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Reporting a Medication Error

Birth control pills—active or placebo tablets?

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With birth control pills (e.g., Tri-Estarylla, Tri-Linyah), confusion is possible between the week 1 tablets that contain norgestimate and ethinyl estradiol and the week 4 tablets that do not contain any medicine. Different brands of these birth control pills have the same medicine and dose in the active tablets, but the tablet colors vary (Table 1).

A woman who previously received Tri-Linyah from her old pharmacy was given Tri-Estarylla from her new pharmacy. Even though the new pharmacy only carried Tri-Estarylla, the amount of norgestimate and ethinyl estradiol was the same as in Tri-Linyah. The woman called the pharmacy and asked why the placebo tablets in the calendar pack were green rather than white. The pharmacist told her that Tri-Estarylla has different color tablets for weeks 1 and 4 than Tri-Linyah (Table 1). These color differences confused the woman. Thankfully, she called the pharmacy before taking the wrong tablets at the wrong time of the month. The pharmacist taught her how to take the pills correctly.

Table 1 lists the differences in the colors used for week 1 and week 4 tablets among the different brand name products. This is of concern, especially for women who are switching between various brand products. Women may inadvertently take the placebo

(no medicine) tablets when they should be taking the week 1 active tablets, especially if the labeling on the calendar pack is confusing or difficult to read. This can reduce the effectiveness of the birth control pills. It would be less confusing if all the norgestimate and ethinyl estradiol birth control pills used the same tablet colors for the same weeks of treatment.

 table for bcp pills

Here’s what you can do: When picking up birth control pills at your pharmacy, talk to your pharmacist to make sure you know how to take the medicine. Also, when you pick up any medicine at your pharmacy, open the bag and look at the medicine. If you notice any change in your medicine, such as the name of the product or the color or size of the tablet, ask the pharmacist to confirm that it is the correct medicine, and then learn how to take it.


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