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  • Generic Name: (ethinyl estradiol/ferrous fumarate/norethindrone acetate, ethinyl estradiol/norethindrone acetate)
    Other Brands: Gildess Fe 1/20, Gildess Fe 1.5/30, Loestrin 21, Loestrin 21 1/20, Loestrin 21 1.5/30, Loestrin Fe, Loestrin Fe 1/20, Loestrin Fe 1.5/30, Microgestin 1/20, Microgestin 1.5/30, Microgestin Fe 1/20, Microgestin Fe 1.5/30
  • Last Revised: 07/2015
    • What is this medication and its most common uses?

      Junel is a birth control pill used to prevent pregnancy. Junel is available as Junel 1/20, Junel 1.5/30, Junel Fe 1/20, and Junel Fe 1.5/30.

    • What should I know when beginning and continuing on this medication?

      How does this medication work?

      Junel delivers hormones to block ovulation. If ovulation does not occur, your egg is not released, thereby preventing you from becoming pregnant.

      What are the beneficial effects of this medication and when should I begin to have results?

      What: When Junel is taken correctly without missing any pills, the chance of becoming pregnant is approximately 1 in 100 women per year. Junel may also help regulate your menstrual cycle, so your periods may be more predictable.

      When: The effects of pregnancy prevention are different depending on the day you start your first pack of pills. If you start on the Sunday after your period begins, then it may take 7 days for the pills to take effect (and you should therefore use another method of birth control as a back-up method during this time). If you start on the first day of your period, the pill should be effective right away, and you therefore will not need a back-up method of birth control.

      How do I know it is working?

      If you are taking the pills as directed by your healthcare provider and not missing any doses, you should be protected from becoming pregnant.

    • What are the possible side effects of this medication?

      The following is not a full list of side effects. Side effects cannot be anticipated. If any develop or change in intensity, tell your healthcare provider as soon as possible. Only your healthcare provider can determine if it is safe for you to continue taking this medication.

      Cigarette smoking increases the risk of serious heart-related side effects from use of birth control pills. This risk increases with age (especially if you are >35 years old) and heavy smoking (15 or more cigarettes per day). Do not smoke while you are taking birth control pills.

      More common side effects may include: nausea, vomiting, bleeding between your menstrual periods, weight gain, breast tenderness, difficulty wearing contact lenses.

      Less common side effects may include:

      Blood clots in your legs, lungs, or eyes, with symptoms such as sharp chest pain, coughing up blood, sudden shortness of breath, pain in your calf, or sudden partial or complete loss of vision.

      Stroke, angina (chest pain), or a heart attack, with symptoms such as crushing chest pain or heaviness in your chest, sudden severe headache or vomiting, dizziness or fainting, changes in your vision or speech, or weakness or numbness in an arm or leg. Smoking greatly increases the possibility of suffering a heart attack or stroke.

      Noncancerous but dangerous liver tumors or other liver problems, with symptoms such as severe pain or tenderness in your stomach area, or yellowing of your skin or the whites of your eyes, often accompanied by fever, fatigue, loss of appetite, dark-colored urine, or light-colored bowel movements.

      Increased risk of developing breast cancer, especially after using hormonal birth control at a younger age. After you stop using hormonal birth control, the chances of developing breast cancer begin to go back down. Examine your breasts monthly and call your healthcare provider if you feel a lump.

      Birth control pills may also cause fluid retention with swelling of your fingers or ankles, increased blood pressure, or increased risk of developing gallbladder disease.

    • Who should not take this medication?

      Do not take Junel if you are allergic to it or any of its ingredients.

      Do not take Junel if you have a history of heart attack or stroke; heart disease; blood clots in your legs, lungs, or eyes; angina; breast cancer or cancer of the lining of your uterus, cervix, or vagina; unexplained vaginal bleeding (until a diagnosis is reached by your healthcare provider); yellowing of your skin or the whites of your eyes during pregnancy or during previous use of birth control pills; or liver tumors.

      Do not take Junel if you are or think you may be pregnant.

    • What should I tell my healthcare provider before I take the first dose of this medication?

      Tell your healthcare provider about all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with Junel. Tell your healthcare provider if you have ever had any of the health conditions listed above. Also, talk to your healthcare provider about your complete medical history, especially if you have or have had breast nodules; fibrocystic disease of the breast (lumpy and painful breasts); an abnormal breast x-ray or mammogram; diabetes; high cholesterol or triglyceride (fats in your blood) levels; high blood pressure; migraines or other headaches; seizures; depression; gallbladder, heart, liver, or kidney disease; irregular menstrual periods; if you wear contact lenses; or if you plan to have surgery with prolonged bed rest.

