depression
  26. diarrhea
  27. diplopia
  28. dysmenorrhea
  29. dyspepsia
  30. edema
  31. elevated hepatic enzymes
  32. emotional lability
  33. erythema multiforme
  34. erythema nodosum
  35. fatigue
  36. fluid retention
  37. galactorrhea
  38. gingivitis
  39. headache
  40. hepatitis
  41. hepatoma
  42. hirsutism
  43. hyperlipidemia
  44. hypertension
  45. hypertriglyceridemia
  46. intracranial bleeding
  47. irritability
  48. jaundice
  49. lactation suppression
  50. leukorrhea
  51. libido decrease
  52. libido increase
  53. lupus-like symptoms
  54. maculopapular rash
  55. mastalgia
  56. melasma
  57. menorrhagia
  58. menstrual irregularity
  59. migraine
  60. musculoskeletal pain
  61. myalgia
  62. myocardial infarction
  63. nausea
  64. new primary malignancy
  65. optic neuritis
  66. pancreatitis
  67. papilledema
  68. peliosis hepatis
  69. pelvic pain
  70. photosensitivity
  71. porphyria
  72. pruritus
  73. pulmonary embolism
  74. rash
  75. retinal thrombosis
  76. rhinitis
  77. sinusitis
  78. stroke
  79. thromboembolism
  80. thrombosis
  81. urticaria
  82. vaginal discharge
  83. vaginal irritation
  84. vaginitis
  85. visual impairment
  86. vomiting
  87. weight gain
  88. weight loss

Monitoring Parameters

  • pap smear
  • pelvic exam

Contraindications

  • acquired immunodeficiency syndrome (AIDS)
  • atrial fibrillation
  • breast cancer
  • breast-feeding
  • cerebrovascular disease
  • cervical cancer
  • children
  • chloasma
  • cholestasis
  • contact lenses
  • coronary artery disease
  • coronary thrombosis
  • depression
  • diabetes mellitus
  • endocarditis
  • endometrial cancer
  • gallbladder disease
  • glaucoma
  • headache
  • hepatic disease
  • hepatitis
  • hepatocellular cancer
  • hereditary angioedema
  • history of angioedema
  • human immunodeficiency virus (HIV) infection
  • hypercalcemia
  • hypercholesterolemia
  • hyperlipidemia
  • hypertension
  • hypertriglyceridemia
  • hypothyroidism
  • jaundice
  • migraine
  • myocardial infarction
  • obesity
  • obstetric delivery
  • ovarian cancer
  • porphyria
  • pregnancy
  • protein C deficiency
  • protein S deficiency
  • renal disease
  • stroke
  • surgery
  • systemic lupus erythematosus (SLE)
  • thromboembolic disease
  • thromboembolism
  • thrombophlebitis
  • thyroid disease
  • tobacco smoking
  • uterine cancer
  • vaginal bleeding
  • vaginal cancer
  • valvular heart disease
  • visual disturbance

Interactions

  • Acarbose
  • Acebutolol
  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Propoxyphene
  • Acetohexamide
  • Acitretin
  • Albiglutide
  • Aliskiren
  • Aliskiren; Amlodipine
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Aliskiren; Hydrochlorothiazide, HCTZ
  • Aliskiren; Valsartan
  • Alogliptin
  • Alogliptin; Metformin
  • Alogliptin; Pioglitazone
  • Alpha-blockers
  • Alpha-glucosidase Inhibitors
  • Alprazolam
  • Amikacin
  • Amiloride
  • Amiloride; Hydrochlorothiazide, HCTZ
  • Aminoglycosides
  • Amiodarone
  • Amitriptyline; Chlordiazepoxide
  • Amlodipine
  • Amlodipine; Atorvastatin
  • Amlodipine; Benazepril
  • Amlodipine; Celecoxib
  • Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
  • Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
