Instruct the patient to begin taking norethindrone acetate and ethinyl estradiol tablets and ferrous fumarate tablets either on the first day of her menstrual period (Day 1 Start) or on the first Sunday after the onset of her menstrual period (Sunday Start).

Day 1 Start

During the first cycle of norethindrone acetate and ethinyl estradiol tablets and ferrous fumarate tablets use, instruct the patient to take one white norethindrone acetate and ethinyl estradiol tablet daily, beginning on Day one (1) of her menstrual cycle (the first day of menstruation is Day one). She should take one white norethindrone acetate and ethinyl estradiol tablet daily for 24 consecutive days, followed by one brown ferrous fumarate tablet daily on days 25 through 28. Norethindrone acetate and ethinyl estradiol tablets and ferrous fumarate tablets should be taken in the order directed on the package at the same time each day. Instruct the patient to use a non-hormonal contraceptive as back-up during the first 7 days if she starts taking norethindrone acetate and ethinyl estradiol tablets and ferrous fumarate tablets on a day other than the first day of her menstrual cycle. The possibility of ovulation and conception prior to initiation of medication should be considered.

Sunday Start

During the first cycle of norethindrone acetate and ethinyl estradiol tablets and ferrous fumarate tablets use, instruct the patient to take one white norethindrone acetate and ethinyl estradiol tablet daily, beginning on the first Sunday after the onset of her menstrual period. She should take one white norethindrone acetate and ethinyl estradiol tablet daily for 24 consecutive days, followed by one brown ferrous fumarate tablet daily on days 25 through 28. Norethindrone acetate and ethinyl estradiol tablets and ferrous fumarate tablets should be taken in the order directed on the package at the same time each day. Norethindrone acetate and ethinyl estradiol tablets and ferrous fumarate tablets should not be considered effective as a contraceptive until after the first 7 consecutive days of product administration. Instruct the patient to use a non-hormonal contraceptive as back-up during the first 7 days. The possibility of ovulation and conception prior to initiation of medication should be considered.

The patient should begin her next and all subsequent 28-day regimens of norethindrone acetate and ethinyl estradiol tablets and ferrous fumarate tablets on the same day of the week that she began her first regimen, following the same schedule. She should begin taking her white norethindrone acetate and ethinyl estradiol tablets on the next day after ingestion of the last brown ferrous fumarate tablet, regardless of whether or not a menstrual period has occurred or is still in progress. Anytime a subsequent cycle of norethindrone acetate and ethinyl estradiol tablets and ferrous fumarate tablets is started later than the day following administration of the last brown ferrous fumarate tablet, the patient should use another method of contraception until she has taken a white norethindrone acetate and ethinyl estradiol tablet daily for 7 consecutive days.

For postpartum women who do not breastfeed or after a second trimester abortion, start norethindrone acetate and ethinyl estradiol tablets and ferrous fumarate tablets no earlier than 4 weeks postpartum due to the increased risk of thromboembolism. If the patient starts on norethindrone acetate and ethinyl estradiol tablets and ferrous fumarate tablets postpartum and has not yet had a period, evaluate for possible pregnancy, and instruct her to use an additional method of contraception until she has taken norethindrone acetate and ethinyl estradiol tablets and ferrous fumarate tablets for 7 consecutive days.

Norethindrone acetate and ethinyl estradiol tablets and ferrous fumarate tablets may be initiated immediately after a first-trimester abortion or miscarriage; if the patient starts norethindrone acetate and ethinyl estradiol tablets and ferrous fumarate tablets immediately, additional contraceptive measures are not needed.