Is Blisovi Fe 1/20 a combination pill?

Medically reviewed by Dr. Jamie Winn
Aug 18, 2023

The most commonly prescribed birth control pills combine synthetic estrogen and progestin, which is a synthetic form of progesterone. Progestins can be used by themselves or in combined oral contraceptives (COCs) to treat painful periods (dysmenorrhea), abnormal menstrual cycles, unusual uterine bleeding, and endometriosis-related pain. Estrogen’s primary role in COCs is to control menstrual bleeding. Progestin is also added to estrogen in hormone replacement therapy (HRT) and COCs to reduce the risk of uterine cancer in women who still have their uterus.

Blisovi Fe 1/20 is a combination birth control pill that has 21 active tablets and 7 tablets that contain an iron supplement. The 21 active tablets contain 1 mg of norethindrone acetate (a progestin) and 20 mcg of ethinyl estradiol (an estrogen). The other 7 tablets contain 75 mg of ferrous fumarate, which does not serve any medicinal purpose. It is used to help you remember to take the tablets every day.

While it is typically used to prevent pregnancy, Blisovi Fe 1/20 can also help regulate your menstrual cycle, decrease your risk of ovarian cysts, and treat acne. Blisovi Fe 1/20 does not protect you against HIV/AIDs and other sexually transmitted diseases.

Blisovi Fe 1/20 FAQs

How does Blisovi Fe 1/20 work?

Blisovi Fe 1/20 is a hormonal form of birth control that contains a progestin called norethindrone acetate and an estrogen called ethinyl estradiol. It works in 3 different ways to prevent pregnancy. It blocks sperm by creating thick cervical mucus, thins your uterine wall to prevent fertilized eggs from attaching to it, and prevents ovulation so there is no egg released from the ovary to fertilize.

How do you use Blisovi Fe 1/20?

Blisovi Fe 1/20 is taken by mouth once daily. It should be taken at the same time every day. Because nausea is a possible side effect, you can take this medication with a meal or snack if needed. Blisovi Fe 1/20 will be less effective if you experience vomiting or diarrhea shortly after taking the pill. If you do have diarrhea or vomiting, you may need to use a backup birth control method such as condoms or spermicide.

You should take the tablets in the order that the blister pack indicates. Blisovi Fe 1/20 contains 21 days of active pills and then a week of an iron supplement. You should experience your period during the 7 days when you are on the iron supplement pills.

What are the side effects of Blisovi Fe 1/20?

These are the most common side effects seen in clinical trials include:

Nausea
Headache
Breast tenderness
Yeast infection
Acne
Mood changes
Menstrual cramps
Bacterial vaginal infection
Weight gain

Other side effects of Blisovi Fe 1/20 include:

Abnormal menstrual cycles and breakthrough bleeding
Bloating
Increased cholesterol
Increased blood sugar
Increased triglycerides
Rash
Severe headaches and migraines
Chest pain
Appetite changes including loss of appetite
Vision changes and contact lenses discomfort

Rarely, Blisovi Fe 1/20 can cause some serious side effects, including:

Increased risk of blood clots, strokes, and heart attacks, especially in women over the age of 35 that smoke
Increased risk of stroke and blood clots, especially in the first year of taking Blisovi Fe 1/20
Increased risk of liver tumors, liver disease, and jaundice (yellowing of your skin or eyes)
Serious life-threatening allergic reaction (hives, swelling of your face, lips, tongue, mouth, or throat, and shortness of breath)
Hypertension (high blood pressure)
Gallbladder disease and gallstones
Possible increased risk of cancer, including endometrial and breast cancer

These are not all of the possible side effects of Blisovi Fe 1/20. You should always seek medical advice from your healthcare professional for any questions or concerns about your medical condition or treatment. Read all prescribing information, medication guides, or drug information sheets that come with this medication. You can report adverse effects to the FDA at www.fda.gov/medwatch or 1-800-FDA-1088.

What drugs interact with Blisovi Fe 1/20?

When Blisovi Fe 1/20 is taken with other prescription drugs, over-the-counter medications, vitamins, and supplements, it may change how they work or increase the frequency or severity of side effects. Some drug interactions with Blisovi Fe 1/20 include:

Hepatitis C virus combination drugs that contain ritonavir/ombitasvir/paritaprevir, with or without dasabuvir
St. John’s wort
Carbamazepine
Phenytoin
Atorvastatin
Tetracyclines
Rifampin

Does Blisoivi Fe 1/20 have a boxed warning?

Blisovi Fe 1/20 carries a boxed warning from the FDA concerning smoking and the increased risk of serious, sometimes life-threatening cardiovascular events such as stroke and heart attack when using combination oral contraceptives (COC). This risk increases with age and if you are a heavy smoker (15 or more cigarettes per day). Blisovi Fe 1/20 should not be used in women who are over 35 years old and smoke.

Who should not take Blisovi Fe 1/20?

You should avoid using Blisovi Fe 1/20 if you:

Are over the age of 35 and smoke
Have liver disease or liver tumors
Had blood clots or have a clotting disorder
Have an irregular heartbeat or heart valve issue that increases your risk of blood clots
Had a heart attack or stroke
Have uncontrolled high blood pressure or heart disease
Have diabetes with nerve, kidney, blood vessel, or eye damage
Have any unexplained vaginal bleeding
Had breast cancer or other progestin- or estrogen-sensitive cancer
Are pregnant or breastfeeding
Are taking Hepatitis C drug combinations containing paritaprevir/ombitasvir/ritonavir, with or without dasabuvir

You should also be sure that your healthcare provider is aware of all your other medical conditions, including if you:

Have high cholesterol
Gave birth within the previous month
Have thyroid disease
Have kidney disease
Have migraines or severe headaches

How much does Blisovi Fe 1/20 cost?

Blisovi Fe 1/20 is a generic version of Loestrin Fe 1/20. The average retail cost is around $25 for 1 package (28-day supply). Your cost may be cheaper if your insurance covers this medication.

How do you store Blisovi Fe 1/20?

Blisovi Fe 1/20 should be stored at room temperature around 77° F (25° C). However, excursions are permitted as long as temperatures remain between 59 to 86° F (15 to 30° C). Keep out of the reach of children.

Do you gain weight on Blisovi Fe 1/20 birth control?

For most women, oral birth control pills such as Blisovi Fe 1/20 will not have a significant effect on their weight. However, weight gain was listed as a common side effect that occurred in at least 2% of women in the clinical trials of this medication. This weight gain could be caused by factors other than Blisovi Fe 1/20.

Since Blisovi Fe 1/20 has been on the market, there have been reports of weight gain, weight loss, as well as an increase or decrease in appetite. It is not known if the medication was the cause of these weight fluctuations.

What are the odds of getting pregnant on Blisovi Fe 1/20?

When oral contraceptives are taken correctly without missing pills, the chance of you becoming pregnant is less than 1%. The chance of becoming pregnant increases with each missed pill during a menstrual cycle.

Does Blisovi Fe 1/20 give you acne?

While it is sometimes used to help with acne, one of its common side effects is acne. This typically means it occurred in 1% or more of patients participating in the clinical study.

Related medications

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Blisovi 24 Fe (norethindrone acetate/ethinyl estradiol)
Junel Fe 1.5/30 (norethindrone acetate/ethinyl estradiol)
Larin Fe 1.5/30 (norethindrone acetate/ ethinyl estradiol/ ferrous fumarate)
Lo Loestrin Fe (norethindrone acetate/ ethinyl estradiol)
Microgestin Fe 1.5/30 (norethindrone acetate/ ethinyl estradiol/ ferrous fumarate)