    • What is the usual dosage?

      The information below is based on the dosage guidelines your healthcare provider uses. Depending on your condition and medical history, your healthcare provider may prescribe a different regimen. Do not change the dosage or stop taking your medication without your healthcare provider's approval.

      Junel 1/20

      Women and adolescents who have had their first menstrual period: There are 21 light-yellow "active" pills in the pill pack.

      Sunday Start: Take the first light-yellow "active" pill of the first pack on the Sunday after your period begins, even if you are still bleeding. If your period begins on a Sunday, start the pack that same day. Take the light-yellow "active" pills once a day for 21 days. The last tablet is taken on a Saturday. No tablets are taken for 7 days, and then a tablet from a new pack is taken the next day (Sunday).

      Day 1 Start: Take the first light-yellow "active" pill of the first pack during the first 24 hours of your period. Take the light-yellow "active" pills once a day from the first day through the 21st day of the menstrual cycle (counting the day your period starts as Day 1). No tablets are taken for 7 days, then a new course is started the next day.

      Junel 1.5/30

      Women and adolescents who have had their first menstrual period: There are 21 pink "active" pills in the pill pack.

      Sunday Start: Take the first pink "active" pill of the first pack on the Sunday after your period begins, even if you are still bleeding. If your period begins on a Sunday, start the pack that same day. Take the pink "active" pills once a day for 21 days. The last tablet is taken on a Saturday. No tablets are taken for 7 days, and then a tablet from a new pack is taken the next day (Sunday).

      Day 1 Start: Take the first pink "active" pill of the first pack during the first 24 hours of your period. Take the pink "active" pills once a day from the first day through the 21st day of the menstrual cycle (counting the day your period starts as Day 1). No tablets are taken for 7 days, and then a new course is started the next day.

      Junel Fe 1/20

      Women and adolescents who have had their first menstrual period: There are 21 light-yellow "active" pills and 7 brown iron pills in the pill pack.

      Sunday Start: Take the first light-yellow "active" pill of the first pack on the Sunday after your period begins, even if you are still bleeding. If your period begins on a Sunday, start the pack that same day. Take one light-yellow "active" pill once a day for 21 days followed by one brown iron pill per day for 7 days. After all 28 pills have been taken, start a new course the next day (Sunday).

      Day 1 Start: Take the first light-yellow "active" pill of the first pack during the first 24 hours of your period. Take one light-yellow "active" pill once a day from the first day through the 21st day of the menstrual cycle (counting the day your period starts as Day 1) followed by one brown iron pill per day for 7 days. Take the pills without interruption for 28 days. After all 28 pills have been taken, start a new course the next day.

      Junel Fe 1.5/30

      Women and adolescents who have had their first menstrual period: There are 21 pink "active" pills and 7 brown iron pills in the pill pack.

      Sunday Start: Take the first pink "active" pill of the first pack on the Sunday after your period begins, even if you are still bleeding. If your period begins on a Sunday, start the pack that same day. Take one pink "active" pill once a day for 21 days followed by one brown iron pill per day for 7 days. After all 28 pills have been taken, start a new course the next day (Sunday).

      Day 1 Start: Take the first pink "active" pill of the first pack during the first 24 hours of your period. Take one pink "active" pill once a day from the first day through the 21st day of the menstrual cycle (counting the day your period starts as Day 1) followed by one brown iron pill per day for 7 days. Take the pills without interruption for 28 days. After all 28 pills have been taken, start a new course the next day.

    • How should I take this medication?

      Before you start taking your pills, be sure to read the directions. Take one pill at the same time every day until the pack is empty. It is preferable to take the pill with a meal or at bedtime.

      If you are switching from a 21-day pack of birth control, wait 7 days to start Junel. If you are switching from a 28-day pack of birth control, start Junel on the same day that a new pack of the previous pills should have been started.

      For the first cycle of a Sunday Start regimen, use another method of birth control (such as condoms or foam) as a back-up method if you have sex anytime from the Sunday you start your first pack until the next Sunday (7 days).

      You will not need to use a back-up method of birth control for the first cycle of a Day 1 Start regimen, since you are starting the pill at the beginning of your period.

