Ethinylestradiol
Pronunciation: (eth-in-il-es-TRAD-ee-ol).
- Generic name
- Ethinylestradiol
- Brand names
- Norimin, Triquilar, Alesse, Mala-D, Marvelon, Ovral
- Drug class
- Estrogen (Synthetic Estrogen, Hormonal Contraceptive)
Availability and supply rules vary by country
Trade names by country:
Australia: · Full directory
What Ethinylestradiol is and how it works
Uses, formulations, monitoring, and supply rules can differ by patient, product, and country. Follow the exact local product information and professional advice.
Mechanism of action: how Ethinylestradiol works
Ethinylestradiol is a synthetic estrogen that binds to estrogen receptors in target tissues, mimicking the effects of endogenous estradiol. In combination oral contraceptives, it suppresses the secretion of gonadotropins (FSH and LH) from the anterior pituitary, inhibiting ovulation. It also alters the cervical mucus, making it less permeable to sperm, and changes the endometrial lining to reduce the likelihood of implantation. (2)
What Ethinylestradiol is used for
Hormonal contraception
Hormonal contraception (2)
Treatment of menopausal symptoms
Treatment of menopausal symptoms (2)
Treatment of hypogonadism in females
Treatment of hypogonadism in females (2)
Management of certain menstrual disorders
Management of certain menstrual disorders (2)
Treatment of acne (in combination with progestins)
Treatment of acne (in combination with progestins) (2)
Before taking Ethinylestradiol
Do not take / not appropriate for
- history of thromboembolic disorders, stroke, myocardial infarction, estrogen-dependent tumors, severe hepatic impairment, undiagnosed vaginal bleeding, and known hypersensitivity. (Contraindication) (2)
Tell your clinician about
(2)How to take Ethinylestradiol
- General Instructions: Take Ethinylestradiol at the same time each day, with or without food. Follow your healthcare provider's instructions and the specific dosing schedule provided.. Adult Dosing: Typical dose for contraception: 20–50 mcg daily, usually in combination with a progestin, for 21 days followed by a 7-day pill-free interval or placebo.. Pediatric Dosing: Not recommended for prepubertal children. For adolescents, dosing is similar to adults but should be initiated under specialist supervision.. Administration: Swallow tablets whole with water. Do not skip doses. If vomiting or severe diarrhea occurs within 3–4 hours of taking a dose, follow missed dose instructions.. When To Stop: Seek medical attention immediately if you develop symptoms of blood clots or jaundice, or if pregnancy is suspected; let the clinician you see advise on whether to continue or stop.. Storage: Store at 25C (77F), with excursions permitted between 15-30C (59-86F), away from moisture, heat, and light. Keep out of reach of children.
- This page does not provide a dose calculator. Dosing must follow the prescriber, pharmacist, or product label.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (2)
Missed dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular schedule. Do not take an extra dose. If you miss more than one dose, follow the instructions provided with your medication or consult your healthcare provider. Use backup contraception if needed.
Overdose
Symptoms of overdose may include nausea, vomiting, and withdrawal bleeding. Seek emergency medical attention if an overdose is suspected. There is no specific antidote; treatment is supportive. (2)
Side effects
Side effects and their urgency vary; report severe, persistent, or concerning symptoms to a healthcare professional.
Nausea
Incidence: Reported in the clinician-authored database; frequency not established
Breast tenderness
Incidence: Reported in the clinician-authored database; frequency not established
Headache
Incidence: Reported in the clinician-authored database; frequency not established
Weight changes
Incidence: Reported in the clinician-authored database; frequency not established
Mood changes
Incidence: Reported in the clinician-authored database; frequency not established
Blood clots
Incidence: Reported in the clinician-authored database; frequency not established
Stroke
Incidence: Reported in the clinician-authored database; frequency not established
Heart attack
Incidence: Reported in the clinician-authored database; frequency not established
Serious warnings
BOXED WARNING — Cigarette smoking and serious cardiovascular events — serious
Symptoms: BOXED WARNING — Cigarette smoking and serious cardiovascular events: smoking increases the risk of serious cardiovascular events (including fatal heart attack, blood clots, and stroke) from ethinylestradiol-containing combined hormonal contraceptives. This risk rises with age (especially over 35) and number of cigarettes smoked. Women over 35 who smoke should not use these products.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
May increase risk of certain cancers (breast, endometrial) in some individuals — serious
Symptoms: May increase risk of certain cancers (breast, endometrial) in some individuals. Not recommended during pregnancy or breastfeeding. May cause elevated blood pressure; monitor regularly. Can interact with other medications, including some antibiotics and anticonvulsants.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
Contraindications — serious
Symptoms: Contraindications: high risk of arterial or venous thrombotic disease (including smoking over age 35, prior blood clots, inherited clotting disorders, cerebrovascular or coronary artery disease, thrombogenic heart conditions, uncontrolled hypertension, diabetes with vascular disease, or migraine with aura); liver tumors or liver disease; undiagnosed abnormal uterine bleeding; pregnancy; current or past breast cancer; and concurrent use of certain hepatitis C drug combinations (ombitasvir/paritaprevir/ritonavir with or without dasabuvir). (Corrected/expanded from an earlier version that listed smoking over 35 only as a caution — FDA labeling treats it as a formal contraindication.)
