Norifam is the only once a month injectable contraceptive that is FDA registered and approved in the Philippines. Norifam Injection is a combination of two hormones: Norethisterone and Estradiol Valerate. It is depot preparation. The contraceptive effect is based on an Interaction of central and peripheral mechanism, primarily on ovulation inhibition and alteration of the cervical mucus. Norifam also causes morphological and enzymatic changes in the endometrium which have the effect of rendering nidation difficult. The contraceptive effect of Norifam is similar to that achieved by daily ingestion of combined oral contraceptive pills.
 
FDA Registration and Approval
 
How it works and why it is OBGYN and Midwife Recommended:
WHY NORIFAM?
Because it is SAFE, EFFECTIVE and HASSLE-FREE.
 
✓ Norifam is SAFE because it’s been formulated to be gentle to a woman’s body, ensuring good menstrual cycle with less spotting in between periods. It is the ONLY FDA Registered 1-month injectable contraceptive in the Philippines.
 
✓ Norifam is 99.95% EFFECTIVE from unwanted pregnancy. It has significantly less recorded cases of adverse side effects when compared to the DMPA 3-month injectable (bleeding, ACNE breakouts, no menstruation).
 
✓ Norifam is HASSLE-FREE because it requires NO DAILY ACTION. With pills, it’s common for women to forget taking it for a day; with condoms, there’s a 13% failure rate where it breaks – both scenarios have heightened risks for unwanted pregnancy. Whereas with Norifam, you only get an injection once a month and you’re already safe from unplanned pregnancy for 30 days!

The recommended dose is 1 Norifam Injection at the interval of 30 days. The first intramuscular injection is on the first day of menstrual cycle (1st day of bleeding) or the next day. The following injection is to be given regardless of the cycle pattern at intervals of 30 ± 3 days. Example, Minimum 27 days, Maximum 33 days.

Norifam must be administered extremely slowly as a deep intramuscular injection preferably intragluteal, alternatively into the upper arm. It is advised to place a plaster over the injection site after the injection to prevent any reflux of solution. A vaginal bleeding episode will occur within one to two weeks after the first injection. This is normal and if the treatment is continued, bleeding episodes will usually occur at 30 days interval. Pregnancy should be ruled out if no withdrawal bleeding occurs within 30 days after an injection.

You can immediately have contact with your partner immediately after 28 hours from the time of the shot. For extra safety, 48 hours is the best, you can use backup contraceptives until then. 

 

Safe and Suitable for Nearly All Women

Nearly all women can use Norifam safely and effectively, including women who:

    1.  Have or have not had children
    2.  Are married or are not married
    3.  Are of any age, including adolescents and women over 40 years old
    4.  Have just had an abortion or miscarriage
    5.  Smoke any number of cigarettes daily and are under 35 years old
    6.  Smoke fewer than 15 cigarettes daily and are over 35 years old
    7.  Have anemia now or had anemia in the past
    8.  Have varicose veins
    9.  Are living with HIV, whether or not on antiretroviral therapy

Women who Cannot use Norifam

Women with these pre-existing conditions cannot take Norifam and should consult with their doctor for an alternative family planning method.

  1.  Pregnant/Breastfeeding babies less than 6 months old
  2.  Above 35 year old women smoking 15+ cigarettes a day
  3.  Liver Disease (hepatitis)
  4.  Tumors or malignant cancers (breast/liver)
  5.  High blood pressure above 160/100 mmHg
  6.  10+ years Diabetic with organ damage
  7.  Had blood clots (past/present)
  8.  Migraine with Aura (frequent migraines that last 20 minutes to one hour)
  9.  If you’re about to have surgery on your legs. You can take Norifam after 2 weeks.
  10.  Lamotrigine users

Avoid Unnecessary Procedures

Women can begin using Norifam:

  1. Without a pelvic examination
  2. Without any blood tests or other routine laboratory tests
  3.  Without cervical cancer screening
  4.  Without a breast examination
  5.  Without a pregnancy test. A woman can begin using monthly injectables even when she is not having monthly bleeding at the time, if it is reasonably certain she is not pregnant.

