What are the side effects of the birth control pill Blisovi Fe?

Medically reviewed by Dr. Jamie Winn
Aug 21, 2023

Blisovi Fe is a hormonal combination birth control pill containing a progestin (norethindrone acetate), an estrogen (ethinyl estradiol), and an iron supplement (ferrous fumarate). Blisovi Fe is a generic version of the brand-name medication Loestrin Fe. It comes in several different strengths, including Blisovi Fe 1/20, Blisovi Fe 1.5/30, and Blisovi 24 Fe. In addition to being used as a contraceptive, Blisovi Fe can be used to regulate menstrual periods and decrease the risk of ovarian cysts. Blisovi Fe does not protect against sexually transmitted diseases such as HIV.

While this medication is generally well tolerated, it may cause some side effects. The most common side effects of Blisovi Fe include nausea, vomiting, stomach pain or cramps, bloating, breakthrough bleeding, or irregular menstrual cycles. Although not common, it may also cause more serious side effects, including an increased risk of blood clots, stroke, and other heart problems. This risk is further increased if you are over 35 years of age and smoke.

What else do you need to know about Blisovi Fe? Keep reading and we will go into more detail about its side effects, how it works, and other precautions that may need to be taken with this medication.

What does Blisovi Fe do?

Blisovi Fe contains 2 hormones, norethindrone acetate and ethinyl estradiol, which work together to stop you from becoming pregnant. It does this by preventing your ovaries from releasing eggs (ovulation). It also causes changes in your cervical mucus, which makes it difficult for sperm to get into the womb (uterus). Finally, it changes the lining of your uterus so that a fertilized egg has a hard time attaching to the womb.

What are the common side effects of Blisovi Fe?

Common side effects of Blisovi Fe

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

Headache
Breast tenderness
Yeast infection
Nausea
Abdominal pain
Bloating
Acne
Menstrual cramps
Mood changes
Bacterial vaginal infection
Breakthrough bleeding or irregular bleeding
Weight gain

Other side effects of Blisovi Fe from post-market experience

Changes in blood sugar
Rash
Itching
Migraine or severe headaches
Dizziness
Appetite changes
Chest pain
Difficulty wearing contact lenses or vision changes
Increased triglycerides

What are the serious side effects of Blisovi Fe?

Serious heart problems and smoking: If you are over the age of 35 and smoke, you are at an increased risk of serious heart problems, such as blood clots, heart attacks, and strokes. Contact your healthcare provider to discuss a safer form of birth control if you smoke.
Increased risk of blood clots and stroke: Even if you do not smoke, Blisovi Fe increases your risk of blood clots in your brain (stroke), lungs (pulmonary embolism), heart (heart attack), and legs (deep vein thrombosis). This is increased if you smoke, are obese, are over 40, have diabetes, have high blood pressure, have heart disease, or take this medication less than a month after giving birth. Your risk of stroke or blood clot is highest during your first year of taking Blisovi Fe.
Allergic reaction: Stop Blisovi Fe and seek immediate medical attention if you experience swelling of your face, lips, tongue, mouth, or throat, which can lead to trouble breathing or shortness of breath.
Liver disease: You should not use Blisovi Fe if you have hepatitis, cirrhosis, or liver tumors. Stop Blisovi Fe if you develop signs of jaundice or serious liver problems, including loss of appetite, upper stomach pain, fatigue, dark urine, clay-colored stools, and jaundice (yellowing of your skin or eyes).
High blood pressure: Blisovi Fe can raise your blood pressure. Be sure to monitor your blood pressure while on this medication.
Gallbladder disease: Studies suggest you have a small increased risk of developing gallbladder disease while taking oral contraceptives such as Blisovi Fe. This risk is further increased if you have a history of gallstones or gallbladder disease.
Increased blood sugar and cholesterol: Blisovi Fe can increase your cholesterol and blood sugar levels. Use with caution and monitor these levels if you have prediabetes, diabetes, or high cholesterol.
Possible increased risk of endometrial or breast cancer: While studies have shown mixed results, you should not take this medication if you have breast cancer or other progestin- or estrogen-sensitive cancer.

Contact your healthcare professional for medical advice about any possible adverse effects you experience while taking Blisovi Fe. You can report your adverse effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

What drug interactions are there with Blisovi Fe?

When Blisovi Fe 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 include:

Ritonavir/paritaprevir/ombitasvir, with or without dasabuvir
St. John’s Wort
Phenytoin
Carbamazepine
Rifampin

Boxed warning

Cigarette smoking increases the risk of severe cardiovascular events when using combination oral contraceptives (COC).

Blisovi Fe should not be used in women who are over 35 years old and smoke.

What are some other precautions with Blisovi Fe?

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

Are over 35 years old and smoke
Have a history of or are at an increased risk of heart disease, high blood pressure, blood clots, or stroke
Have a history of liver disease or tumors
Have high cholesterol
Have abnormal uterine or vaginal bleeding
Have breast cancer or other progestin or estrogen-sensitive cancer.
Gave birth within the last month
Are breastfeeding
Have thyroid disease
Have kidney disease

How do you use Blisovi Fe?

Blisovi Fe is taken by mouth once a day. It should be taken at the same time of day each day. Pick a time that is easy for you to remember or set an alarm to help remind you. Blisovi Fe can be taken with or without food. If you become nauseous after taking this medication, try taking it with food.

There are 2 ways to start taking Blisov Fe. You can either start on a Sunday (Sunday Start) or on the first day of your menstrual period (Day 1 Start). If you use the Sunday Start, you will need to use a non-hormonal backup contraceptive including condoms and spermicide for the first 7 days after beginning this medication. If you use the Day 1 Start, you do not have to use a backup contraceptive.

Be sure to not miss doses of Blisovi Fe. This can cause spotting as well as increase your risk of pregnancy. If you miss a dose of Blisovi Fe, read the package insert that comes with the medication or contact your healthcare provider.

How do you store Blisovi Fe?

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