Comparison of Oral Contraceptives and Non-Oral Alternatives (United States)

Click HERE to access the Canadian version of this resource.

(Full update February 2024)

This list is not comprehensive and the 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/). For information on which hormonal contraceptive to use (e.g., in patients with obesity, acne, endometriosis, dysmenorrhea), see our resource, Choosing a Contraceptive.

Products

Estrogen

Progestin

MONOPHASIC PILLS

Apri

Cyred EQ

desogestrel/EE

Desogen

Enskyce

Isibloom

Juleber

Kalliga

Reclipsen

EE 30 mcg

x 21 days

Desogestrel 0.15 mg

x 21 days

drospirenone/EEe

Ocella

Safyrale

Syeda

Tydemye

Yasmin

Zumandimine

EE 30 mcg

x 21 days

Drospirenone 3 mg

x 21 days

Beyaze

drospirenone/EEe

Gianvi

Jasmiel

Loryna

Lo-Zumandimine

Nikki

Vestura

Yaz

EE 20 mcg

x 24 days

Drospirenone 3 mg

x 24 days

Nextstellis

Estetrol 14.2 mg

x 24 days

Drospirenone 3 mg

x 24 days

ethynodiol diacetate/EE

Kelnor 1/35

Zovia 1/35

EE 35 mcg

x 21 days

Ethynodiol diacetate 1 mg

x 21 days

ethynodiol diacetate/EE

Kelnor 1/50-28

EE 50 mcg

x 21 days

Ethynodiol diacetate 1 mg

x 21 days

Altavera

Ayuna

Chateal EQ

Kurvelo

levonorgestrel/EE

Levora

Marlissa

Portia

EE 30 mcg

x 21 days

Levonorgestrel 0.15 mg

x 21 days

Iclevia

Introvale

Jolessa

levonorgestrel/EE

Setlakin

EE 30 mcg

x 84 days

Levonorgestrel 0.15 mg

x 84 days

Afirmelle

Aubra EQ

Aviane

Balcoltrad

Delyla

Falmina

Joyeauxd

Lessina

levonorgestrel/EE +/- Fe

Lutera

Sronyx

Tyblume (chewable)

Vienva

EE 20 mcg

x 21 days

Levonorgestrel 0.1 mg

x 21 days

Amethyst

Dolishale

levonorgestrel/EE

EE 20 mcg

x 28 days

(continuous, no pill-free interval)

Levonorgestrel 90 mcg

x 28 days

(continuous, no pill free interval)

Balziva

Briellyn

Nexesta Fe (chewable)

norethindrone/EE/Fe (chewable)

Ovcon

Philith

Vyfemla

Wymzya Fe(chewable)

Zenchent

EE 35 mcg

x 21 days

Norethindrone 0.4 mg

x 21 days

Brevicon

Necon 0.5/35

Nortrel 0.5/35

Wera

EE 35 mcg

x 21 days

Norethindrone 0.5 mg

x 21 days

Kaitlib Fe (chewable)

Layolis Fe (chewable)

norethindrone/EE/Fe (chewable)

EE 25 mcg

x 24 days

Norethindrone 0.8 mg

x 24 days

Alyacen 1/35

Dasetta 1/35

Nortrel 1/35

Nylia 1/35

Ortho-Novum 1/35

Pirmella 1/35

EE 35 mcg

x 21 days

Norethindrone 1 mg

x 21 days

Aurovela 1/20+/- Fe

Blisovi Fe 1/20

Hailey Fe 1/20

Junel 1/20+/- Fe

Larin 1/20+/- Fe

Loestrin 1/20+/- Fe

Microgestin 1/20+/- Fe

norethindrone/EE +/- Fe

Tarina Fe 1/20 EQ

EE 20 mcg

x 21 days

Norethindrone acetate 1 mg

x 21 days

Aurovela 24 Fe 1/20

Blisovi 24 Fe

Charlotte 24 Fe(chewable)

Finzalad(chewable)

Gemmilyd(capsule)

Hailey 24 Fe

Junel Fe 24

Larin 24 Fe

Merzeed(capsule)

Mibelas 24 Fe (chewable)

Microgestin 24 Fe

Minastrin 24 Fe (chewable)

norethindrone acetate/EE/Fe

(capsule & chewable)

Tarina 24 Fe

Taytullad(capsule)

