NGM is rapidly and completely metabolized by first pass (intestinal and/or hepatic) mechanisms to norelgestromin (NGMN) and norgestrel (NG), which are the major active metabolites of NGM.Mean pharmacokinetic parameters for NGMN, NG and EE during three cycles of administration of Tri-Lo-Mili are summarized in Table 3.Peak serum concentrations of NGMN and EE were generally reached by 2 hours after administration of Tri-Lo-Mili. Follow what your doctor has told you to do about using a non-hormone type of birth control. For this reason, COCs are contraindicated in women who are over 35 years of age and smoke Table 1: Instructions for Administration of Tri-Lo-Mili (norgestimate and ethinyl estradiol tablets)Starting COCs in women not currently using hormonal contraception (Day 1 Start or Sunday Start)Due to the potential risk of becoming pregnant, use additional non-hormonal contraception (such as condoms and spermicide) for the first seven days of the patient’s first cycle pack of Tri-Lo-Mili (norgestimate and ethinyl estradiol tablets).Switching to Tri-Lo-Mili (norgestimate and ethinyl estradiol tablets) from another oral contraceptiveSwitching from another contraceptive method to Tri-Lo-Mili (norgestimate and ethinyl estradiol tablets)Start Tri-Lo-Mili (norgestimate and ethinyl estradiol tablets):Complete instructions to facilitate patient counseling on proper tablet usage are located in the FDA-Approved Patient Labeling.Starting Tri-Lo-Mili (norgestimate and ethinyl estradiol tablets) after Abortion or MiscarriageStarting Tri-Lo-Mili (norgestimate and ethinyl estradiol tablets) after ChildbirthTable 2: Instructions for Missed Tri-Lo-Mili (norgestimate and ethinyl estradiol tablets)Additional non-hormonal contraception (such as condoms and spermicide) should be used as back-up if the patient has sex within 7 days after missing tablets.Additional non-hormonal contraception (such as condoms and spermicide) should be used as back-up if the patient has sex within 7 days after missing tablets.Neoplasms Benign, Malignant and Unspecified (Including Cysts and Polyps)Musculoskeletal, Connective Tissue, and Bone DisordersGeneral Disorders and Administration Site ConditionsSubstances Decreasing the Plasma Concentrations of COCsSubstances Increasing the Plasma Concentrations of COCsHuman Immunodeficiency Virus (HIV)/Hepatitis C Virus (HCV) Protease Inhibitors andWhat is the most important information I should know about Tri-Lo-Mili?If any of these conditions happen while you are taking Tri-Lo-Mili, stop taking Tri-Lo-Mili right away and talk to your healthcare provider. It is important to take it at about the same time every day.2. Although some past studies have suggested that COCs might increase the incidence of breast cancer, more recent studies have not confirmed such findings.The estrogen component of COCs may raise the serum concentrations of thyroxine-binding globulin, sex hormone-binding globulin, and cortisol-binding globulin. Although some past studies have suggested that COCs might increase the incidence of breast cancer, more recent studies have not confirmed such findings.The estrogen component of COCs may raise the serum concentrations of thyroxine-binding globulin, sex hormone-binding globulin, and cortisol-binding globulin. Tri-Lo-Mili is a birth control pill (oral contraceptive) used by women to prevent pregnancy. If you have PCOS and you want to go on birth control to either treat your symptoms or prevent pregnancy—or both!—choosing your method can be tricky. Day 1 Start: Take first active tablet without regard to meals on the first day of menses. However, the risk of liver cancers in COC users is less than one case per million users.During clinical trials with the Hepatitis C combination drug regimen that contains ombitasvir/paritaprevir/ritonavir, with or without dasabuvir, ALT elevations greater than 5 times the upper limit of normal (ULN), including some cases greater than 20 times the ULN, were significantly more frequent in women using ethinyl estradiol-containing medications, such Tri-Lo-Mili is contraindicated in women with uncontrolled hypertension or hypertension with vascular disease Studies suggest a small increased relative risk of developing gallbladder disease among COC users. The dose of replacement thyroid hormone or cortisol therapy may need to be increased.A woman who is taking COCs should have a yearly visit with her healthcare provider for a blood pressure check and for other indicated healthcare.In women with hereditary angioedema, exogenous estrogens may induce or exacerbate symptoms of angioedema.Chloasma may occasionally occur, especially in women with a history of chloasma gravidarum. Counsel women to use an alternative method of contraception or a back-up method when enzyme inducers are used with COCs, and to continue back-up contraception for 28 days after discontinuing the enzyme inducer to ensure contraceptive reliability.Co-administration of atorvastatin or rosuvastatin and certain COCs containing EE increase AUC values for EE by approximately 20 to 25%. The box on the bottom of the chart shows the chance of getting pregnant for women who do not use birth control and are trying to get pregnant.Serious blood clots can happen especially if you smoke, are obese, or are older than 35 years of age.