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Recorded interactions | Ethinylestradiol may interact with medications that induce liver enzymes (such as rifampin, phenytoin, carbamazepine, barbiturates), reducing contraceptive effectiveness; backup contraception is advised for 28 days after stopping an enzyme-inducing drug. Some antibiotics, antiretrovirals, and herbal supplements (like St. John's Wort) can also decrease its efficacy. Colesevelam (a cholesterol-lowering bile-acid binder) significantly decreases ethinylestradiol levels when taken together. Always inform your healthcare provider about all medications and supplements you are taking. | (1) |
Pregnancy, breastfeeding, kidney/liver function, age
Pregnancy
Contraindicated during confirmed pregnancy. Ethinylestradiol-containing contraceptives must not be used to induce withdrawal bleeding as a pregnancy test. No increased risk of birth defects has been shown from inadvertent early-pregnancy exposure, but the medicine is not used during pregnancy; seek medical advice promptly if pregnancy is suspected. (2)
Breastfeeding
Nursing mothers are generally advised to use other forms of contraception, because combined hormonal contraceptives can reduce breast-milk production; small amounts of hormone pass into breast milk. Discuss contraceptive options with a healthcare provider while breastfeeding. (2)
Children
Frequency: Not applicable. Weight Based: Not recommended for pediatric use. Max Daily Dose: Not applicable. Max Single Dose: Not applicable. Age Restrictions: Safety not established in children. (2)
Renal_impairment
Contraindicated in liver tumors or significant liver disease. No specific renal-dosing adjustment is published; ethinylestradiol-containing products are not typically renally dosed. (2)
Hepatic_impairment
Contraindicated in liver tumors or significant liver disease. No specific renal-dosing adjustment is published; ethinylestradiol-containing products are not typically renally dosed. (2)
Monitoring
(2)Storage
Store at 25C (77F), with excursions permitted between 15-30C (59-86F), away from moisture and heat, protected from light. Keep out of reach of children.
Professional information
Clinician-facing context only. This section does not replace current product labeling.
General
Indication: Hormonal contraception
Dose summary: Typically, 20-35 mcg of ethinylestradiol is administered once daily.
Renal context: No specific renal-impairment dose adjustment is published; ethinylestradiol-containing products are not typically renally dosed. (2)
Frequently asked questions
What is Ethinylestradiol used for?
Ethinylestradiol is primarily used in combination oral contraceptives to prevent pregnancy. It is also used for hormone replacement therapy, treating menstrual disorders, and sometimes for acne management.
How effective is Ethinylestradiol for birth control?
When taken correctly and consistently, Ethinylestradiol-containing contraceptives are over 99% effective at preventing pregnancy.
Can I take Ethinylestradiol if I smoke?
Smoking increases the risk of serious cardiovascular side effects, especially in women over 35. It is strongly advised not to smoke while taking Ethinylestradiol.
What should I do if I miss a dose?
Take the missed dose as soon as you remember. If you miss more than one dose, follow the instructions provided with your medication or consult your healthcare provider. Use backup contraception if needed.
Are there any foods or medications I should avoid?
Avoid grapefruit juice and inform your doctor about all medications and supplements, as some can reduce the effectiveness of Ethinylestradiol.
What are the signs of a serious side effect?
Warning signs include sudden severe headache, vision changes, chest pain, leg swelling, or yellowing of the skin or eyes. Seek medical attention immediately if these occur.
Can Ethinylestradiol be used during pregnancy or breastfeeding?
No, Ethinylestradiol should not be used during pregnancy or breastfeeding. Inform your doctor if you become pregnant while taking this medication.
What happens if I take too much Ethinylestradiol?
Taking too much Ethinylestradiol can lead to symptoms such as nausea, vomiting, and vaginal bleeding. While generally not life-threatening, it's crucial to seek immediate medical attention or contact a poison control center if an overdose is suspected. Emergency help should be sought for severe symptoms or concerns.
Can I drink alcohol while taking Ethinylestradiol?
While moderate alcohol consumption is generally not contraindicated with Ethinylestradiol, excessive alcohol intake can potentially increase the risk of certain side effects, particularly liver-related issues, as both substances are metabolized by the liver. It's always best to discuss alcohol consumption with your healthcare provider to understand personalized risks.
Is Ethinylestradiol safe during pregnancy?
Ethinylestradiol-containing contraceptives are contraindicated during confirmed pregnancy and are not used to test for pregnancy. If you are pregnant or suspect you might be, contact your healthcare provider immediately; they will advise on next steps.
What is the mechanism of action of Ethinylestradiol?
Ethinylestradiol is a synthetic estrogen that binds to estrogen receptors in target tissues, mimicking the effects of endogenous estradiol. In combination oral contraceptives, it suppresses the secretion of gonadotropins (FSH and LH) from the anterior pituitary, inhibiting ovulation. It also alters the cervical mucus, making it less permeable to sperm, and changes the endometrial lining to reduce the likelihood of implantation. (2)
What is the generic name of Ethinylestradiol?
The generic name is Ethinylestradiol. It is sold under brand names including Norimin, Triquilar, Alesse, Mala-D, Marvelon, Ovral.
What class of drug is Ethinylestradiol?
Ethinylestradiol is classed as: Estrogen (Synthetic Estrogen, Hormonal Contraceptive).
References
- Ethinylestradiol clinician-authored medicine recordMedGuideGlobal internal clinical knowledge base · Not country-specific · accessed 2026-08-06 · source 1
- Norgestimate and Ethinyl Estradiol Tablets prescribing informationU.S. Food and Drug Administration (DailyMed) · United States · accessed 2026-08-06 · source 2
Brand names by country
Single-ingredient Ethinylestradiol names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.