Comparison of Oral Contraceptives and Non-Oral Alternatives

Full update August 2020

Abbreviations: EE = ethinyl estradiol; Fe = iron.

Productsa,d

Manufacturer

Estrogen

Progestin

LOW-DOSE MONOPHASIC PILLS

Afirmelle
Aubra EQ
Aviane
Balcoltrak
Falmina
Larissia
Lessina
levonorgestrel/EE
levonorgestrel/EE
Lutera
Orsythia
Sronyx
Vienva

Aurobindo
Afaxys
Teva
Avion
Northstar
Amneal
Teva
Mylan
Lupin
Mayne Pharma
Par
Mayne Pharma
Xiromed

 

EE 20 mcg

Levonorgestrel 0.1 mg

Aurovela 1/20
Aurovela Fe 1/20
Blisovi Fe 1/20
Hailey Fe 1/20
Junel 1/20
Junel Fe 1/20
Larin 1/20
Larin Fe 1/20
Loestrin-21 1/20
Loestrin Fe 1/20
Microgestin 1/20
Microgestin Fe 1/20
norethindrone/EE
norethindrone/EE
norethindrone/EE/Fe
Tarina Fe 1/20 EQ

Aurobindo
Aurobindo
Lupin
Glenmark
Teva
Teva
Northstar
Northstar
Teva branded
Teva branded
Mayne Pharma
Mayne Pharma
Glenmark
Mylan
Mylan
Afaxys

 

EE 20 mcg

Norethindrone acetate
1 mg

Altavera
Ayuna
Chateal EQ
Kurvelo
levonorgestrel/EE
Levora
Lillow
Marlissa
Portia-
28

Xiromed
Aurobindo
Afaxys
Lupin
Mylan
Mayne Pharma
Amneal
Glenmark
Teva

 

EE 30 mcg

Levonorgestrel 0.15 mg

Cryselle-28
Elinest
Low-Ogestrel-28

Teva
Northstar
Mayne Pharma

 

EE 30 mcg

Norgestrel 0.3 mg

Aurovela 1.5/30
Aurovela Fe 1.5/30
Blisovi Fe 1.5/30
Hailey 1.5/30
Hailey Fe 1.5/30
Junel 1.5/30
Junel Fe 1.5/30
Larin 1.5/30
Larin Fe 1.5/30
Loestrin 1.5/30-
21
Loestrin Fe 1.5/30
Microgestin 1.5/30
Microgestin Fe 1.5/30

Aurobindo
Aurobindo
Lupin
Glenmark
Glenmark
Teva
Teva
Northstar
Northstar
Teva branded
Teva branded
Mayne Pharma
Mayne Pharma

 

EE 30 mcg

Norethindrone acetate
1.5 mg

Apri
Cyred EQ
desogestrel/EE
Emoquette
Enskyce
Isibloom
Juleber
Reclipsen

Teva
Afaxys
Mylan
Par
Lupin
Xiromed
Northstar
Teva

 

EE 30 mcg

Desogestrel 0.15 mg

drospirenone/EE
drospirenone/EE
drospirenone/EE
drospirenone/EE
Ocella
Safyralc
Syeda
Tydemyc
Yasmin
Zumandimine

Lupin
Glenmark
Apotex
Mylan
Teva
Bayer
Xiromed
Lupin
Bayer
Aurobindo

 

EE 30 mcg

Drospirenone 3 mg

Kelnor 1/35
Zovia 1/35

Teva
Mayne Pharma

 

EE 35 mcg

Ethynodiol diacetate
1 mg

Estarylla
Femynor
Mili
Mono-Linyah
norgestimate/EE
norgestimate/EE
Previfem
Sprintec
VyLibra

Xiromed
Amneal
Aurobindo
Northstar
Glenmark
Lupin
Par
Teva
Afaxys

 

EE 35 mcg

Norgestimate 0.25 mg

Balziva
Briellyn
Femcon Fe
chewable
Philith
Vyfemla
Wymzya Fe
chewable

Teva
Glenmark
Allergan
Northstar
Lupin
Lupin

 