Norifam for Women with HIV

  1.  Women living with HIV or on antiretroviral therapy can safely use monthly injectables.
  2.  Urge these women to use condoms along with monthly injectables. Used consistently and correctly, condoms help prevent transmission of HIV and other STIs. 
IF YOU ARE FULLY BREASTFEEDING
It’s safe but delay your first injection until 6 months after giving birth or when breast milk is no longer Baby’s main food – whichever comes first.

If the mom’s period has not yet returned after 6 months of giving birth, you can still start on Norifam at any time if it reasonably certain you are not pregnant. However, you will need a backup method for the first 7 days after the injection. If your monthly menstruation has returned, you can start with Norifam on your first day of menstruation.
 
IF YOU ARE PARTIALLY BREASTFEEDING
Delay your first injection until at least 6 weeks after giving birth.
 
If your monthly period has not returned, you can still start on Norifam at any time if it reasonably certain you are not pregnant. However, you will need a backup method for the first 7 days after the injection. If your monthly menstruation has returned, you can start with Norifam on your first day of menstruation.
 
IF NOT BREASTFEEDING AFTER GIVING BIRTH
You can start on Norifam after at any time on days 21-28 days. However, if there are any additional risks for Venous Thromboembolism (VTE), please delay and wait until after 6 weeks.
NO MORE (common with the pills/other progestin only injectables):
❎ Hormonal ACNE breakouts
❎ Sagging/Drying ng Skin
❎ Weight Gain
 
WHAT TO EXPECT:
✅ Early Menstruation by 2 weeks after the first injection. This normalizes after a month.
✅ 3 out of 10 women experience spotting on the 2nd-3rd month. Your menstruation becomes regular on the 4th-5th month. It’s normal and is called breakthrough bleeding.
✅ Regular Menstruation
 
Post-survey Feedback:
✅ Clearer Skin
✅ No weight gain
✅ Firmness of Breasts
✅ Feeling of wetness
 
Other possible side effects:
Headaches Asthenia (weakness & fatigue), Gastric Upset, Nervousness, Changes in Libido
1) Pregnancy or suspected pregnancy
2) Malignancy of breast
3) Vaginal undiagnosed bleeding
4) Moderate to severe hypertension
5) Arterial thrombosis present or in history (E.g., Myocardial infraction, cerebrovascular accident)
6) Severe liver disease,
7) Cholestatic Jaundice or hepatitis
8) Hypersensitivity to any of the component of Norifam

Irregular cycles and reduced reliability of oral contraceptives may occur when this preparation are used concomitantly with drugs such as anti-convulsants, barbiturates (sedative-hypnotic medications, antibiotics (e.g. tetracyclines, ampicillin, rifampicin, etc.). Since Norifam may interact with other drugs, patient should be informed if other medicine is being taken regularly (e.g., barbiturates phenylbutazone, hydantoins, rifampicin, ampicillin). The need for oral anti-diabetics or insulin can change.

—ADMINISTRATION—
One Norifam Injectable contraceptive at an interval of 30 days. The first intramuscular injection is on the first day of menstrual cycle (1st day of bleeding).

The following injection is to be given regardless of the cycle pattern at intervals of 30 ± 3 days. Example, Minimum 27 days, Maximum 33 days.

You can immediately have sexual contact after 28 hours. For women with preconditions but can still use, 48 hours would be best.

If Contact cannot be abstained during the recommended duration, use backup contraceptives like spermicides or condoms.

Deep intramuscular injection into the hip, upper arm, buttock, or outer thigh.

1) At your local lying-in clinic.
2) At your OBGYN’s clinic
3) Barangay Health Center
1. Are you breastfeeding a baby less than 6 months old? 

❏ NO  ❏ YES. IF YES. If fully or nearly fully breastfeeding: She can start 6 months after giving birth or when breast milk is no longer the baby’s main food—whichever comes first. If partially breastfeeding: She can start Norifam as soon as 6 weeks after giving birth.

