What Is Ortho Tri-Cyclen 28 Day?

Ortho Tri-Cyclen 28 Day is a triphasic combination oral contraceptive (birth control pill) containing two hormones: the progestin Norgestimate and the estrogen Ethinyl Estradiol (0.035 mg). It prevents pregnancy by stopping ovulation, thickening cervical mucus, and altering the uterine lining. It is also FDA-approved for the treatment of moderate acne in women 15 and older.

Brand, Generic, and Manufacturer

Ortho Tri-Cyclen was originally manufactured by Janssen Pharmaceuticals (a Johnson & Johnson company). The brand has been discontinued, but several generic equivalents are widely available:

• Tri-Sprintec (Teva)
• Tri-Estarylla (various)
• Tri-Previfem (various)
• Tri-Mili (various)
• Tri-Linyah (various)
• TriNessa / Tri-Nessa (various)

All generics contain the same active ingredients in the same doses and are rated as therapeutically equivalent by the FDA.

Drug Class

Ortho Tri-Cyclen belongs to the combination oral contraceptive (COC) drug class, specifically the triphasic subtype. "Triphasic" means the progestin dose changes across three phases during the cycle, while the estrogen dose remains constant. It is not a controlled substance.

What Is Ortho Tri-Cyclen Used For?

FDA-Approved Uses

• Pregnancy prevention in women of reproductive age
• Moderate acne treatment in females at least 15 years old who have started menstruating and want oral contraception

Common Off-Label Uses

Doctors also prescribe Norgestimate/Ethinyl Estradiol for:

• Regulating irregular menstrual cycles
• Managing symptoms of polycystic ovary syndrome (PCOS)
• Reducing menstrual cramps (dysmenorrhea)
• Managing endometriosis symptoms
• Treating heavy menstrual bleeding (menorrhagia)

How Is Ortho Tri-Cyclen 28 Day Taken?

The pack contains 28 tablets: 21 active pills and 7 inactive (placebo) pills.

The Three Phases

1. Days 1–7 (White tablets): 0.180 mg Norgestimate / 0.035 mg Ethinyl Estradiol
2. Days 8–14 (Light blue tablets): 0.215 mg Norgestimate / 0.035 mg Ethinyl Estradiol
3. Days 15–21 (Blue tablets): 0.250 mg Norgestimate / 0.035 mg Ethinyl Estradiol
4. Days 22–28 (Dark green tablets): Inactive/placebo — your period typically occurs during this week

How to Start

There are two common ways to start:

• Day 1 Start: Take your first pill on the first day of your period. No backup contraception needed.
• Sunday Start: Take your first pill on the first Sunday after your period begins. Use backup contraception (like condoms) for the first 7 days.

Important Dosing Rules

• Take one pill at the same time every day
• Can be taken with or without food
• After finishing all 28 pills, start a new pack immediately — no gap between packs
• If you miss a pill, refer to the patient insert or call your doctor. Missing pills increases pregnancy risk.

Who Should NOT Take Ortho Tri-Cyclen?

Do not use this medication if you have any of the following:

• Are over 35 and smoke (FDA black box warning)
• History of blood clots (DVT or pulmonary embolism)
• History of stroke or heart disease
• Uncontrolled high blood pressure
• Diabetes with vascular complications
• Migraines with aura
• Undiagnosed abnormal uterine bleeding
• Breast cancer or other hormone-sensitive cancer
• Active liver disease or liver tumors
• Are pregnant
• Taking Hepatitis C medications containing Ombitasvir/Paritaprevir/Ritonavir

For a full list of side effects and warnings, see our detailed guide. For information about drug interactions, check our interactions guide.

How Much Does Ortho Tri-Cyclen 28 Day Cost?

Since the brand is discontinued, you'll be getting a generic. Here's what to expect:

• With insurance: Most plans cover generic Norgestimate/Ethinyl Estradiol with no copay under the ACA contraceptive mandate.
• Without insurance (cash price): $13–$55 per pack at retail price.
• With a discount card: As low as $6–$25 per 28-day pack. GoodRx shows prices around $14, and SingleCare lists Tri-Estarylla as low as $6 at some pharmacies.

For a complete breakdown of savings options, read our guide to saving money on Ortho Tri-Cyclen 28 Day.

Final Thoughts

Ortho Tri-Cyclen 28 Day remains one of the most well-known triphasic birth control pills, and its generics are affordable and widely available. Whether you're using it for pregnancy prevention, acne treatment, or menstrual regulation, it's a proven medication with decades of clinical use behind it.

If you need help finding a generic version in stock near you, Medfinder can show you real-time pharmacy availability. And if you need a prescription, check our guide on how to find a doctor who can prescribe Ortho Tri-Cyclen 28 Day.