EE 35 mcg

Norethindrone 0.4 mg

Necon
Nortrel 0.5/35
Wera

Mayne Pharma
Teva
Northstar

 

EE 35 mcg

Norethindrone 0.5 mg

Alyacen 1/35
Cyclafem 1/35
Dasetta 1/35
Nortrel 1/35
-21
Nortrel 1/35
-28
Ortho-Novum 1/35
Pirmella 1/35


Glenmark
Par
Northstar
Teva
Teva
Janssen
Lupin

EE 35 mcg

Norethindrone 1 mg

HIGH-DOSE MONOPHASIC PILLS

Kelnor 1/50-28

Teva

 

EE 50 mcg

Ethynodiol diacetate 1 mg

BIPHASIC PILLS

Azurette
Bekyree
desogestrel/EE
Kariva
Mircette
Pimtrea
Simliya
Viorele
Volnea

 

Mayne Pharma
Lupin
Mylan
Teva
Teva branded
Northstar
Aurobindo
Glenmark
Xiromed

 

EE 20 mcg x 21 days,
placebo x 2 days,
10 mcg x 5 days

Desogestrel
0.15 mg x 21 days

TRIPHASIC PILLS

Estrostep Fe
Tilia Fe
Tri-Legest Fe-28


Allergan
Mayne Pharma
Teva

EE 20 mcg x 5 days,
30 mcg x 7 days,
35 mcg x 9 days

Norethindrone acetate
1 mg x 21 days

norgestimate/EE
Tri-Lo-Estarylla
Tri-Lo-Marzia
Tri-Lo-Mili
Tri-Lo-Sprintec
Tri-VyLibra Lo

 

Glenmark
Xiromed
Lupin
Aurobindo
Teva
Afaxys

EE 25 mcg x 21 days

Norgestimate
0.18 mg x 7 days,
0.215 mg x 7 days,
0.25 mg x 7 days

Caziantn
Cyclessa
Velivet

Mayne Pharma
Aspen Global
Teva

EE 25 mcg x 21 days

Desogestrel
0.1 mg x 7 days,
0.125 mg x 7 days,
0.15 mg x 7 days

 

Enpresse
Levonest
levonorgestrel/EE
Trivora

 

Teva
Northstar
Lupin
Mayne Pharma

EE 30 mcg x 6 days,
40 mcg x 5 days,
30 mcg x 10 days

Levonorgestrel
0.05 mg x 6 days,
0.075 mg x 5 days,
0.125 mg x 10 days

 

norgestimate/EE
norgestimate/EE
Tri-Estarylla
Tri Femynor
Tri-Linyah
Tri-Mili
Tri-Previfem
Tri-Sprintec
Tri-VyLibra

Glenmark
Lupin
Xiromed
Amneal
Northstar
Aurobindo
Par
Teva
Afaxys

 

EE 35 mcg x 21 days

Norgestimate
0.18 mg x 7 days,
0.215 mg x 7 days,
0.25 mg x 7 days

Aranelle
Leena

Teva
Mayne Pharma

EE 35 mcg x 21 days

Norethindrone
0.5 mg x 7 days,
1 mg x 9 days,
0.5 mg x 5 days

 

Alyacen 7/7/7
Cyclafem 7/7/7
Dasetta 7/7/7
Nortrel 7/7/7
Ortho-Novum 7/7/7
Pirmella 7/7/7


Glenmark
Par
Northstar
Teva
Janssen
Lupin

EE 35 mcg x 21 days

Norethindrone
0.5 mg x 7 days,
0.75 mg x 7 days,
1 mg x 7 days


FOUR-PHASIC PILLS

Natazia

Bayer

Estradiol valerate 3 mg x 2 days, then 2 mg x 22 days, then 1 mg x 2 days, then
2-day pill-free interval

Dienogest
none x 2 days, then
2 mg x 5 days, then
3 mg x 17 days, then
none x 4 days

 