  • Amlodipine; Olmesartan
  • Amlodipine; Telmisartan
  • Amlodipine; Valsartan
  • Amobarbital
  • Amoxicillin
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Amoxicillin; Clavulanic Acid
  • Ampicillin
  • Ampicillin; Sulbactam
  • Amprenavir
  • Anastrozole
  • Angiotensin II receptor antagonists
  • Angiotensin-converting enzyme inhibitors
  • Apalutamide
  • Aprepitant, Fosaprepitant
  • Armodafinil
  • Artemether; Lumefantrine
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Atazanavir
  • Atazanavir; Cobicistat
  • Atenolol
  • Atenolol; Chlorthalidone
  • Atorvastatin
  • Atorvastatin; Ezetimibe
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • Azelastine; Fluticasone
  • Azilsartan
  • Azilsartan; Chlorthalidone
  • Azithromycin
  • Aztreonam
  • Bacitracin
  • Barbiturates
  • Beclomethasone
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Benazepril
  • Benazepril; Hydrochlorothiazide, HCTZ
  • Bendroflumethiazide; Nadolol
  • Beta-adrenergic blockers
  • Betamethasone
  • Betaxolol
  • Bexarotene
  • Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Bisoprolol
  • Bisoprolol; Hydrochlorothiazide, HCTZ
  • Boceprevir
  • Bosentan
  • Brigatinib
  • Brimonidine; Timolol
  • Bromocriptine
  • Budesonide
  • Budesonide; Formoterol
  • Bumetanide
  • Butabarbital
  • Caffeine
  • Caffeine; Ergotamine
  • Calaspargase pegol
  • Calcium
  • Calcium-channel blockers
  • Canagliflozin
  • Canagliflozin; Metformin
  • Candesartan
  • Candesartan; Hydrochlorothiazide, HCTZ
  • Captopril
  • Captopril; Hydrochlorothiazide, HCTZ
  • Carbamazepine
  • Carbapenems
  • Carbenicillin
  • Carteolol
  • Carvedilol
  • Cefaclor
  • Cefadroxil
  • Cefazolin
  • Cefdinir
  • Cefditoren
  • Cefepime
  • Cefiderocol
  • Cefixime
  • Cefotaxime
  • Cefotetan
  • Cefoxitin
  • Cefpodoxime
  • Cefprozil
  • Ceftaroline
  • Ceftazidime
  • Ceftazidime; Avibactam
  • Ceftibuten
  • Ceftizoxime
  • Ceftolozane; Tazobactam
  • Ceftriaxone
  • Cefuroxime
  • Cenobamate
  • Central-acting adrenergic agents
  • Cephalexin
  • Charcoal
  • Chenodiol
  • Chloramphenicol
  • Chlordiazepoxide
  • Chlordiazepoxide; Clidinium
  • Chlorothiazide
  • Chlorpropamide
  • Chlorthalidone
  • Chlorthalidone; Clonidine
  • Ciclesonide
  • Cimetidine
  • Ciprofloxacin
  • Clarithromycin
  • Clevidipine
  • Clindamycin
  • Clobazam
  • Clonazepam
  • Clonidine
  • Clorazepate
  • Cobicistat
  • Colesevelam
  • Colistimethate, Colistin, Polymyxin E
  • Corticosteroids
  • Cortisone
  • Cosyntropin
  • Cyclosporine
  • Dabrafenib
  • Dalbavancin
  • Dantrolene
  • Dapagliflozin
  • Dapagliflozin; Metformin
  • Dapagliflozin; Saxagliptin
  • Daptomycin
  • Daratumumab; Hyaluronidase
  • Darunavir
  • Darunavir; Cobicistat
  • Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Deferasirox
  • Deflazacort
  • Delafloxacin
  • Demeclocycline
  • Dexamethasone
  • Diazepam
  • Dicloxacillin
  • Diltiazem
  • Dipeptidyl Peptidase-4 Inhibitors
  • Dirithromycin
  • Doripenem
  • Dorzolamide; Timolol
  • Doxazosin
  • Doxycycline
  • Dronedarone
  • Dulaglutide
  • Duloxetine
  • Efavirenz
  • Efavirenz; Emtricitabine; Tenofovir
  • Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
  • Elagolix
  • Elagolix; Estradiol; Norethindrone acetate
  • Elvitegravir