 

2. Have you had a baby in the last 3 weeks and you are not breastfeeding?

❏ NO  ❏ YES. IF YES. You can start Norifam as soon as 3 weeks after childbirth. (If there is an additional risk that she might develop a blood clot in a deep vein [deep vein thrombosis, or VTE], then you should not start Norifam at 3 weeks after childbirth, but can start at 6 weeks instead. These additional risk factors include previous VTE, thrombophilia, caesarean delivery, blood transfusion at delivery, postpartum hemorrhage, pre-eclampsia, obesity [>_30 kg/m2], smoking, and being bedridden for a prolonged time.)

 

3. Do you smoke 15 or more cigarettes a day?

❏ NO  ❏ YES. IF YES. If you’re a woman who is 35 years of age or older and smokes more than 15 cigarettes a day, do not use Norifam. If you still want to continue smoking, please consult your OBGYN or Licensed Healthcare Practitioner for another family planning method.

 

4. Do you have severe liver disease—active hepatitis, severe cirrhosis, or liver tumor?

❏ NO  ❏ YES. IF YES. If you have active hepatitis, severe cirrhosis, or liver tumor, you can use Norifam. Ask your doctor or licensed healthcare practitioner for another family planning method without hormones. (If you have mild cirrhosis or gallbladder disease, you can use Norifam.)

 

5. Do you have high blood pressure?

❏ NO  ❏ YES. IF YES. If you cannot have your blood pressure checked and you have a history of high blood pressure, or if you are being treated for high blood pressure, do not use Norifam. Consult your doctor or licensed healthcare practitioner and ask for a blood pressure check if possible and ask them for advise for other family planning methods without estrogen. Have your blood pressure checked if possible:

  • If blood pressure is below 140/90 mm Hg, you can use for Norifam.
  • If systolic blood pressure is 140 mm Hg or higher or diastolic blood pressure is 90 or higher, do not use Norifam. Ask your doctor or licensed healthcare practitioner for another family planning method without estrogen, but not progestin-only injectables if systolic blood pressure is 160 or higher or diastolic pressure is 100 or higher.

(One blood pressure reading in the range of 140–159/ 90–99 mm Hg is not enough to diagnose high blood
pressure. You can use another family planning method until you can return for another blood pressure check, If blood pressure at next check is below 140/90, you can use Norifam.)

 

6. Have you had diabetes for more than 20 years or damage to your arteries, vision, kidneys, or nervous system caused by diabetes?

❏ NO  ❏ YES. IF YES. Do not use Norifam. Ask your doctor or licensed healthcare practitioner for another family planning method without estrogen but not progestin-only injectables.

 

7. Have you ever had a stroke, blood clot in your leg or lungs, heart attack, or other serious heart problems?

❏ NO  ❏ YES. IF YES. If you have heart attack, heart disease due to blocked or narrowed arteries, or stroke, do not use Norifam. Ask your doctor or licensed healthcare practitioner for another family planning method without estrogen but not progestin-only injectables. If you have a current blood clot in the deep veins of the leg (not a superficial clot) or in the lungs, ask your doctor or licensed healthcare practitioner for another family planning method without hormones.

Backup methods include abstinence, male and female condoms, spermicides, and withdrawal. Spermicides and withdrawal are the least effective contraceptive methods. If possible, use condoms.

 

8. Do you have or have you ever had breast cancer?

❏ NO  ❏ YES. IF YES. Do not use Norifam. Consult your doctor or licensed healthcare practitioner for another family planning method without hormones.

 

9. Do you sometimes see a bright area of lost vision in the eye before a very bad headache migraine aura)? Do you get throbbing, severe head pain, often on one side of the head, that can last from a few hours to several days and can cause nausea or vomiting (migraine headaches)? Such headaches are often made worse by light, noise, or moving about.

❏ NO  ❏ YES. IF YES. If you have migraine aura at any age, Do not use Norifam. If you have migraine headaches without aura and is age 35 or older, Do not use Norifam. Consult your doctor or licensed healthcare practitioner for another family planning method without estrogen. If you are under age 35 and has migraine headaches without aura, you can use Norifam

 

10. Are you planning major surgery that will keep you from walking for one week or more?

❏ NO  ❏ YES. IF YES. If so, you can start Norifam 2 weeks after the surgery. Until you can start Norifam, she should use a backup method.

