Blisovi Fe 1/20 is a combination birth control pill containing two hormones: 1 mg of norethindrone acetate (a progestin) and 20 mcg of ethinyl estradiol (an estrogen). It comes in a 28-day pack and is taken once daily to prevent pregnancy. The “Fe” in the name refers to iron, which is included in the non-hormonal reminder pills.
What’s in the Pack
Each 28-day pack contains two types of tablets arranged in four rows of seven. The first 21 pills are yellow “active” tablets that contain the two hormones. The remaining 7 pills are brown tablets that contain 75 mg of ferrous fumarate, a form of iron. These brown pills have no hormonal effect and don’t contribute to pregnancy prevention. They exist to keep you in the habit of taking a pill every day so you don’t lose track of your cycle.
The iron in the brown tablets is a small supplemental dose, but the prescribing information notes that these tablets “do not serve any therapeutic purpose.” Your period typically arrives during this brown-pill week.
How It Prevents Pregnancy
Like other combination birth control pills, Blisovi Fe 1/20 works through three mechanisms. The hormones stop your ovaries from releasing an egg each month. They also thicken the mucus at the opening of the cervix, making it harder for sperm to reach an egg. And they thin the lining of the uterus, which makes implantation less likely in the rare event that fertilization occurs.
With the “20” in its name referring to the 20-microgram estrogen dose, Blisovi Fe 1/20 sits at the lower end of estrogen content among combination pills. Lower-estrogen formulations tend to cause fewer estrogen-related side effects like bloating and breast tenderness, though individual responses vary.
How to Take It
You take one yellow pill at the same time every day for 21 consecutive days. When you finish all 21 yellow tablets, you immediately start the brown tablets, one per day for 7 days, with no gap between the two. When you finish a pack, you start a new one the next day. Consistency matters: taking your pill at the same time each day keeps hormone levels steady and maximizes effectiveness.
If you miss a yellow pill, take it as soon as you remember. If you don’t realize until the next day, take two pills that day. Missing two or more active pills in a row reduces your protection significantly, and you should use a backup method like condoms for at least 7 days. If you miss any of the brown reminder pills, you can simply discard the missed ones and continue on schedule, since they contain no hormones.
Common Side Effects
The most frequently reported side effects are nausea, vomiting, bleeding between periods (breakthrough bleeding or spotting), weight gain, breast tenderness, and difficulty wearing contact lenses. These tend to be most noticeable in the first one to three months as your body adjusts, and they often improve or disappear after that initial period.
Other reported side effects include:
- Digestive issues: abdominal cramps and bloating
- Mood changes: depression
- Skin changes: melasma (dark patches on the face), which can sometimes persist even after stopping the pill
- Menstrual changes: lighter periods, changes in flow, or missed periods entirely
- Other: headaches, migraines, fluid retention, and vaginal yeast infections
Some people also notice changes in corneal curvature, which is why contact lenses may feel uncomfortable. If you wear contacts and notice vision changes or irritation after starting Blisovi Fe 1/20, that’s a recognized effect worth mentioning to your eye care provider.
Serious Risks to Know About
All combination birth control pills carry an increased risk of blood clots, stroke, and heart attack. This risk is relatively small for most people, but it rises sharply for smokers over age 35. If you smoke and are 35 or older, combination pills like Blisovi Fe 1/20 are generally not recommended.
Other factors that increase your cardiovascular risk while on this pill include a history of blood clots, high blood pressure, certain types of migraines (particularly migraines with aura), and prolonged immobility such as after surgery or during long flights. These risks apply to all combination oral contraceptives, not just this one.
How It Compares to Similar Pills
Blisovi Fe 1/20 is a generic version of the brand-name pill Loestrin Fe 1/20. It shares the same active ingredients in the same doses. Other generics with the identical 1 mg norethindrone acetate / 20 mcg ethinyl estradiol formulation include Junel Fe 1/20 and Larin Fe 1/20. If your pharmacy switches you between any of these, the hormonal content is the same. The inactive ingredients (fillers, dyes, coatings) may differ slightly, which occasionally affects tolerability for sensitive individuals, but the clinical effect is equivalent.
There is also a Blisovi Fe 1.5/30 version, which contains a higher dose of both hormones (1.5 mg norethindrone acetate and 30 mcg ethinyl estradiol). Your prescriber chooses between these based on your health profile and how you respond to different hormone levels.
Temporary Infertility After Stopping
When you stop taking Blisovi Fe 1/20, there may be a short delay before your normal fertility returns. This temporary infertility is a recognized effect listed in the prescribing information, and it resolves on its own. Most people resume ovulating within one to three months, though for some it takes longer. This delay does not mean the pill has caused any lasting change to your reproductive system.