EXTENDED-CYCLE PILLS

Lo Loestrin Fe

Allergan

EE 10 mcg x 26 days

Norethindrone acetate
1 mg x 24 days

 

Aurovela 24 Fe
Blisovi 24 Fe
Charlotte 24 Fe
chewable
Hailey 24 Fe
Junel Fe 24
Larin 24 Fe
Melodetta 24 Fe
chewable
Mibelas 24 Fe
Minastrin 24 Fe
chewable
norethindrone acetate/EE/Fe
norethindrone acetate/EE/Fe
Tarina 24 Fe
Taytullai

Aurobindo
Lupin
Glenmark
Glenmark
Teva
Northstar
Amneal
Lupin
Allergan
Teva
Xiromed
Afaxys
Allergan

 

EE 20 mcg x 24 days

Norethindrone acetate
1 mg x 24 days

Generess Fe chewable
Kaitlib Fe chewable
Layolis Fe
norethindrone/EE/Fe chewable

Allergan
Lupin
Teva
Mylan

 

EE 25 mcg x 24 days

Norethindrone
0.8 mg x 24 days

Amethia Lon
Camrese Lo
levonorgestrel/EE
LoJaimiess
LoSeasonique

Mayne Pharma
Teva
Lupin
Xiromed
Teva branded

 

EE 20 mcg x 84 days,
10 mcg x 7 days

Levonorgestrel
0.1 mg x 84 days

Quartette
Rivelsa

Teva branded
Teva

EE 20 mcg x 42 days,
25 mcg x 21 days,
30 mcg x 21 days,
10 mcg x 7 days

 

Levonorgestrel
0.15 mg x 84 days

Icleviaj
Introvale
Jolessa
levonorgestrel/EE
levonorgestrel/EE
levonorgestrel/EE
Setlakin

Aurobindo
Xiromed
Teva
Lupin
Glenmark
Mylan
Northstar

 

EE 30 mcg x 84 days

Levonorgestrel
0.15 mg x 84 days

Amethia
Ashlyna
Camrese
Daysee
Jaimiess
levonorgestrel/EE
Seasonique
Simpesse


Mayne Pharma
Glenmark
Teva
Lupin
Xiromed
Mylan
Teva branded
Aurobindo

EE 30 mcg x 84 days,
10 mcg x 7 days

Levonorgestrel
0.15 mg x 84 days

Beyazc
drospirenone/EE
drospirenone/EEc
Gianvi
Jasmiel
Loryna
Lo-Zumandimine
Nikki
Yaz


Bayer
Glenmark
Lupin
Teva
Afaxys
Xiromed
Aurobindo
Lupin
Bayer

EE 20 mcg x 24 days

Drospirenone
3 mg x 24 days

CONTINUOUS-CYCLE PILLS (no pill-free interval)

Amethyst
levonorgestrel/EE

 

Teva
Glenmark

EE 20 mcg

Levonorgestrel 90 mcg

PROGESTIN-ONLY PILLS - “Mini-pill”

Slynd

Exeltis USA

Not applicable

Drospirenone 4 mg
x 24 days

 

Camila
Deblitane
Errin
Heather
Incassia
Jencycla
Nora-BE
norethindrone 0.35 mg
norethindrone 0.35 mg
norethindrone 0.35 mg
Norlyda
Ortho Micronor
Sharobel
Tulana

Mayne Pharma
Northstar
Mayne Pharma
Glenmark
Aurobindo
Lupin
Teva
Lupin
Mylan
Glenmark
Amneal
Janssen
Northstar
Afaxys

 

Not applicable

Norethindrone 0.35 mg

EMERGENCY CONTRACEPTION

Ella

HRA Pharma

Not applicable

Ulipristal 30 mg tablet
(progesterone receptor modulator)

 

EContra One Step
levonorgestrel
My Way
New Day
Opcicon One-Step
Plan B One-Step
Preventeza

Afaxys
Xiromed
Lupin
Northstar
Sun Pharma
Foundation
Combe

 

Not applicable

Levonorgestrel
1.5 mg tablet x 1


NON-ORAL ALTERNATIVES TO ORAL CONTRACEPTION

Brand Named
Dose/Route/Costl

Manufacturer

Estrogen

Progestin

Annovera13,m

WAC ~$2,000

Vaginal ring inserted and left in for 3 weeks and removed for 1 week. Ring should be washed and can be reused for up to 13 cycles.