EE 20 mcg

x 24 days

Norethindrone acetate 1 mg

x 24 days

Aurovela 1.5/30+/- Fe

Blisovi Fe 1.5/30

Hailey 1.5/30+/- Fe

Junel 1.5/30+/- Fe

Larin 1.5/30+/- Fe

Loestrin 1.5/30+/- Fe

Microgestin 1.5/30+/- Fe

norethindrone acetate/EE +/- Fe

EE 30 mcg

x 21 days

Norethindrone acetate 1.5 mg

x 21 days

Estarylla

Mili

Mono-Linyah

norgestimate/EE

Nymyo

Previfem

Sprintec

VyLibra

EE 35 mcg

x 21 days

Norgestimate 0.25 mg

x 21 days

Cryselle

Elinest

Low-Ogestrel

norgestrel/EE

Turqoz

EE 30 mcg

x 21 days

Norgestrel 0.3 mg

x 21 days

BIPHASIC PILLS

Azurette

desogestrel/EE

Kariva

Pimtrea

Simliya

Viorele

Volnea

EE 20 mcg x 21 days,

placebo x 2 days,

10 mcg x 5 days

Desogestrel 0.15 mg

x 21 days

Camrese Lo

levonorgestrel/EE

LoJaimiess

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

Levonorgestrel 0.1 mg

x 84 days

Amethia

Ashlyna

Camrese

Daysee

Jaimiess

levonorgestrel/EE

Simpesse

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

Levonorgestrel 0.15 mg

x 84 days

Lo Loestrin Fe

EE 10 mcg

x 26 days

Norethindrone acetate 1 mg

x 24 days

TRIPHASIC PILLS

Caziant

Cyclessa

Velivet

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

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

Aranelle

Leena

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

Dasetta 7/7/7

Nortrel 7/7/7

Nylia 7/7/7

Ortho-Novum 7/7/7

Pirmella 7/7/7

EE 35 mcg

x 21 days

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

Estrostep Fe

Tilia Fe

Tri-Legest Fe

norethindrone/EE/Fe

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

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

norgestimate/EE

Tri-Estarylla

Tri-Linyah

Tri-Mili

Tri-Nymyoj

Tri-Sprintec

Tri-VyLibra

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

QUADRIPHASIC PILLS

Natazia

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

Fayosim

levonorgestrel/EE

Rivelsa

EE 20 mcg x 42 days, then

25 mcg x 21 days, then

30 mcg x 21 days, then

10 mcg x 7 days

Levonorgestrel 0.15 mg

x 84 days

PROGESTIN-ONLY PILLS (“mini-pill”)

Slynd

Not applicable

Drospirenone 4 mg
x 24 days

Camila

Deblitane

Errin

Heather

Incassia

Jencycla

Lyleq

Nora-BE

norethindrone 0.35 mg

Norlyroc

Ortho Micronor

Sharobel

Tulana

Not applicable

Norethindrone 0.35 mg

x 28 days

(continuous, no pill-free interval)

Opill(OTC)

Not applicable

Norgestrel 0.075 mg

x 28 days

(continuous, no pill-free interval)

EMERGENCY CONTRACEPTION

Aftera

AfterPill

Curae

EContra EZ

EContra One-Step

Fem Choice

Her Style

levonorgestrel

My Choice

My Way

New Day

Opcicon One-Step

Option 2

Plan B One-Step

PostDay One-Step

Preventeza

React

Take Action

Not applicable

Levonorgestrel
1.5 mg tablet x 1

Ella

Not applicable

Ulipristal

30 mg tablet x 1

(progesterone receptor modulator)

Continue to the next page for Non-Oral Contraceptive Options

NON-ORAL ALTERNATIVES TO ORAL CONTRACEPTION

Brand Name

Dose/Route/
Cost per yearc

Manufacturer

Estrogen

Progestin

Annovera13

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.

~$2,300

TherapeuticsMD

Ethinyl estradiol

13 mcg/day

Segesterone acetate

150 mcg/day

Depo-Provera CI3

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

~$220 (Pfizer)

~$160 (generics)

Pfizer

multiple generic manufacturers

None

Medroxyprogesterone acetate

150 mg

Depo-SubQ Provera 1044

0.65 mL (104 mg)

subcutaneous injection into the anterior thigh or

abdomen, once every
3 months (12 to 14 weeks).

~$220

Pfizer

None

Medroxyprogesterone acetate

104 mg

Kyleena2

(IUD)

~$220/year (~1,100/device)

Bayer

None

Levonorgestrel

17.5 mcg/day (after first 24 days of insertion), then reduces to
7.4 mcg/day after five years. Must be removed by the end of the fifth year.

