Lo Loestrin Fe
Please see full Prescribing Information, including Boxed Warning. Learn about Lo Loestrin® Fe (norethindrone acetate and ethinyl estradiol tablets, ethinyl estradiol tablets and ferrous fumarate tablets). A combination oral contraceptive with the lowest daily dose of estrogen with just 10 mcg.

Bleeding profile

  • May provide short, lighter periods1,3
    • Mean duration of withdrawal bleeding was <2 days per cycle
    • Patient-reported intensity of withdrawal bleeding was lighter than normal
  • Incidence of amenorrhea increased over the course of the study; from 32% in Cycle 1 to 49% in Cycle 131,3,*

Unscheduled (breakthrough or intracyclic) bleeding and spotting sometimes occur in patients on COCs, especially during the first three months of use. If bleeding persists or occurs after previously regular cycles, check for causes such as pregnancy or malignancy. Counsel patients that amenorrhea may occur. Rule out pregnancy in the event of amenorrhea in two or more consecutive cycles.

*A subject was considered to have amenorrhea for
any interval with no reported bleeding or spotting.

Lo Loestrin Fe is the only available ultra-low-dose option with 10 mcg of daily estrogen that provides effective pregnancy prevention with an acceptable bleeding profile.1,3



Lo Loestrin® Fe is an estrogen/progestin combination oral contraceptive (COC) indicated for use by women to prevent pregnancy. The efficacy of Lo Loestrin Fe in women with a body mass index (BMI) of >35 kg/m2 has not been evaluated.


Cigarette smoking increases the risk of serious cardiovascular events from combination oral contraceptive (COC) use. This risk increases with age, particularly in women over 35 years of age, and with the number of cigarettes smoked. For this reason, COCs should not be used by women who are over 35 years of age and smoke.


Lo Loestrin Fe is contraindicated in pregnant patients, in women with a high risk of arterial or venous thrombotic diseases, liver tumors (benign or malignant) or liver disease, undiagnosed abnormal uterine bleeding, or breast cancer or other estrogen- or progestin-sensitive cancer, now or in the past, and in women using Hepatitis C drugs containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir.

Warnings and Precautions

Discontinue Lo Loestrin Fe if a thrombotic event occurs, and at least 4 weeks before and through 2 weeks after major surgery. Lo Loestrin Fe should not be started any earlier than 4 weeks after delivery, in women who are not breastfeeding. If jaundice occurs, treatment should be discontinued.

Lo Loestrin Fe should not be prescribed for women with uncontrolled hypertension or hypertension with vascular disease. Women who are pre-diabetic or diabetic should be monitored while using Lo Loestrin Fe. Alternate contraceptive methods should be considered for women with uncontrolled dyslipidemia. Patients using Lo Loestrin Fe who have a significant change in headaches or irregular bleeding or amenorrhea should be evaluated.

Adverse Reactions

In the clinical trial for Lo Loestrin Fe, serious adverse reactions included deep vein thrombosis, ovarian vein thrombosis, and cholecystitis. The most common adverse reactions (incidence ≥2%) were nausea/vomiting, headache, bleeding irregularities, dysmenorrhea, weight fluctuation, breast tenderness, acne, abdominal pain, anxiety, and depression.

Patients should be counseled that COCs do not protect against HIV infection (AIDS) and other sexually transmitted diseases.

Please see full Prescribing Information, including Boxed Warning, for Lo Loestrin Fe.


  1. Lo Loestrin® Fe prescribing information. Irvine, CA: Allergan USA, Inc.; 2017.
  2. US Food and Drug Administration. Guidance for industry: labeling for combined oral contraceptives. Published March 2004. Accessed August 24, 2015.
  3. Data on file. Allergan USA, Inc.: Rockaway, NJ.
  4. The Alan Guttmacher Institute. Fulfilling the promise: public policy and U.S. family planning clinics. Accessed August 24, 2015.
  5. Previfem® prescribing information. Huntsville, AL: Qualitest Pharmaceuticals; 2009.
  6. Oral contraceptive survey. Harris Poll. July 2014.
  7. Nakajima ST, Archer DF, Ellman H. Contraception. 2007;75(1):16-22.
  8. Willis SA, Kuehl TJ, Spiekerman AM, et al. Contraception. 2006;74(2):100-103.
  9. Spona J, Elstein M, Feichtinger W, et al. Contraception. 1996;54(2):71-77.