Lizinna Tablets

Lizinna is a combined oral contraceptive tablet containing norgestimate 250 micrograms and ethinylestradiol 35 micrograms per tablet. It is licensed in the United Kingdom for the prevention of pregnancy. Lizinna belongs to the combined hormonal contraceptive group of medicines and works by suppressing ovulation while also altering cervical mucus and the endometrial lining to prevent fertilisation and implantation. It is available as a film-coated tablet taken daily in a 21-day active tablet, seven-day break cycle. Lizinna is intended for adult women and is the generic equivalent of Cilest, which contains the same active ingredients at identical doses. This page provides information about how Lizinna works, how to take it, dosing guidance, and important safety information.

Lizinna is a monophasic combined oral contraceptive tablet manufactured by Gedeon Richter UK Ltd. Monophasic means every active tablet in the 21-tablet pack delivers the same hormone dose throughout the course. Each tablet contains:

1. Norgestimate 250 micrograms: a synthetic third-generation progestogen
2. Ethinylestradiol 35 micrograms: a synthetic oestrogen

Norgestimate is converted in the body to its active metabolite, norelgestromin, which carries out the progestogenic effects. Norgestimate-containing pills carry a similar VTE risk profile to other third-generation progestogens such as desogestrel and gestodene, which is somewhat higher than levonorgestrel-containing pills according to MHRA guidance.

Lizinna is the generic equivalent of Cilest, previously manufactured by Janssen-Cilag. Both contain norgestimate 250 micrograms and ethinylestradiol 35 micrograms and are considered clinically equivalent. Cilest was discontinued in the UK market; Lizinna has continued to provide the same active combination for women who were previously prescribed Cilest. A prescription from a registered clinician is required before Lizinna can be supplied.

Suppressing Ovulation

The primary contraceptive action of Lizinna is ovulation suppression. Ethinylestradiol and norgestimate act together on the pituitary gland to inhibit the release of follicle-stimulating hormone and luteinising hormone. Without the luteinising hormone surge, no egg is released from the ovary. Ovulation suppression is the dominant mechanism through which Lizinna prevents pregnancy.

Cervical Mucus Thickening

Norgestimate increases the thickness and viscosity of cervical mucus, making it more resistant to sperm penetration. This secondary mechanism provides contraceptive protection on any cycle where ovulation suppression is not fully complete.

Endometrial Effect

The combined hormonal action alters the endometrial lining of the uterus, reducing its receptiveness to implantation. This third mechanism contributes additional contraceptive security, though ovulation suppression remains the primary protective action.

The 21-Day Cycle and Withdrawal Bleed

Taking active tablets for 21 consecutive days maintains the hormonal suppression necessary for contraception. When the tablets stop after day 21, oestrogen and progestogen levels fall, producing a withdrawal bleed during the seven-day break. This bleed is not a true menstrual period. It is a pharmacological consequence of hormone withdrawal and is typically lighter and shorter than a natural period. The seven-day break must not be extended beyond seven days, as a longer gap risks allowing ovarian follicle activity to resume before the next pack re-establishes hormonal suppression.

Starting Your First Pack

1. Day 1 start: Begin on the first day of your period. Protection is immediate from the first tablet.
2. Days 2 to 5 start: Begin within the first five days of your period. Use a barrier method such as condoms for the first seven days of tablet-taking.
3. Switching from another combined pill: Take the first Lizinna tablet the day after your last active tablet from the previous pack. No break is needed and protection carries over.
4. Switching from a progestogen-only pill: Start Lizinna on any day. Use a barrier method for the first seven days.

Daily Use

Take one tablet at the same time every day for 21 consecutive days. After the 21st tablet, take a seven-day break. Begin the next pack on day 29, regardless of whether the withdrawal bleed has finished. The break must not exceed seven days.

1. Swallow each tablet whole with water.
2. Taking tablets at a consistent daily time helps maintain steady hormone levels.
3. Do not extend the seven-day break. Starting a new pack late increases the risk of ovulation.
4. Vomiting within two hours of taking a tablet, or a bout of severe diarrhoea, may reduce absorption. Apply the missed pill guidance below.

Missed Pills

1. Under 24 hours late: take the missed tablet as soon as you remember and continue the pack at the usual time. Protection is maintained.
2. More than 24 hours late: take the missed tablet now and take the next one at the usual time, even if two fall on the same day. Use a barrier method for the next seven days.
3. Two or more consecutive missed tablets: take only the most recently missed tablet and discard the earlier ones. Continue the pack and use barrier contraception for seven days. If the missed tablets fell in week one of the pack and unprotected sex occurred during that window, seek advice about emergency contraception from your prescriber or pharmacist without delay.