 

11. Do you have several conditions that could increase your chances of heart disease (coronary artery disease) or stroke, such as older age, smoking, high blood pressure, or diabetes?

❏ NO  ❏ YES. IF YES. Do not use Norifam. Ask your doctor or licensed healthcare practitioner for another family planning method without estrogen, but not progestin-only injectables

 

12. Are you taking lamotrigine?

❏ NO  ❏ YES. IF YES. Do not use Norifam. Norifam can make lamotrigine less effective. Ask your doctor or licensed healthcare practitioner for another family planning method without estrogen.

Also, you should not use Norifam if you have thrombogenic mutations or lupus with positive (or unknown) antiphospholipid antibodies. For complete classifications, always consult your doctor or licensed healthcare practitioner. Be sure to know the health benefits as well as the risks and possible side effects before use.

It would depend where your address is located. But generally, shipping would be faster if you’re from Luzon and Visayas because that’s where our Fulfillment Centers are at.
 
If within Metro Manila, 1-3 days. If outside the Metro Manila province 3-5 days and if island 5-7.
 
If within Cebu City, 1-3 days. If outside Metro Cebu po, 3-5 days. If island po 5-7 days.
 
If Mindanao 5-7 days.
NORIFAM is manufactured by ZAFA Pharmaceutical Laboratories (Private) Limited and Imported/Distributed by Amtol Pharma Imports Inc. FDA Registration Number: DR-XY35422. The Norifam 1-month combined injectable contraceptive is the first, safest and only time tested FDA registered 1-month injectable contraceptive in the Philippines!
  • FDA Registered
  • Safe & Effective
  • No Weight Gain
  • Regular Monthly Period
  • Quick Return to Fertility
  • Glowing Skin
  • 30-Day Peace of Mind
  • Hassle Free 99.95% Protection
  • Less Side Effects
Always consult your local OBYGN or MIDWIFE! Ask them about NORIFAM the TIME TESTED One Month Combined Injectable Contraceptive that more and more women are using! 1 Box of Norifam comes with: One (1) mL ampule of Norethisterone Enanthate 50 mg + Estradiol Valerate 5 mg and one (1) FREE Sterile Disposable Syringe.
Always consult your local OBYGNE or MIDWIFE! A thorough general medical and gynecological exam should be carried out before starting the drug. Pregnancy must be excluded out. Clinical check-ups are recommended about every six months during the use of the drug.

NORIFAM is not recommended for women who have certain preconditions; women who have these contraindications are not recommended to take Norifam (Norethistene Enanthane 50 mg + Estradiol Valerate 5 mg):
Side Effects: Headache, asthenia, gastric upset, weight changes, nervousness, changes in libido, menstrual irregularities, feeling of tension in breasts, irregular bleeding, Inform your doctor of any side effects experienced.

Norifam may have bad drug interactions with these medications: Anti-convulsant, barbiturates, antibiotics, anti-diabetics and insulin. Inform your doctor about any drugs, vitamins and herbal supplements you are using before taking Norifam.

The major difference between Norifam and Progestin-only (3 months/2 months) injectables is that Norifam is a once-a-month injectable that contains estrogen plus progestins, making it a combined method. Norifam contains less progestin resulting in more regular bleeding and fewer bleeding disturbances than the progestin-only injectables – making Norifam the preferred choice.

Largely, yes. The 1 mL Norifam 1-month Combined Injectable Contraceptive is similar to combined oral contraceptives (COCs). There are few long-term studies done on Norifam 1-month Combined Injectable Contraceptive, but researchers assume that most of the findings about COCs also apply it. The Norifam 1-month Combined Injectable Contraceptive, however, do not pass through the liver first because they are not taken by mouth like COCs. Short-term studies have shown that it has less effect than COCs on blood pressure, blood clotting, the breakdown of fatty substances (lipid metabolism), and liver function.

