What is the dosage of Estrostep (Norethindrone Acetate and Ethinyl Estradiol) with Iron (Fe)?

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Last updated: February 21, 2025View editorial policy

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From the Guidelines

The typical dosage for Estrostep Fe is one tablet taken orally once daily, at the same time each day, with each pack containing 21 active tablets followed by 7 iron-containing placebo tablets. The active tablets contain ethinyl estradiol (an estrogen) and norethindrone acetate (a progestin) in varying doses throughout the cycle, as described in the study 1. It's crucial to take the pill at the same time every day to maintain consistent hormone levels and maximize effectiveness. If you miss a dose, take it as soon as you remember, even if it means taking two pills in one day. If you miss two or more pills, use a backup contraceptive method for 7 days, as recommended by the CDC 1. Estrostep Fe works by preventing ovulation, thickening cervical mucus, and altering the uterine lining. The iron in the placebo pills helps prevent anemia during menstruation. Some key points to consider when taking Estrostep Fe include:

  • Starting with the first active tablet on the first day of your menstrual period
  • Taking one tablet daily for 28 consecutive days, then starting a new pack immediately without any breaks
  • Being aware of potential drug interactions, such as those with anticonvulsants and antiretroviral drugs, which may decrease COC effectiveness 1
  • Understanding that typical use failure rates are 9% in adults and may be higher in adolescents, and counseling should include strategies to promote daily adherence 1. Always consult your healthcare provider for personalized dosing instructions, as they may adjust the regimen based on your individual needs and medical history.

From the FDA Drug Label

DOSAGE AND ADMINISTRATION Therapy with norethindrone acetate tablets must be adapted to the specific indications and therapeutic response of the individual patient. The FDA drug label does not answer the question.

From the Research

Dosage of Estrostep

The dosage of Estrostep (Norethindrone Acetate and Ethinyl Estradiol) with Iron (Fe) is as follows:

  • 1 mg of norethindrone acetate daily combined with:
    • 20 microg of ethinyl estradiol daily for the first 5 days
    • 30 microg of ethinyl estradiol daily for the next 7 days
    • 35 microg of ethinyl estradiol daily for 9 days
  • No medication is given for 7 days in each cycle to allow for withdrawal bleeding 2
  • The estrogen dose is gradually increased, while the progestin dose remains constant throughout the cycle 3

Key Components

  • Norethindrone acetate: 1 mg daily
  • Ethinyl estradiol:
    • 20 microg daily for days 1-5
    • 30 microg daily for days 6-12
    • 35 microg daily for days 13-21
  • Iron (Fe): included in the formulation, but the specific dosage is not specified in the provided studies 3, 2

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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