• Combined contraceptive pill
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What is Synphase?

Synphase is an oral contraceptive pill, which is commonly known as 'the pill'.

It is taken to prevent pregnancy in women. Synphase is what is called a combined pill, because it contains two different hormones, a progestogen called norethisterone and an oestrogen hormone called ethinylestradiol. You should take one pill at the same time each day.

You can buy Synphase online from Medicine Direct when you have been given a prescription by a registered prescriber. Just complete an online consultation on our website and you will be prescribed this contraceptive pill if it is safe for you to take.

Synphase combined pill: What you need to know

Synphase comes in packs that contain 21 tablets, which should be taken in a specific order. You will take one tablet every day for 21 days, then have a 7 day break where you do not take any tablets. During this break, you will have a normal withdrawal bleed.

Synphase belongs to a group of medicines called combined oral contraceptives.

Synphase works to prevent pregnancy by preventing an egg from being released from the ovaries. Ovulation occurs once a month during a normal menstrual cycle and is a process controlled by the female sex hormones progesterone and oestrogen. During ovulation, one egg is normally released each month. The active ingredients contained in Synphase tablets, norethisterone and ethinylestradiol, mimic the effects of progestogen and oestrogen and stop the ovaries from releasing an egg.

Aside from this action, Synphase also thickens the fluid in the cervix, which makes it much harder for sperm to enter the uterus and fertilise an egg that may already have been released.

Additionally, Synphase will reduce the build-up of the endometrium (wall of the uterus), which normally happens during a menstrual cycle. By reducing this build-up, it is far less likely that any fertilised egg will be able to grow inside the womb. An added benefit of this medicine is that it will work to make your periods lighter.

You are also less likely to suffer side effects while taking Synphase thanks to the biphasic course of norethisterone this medicine contains. This means that it imitates the natural hormone cycle very closely.

What else do I need to know?

Providing you start taking this medicine during the first five days of your period, you will be protected from pregnancy straight away. If you start to use Synphase tablets later in your menstrual cycle than this, you will need to use a condom for the first week of taking this medication.

Please remember, an oral contraceptive pill like Synphase will only work to prevent you from getting pregnant. It does not protect you from catching sexually transmitted infections (STIs). You will still need to use a condom for this kind of protection.

Alternatives to Synphase

Many different oral contraceptives are available to buy as an alternative to Synphase.

You can buy oral contraceptive pills from Medicine Direct after an online consultation, including:

  • Microgynon
  • Ovranette
  • Dianette
  • Yasmin
  • Rigevidon

Other contraceptive alternatives include:

  • Male and female condoms
  • The contraceptive patch
  • Intrauterine device (IUD)
  • The contraceptive injection
  • The contraceptive implant

Speak to your doctor or pharmacist about suitable alternatives you could try.

Who is Synphase suitable for?

Synphase is not a suitable combined pill for everyone to take.

Do not use this contraceptive pill if any of the following apply to you:

  • You are allergic to norethisterone or ethinylestradiol, or any of the other ingredients this medication contains (please refer to the Ingredients tab for a full list)
  • You have ever had a stroke, heart attack or have had angina
  • You have any body fat disorders or high levels of fat in your blood
  • You have ever had blood clots in the veins, lungs, legs, brain or any other part of your body
  • You have a family history of clotting issues
  • You have or have ever suffered with severe migraines
  • You have or have ever had a severe chronic liver disease, such as liver tumours
  • You have or have ever had breast cancer, cervical cancer, vaginal cancer or womb cancer
  • You have or have ever had any unexplained vaginal bleeding
  • You have hepatitis C and are using any medicines that contain ombitasvir/paritaprevir/ritonavir and/or dasabuvir
  • You are pregnant or there is a chance you might be pregnant
  • You suffered from jaundice or pruritus during a previous pregnancy

Do not start taking Synphase without talking to your doctor or pharmacist if you have or have ever suffered with any of the following problems:

  • Liver dysfunction
  • Asthma
  • Headaches
  • Migraines
  • Diabetes
  • Kidney disease
  • Any disease that is likely to be made worse by pregnancy
  • Gallstones
  • Sickle-cell anaemia
  • Porphyria
  • Otosclerosis
  • Irregular periods
  • Severe depression
  • Any breast problems
  • Multiple sclerosis (MS)
  • Chloasma
  • Tetany
  • Varicose veins
  • Slow or sudden development of visual problems, such as partial loss of vision
  • Fibroids in the uterus
  • High blood pressure
  • Sharp abdominal pain
  • Epilepsy
  • Cardiovascular disease

Possible side effects

Like all medicines, Synphase can cause side effects. However, not everyone who uses this combined pill will suffer from them.

Some research has suggested that taking the combined oral pill can increase your risk of developing blood clots and certain types of cancer. Please refer to the 'Warnings' tab for more information on this.

Talk to your doctor or pharmacist if you suffer from any of the following side effects:

  • High blood pressure
  • Depression
  • Headaches
  • Feeling sick
  • Upset stomach
  • Irregular bleeding from the vagina
  • Swollen or sore breasts
  • Appetite changes
  • Changes in your sex drive
  • Weight gain
  • Changes in how your body breaks down sugars, fats or vitamins
  • Womb disorders getting worse

Please note, this list is not exhaustive. Please refer to the Side Effects tab for more information.

Synphase Dosage 

How do you take Synphase?

Our pharmacists and prescribers follow NICE guidelines when prescribing Synphase

To effectively prevent pregnancy, you must take Synphase tablets exactly as your doctor or pharmacist has instructed you. Please read the patient information leaflet thoroughly before you start taking it. Talk to your doctor or pharmacist if you are still unclear about anything.

Each pack of Synphase contains 21 tablets:

  • Seven blue tablets
  • Nine white tablets
  • Five more blue tablets

Each colour contains a different dose of hormones. When taken in the correct order, they will mimic the natural rise and fall of your body's hormones during the menstrual cycle.

One tablet should be taken each day in the right order. Swallow the tablet whole with a drink of water. Do not crush or chew them.

You can take this medication with or without food. This pill can be taken at any time of day that is convenient for you. However, you must take it at the same time each day.


Take the tablet that is marked 'start here' on the strip on your first day of your period. Talk to your doctor or pharmacist about the best time to start taking this medication if you are not having periods. Providing you begin taking Synphase during the first five days of your period, you will have contraceptive protection straight away. If you begin taking it after this time, you will need to use a condom for the first seven days of taking Synphase tablets.

For the first seven days, you will take the blue tablets, which contain 0.5mg of norethisterone. Once you have taken these tablets, start taking the white tablets immediately; you will take these for nine days. Start taking the blue tablets again for five days once you have taken all of the white tablets.

After you have taken all 21 tablets in the pack, do not take any pills for seven days. You will have a normal withdrawal bleed during this seven-day break.

Once this seven day break is over, begin taking your next pack of tablets straight away, in the same configuration as the last pack.

What if I miss a pill?

If you have missed one pill, take it as soon as you remember, then take your next pill at your usual time. This may mean that you need to take more than one pill in the same day.

If you are later than 12 hours in taking the pill, or you have missed more than one pill, you may not have full contraceptive protection. You should take the last pill you missed and carry on taking Synphase as usual. However, use an extra method of contraception, such as a condom, for the next seven days.

If you have fewer than seven tablets left in a pack after forgetting to take one, finish that blister pack then start the next one without your usual break. This may mean you do not get a period until you have finished two blister packs, but this will not do you any harm.

What if I take more than I am supposed to?

If you have taken too many tablets, you may suffer vomiting, vaginal bleeding or breast swelling. Call 111 or go to A&E as soon as possible if you have taken more Synphase than you were supposed to.

When should I start taking Synphase?

