What’s the Best Birth Control Pill? How to Pick a Birth Control Brand That’s Right for You
There are so many types of birth control pills to choose from. Learn about the different names, types, their side effects, safety, and how well they work.
norethindrone acetate / ethinyl estradiol / ferrous fumarate
Used for Birth Control
Used for Birth Control
Junel Fe 24 is a birth control pill that's taken every day to prevent pregnancy. As a combined oral contraceptive (COC), the active pills contain 2 hormones: norethindrone (a progestin) and ethinyl estradiol (an estrogen), while the inactive pills have some iron. It has a lower estrogen dose and 24 active tablets, compared to the usual 21 in similar COCs. Junel Fe 24 is a monophasic birth control, meaning all active tablets have the same hormone levels. Common side effects include headache, nausea, and weight gain.
Junel Fe 24 is a generic of the discontinued brand name Loestrin 24 Fe. Other generics like Junel Fe 24 include Aurovela 24 fe, Blisovi 24 Fe, Hailey 24 Fe.
What is Junel Fe 24?
What is Junel Fe 24 used for?
- To prevent pregnancy
How Junel Fe 24 works
Junel Fe 24 is a combination medication that contains two hormones: norethindrone (a progestin) and ethinyl estradiol (an estrogen). These hormones work together to prevent pregnancy by:
- Stopping ovulation (release of an egg from the ovary)
- Changing cervical mucus to block sperm movement
- Changing the lining of the uterus so it's more difficult for a fertilized egg to implant
Junel Fe 24 also contains inactive (hormone-free) tablets with ferrous fumarate. This iron supplement is added to reduce your risk of anemia during the days you’re taking the inactive tablets and may experience bleeding.
Drug facts
| Common Brands | Junel Fe 24, Aurovela 24 Fe, Larin 24 Fe, Tarina 24 Fe, Microgestin 24 Fe |
|---|---|
| Drug Class | Estrogen / Progestin combined contraceptive |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | Lower-cost generic available |
| Availability | Prescription only |
Side effects of Junel Fe 24
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Headache (6%)
- Vaginal yeast infection (6%)
- Nausea (5%)
- Menstrual cramps (4%)
- Breast tenderness (3%)
- Acne (3%)
- Bacterial vaginal infection (3%)
Less Common Side Effects
- Weight gain
- Mood changes
- Irregular bleeding
- Depression
- Higher blood pressure
Junel Fe 24 serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Heart attack: chest pain, arm pain, shortness of breath, stomach discomfort, sweating, nausea, dizziness
- Stroke: sudden numbness or weakness on one side of the body, drooping face, confusion, trouble seeing, headache, difficulty walking
- Deep vein thrombosis (blood clot in the leg): leg cramp, swelling, pain, muscle tightness
- Pulmonary embolism (blood clot in the lung): cough, chest pain, trouble breathing, racing heart
- Serious liver problems: yellowing of the skin or the whites of the eyes, tiredness, stomach pain
The following Junel Fe 24 side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Blood clot—pain, swelling, or warmth in the leg, shortness of breath, chest pain
- Gallbladder problems—severe stomach pain, nausea, vomiting, fever
- Increase in blood pressure
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- New or worsening migraines or headaches
- Stroke—sudden numbness or weakness of the face, arm or leg, trouble speaking, confusion, trouble walking, loss of balance or coordination, dizziness, severe headache, change in vision
- Unusual vaginal discharge, itching, or odor
- Worsening mood, feelings of depression
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Breast pain or tenderness
- Dark patches of skin on the face or other sun-exposed areas
- Irregular menstrual cycles or spotting
- Nausea
- Weight gain
Get your GoodRx coupon
$46.52
GoodRx discount
$18.01
Pros and cons of Junel Fe 24
Pros
- Taken once daily with or without food
- Works well to prevent pregnancy
- Inactive pills contain iron, which might lower your risk for anemia
Cons
- Raises the risk of a blood clot
- Raises the risk of liver problems
- Instructions for missed doses vary by week and number of doses missed
Pharmacist tips for Junel Fe 24
- Set an alarm for the same time every day to help you remember to take Junel Fe 24. The chance of accidentally getting pregnant gets higher if you forget to take a pill while you're sexually active.