Liletta12

(IUD)

~$110/year (~$890/device)

AbbVie

None

Levonorgestrel

~20 mcg/day initially
then to about 6.5 mcg/day after
8 years. Must be removed by the end of the eighth year.b

Mirena6

(IUD)

~$140/year (~$1,100/device)

Bayer

None

Levonorgestrel 21 mcg/day

(after 24 days, then reduced to about
11 mcg/day after 5 years, and about
7 mcg/day after 8 years. Must be removed after eight years.b

Nexplanon5

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

~380/year (~$1,150/implant)

Organon USA

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 by the end of the third year.

NuvaRing,7 generics

Vaginal ring inserted and left in for 3 weeks, followed by one ring-free week. Repeat cycle with a new ring.

~$2,600 (NuvaRing)

~$1,820 (Haloette)

~$1,690 (other generics)

~$1,365 (EluRyng)

~$1,040 (EnilloRing)

Organon USA (NuvaRing)

Various generics: Amneal (EluRyng), Mayne Pharma (Haloette), Xiromed (EnilloRing), Prasco, Teva, AvKARE, NorthStar

Ethinyl estradiol

15 mcg/day

Etonogestrel

(active form of desogestrel)
0.12 mg/day

ParaGard1

(IUD)

~$110/year (~$1,085/device)

Cooper Surgical

Non-hormonal, copper IUD.

Must be removed after ten years.

Phexxi15

(vaginal gel)

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

~$350/12 prefilled applicators

Evofem Biosciences

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

Skyla8

(IUD)

~$305/year (~$915/device)

Bayer

None

Levonorgestrel 14 mcg/day

(after first 24 days of insertion and declines to 5 mcg/day after three years). Must be removed by the end of the third year.

Twirla14

Transdermal patch applied weekly for 3 weeks, followed by one patch-free week.

~$2,500

Agile Therapeutics

Ethinyl estradiol

30 mcg/day

Levonorgestrel

120 mcg/day

Xulane,9 Zafemy,11 generic

Transdermal patch applied weekly for 3 weeks, followed by one patch-free week.a

~$530

Mylan

(Xulane)

Amneal

(Zafemy)

Ethinyl estradiol

35 mcg/day

Norelgestromin

(active form of norgestimate)

150 mcg/day

Abbreviations: BMI = body mass index; EE = ethinyl estradiol; Fe = iron; OTC = over-the-counter.

  1. Have been used continuously with 12 active patches in a row followed by 7-day patch-free interval.10
  2. Must be removed after five years when used to treat heavy menstrual bleeding.6,12
  3. Pricing based on wholesale acquisition cost (WAC). Medication pricing by Elsevier, accessed February 2024.
  4. Products contain iron. Note that additional products (identified by “Fe” in their name) in the above chart also contain iron in some of the tablets/capsules.
  5. Product formulated with folate.

References

  1. Product information for Paragard. Copper Surgical. Trumbull, CT 06611. February 2020.
  2. Product information for Kyleena. Bayer HealthCare Pharmaceuticals. Whippany, NJ 07981. July 2021.
  3. Product information for Depo-Provera CI. Pfizer. New York, NY 10017. December 2020.
  4. Product information for Depo-SubQ Provera 104. Pfizer. New York, NY 10017. December 2020.
  5. Product information for Nexplanon. Organon USA. Jersey City, NJ 07302. September 2023.
  6. Product information for Mirena. Bayer HealthCare Pharmaceuticals. Whippany, NJ 07981. August 2022.
  7. Product information for NuvaRing. Organon USA. Jersey City, NJ 07302. January 2023.
  8. Product information for Skyla. Bayer HealthCare Pharmaceuticals. Whippany, NJ 07981. July 2021.
  9. Product information for Xulane. Mylan Pharmaceuticals. Morgantown, WV 26505. March 2022.
  10. Stewart FH, Kaunitz AM, Laguardia KD, et al. Extended use of transdermal norelgestromin/ethinyl estradiol: a randomized trial. Obstet Gynecol. 2005 Jun;105(6):1389-96.
  11. Product information for Zafemy. Amneal Pharmaceuticals. Bridgewater, NJ 08807. April 2022.
  12. Product information for Liletta. Abbvie. North Chicago, IL 60064. June 2023.
  13. Product information for Annovera. TherapeuticsMD. Boca Raton, FL 33431. April 2022.
  14. Product information for Twirla. Agile Therapeutics. Princeton, NJ 08540. November 2023.
  15. Product information for Phexxi. Evofem Biosciences. San Diego, CA 92130. November 2023.

Cite this document as follows: Clinical Resource,Comparison of Oral Contraceptives and Non-Oral Alternatives (United States). Pharmacist’s Letter/Pharmacy Technician’s Letter/Prescriber Insights. February 2024. [400266]

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