No. Good evidence from studies on other hormonal methods shows that hormonal contraception will not cause birth defects and will not otherwise harm the fetus if a woman becomes pregnant while using the Norifam 1-month Combined Injectable Contraceptive or accidentally starts injectables when she is already pregnant.
No. Research on combined contraceptives finds that they do not disrupt an existing pregnancy. They should not be used to try to cause an abortion. They will not do so.
No. Some providers think that the next injection should be given only when the next monthly bleeding begins. Bleeding episodes should not guide the injection schedule, however. Your next injection should be given regardless of your menstrual cycle at intervals of 30 ± 3 days. This means a minimum of 27 days and maximum of 33 days since your last injection. If you forgot to visit your OB during those days, your next Norifam injection would be on your next menstrual period.
No. A woman may experience some vaginal bleeding (a “withdrawal bleed”) as a result of an injection, but there is no evidence that giving a woman who has irregular bleeding a single injection of a monthly injectable will cause her monthly bleeding to begin properly about one month later. Also, giving a pregnant woman an injection will not cause an abortion.
Women younger than age 35 who smoke any number of cigarettes and women 35 and older who smoke fewer than 15 cigarettes a day can safely use the Norifam 1-month Combined Injectable Contraceptive. (In contrast, women 35 and older who smoke any number of cigarettes should not use combined oral contraceptives.) Women 35 and older who smoke more than 15 cigarettes a day should choose a method without estrogen such as progestin-only injectables, if available. All women who smoke should be urged to stop smoking.
Generally, no. Some women using the 1 mL Norifam 1-month Combined Injectable Contraceptive report these complaints. The great majority of injectables users do not report any such changes, however, and some report that both mood and sex drive improve. It is difficult to tell whether such changes are due to Norifam or to other reasons. There is no evidence that Norifam 1-month Combined Injectable Contraceptive affect women’s sexual behavior.
Yes. The Norifam 1-month Combined Injectable Contraceptive are safe for women with varicose veins. Varicose veins are enlarged blood vessels close to the surface of the skin. They are not dangerous. They are not blood clots, nor are these veins the deep veins in the legs where a blood clot can be dangerous (deep vein thrombosis). A woman who has or has had deep vein thrombosis should not use Norifam.
No. There may be a delay in regaining fertility after stopping the 1 mL Norifam 1-month Combined Injectable Contraceptive, but in time the woman will be able to become pregnant as before, although fertility naturally decreases as women get older with or without contraceptives. The bleeding pattern a woman had before she used Norifam 1-month Combined Injectable Contraceptive generally returns a month after the last injection.
Women who stop using Norifam 1-month Combined Injectable Contraceptive wait about one month longer on average to become pregnant than women who have used other methods. This means they become pregnant on average 5 months after their last injection. These are averages. A woman should not be worried if she has not become pregnant even as much as 12 months after stopping use. After stopping the Norifam 1-month Combined Injectable Contraceptive, a woman may ovulate before her monthly bleeding returns—and thus can become pregnant. If she wants to continue avoiding pregnancy, she should start another method before monthly bleeding returns.
CharacteristicProgestin Only InjectableNorifam 1-Month Combined Injectable Contraceptive
Time between injections3 months.1 month.
How early or late a client can have the next injection2 weeks before or 4 weeks after scheduled injection date.7 days before or after scheduled injection date.
Injection techniqueDeep intramuscular (IM) injection into the hip, upper arm, or buttock.
Subcutaneous injection
into back of upper arm, abdomen, or front of thigh.
Deep intramuscular injection into the hip, upper arm, buttock, or outer thigh.
Typical bleeding patterns in first yearIrregular and prolonged bleeding at first, then no bleeding or infrequent bleeding. About 40% of users have no monthly bleeding after 1 year.Irregular, frequent,
or prolonged bleeding in first 3 months. Mostly
regular bleeding patterns by 1 year. About 2% of users have no monthly
bleeding after 1 year.
Average weight gain1–2 kg per year.1 kg per year.
Pregnancy rate, as commonly usedAbout 4 pregnancies per 100 women in the first year.About 3 pregnancies per 100 women in the first year.
Average delay in time to pregnancy after stopping injections4 months longer than for women who used other methods.1 month longer than for women who used other methods.

 

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