- Junel Fe 24 doesn't protect you against human immunodeficiency virus (HIV) or other sexually transmitted infections (STIs). Be sure to use a condom during sex to lower your risk of getting HIV and other STIs.
- Let your OB-GYN provider or pharmacist know all of your current medications. Certain medications like rifampin (Rifadin), can interact with Junel Fe 24 and make it work less well to prevent pregnancy. And you might need to use a back-up method of birth control.
- If you start Junel Fe 24 on the first Sunday after your period, use a back-up method of birth control for 7 days because its pregnancy-prevention effects haven't fully kicked in yet. But if you start Junel Fe 24 on the first day of your period, you won't need to use a back-up birth control.
- If you want to start Junel Fe 24 after having a baby, check with your OB-GYN provider first. You need to wait at least 4 weeks after delivering your baby before you can start this medication. Starting any earlier raises your risk of blood clots.
- If you vomit or have diarrhea within 3 to 4 hours after taking Junel Fe 24, take another active tablet from your pack. If these symptoms last more than 1 day, the medication might not work as well to prevent pregnancy. So it's recommended to use another form of birth control, like condoms or spermicides, until you speak with your OB-GYN.
- Wear sunscreen and avoid tanning beds to protect your skin while you're taking Junel Fe 24. This medication can cause some areas of the face, such as the forehead, nose, and cheeks, to darken. Exposure to ultraviolet (UV) rays can darken these areas of skin even more.
- Speak to your OB-GYN provider before starting Junel Fe 24 if you're breastfeeding. This medication can lower your milk supply so you might need to consider another form of birth control.
Risks and warnings for Junel Fe 24
Junel Fe 24 can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Cigarette smoking and risk for blood clots
- Risk factors: Over 35 years old who smoke cigarettes
If you smoke cigarettes, using combined oral contraceptives (COCs), like Junel Fe 24, raises your risk for blood clots. These blood clots can lead to more serious problems, such as heart attack and stroke. People aged 35 years and older who smoke are at even higher risk for these problems. If you smoke, talk with your OB-GYN provider about safer birth control alternatives.
Blood clots and strokes
- Risk factors: Age 35 or older and smoke | Recent surgery with a long period of bed rest | Starting Junel Fe 24 less than a month after childbirth | High blood pressure | People identified as obese | High cholesterol | Diabetes | Higher dose of estrogen
Junel Fe 24 raises your risk of blood clots. These clots can occur anywhere in your body, including your lungs (pulmonary embolism or PE), legs (deep vein thrombosis or DVT), brain (stroke), and heart (heart attack). Get emergency help right away if you have any signs of a blood clot.
- Brain: weakness or numbness in your arms, legs, or face on one side of the body, trouble speaking, blurred vision, dizziness, loss of balance, trouble walking, or confusion
- Eyes: trouble seeing, bulging eye, double vision
- Heart: chest pain, sweating, nausea, or dizziness
- Lungs: trouble breathing, chest pain, or cough
- Legs: cramps, swelling, pain, or muscle tightness
If you need to have surgery, tell your care team you're taking Junel Fe 24. They might have you stop taking it 4 weeks before until 2 weeks after your surgery to lower your risk of blood clots. If you recently delivered a baby, you shouldn't start Junel Fe 24 until 4 weeks after delivery if you're not breastfeeding your child.
Liver problems
- Risk factors: History of liver problems | Taking certain hepatitis C combination medications
Don't take Junel Fe 24 if you have liver problems. Although rare, COCs like Junel Fe 24 can raise your risk of benign liver tumors. Signs of liver problems can include jaundice (yellowing of the skin or eyes), along with fever, tiredness, loss of appetite, or dark colored urine.
High blood pressure
- Risk factors: Older age | Taking COCs for a long time
Junel Fe 24 can raise your blood pressure, so you might want to check your blood pressure while you're taking this medication. The risk is higher in older adults that have taken birth control for a long time. Stop taking Junel Fe 24 and let your care team know if your blood pressure is unusually high.
