The Function of the Brown Placebo Pills
Within the 28-day Lo Loestrin Fe blister pack, the two brown pills are known as placebo, or inactive, tablets. Unlike the blue and white pills that contain active hormones, the brown pills contain no hormones and do not contribute to preventing pregnancy.
Their primary function is to serve as a reminder to maintain the habit of taking a pill every day during the last two days of the cycle. During these two days, a user experiences withdrawal bleeding, which is a bleed that simulates a menstrual period. Taking a pill consistently, even an inactive one, helps users stay on schedule and remember to start the new pack of active pills on time, thereby ensuring continued contraceptive efficacy.
The Role of Ferrous Fumarate
Instead of being simple sugar pills, the two brown tablets in Lo Loestrin Fe contain 75 mg of ferrous fumarate, a form of iron. The inclusion of iron is a common practice in some birth control brands to potentially help supplement iron lost during the monthly withdrawal bleed, though the amount is not sufficient to treat a diagnosed iron deficiency. While this addition offers a minor health benefit, the primary purpose remains that of a placebo for routine maintenance.
The Other Pills in the Lo Loestrin Fe Pack
To fully understand the role of the brown pills, it is essential to know what the other tablets in the pack do. The Lo Loestrin Fe pack is a 28-day regimen that includes three types of pills taken in a specific order.
The 24 Blue Active Pills
The first 24 pills in the pack are blue, round, and contain the active hormonal ingredients. Each blue tablet contains:
- 1 mg of norethindrone acetate (a progestin hormone).
- 10 mcg of ethinyl estradiol (an estrogen hormone).
These hormones work together to prevent pregnancy primarily by suppressing ovulation, thickening cervical mucus to block sperm, and altering the uterine lining to prevent implantation.
The 2 White Active Pills
The blue tablets are followed by two white, hexagonal tablets. These are also considered active pills, but they contain only ethinyl estradiol (10 mcg) and no progestin. The purpose of these two tablets is to help maintain a low dose of estrogen for a short period before the placebo phase, which can lead to a shorter and lighter withdrawal bleed.
Comparison of Pill Types in Lo Loestrin Fe
| Pill Color | Number in Pack | Active Ingredient(s) | Primary Purpose |
|---|---|---|---|
| Blue | 24 | Norethindrone acetate (1mg) & Ethinyl estradiol (10mcg) | Prevents ovulation, thickens cervical mucus. |
| White | 2 | Ethinyl estradiol (10mcg) | Maintains low estrogen levels before the placebo phase. |
| Brown | 2 | Ferrous Fumarate (75mg) | Non-hormonal placebo, reminder to maintain routine. |
What to Do with Missed Pills
Adhering to the schedule is key for preventing pregnancy with Lo Loestrin Fe. The instructions for missed pills differ depending on whether the pill is active (blue or white) or inactive (brown).
- Missed brown (inactive) pill: If you miss one or both of the brown tablets, simply throw away the missed pills and continue taking one pill a day until the pack is empty. Missing an inactive pill does not affect contraceptive protection, but remember to start your new pack on time.
- Missed blue or white (active) pill(s): If you miss any of the 26 active pills, follow the specific instructions provided in the pill pack's patient information leaflet or consult your healthcare provider. Depending on how many pills are missed and when in the cycle, you may need to use a backup birth control method, such as a condom, for at least seven consecutive days.
How to Take Lo Loestrin Fe Correctly
For maximum contraceptive effectiveness, follow these simple steps:
- Take one tablet every day at the same time each day.
- Follow the order directed on the blister pack.
- Do not skip any tablets or take them at intervals exceeding 24 hours.
Conclusion
The two brown pills in a pack of Lo Loestrin Fe are non-hormonal placebo tablets containing ferrous fumarate, an iron supplement. They do not prevent pregnancy but are designed to help maintain the daily pill-taking routine during the withdrawal bleed. The contraceptive action comes from the 24 blue tablets (containing a combination of norethindrone and ethinyl estradiol) and the two white tablets (containing ethinyl estradiol). Consistent and correct use of the active pills is essential for pregnancy prevention, and missing brown pills does not impact contraceptive efficacy as long as the new pack is started on time. For further medical advice, always consult a healthcare professional. You can access the full prescribing information for Lo Loestrin Fe on the DailyMed website.