      If you have vomiting or diarrhea after you take Junel, it may not work as well. Use another birth control method (such as condoms or a spermicide) until you check with your healthcare provider.

      Irregular vaginal bleeding or spotting may occur while you are taking the pills. Irregular bleeding may vary from slight staining between menstrual periods to breakthrough bleeding, which is a flow much like a regular period. Irregular bleeding occurs most often during the first few months of taking the pills, but may also occur after you have been taking the pills for some time. Such bleeding may be temporary and usually does not indicate any serious problems. It is important to continue taking your pills on schedule. Tell your healthcare provider if the bleeding occurs in more than one cycle or lasts for more than a few days.

      There may be times when you may not have regular menstrual periods after you have completed taking a cycle of pills. If you have taken your pills regularly and miss one menstrual period, continue taking your pills for the next cycle, but be sure to inform your healthcare provider. If you have not taken the pills daily as instructed and missed a menstrual period, or if you missed two consecutive menstrual periods, you may be pregnant.

    • What should I avoid while taking this medication?

      Do not smoke cigarettes while you are taking Junel.

      Do not skip pills, even if you are spotting or bleeding between monthly periods, feel sick to your stomach (nausea), or if you do not have sex very often.

    • What are the possible food and drug interactions associated with this medication?

      If Junel is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your healthcare provider before combining Junel with the following: acetaminophen, clofibric acid, cyclosporine, morphine, prednisolone, salicylic acid, temazepam, or theophylline.

    • May I receive this medication if I am pregnant or breastfeeding?

      Do not take Junel if you are pregnant or breastfeeding. Junel can be found in your breast milk if you take it while breastfeeding. Tell your healthcare provider immediately if you are pregnant, plan to become pregnant, or are breastfeeding.

    • What should I do if I miss a dose of this medication?

      Junel 1/20 and Junel Fe 1/20

      If you miss one light-yellow "active" pill, take it as soon as you remember. Take the next pill at your regular time. This means you can take two pills in one day. You do not need a back-up birth control method if you have sex.

      Junel 1.5/30 and Junel Fe 1.5/30

      If you miss one pink "active" pill, take it as soon as you remember. Take the next pill at your regular time. This means you can take two pills in one day. You do not need a back-up birth control method if you have sex.

      If you miss two or more "active" pills of Junel, consult the patient information that accompanied your prescription or call your healthcare provider or pharmacist for advice.

      If you miss any of the 7 brown iron pills, throw away the missed pills. Continue taking the scheduled pills until the pack is finished. You do not need a back-up method of birth control.

    • How should I store this medication?

      Store at room temperature.

    • Who should I contact in case of emergency or overdose?
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      In the event of a medical emergency call your doctor or 9-1-1 immediately. In the event of overdose, call your doctor or poison control for further instructions.
      National Poison Control#: Call 1-800-222-1222

      This PDR+ drug information has been developed by the Physicians’ Desk Reference Network (PDRN), a source of medication information trusted by doctors for over 65 years.

      This monograph summarizes the most important information about your medication and does not cover all the information you may need. If you have any questions or concerns or want to learn more about your medication, ask your healthcare provider; he/she will be able to provide answers to your questions. This medication should only be used by the patient for whom it was prescribed and should not be shared with other people.
    • Additional patient resources.
      back to top Use your PDR® Pharmacy Discount Card when you or a family member fills a prescription and ask for your PDR® Discount every
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    This discount plan is NOT insurance or a Medicare prescription drug plan. The plan is not intended as a substitute for insurance and does not meet creditable coverage requirements under state or federal law. The plan provides discounts at participating pharmacies on certain pharmaceutical supplies, prescription drugs, or medical equipment and supplies. The range of discounts will vary depending on the products received. Members are obligated to pay the pharmacy the entire amount of the discounted rate for such products at the point of sale. The plan does not pay pharmacies for products provided to members. No enrollment or periodic fees apply. The pharmacy may pay the plan a fee from amounts the pharmacy collects from the member. The discount plan organization is ProCare Pharmacy Benefit Manager, Inc.,1267 Professional Parkway, ProCare Office Park, Gainesville, GA 30507, 1-888-299-5383. Customer service is provided by PDR, LLC., 5 Paragon Drive, Montvale, NJ, 07645, 1-800-232-7379, www.pdr.net/DiscountCard, customerservice@pdr.net.