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
  • Empagliflozin
  • Empagliflozin; Linagliptin
  • Empagliflozin; Linagliptin; Metformin
  • Empagliflozin; Metformin
  • Enalapril, Enalaprilat
  • Enalapril; Felodipine
  • Enalapril; Hydrochlorothiazide, HCTZ
  • Enasidenib
  • Encorafenib
  • Enzalutamide
  • Eprosartan
  • Eprosartan; Hydrochlorothiazide, HCTZ
  • Eravacycline
  • Ertapenem
  • Ertugliflozin
  • Ertugliflozin; Metformin
  • Ertugliflozin; Sitagliptin
  • Erythromycin
  • Erythromycin; Sulfisoxazole
  • Eslicarbazepine
  • Esmolol
  • Estazolam
  • Ethacrynic Acid
  • Exemestane
  • Exenatide
  • Felbamate
  • Felodipine
  • Fidaxomicin
  • Flibanserin
  • Fludrocortisone
  • Flunisolide
  • Flurazepam
  • Fluticasone
  • Fluticasone; Salmeterol
  • Fluticasone; Umeclidinium; Vilanterol
  • Fluticasone; Vilanterol
  • Formoterol; Mometasone
  • Fosamprenavir
  • Fosinopril
  • Fosinopril; Hydrochlorothiazide, HCTZ
  • Furosemide
  • Gemifloxacin
  • Gentamicin
  • Glimepiride
  • Glimepiride; Pioglitazone
  • Glimepiride; Rosiglitazone
  • Glipizide
  • Glipizide; Metformin
  • Glyburide
  • Glyburide; Metformin
  • Glycylcyclines
  • grapefruit juice
  • Green Tea
  • Griseofulvin
  • Guanabenz
  • Guanfacine
  • Hemin
  • Hyaluronidase
  • Hyaluronidase, Recombinant; Immune Globulin
  • Hydantoins
  • Hydralazine
  • Hydralazine; Hydrochlorothiazide, HCTZ
  • Hydralazine; Isosorbide Dinitrate, ISDN
  • Hydrochlorothiazide, HCTZ
  • Hydrochlorothiazide, HCTZ; Irbesartan
  • Hydrochlorothiazide, HCTZ; Lisinopril
  • Hydrochlorothiazide, HCTZ; Losartan
  • Hydrochlorothiazide, HCTZ; Methyldopa
  • Hydrochlorothiazide, HCTZ; Metoprolol
  • Hydrochlorothiazide, HCTZ; Moexipril
  • Hydrochlorothiazide, HCTZ; Olmesartan
  • Hydrochlorothiazide, HCTZ; Propranolol
  • Hydrochlorothiazide, HCTZ; Quinapril
  • Hydrochlorothiazide, HCTZ; Spironolactone
  • Hydrochlorothiazide, HCTZ; Telmisartan
  • Hydrochlorothiazide, HCTZ; Triamterene
  • Hydrochlorothiazide, HCTZ; Valsartan
  • Hydrocortisone
  • Icosapent ethyl
  • Idelalisib
  • Imipenem; Cilastatin
  • Imipenem; Cilastatin; Relebactam
  • Incretin Mimetics
  • Indinavir
  • Insulin Degludec; Liraglutide
  • Insulin Glargine; Lixisenatide
  • Insulins
  • Irbesartan
  • Isoniazid, INH; Pyrazinamide, PZA; Rifampin
  • Isoniazid, INH; Rifampin
  • Isotretinoin
  • Isradipine
  • Ivosidenib
  • Kanamycin
  • Labetalol
  • Lamotrigine
  • Lefamulin
  • Leflunomide
  • Lenalidomide
  • Lesinurad
  • Lesinurad; Allopurinol
  • Letrozole
  • Levobetaxolol
  • Levobunolol
  • Levofloxacin
  • Levothyroxine
  • Levothyroxine; Liothyronine (Porcine)
  • Levothyroxine; Liothyronine (Synthetic)
  • Linagliptin
  • Linagliptin; Metformin
  • Lincomycin
  • Lincosamides
  • Linezolid
  • Liothyronine
  • Liraglutide
  • Lisinopril
  • Lixisenatide
  • Lomitapide
  • Loop diuretics
  • Lopinavir; Ritonavir
  • Lorlatinib
  • Losartan
  • Lumacaftor; Ivacaftor
  • Mecamylamine
  • Meglitinides
  • Melatonin
  • Mephobarbital
  • Meropenem
  • Meropenem; Vaborbactam
  • Metformin
  • Metformin; Pioglitazone
  • Metformin; Repaglinide
  • Metformin; Rosiglitazone
  • Metformin; Saxagliptin
  • Metformin; Sitagliptin
  • Methohexital
  • Methyclothiazide
  • Methyldopa
  • Methylprednisolone