High blood sugar and triglycerides
- Risk factors: Prediabetes or diabetes | History of high triglycerides
Junel Fe 24 can raise your blood sugar and triglyceride (fat) levels. If you have diabetes or prediabetes, let your prescriber know if you experience any changes in your blood sugar. A rise in triglycerides can lead to serious conditions like inflammation of the pancreas (pancreatitis). Get emergency medical help if you notice symptoms of pancreatitis, which can include stomach pain, nausea, or vomiting.
Headache
Let your HCP know if you experience new or worsening migraines or headaches while taking Junel Fe 24. You'll have to stop this medication if your migraine or headache doesn't go away or becomes severe.
Irregular bleeding
People who take Junel Fe 24 can sometimes experience breakthrough bleeding and spotting, especially during the first 3 months of taking this medication. Irregular bleeding can vary from slight staining to bleeding similar to a regular period. This problem might be temporary, so continue taking your medication as directed. Let your OB-GYN provider know if the bleeding is a problem for you. If you missed your period(s), contact your OB-GYN provider or get a pregnancy test to make sure you're not pregnant.
Depression
Talk to your OB-GYN provider if you experience symptoms of depression or worsening depression while taking Junel Fe 24. Your prescriber might consider stopping this medication if you have serious depression.
Risk for breast and cervical cancer
- Risk factors: History of breast or cervical cancer | Taking COCs for a long time
Study results are mixed, but there's a possibility that Junel Fe 24 and other COCs can raise your risk for breast and cervical cancer.
Don't take Junel Fe 24 if you currently have or have had breast cancer because some types of breast cancer grow faster in the presence of estrogen, an ingredient in this medication. You can perform breast self-checks regularly at home and get yearly breast exams with your HCP to help with early breast cancer detection. Let your HCP know if you notice any new or abnormal lumps, pain, or swelling in your breasts.
Make sure you follow up with your OB-GYN provider to get proper screenings for cervical cancer. Report any signs of vaginal bleeding or discharge that's not normal.
Worsening of other health conditions
- Risk factors: History of hereditary angioedema | History of chloasma gravidarum
If you have certain conditions, such as hereditary angioedema or chloasma (a skin condition that causes dark patches on the face), talk to your healthcare professional before taking Junel Fe 24 because it might worsen your symptoms. If you have a history of chloasma, limit exposure to the sun or UV light while taking birth control pills like Junel Fe 24.
Junel Fe 24 dosage
The average cost for 3 packages of 28 tablets of 1mg/20mcg of Junel Fe 24 is $30.97 with a free GoodRx coupon. This is 87.97% off the average retail price of $257.46. 
Package
Package| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 28 tablets of 1mg/20mcg | 3 packages | $30.97 | $10.32 |
Typical dosage for Junel Fe 24
Junel Fe 24 (and other branded generics) comes in a 28-day pack. Your medication might look different depending on which branded generic your healthcare professional (HCP) prescribes. Follow your HCP's instructions or the directions on the package when taking it.
There are 24 active tablets containing 1 mg norethindrone acetate and 20 mcg ethinyl estradiol. There are 4 placebo tablets and each contain 75 mg of ferrous fumarate.
The typical dose is to take 1 active tablet by mouth daily for 24 days, followed by 1 placebo tablet daily for the remaining 4 days.
How much does Junel Fe 24 cost?
To access savings, use a GoodRx coupon and pay just a fraction of the retail price.
Junel Fe 24 (generic)
$18.01
Junel Fe 24 contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Junel Fe 24 will not be safe for you to take.
- Over 35 years old who smoke
- Currently have or have had a blood clot
- Blood clotting condition
- Stroke
- Coronary artery disease (CAD)
- Certain heart rhythm problems, like atrial fibrillation (AFib)
- High blood pressure that's not under control
- Diabetes with high blood pressure or organ damage
- Migraine headaches with aura
- Any migraine headaches for those over 35 years old
- Liver problems or liver disease
- Unexplained vaginal bleeding that hasn't been diagnosed
- Currently have or have had breast cancer
- Take hepatitis C combination medications containing ombitasvir/paritaprevir/ritonavir
What are alternatives to Junel Fe 24?
There are a number of medications that your doctor can prescribe in place of Junel Fe 24. Compare a few possible alternatives below.
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