Ideally, you should start to take this contraceptive pill on the first day of your period. This will give you contraceptive protection straight away. If you start taking this medication any later than the fifth day of your period, you will not be protected straight away and will need to use a barrier method of protection, such as a condom, for the first seven days.

I have missed the first pill in a packet. Will Synphase still be effective?

If you have taken all the pills in the previous packet as you should have done, and you have only missed one pill in your first week, you should still have contraceptive protection. Please bear in mind, it is imperative to use Synphase correctly during the first week of a pack.

Is it common to notice spotting following a missed pill?

Yes, this is not unusual. The spotting could continue until you have finished your current pack of pills.

Is it common to have a late period following a missed pill?

Take a pregnancy test to rule out pregnancy if you have recently missed a period and your period is late. However, a delayed period is quite common while taking oral contraceptives.

What should I do if I have missed three or more pills?

If you miss three or more pills from the first week of the pack, you will not have contraceptive protection and will need to use a condom for the next seven days. If it is in the last week of the pack, you will likely still be protected from pregnancy, but you must start your next pack of pills without taking the usual seven day break. If you have missed more than three pills, it is advisable to use a condom for the next week to ensure complete protection.

Will having diarrhoea affect my protection?

If you have severe diarrhoea, it may affect your protection. If this happens, keep taking the pills as usual but use a condom for the duration of your illness and for the next seven days. If these seven days continue past the end of the blister strip, start to take the pills in the next pack without the seven day break.

Is it safe to drink while taking Synphase?

Yes, you can drink alcohol while taking Synphase.

How do I store Synphase?

Store this medicine out of the sight and reach of children. Store out of direct sunlight in temperatures lower than 25C.

What does this pill contain?

Synphase tablets contain two active ingredients: norethisterone and ethinylestradiol.Blue tablets contain 0.5mg norethisterone, 35mcg ethinylestradiol. White tablets contain 1mg norethisterone, 35mcg ethinylestradiol.Each tablet also contains the following: maize starch, polyvidone, lactose, magnesium stearate and colouring E132 (in the blue pills only).

Can I use Synphase while pregnant?

No, you must not use Synphase if you are pregnant. If you think you might be pregnant, take a pregnancy test and speak to your doctor as soon as possible.

Synphase Side Effects

Stop taking Synphase and seek medical attention straight away if you get any of the following side effects. These may be symptoms of a blood clot:

  • You feel dizzy or faint
  • You suffer unusual and sudden severe headaches
  • You have inflamed or painful veins in the legs
  • You have stomach swelling or tenderness
  • You cough up blood
  • You develop any sight or speech problems
  • You suffer migraines which get worse, particularly if you see flashing lights, your sight is affected, your limbs feel weak, you have strange sensations in your limbs or lose the feeling in your limbs completely, you suffer from fits
  • You suffer a migraine attack for the first time
  • You find it painful to breathe or you suffer shortness of breath

Serious allergic reaction

In rare cases, it is possible that you may suffer a serious allergic reaction to Synphase and require immediate treatment in hospital.

Please call 999 or go to A&E straight away if you notice any of the symptoms listed below:

  • You are finding it hard to speak or breathe
  • Your chest or throat feels tight
  • You have swelling in your mouth, face, tongue, lips or throat
  • You develop a skin rash that may include red, itchy, swollen, blistered or peeling skin
  • You are wheezing
  • You have a fever

These could be signs of an allergic reaction.

Always read the patient information leaflet for a complete list of side effects and advice on how to deal with them. If you are worried about side effects or have any questions, please do not hesitate to speak to your doctor or pharmacist before you start using this medicine.

Synphase Warnings

Before you start to use oral contraceptives like Synphase, you must inform your doctor or pharmacist if you are already taking any other medication. This includes both prescription and non-prescription medicine, herbal remedies, vitamins and supplements.

