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  • Generic Name: (dienogest/estradiol valerate)
    Other Brands: Natazia
  • Last Revised: 10/2015
    • What is this medication and its most common uses?

      Natazia is a birth control pill used to prevent pregnancy. Natazia is also used to treat heavy menstrual bleeding in women who choose to use Natazia for birth control.

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

      How does this medication work?

      Natazia delivers hormones to block ovulation (the release of an egg from an ovary). If ovulation does not occur, your egg is not released, thereby preventing you from becoming pregnant. Natazia also decreases menstrual bleeding by thinning the lining of the uterus.

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


      Birth Control: When Natazia is taken correctly without missing any pills, the chance of becoming pregnant is approximately 1-2 in 100 women per year.

      Heavy Menstrual Bleeding: Natazia has been shown in two separate clinical trials to reduce menstrual bleeding by an average of 78% and 72%.


      Birth Control: If you start Natazia on the first day of your period, it may take 9 days for the pill to take effect (and you should therefore use another method of birth control as a backup method during this time).

      Heavy Menstrual Bleeding: Heavy bleeding was shown to have a 50% reduction of blood loss by the second period cycle.

      How do I know it is working?

      If you are taking the pill as directed by your healthcare provider and not missing any doses, you should be protected from becoming pregnant. You may also notice a reduction in your menstrual bleeding.

    • 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 with the number of cigarettes smoked. Women >35 years old who smoke should not take Natazia.

      More common side effects may include: spotting or bleeding between menstrual periods, nausea, vomiting, breast tenderness, headache, acne (pimples), mood changes, increased weight.

      Less common side effects may include:

      Blood clots in your legs, lungs, eyes, heart, or brain. Call your healthcare provider right away if you experience persistent leg pain, sudden shortness of breath, sudden blindness (partial or complete), severe pain in your chest, sudden or severe headache, weakness or numbness in an arm or leg, trouble speaking, or yellowing of the skin or eyeballs.

      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.

      Birth control pills may increase your risk of developing gallbladder disease.

      Natazia may also cause increased blood pressure, high cholesterol (fats in your blood) levels, bloating, or blotchy darkening of your skin.

    • Who should not take this medication?

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

      Do not take Natazia if you are >35 years old and a smoker; if you have a history of blood clots in your arms, legs or lungs; heart disease; heart attack; stroke; uncontrolled high blood pressure; diabetes with kidney, eye, nerve, or blood vessel damage; certain types of headaches; unexplained vaginal bleeding (until a diagnosis is reached by your healthcare provider); certain heart valve problems or heart rhythm abnormalities that can cause blood clots to form in the heart; an inherited problem with your blood that makes it clot more than normal; breast or uterine cancer; liver tumors or active liver disease.

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

    • 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 Natazia. Tell your healthcare provider if you 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 cancer; diabetes; high cholesterol or triglyceride (fats in your blood) levels; high blood pressure; headaches or migraines; depression; problems with your gallbladder, liver, heart, or kidney.

    • 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.

      Women and adolescents who have had their first menstrual period: There are 26 "active" pills in various colors, and 2 white "reminder" pills in the pill pack.

      Days 1 and 2: Take 1 dark yellow pill each day.
      Days 3-7: Take 1 medium red pill each day.
      Days 8-24: Take 1 light yellow pill each day.
      Days 25 and 26: Take 1 dark red pill each day.
      Days 27 and 28: Take 1 white pill each day.

      After taking the last white pill on day 28 of the pill pack, start taking the first dark yellow pill from a new pill pack the very next day.

    • How should I take this medication?

      Before you start taking your pills, be sure to read the directions. Take one pill every day at the same time in the order directed on the pill pack until empty. When you finish a pack, start the next pack on the day after your last white "reminder" pill.

      Do not wait any days between packs. If you are switching from another brand of pills, start Natazia on the same day that a new pack of the previous pills should have been started. If you are switching from another birth control method, talk to your healthcare provider about what you should do.

      If you have vomiting or diarrhea within 4 hours of taking Natazia, follow the instructions for "what should I do if I miss any pills."

    • What should I avoid while taking this medication?

      Do not smoke cigarettes while taking Natazia.

      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 Natazia is taken with certain other drugs, the effect of either could be increased, decreased, or altered. Natazia may interact with numerous medications. Therefore, it is very important that you tell your healthcare provider about any other medications you are taking.

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

      Do not take Natazia if you are pregnant or breastfeeding. Natazia 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?

      If you forgot to start a new pill pack, use a backup contraception (such as condoms and spermicides) anytime you have sex. Contact your healthcare provider if you are unsure whether you are pregnant.

      If it has been less than 12 hours since your missed pill, take the missed dose as soon as you remember then take the next pill at the usual time. You do not need to use a backup contraception.

      If you miss 1 pill for more than 12 hours or miss 2 pills in a row, call your healthcare provider for instructions.

    • 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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