For vomiting, diarrhoea, or scenarios not covered above, refer to the Patient Information Leaflet or contact your pharmacist directly.

Tablet Composition

1. Norgestimate 250 micrograms per tablet
2. Ethinylestradiol 35 micrograms per tablet
3. Monophasic: every active tablet contains an identical dose
4. 21 active film-coated tablets per pack; no inactive placebo tablets

Dosage Regimen

One tablet taken daily at the same time for 21 consecutive days, followed by a seven-day tablet-free interval. The dose is fixed throughout the course. There is no titration, escalation, or variation between tablets. Your prescriber confirms the most appropriate starting day for your individual circumstances.

Lizinna and Cilest

Cilest was the original branded combined pill containing norgestimate 250 micrograms and ethinylestradiol 35 micrograms. It was manufactured by Janssen-Cilag and has since been discontinued in the UK. Lizinna is the continuing generic preparation containing the same active ingredients at the same doses. Women who were previously prescribed Cilest have been transitioned to Lizinna, and the contraceptive content and clinical effect are identical. If you have been switched from Cilest to Lizinna, no adjustment to how you take the pill is needed.

The following side effect information is based on the current UK SmPC for Lizinna. Not every woman will experience side effects. Many women tolerate Lizinna without significant problems. Read the full Patient Information Leaflet before starting treatment.

Common Side Effects

• Headache or migraine
• Nausea, particularly in the first few weeks of use
• Breast tenderness or discomfort
• Mood changes, including low mood or irritability
• Changes in libido
• Irregular spotting or changes to the withdrawal bleed pattern, especially in the first one to three cycles
• Changes in vaginal discharge

Less Common Side Effects

• Weight changes
• Contact lens intolerance due to changes in corneal curvature or moisture
• Chloasma: patches of darker skin on the face, worsened by sun exposure

Serious Side Effects: Seek Urgent Medical Attention If You Experience

• Sudden chest pain, breathlessness, or coughing up blood: possible pulmonary embolism or heart attack.
• Swelling, pain, redness, or warmth in one leg: possible deep vein thrombosis.
• Sudden severe headache, loss of vision, speech difficulty, or one-sided weakness: possible stroke.
• Acute severe abdominal pain: possible liver complication or ectopic pregnancy.
• Yellowing of the skin or whites of the eyes: possible jaundice or hepatic dysfunction.

VTE Risk and Norgestimate

All combined oral contraceptives raise VTE risk above the baseline for women using no hormonal contraception. Norgestimate-containing pills including Lizinna carry a somewhat higher VTE risk than levonorgestrel-containing pills. The risk is broadly comparable to other third-generation progestogen-containing pills such as those with desogestrel or gestodene. MHRA guidance confirms this risk classification. Your prescriber assesses your personal risk factors, including BMI, smoking status, personal and family history of blood clots, and planned periods of immobility, before recommending Lizinna.

Medicines That Reduce Lizinna's Effectiveness

Enzyme-inducing medicines speed up the metabolism of ethinylestradiol and norgestimate, reducing blood hormone levels and contraceptive reliability:

• Rifampicin and rifabutin
• Antiepileptic medicines: phenytoin, carbamazepine, phenobarbital, primidone, and topiramate
• HIV antiretrovirals: ritonavir, efavirenz, and others
• St John's Wort, available without prescription

Declare all medicines, supplements, and herbal products at every consultation. If an enzyme-inducing medicine is introduced while you are taking Lizinna, your prescriber will advise whether additional contraception is required or a switch to a different method is more appropriate.

Lizinna Is Not Suitable If You:

• Have ever had a blood clot: deep vein thrombosis, pulmonary embolism, stroke, or heart attack
• Experience migraine with aura: an absolute contraindication to all oestrogen-containing combined pills regardless of progestogen type or oestrogen dose
• Have uncontrolled high blood pressure
• Have active or past liver disease, liver tumours, or pill-related jaundice
• Have a current or previous diagnosis of breast cancer or a hormone-sensitive malignancy
• Are pregnant or have reason to believe you may be
• Are breastfeeding a baby under six weeks of age
• Smoke and are aged 35 or older
• Have diabetes with established vascular complications

Lizinna May Be Appropriate If You:

• Are a healthy adult woman with no contraindications to combined hormonal contraception
• Were previously prescribed Cilest and have been transitioned to Lizinna as the continuing generic equivalent
• Have no personal or family history of blood clots, stroke, or significant cardiovascular disease
• Do not experience migraine with aura and are not a heavy smoker
• Are not currently taking medicines that interact significantly with combined oral contraceptives

Discuss With Your Prescriber Before Starting If You:

• Smoke and are under 35. Smoking raises cardiovascular risk with all oestrogen-containing contraceptives at every age.
• Have a BMI above 30. Raised BMI is an independent VTE risk factor and is considered as part of the prescriber's assessment.
• Have a first-degree relative who developed a blood clot before the age of 50. This may suggest an inherited clotting tendency.
• Experience migraine without aura. Individual clinical assessment is required before any combined pill is prescribed.
• Are planning long-haul travel or face extended immobility. Both independently raise clot risk.
• Have a history of depression or are currently being treated for a mood disorder.