 

TherapeuticsMD

Ethinyl estradiol
13 mcg/day

Segesterone acetate
150 mcg/day

Depo-Provera CI3

WAC ~$210

Intramuscular (IM) injection in the gluteal or deltoid muscle once every 3 months (13 weeks)

 

Pfizer

None

Medroxyprogesterone acetate
150 mg

Depo-subQ Provera 1044,e

WAC ~$235

0.65 mL (104 mg)
subcutaneous (SC) injection into the anterior thigh or
abdomen, once every
3 months (12 to 14 weeks)

 

Pfizer

None

Medroxyprogesterone acetate
104 mg

Kyleena2
(IUD)

WAC ~$955

Bayer

None

Levonorgestrel
17.5 mcg/day (after first 24 days of insertion), then reduces to
9.8 mcg/day after one year, and to 7.4 mcg/day after five years. Must be removed after 5 years.

 

Liletta12
(IUD)

WAC ~$790

Allergan

None

Levonorgestrel
~20 mcg/day initially
then to about 8.6 mcg/day after 6 years. Must be removed by the end of the sixth year.

 

Mirena6,g
(IUD)

WAC ~$955

 

Bayer

None

Levonorgestrel 20 mcg/day for up to 5 years, then to about 10 mcg/day during year six.

Nexplanon5,f,h

WAC ~$935

Implanted subdermally just under the skin at the inner side of the non-dominant arm.

Merck

None

Etonogestrel
60 to 70 mcg/day (after about 5 to
6 weeks), then reduces to about 35 to 45 mcg/day at the end of the first year, to about 30 to 40 mcg/day at the end of the second year, and to about 25 to 30 mcg/day at the end of the third year. Must be removed after 3 years.

 

NuvaRing,7 EluRyng,14 ethinyl estradiol/etonogestrel vaginal ring (authorized generic of NuvaRing)15

WAC
~$165 (NuvaRing);
~$150 (EluRyng);
~$140 (ethinyl estradiol/
etonogestrel)

Vaginal ring inserted and left in for 3 weeks and removed for 1 week

 

Merck (NuvaRing)

Amneal
(EluRyng)

Prasco
Laboratories
(ethinyl estradiol/
etonogestrel)

Ethinyl estradiol
15 mcg/day

Etonogestrel
(active form of desogestrel)
0.12 mg/day

ParaGard
(IUD)

WAC ~$885

 

Cooper Surgical

Non-hormonal, copper IUD

Phexxi17
(vaginal gel)

WAC ~$270

One applicatorful up to one hour before each episode of vaginal intercourse. Can be used during menstrual cycle.

 

Evofem Biosciences

Non-hormonal, lactic acid, citric acid, and
potassium bitartrate vaginal gel

Skyla8
(IUD)

WAC ~$795


Bayer

None

Levonorgestrel 14 mcg/day
(after first 24 days of insertion and declines to 5 mcg/day after 3 years)

Twirla16,o

WAC ~$55

Transdermal patch applied weekly (for 3 weeks, then week 4 is patch-free)

 

Agile Therapeutics

Ethinyl estradiol
30 mcg/day

Levonorgestrel 120 mcg/day

Xulane9,b

WAC ~$40

Transdermal patch applied weekly (for 3 weeks, then week 4 is patch-free)

