Mili is a combination oral contraceptive pill used to prevent pregnancy. It contains two hormones: norgestimate (a progestin) and ethinyl estradiol (an estrogen). Mili is also sometimes prescribed to treat acne, reduce the risk of ovarian cysts (as in polycystic ovarian syndrome [PCOS]), and manage painful or heavy periods. Like other birth control pills, Mili does not protect against sexually transmitted infections (STIs), so using condoms or other barrier methods is essential for protection.
Important Warnings and Precautions
Before starting Mili, it's crucial to be aware of certain warnings and precautions:
- Smoking: Do not use Mili if you smoke cigarettes or use tobacco and are over 35 years old. Smoking significantly increases the risk of serious cardiovascular side effects, including stroke, heart attack, blood clots, and high blood pressure, especially with hormonal birth control. This risk increases with age and the number of cigarettes smoked.
- Allergies: Tell your doctor or pharmacist if you are allergic to any estrogens (such as ethinyl estradiol, mestranol) or any progestins (such as norethindrone, desogestrel), or if you have any other allergies. The product may contain inactive ingredients that can cause allergic reactions or other problems.
- Medical Conditions: Inform your doctor about any pre-existing medical conditions, including:
- History of blood clots (deep vein thrombosis, pulmonary embolism)
- Blood disorders or blood vessel damage
- Diabetes with kidney, eye, nerve, or blood vessel damage
- Heart problems (rhythm problems, valve problems)
- Uncontrolled high blood pressure or high blood pressure with vascular disease
- Migraines with aura or migraines if you are over 35
- Liver tumors or problems
- Unexplained vaginal bleeding
- Breast cancer
- Surgery and Prolonged Immobility: Tell your doctor if you are about to have surgery or will be confined to a bed or chair for a long time, as these conditions increase the risk of blood clots.
- Pregnancy and Breastfeeding: This medication should not be used during pregnancy. If you become pregnant or think you may be pregnant, tell your doctor right away. A small amount of this medication passes into breast milk and may have undesirable effects on a nursing infant, also norgestimate/ethinyl estradiol may decrease the amount of breastmilk you make.
How to Take Mili
Mili is taken by mouth, usually once daily, as directed by your doctor. It is essential to take the pill at the same time each day, 24 hours apart, to maintain consistent hormone levels.
- Dosage Schedule: A standard pack contains 21 active pills (with hormones) and 7 inactive (reminder) pills. Take one active pill daily for 21 days, followed by one inactive pill daily for 7 days. You should have your period during the fourth week of the cycle. After taking the last inactive tablet, start a new pack the next day, regardless of whether you have your period.
- First-Time Use: If you are not switching from another hormonal birth control method, start the first tablet on the first Sunday following the beginning of your menstrual period or on the first day of your period. If your period begins on a Sunday, begin taking Mili on that day. For the first cycle of use only, use a backup form of non-hormonal birth control (such as condoms, spermicide) for the first 7 days.
- Switching from Other Hormonal Birth Control: Ask your doctor or pharmacist about how to switch from other forms of hormonal birth control to Mili.
- Missed Doses: Refer to the patient information sheet provided with your medication for directions on what to do if you miss a dose. Missing more than one pill may reduce its effectiveness, requiring a backup contraceptive method.
Potential Side Effects
Like all medications, Mili can cause side effects. Common side effects include:
- Nausea
- Vomiting
- Headache
- Bloating
- Breast tenderness
- Swelling of the ankles/feet (fluid retention)
- Weight change
- Vaginal bleeding between periods (spotting) or missed/irregular periods (especially during the first few months)
These side effects are usually mild and temporary. However, if any of these effects last or get worse, tell your doctor or pharmacist promptly.
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Serious side effects are rare but possible. These include:
- Blood clots (heart attack, stroke, blood clots in the lungs or legs)
- Allergic reactions (rash, itching, swelling)
- Increased blood pressure
- Liver problems
- Worsening of migraines
- Changes in vision or trouble wearing contact lenses
- Symptoms of high blood sugar (increased thirst/urination)
Call your doctor immediately if you experience any serious side effects.
Drug Interactions
Mili can interact with other medications, affecting how they work or increasing the risk of side effects. Tell your doctor and pharmacist about all the products you use, including prescription and nonprescription drugs, vitamins, and herbal products. Some drugs may reduce the effectiveness of hormonal birth control, leading to pregnancy. Examples include:
- Griseofulvin
- Modafinil
- Rifamycins (such as rifampin, rifabutin)
- Ritonavir
- St. John's wort
Tell your doctor when you start any new drug, and discuss whether you should use a reliable backup birth control method.
Mili vs. Sprintec
Mili and Sprintec are generic equivalents, meaning they contain the same active ingredients (norgestimate 0.25mg and ethinyl estradiol 0.035mg) in the same dosages. The main difference lies in the manufacturers and inactive ingredients, such as coloring/dyes. Therefore, Mili and Sprintec have the same benefits, side effects, and mode of action. For most people (95%), there is no noticeable difference between the brand name and generic equivalents.
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Additional Benefits
Beyond pregnancy prevention, Mili can offer other benefits:
- Acne Treatment: The hormones in birth control pills may help clear up acne for some women by lowering levels of androgens.
- Reduced Menstrual Symptoms: Mili may reduce the severity of menstrual cramps and pain, and some users experience lighter periods and decreased menstrual flow.
- PCOS Management: Mili can help manage symptoms of polycystic ovarian syndrome (PCOS).
Cost and Availability
With insurance, most birth control is a covered benefit. Without insurance, the cost of Mili can vary. Some online pharmacies offer Mili for around \$30 per pack or \$75 for 3 packs. Another generic equivalent of both brands is \$20 for 1 pack (includes shipping, handling) or \$40 for 3 packs.
Important Considerations
- Regular Check-ups: While taking Mili, regular complete physical exams (including blood pressure, breast exam, pelvic exam, Pap smear) are essential. Follow your doctor's instructions for examining your breasts and report any lumps immediately.
- Laboratory Tests: This medication may interfere with certain lab tests (such as blood clotting factors, thyroid), potentially causing false test results.
- Vision Changes: If you wear contact lenses and notice visual changes or discomfort, consult your eye care specialist.
- Gum Health: Tenderness, swelling, or minor bleeding of the gums may occur. Talk to your dentist if this happens.
Who Should Not Use Mili?
Mili (norgestimate/ethinyl estradiol) is not suitable for everyone. You should not use Mili if you have any of the following conditions:
- Allergies to any of the ingredients
- Smoking and are 35 years of age or older
- History of blood clots (DVT, PE, stroke, heart attack)
- Blood disorders that increase the risk of blood clots
- Plaque buildup in blood vessels or cerebrovascular disease
- Diabetes with kidney, eye, nerve, or blood vessel damage
- Heart rhythm problems or heart valve problems
- Uncontrolled high blood pressure or high blood pressure with vascular disease
- Migraines with aura or certain types of headaches
- Liver tumors or problems
- Unexplained vaginal bleeding
- Breast cancer
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