Pharmacy Planet is a GPhC registered UK online pharmacy. Every prescription issued through our platform is the outcome of an individual clinical consultation reviewed by a registered prescriber. The consultation is the primary step. A prescription is the possible outcome, not a guaranteed one.

When you submit a consultation for Lizinna, you complete a clinical questionnaire covering your health history, current medicines, smoking status, BMI, family history relevant to blood clots and cardiovascular disease, and any previous experience with hormonal contraception. The prescriber reads your responses and makes an independent clinical decision about whether Lizinna is appropriate for your individual circumstances. That decision may result in a prescription for Lizinna, a recommendation for a different combined pill, a suggestion to consider a non-hormonal method, a request for further information, or an indication that a face-to-face review is more appropriate. Submitting a questionnaire does not guarantee a prescription; the prescriber determines the outcome.

Repeat supply prescriptions follow the same individual review process. There is no automatic renewal at Pharmacy Planet. Each repeat consultation allows the prescriber to confirm that continued prescribing remains clinically appropriate for your current health.

• Store below 25°C. Keep the pack away from direct heat, sunlight, and humid environments.
• Leave tablets in the original foil blister strip until the moment of use. The foil protects from moisture and helps you track daily tablet use.
• Store out of reach and sight of children at all times.
• Check the expiry date on the outer carton before use. Do not take tablets past their expiry date.
• Return unused or expired tablets to any UK pharmacy for safe disposal. Pharmacies accept returned medicines under Duty of Care regulations, free of charge. Do not dispose of tablets in household waste or flush them down the toilet.

This reference guide compares the contraceptive preparations available at Pharmacy Planet, grouped by delivery method and formulation type. Every preparation is a Prescription Only Medicine. A registered prescriber will review your individual health profile, contraceptive history, and risk factors before recommending any preparation. This table is a clinical reference, not a recommendation.

Combined Oral Contraceptive Tablets (Monophasic)

Monophasic combined pills contain the same dose of both hormones in every active tablet. The table below compares commonly prescribed monophasic combined oral contraceptives by progestogen type, oestrogen dose, VTE risk category, pack format, and key clinical characteristics.

Important: This comparison is for general information only and does not replace medical advice. A prescriber will decide which treatment is suitable for you following an online consultation.

Lizinna contains norgestimate, a progestogen that is less commonly prescribed than levonorgestrel or desogestrel. This means that some women arriving at a consultation for Lizinna are specifically continuing a prescription they have been on for some time, often previously as Cilest. At Pharmacy Planet, our prescribers understand this context. A repeat prescription for Lizinna still requires an individual clinical review to confirm that your health profile continues to support prescribing this preparation.

We do not issue prescriptions automatically. If your health has changed in a way that affects suitability, the prescriber will tell you and discuss the appropriate next steps. That is what responsible prescribing requires.

Our GPhC registration is published on our website and independently verifiable at www.pharmacyregulation.org. The Internet Pharmacy logo on our site confirms our standing as a legitimate, regulated UK online pharmacy. Our pharmacy team is available before, during, and after your consultation for any questions about Lizinna.

• Gedeon Richter UK Ltd. Lizinna film-coated tablets – Summary of Product Characteristics. Available at: www.medicines.org.uk/emc. Accessed May 2026.
• Faculty of Sexual and Reproductive Healthcare (FSRH). Combined Hormonal Contraception – Clinical Guidance. Available at: www.fsrh.org. Accessed May 2026.
• NHS. Combined pill – your contraception guide. Available at: www.nhs.uk/conditions/contraception/combined-contraceptive-pill. Accessed May 2026.
• British National Formulary (BNF). Ethinylestradiol with norgestimate. Available at: bnf.nice.org.uk. Accessed May 2026.
• MHRA. Combined hormonal contraceptives and venous thromboembolism – updated guidance. Available at: www.gov.uk/government/organisations/medicines-and-healthcare-products-regulatory-agency. Accessed May 2026.