Mylan

Ethinyl estradiol
35 mcg/day

Norelgestromin
(active form of norgestimate)
150 mcg/day

  1. This grouping is not an indication of therapeutic equivalence for purposes of substitution as defined by the FDA’s Orange Book. For therapeutic equivalence, consult the Orange Book (https://www.accessdata.fda.gov/scripts/cder/ob/).
  2. Body weight >90 kg may increase risk of unintended pregnancy.9 Has been used continuously with
    12 active patches in a row followed by 7-day patch-free interval.10
  3. Contains levomefolate (0.451 mg) in each tablet.
  4. For information on which hormonal contraceptive to use, see our charts, Choosing a Hormonal Contraceptive and Contraception for Women with Chronic Medical Conditions.
  5. FDA approved for use as a contraceptive and for management of pain associated with endometriosis.4
  6. Effectiveness rate in very overweight women (e.g., >130% of ideal body weight, BMI >35 kg/m2) unknown.5,11
  7. FDA approved for use as a contraceptive and to treat heavy menstrual bleeding in women who use an IUD for contraception.6
  8. Implanon was previously available in the U.S. Implanon and Nexplanon differ in insertion applicator and radio-opacity.
  9. Available as a softgel capsule. The four non-hormonal capsules each contain ferrous fumarate 75 mg.11
  10. Approved. Not marketed at time of publication.
  11. Contains 36.5 mg ferrous bisglycinate in each inactive tablet.
  12. Pricing based on wholesale acquisition cost (WAC). Medication pricing by Elsevier, accessed August 2020.
  13. Limited data available for women with a BMI >29 kg/m2. Women with BMI >29 kg/m2 excluded from trials after reports of venous thromboembolism in this population.13
  14. Caziant and Amethia Lo have been discontinued. Products may be used through their latest available expiration dates of April 2021 (Caziant) and March 2021 (Amethia Lo).1
  15. Effectiveness of Twirla is reduced in women with a BMI ≥25 kg/m2. Twirla is contraindicated in women with a BMI ≥30 kg/m2, due to risk of venous thromboembolism.16

Project Leader in preparation of this clinical resource (360828): Beth Bryant, Pharm.D., BCPS, Assistant Editor

References

  1. Verbal communication. Ashley (medical information). July 28, 2020. Mayne Pharma. Raleigh, NC 27609.
  2. Product information for Kyleena. Bayer HealthCare Pharmaceuticals. Whippany, NJ 07981. March 2018.
  3. Product information for Depo-Provera CI. Pfizer. New York, NY 10017. January 2017.
  4. Product information for Depo-subQ Provera 104. Pfizer. New York, NY 10017. December 2019.
  5. Product information for Nexplanon. Merck & Co. Whitehouse Station, NJ 08889. November 2019.
  6. Product information for Mirena. Bayer HealthCare Pharmaceuticals. Whippany, NJ 07981. August 2020.
  7. Product information for NuvaRing. Merck & Co. Whitehouse Station, NJ 08889. January 2020.
  8. Product information for Skyla. Bayer HealthCare Pharmaceuticals. Whippany, NJ 07981. March 2018.
  9. Product information for Xulane. Mylan Pharmaceuticals. Morgantown, WV 26505. April 2020.
  10. Stewart FH, Kaunitz AM, Laguardia KD, et al. Extended use of transdermal norelgestromin/ethinyl estradiol: a randomized trial. Obstet Gynecol 2005;105:1389-96.
  11. Product information for Taytulla. Allergan USA. Madison, NJ 07940. October 2019.
  12. Product information for Liletta. Allergan USA. Irvine, CA 92612. October 2019.
  13. Product information for Annovera. TherapeuticsMD. Boca Raton, FL 33431. January 2020.
  14. Product information for EluRyng. Amneal Pharmaceuticals. Bridgewater, NJ 08807. May 2019.
  15. Product information for etonogestrel/ethinyl estradiol vaginal ring. Prasco Laboratories. Mason, OH 45040. January 2020.
  16. Product information for Twirla. Agile Therapeutics. Princeton, NJ 08540. February 2020.
  17. Product information for Phexxi. Evofem Biosciences. San Diego, CA 92130. May 2020.

Cite this document as follows: Clinical Resource, Comparison of Oral Contraceptives and Non-Oral Alternatives. Pharmacist’s Letter/Prescriber’s Letter. August 2020.

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