  • Metolazone
  • Metoprolol
  • Metreleptin
  • Metronidazole
  • Metyrapone
  • Mifepristone
  • Miglitol
  • Miltefosine
  • Mineral Oil
  • Minocycline
  • Minoxidil
  • Mivacurium
  • Modafinil
  • Moexipril
  • Mometasone
  • Morphine
  • Morphine; Naltrexone
  • Moxifloxacin
  • Mycophenolate
  • Nadolol
  • Nafcillin
  • Nebivolol
  • Nebivolol; Valsartan
  • Nefazodone
  • Nelfinavir
  • Neomycin
  • Nevirapine
  • Nicardipine
  • Nifedipine
  • Nimodipine
  • Nisoldipine
  • Nitrofurantoin
  • Nitroprusside
  • Norfloxacin
  • Ofloxacin
  • Olmesartan
  • Omadacycline
  • Ombitasvir; Paritaprevir; Ritonavir
  • Omeprazole; Amoxicillin; Rifabutin
  • Oritavancin
  • Ospemifene
  • Oxacillin
  • Oxazepam
  • Oxcarbazepine
  • Paromomycin
  • Pegaspargase
  • Penbutolol
  • Penicillin G
  • Penicillin G Benzathine
  • Penicillin G Benzathine; Penicillin G Procaine
  • Penicillin G Procaine
  • Penicillin V
  • Pentobarbital
  • Perindopril
  • Perindopril; Amlodipine
  • Pexidartinib
  • Phenobarbital
  • Phenothiazines
  • Phenoxybenzamine
  • Phentermine; Topiramate
  • Phentolamine
  • Pindolol
  • Piperacillin
  • Piperacillin; Tazobactam
  • Pitolisant
  • Plazomicin
  • Polymyxin B
  • Polymyxins
  • Potassium-sparing diuretics
  • Pramlintide
  • Prasterone, Dehydroepiandrosterone, DHEA (Dietary Supplements)
  • Prasterone, Dehydroepiandrosterone, DHEA (FDA-approved)
  • Prazosin
  • Prednisolone
  • Prednisone
  • Primidone
  • Propoxyphene
  • Propranolol
  • Pyrimethamine; Sulfadoxine
  • Quazepam
  • Quinapril
  • Raloxifene
  • Ramipril
  • Reserpine
  • Ribociclib; Letrozole
  • Rifabutin
  • Rifampin
  • Rifamycins
  • Rifapentine
  • Riluzole
  • Ritonavir
  • Rituximab; Hyaluronidase
  • Rivaroxaban
  • Roflumilast
  • Romidepsin
  • Ropinirole
  • Rosuvastatin
  • Rufinamide
  • Sacubitril; Valsartan
  • Saquinavir
  • Sarilumab
  • Saxagliptin
  • Secobarbital
  • Selegiline
  • Semaglutide
  • SGLT2 Inhibitors
  • Siltuximab
  • Simvastatin; Sitagliptin
  • Sincalide
  • Sitagliptin
  • Somatropin, rh-GH
  • Spironolactone
  • St. John’s Wort, Hypericum perforatum
  • Streptogramins
  • Streptomycin
  • Succinylcholine
  • Sugammadex
  • Sulfadiazine
  • Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
  • Sulfasalazine
  • Sulfisoxazole
  • Sulfonamides
  • Sulfonylureas
  • Tacrine
  • Tazemetostat
  • Tedizolid
  • Telaprevir
  • Telavancin
  • Telithromycin
  • Telmisartan
  • Terazosin
  • Teriflunomide
  • Testolactone
  • Tetracycline
  • Thalidomide
  • Theophylline, Aminophylline
  • Thiazide diuretics
  • Thiazolidinediones
  • Thiopental
  • Thyroid hormones
  • Ticarcillin
  • Ticarcillin; Clavulanic Acid
  • Tigecycline
  • Timolol
  • Tinidazole
  • Tipranavir
  • Tizanidine
  • tobacco
  • Tobramycin
  • Tocilizumab
  • Tolazamide
  • Tolbutamide
  • Tolvaptan
  • Topiramate
  • Toremifene
  • Torsemide
  • Trandolapril
  • Trandolapril; Verapamil
  • Tranexamic Acid
  • Trastuzumab; Hyaluronidase
  • Triamcinolone
  • Triamterene
  • Triazolam
  • Tricyclic antidepressants
  • Trimethoprim
  • Ulipristal
  • Ursodeoxycholic Acid, Ursodiol
  • Valproic Acid, Divalproex Sodium
  • Valsartan
  • Vancomycin
  • Verapamil
  • Voriconazole
  • Warfarin
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