It is particularly important that you tell your doctor or pharmacist if you are taking any of the medicines listed below. They may stop this combined pill from working properly:

  • Nevirapine, Ritonavir (to treat HIV and AIDS)
  • Nelfinavir (to treat HIV)
  • Primidone, Phenytoin, Oxacarbazepine, Carbamazepine, Topiramate (to treat epilepsy)
  • Phenobarbital (to treat epilepsy, anxiety and sleeplessness)
  • Griseofulvin (to treat fungal infections)
  • The herbal remedy St. John's Wort (to treat depression)
  • Rifampicin, Rifabutin (to treat bacterial infections)
  • Modafinil (to treat narcolepsy)

Do not use Synphase if you suffer from hepatitis C and are taking any medicines that contain:

  • Ombitasvir
  • Paritaprevir
  • Ritonavir
  • Dasabuvi

For more information on medicines that interact with combined oral pills.  

Taking these medicines alongside this combined pill may cause increases in liver function blood test results.

Synphase may also alter the results of certain tests. If you are required to have any tests, make sure that the medical professional who conducts the test is aware that you are taking Synphase.

Synphase contains lactose. If you have been told by your doctor that you are intolerant to some sugars, talk to your doctor or pharmacist before you start using this medicine.

Oral contraceptives and cancer

You must tell your doctor or pharmacist if you are currently suffering with any type of cancer, or if you have had cancer in the past.

All women are at risk of developing breast cancer. This risk is rare in women under the age of 40 and the risk increases as women age.

Breast cancer is found to be slightly more common in women who take oral contraceptives compared to those who do not take them. If you stop taking oral contraceptives, the risk of breast cancer returns to normal after 10 years of stopping.

It has not been proven that the contraceptive pill increases your risk of getting breast cancer. It may be that because women who use the pill need to see their doctor more regularly, breast cancer is detected sooner than those who do not take the pill.

Some studies have also suggested that women who take the pill are at an increased risk of getting cervical cancer, although this might be due to other causes.

In rare instances, liver cancer has also been detected in women who are using the combined pill, especially if they have used them for a long time.

Research has shown that the combined pill can work to protect you against ovarian cancer and endometrial cancer.

Risk of blood clots

There is evidence to suggest that women are at a higher risk of developing blood clots (thrombosis) when they take the pill. Blood clots can develop in the veins or arteries, which can increase the risk of a heart attack or a stroke.

Please refer to the Side Effects tab for details on the symptoms that you may have developed a blood clot. You must seek immediate medical attention if you get any of these symptoms.

Always read the patient information leaflet, which will accompany your medication, before you start to use Synphase. If you have any questions, please do not hesitate to speak to your doctor or pharmacist.

Pregnancy and breastfeeding

Do not use Synphase if you are currently pregnant, think you might be pregnant, are breastfeeding or are trying to get pregnant.

If you miss a period while taking this contraceptive pill, tell your doctor or pharmacist straight away. You will need to do a pregnancy test before you can carry on taking it.

Full details on who this medicine may not be suitable for can be found in the patient information leaflet, which will come with your medication. Talk to your doctor or pharmacist if you have any concerns.

For more information on oral contraceptives and pregnancy.

Synphase Ingredients

Synphase tablets contain two active substances: norethisterone and ethinylestradiol.

Blue tablets contain 0.5mg norethisterone, 35mcg ethinylestradiol.

White tablets contain 1mg norethisterone, 35mcg ethinylestradiol.

Each tablet also contains the following: maize starch, polyvidone, lactose, magnesium stearate

and colouring E132 (in the blue pills only).

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Please note that next day delivery to Northern Ireland, Scottish Highlands & Islands and British Isles cannot be guaranteed. Please contact our team for more information.

Written byHussain Abdeh MPharm: 2211840

Updated on: 28/05/2021

This content has been written by our Superintendent Pharmacist Hussain Abdeh and has been medically reviewed by our Pharmacist Sonia Khan

Hussain Abdeh Superintendent Pharmacist at Medicine Direct

Hussain Abdeh
MPharm: 2211840

Pharmacist Independent Prescriber

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