Opill
Opill (norgestrel) is the first over-the-counter (OTC) birth control pill approved by the FDA that can be used by all ages. It's a progesterone-only birth control pill and contains norgestrel, a lab-made form of progesterone — so it doesn't have any estrogen in it. Opill (norgestrel) is taken once daily by mouth to prevent pregnancy. The most common side effect is changes in menstrual periods. including breakthrough bleeding and spotting. Opill (norgestrel) shouldn't be used as an emergency contraceptive (morning after pill).
What is Opill (norgestrel)?
What is Opill (norgestrel) used for?
How Opill (norgestrel) works
Opill (norgestrel) is a progestin, a lab-made form of progesterone (a natural hormone). It helps prevent pregnancy by blocking sperm from reaching the egg by thickening cervical mucus. The medication might also stop ovulation, or the release of an egg from the ovary.
Drug Facts
More on Opill (norgestrel) essentials
What are the side effects of Opill (norgestrel)?
Common Side Effects
- Changes in menstrual periods
- Headache
- Dizziness
- Nausea
- Larger appetite
- Stomach pain or cramps
- Bloating
- Feeling tired
- Vaginal discharge
- Nervousness
- Backache
- Breast discomfort
- Acne
Other Side Effects
- Ectopic pregnancy
- Ovarian cysts
- Liver problems
Serious Side Effects
- Possible ectopic pregnancy: stomach pain, spotting
- Liver problems: yellowing of the skin or whites of the eyes, stomach pain, dark-colored urine, clay-colored stool, fever, tiredness, loss of appetite
Source: DailyMed
The following 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
- 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):
- Acne
- Breast pain or tenderness
- Headache
- Increase in appetite
- Irregular menstrual cycles or spotting
- Nausea
- Weight gain
Pros and cons of Opill (norgestrel)
Pros
Available over the counter (OTC) without a prescription
Taken by mouth once a day
Good option for people who can't take estrogen
98% effective at preventing pregnancy with perfect use
Cons
Can cause changes in vaginal bleeding patterns (e.g., spotting)
Doesn't protect against sexually transmitted infections (STIs)
Can't use if you've had breast cancer
Interacts with many medications
Pharmacist tips for Opill (norgestrel)
You can start taking Opill (norgestrel) on any day of the month. When you first start, use a back-up birth control method (like condoms) for 48 hours to prevent pregnancy while waiting for the pill to start working.
Take Opill (norgestrel) at the same time every day. Setting an alarm can help you remember to take the pill on time.
If you miss a dose or take Opill (norgestrel) 3 or more hours late, take it as soon as you remember. Use back-up birth control each time you have sex for the next 48 hours.
If you have severe diarrhea or throw up within 4 hours of taking Opill (norgestrel), use back-up birth control if you have sex during the next 48 hours, as the pill might not be fully absorbed.
After you finish a pack of Opill (norgestrel), start a new pack right away the following day. Don't take breaks between packs.
Irregular periods and spotting are common while using Opill (norgestrel). If you miss two periods in a row or if your period is late and missed a pill, take a pregnancy test to be sure.
If you become pregnant while you're taking Opill (norgestrel), stop taking it and call your OB-GYN provider.
If you have bleeding after sex, periods lasting more than 8 days, unusually heavy bleeding, migraines with vision changes, or worsening migraines, contact your healthcare professional. They can check to see what's going on.
Frequently asked questions about Opill (norgestrel)
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What are the risks and warnings for Opill (norgestrel)?
Opill (norgestrel) 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.
Ectopic pregnancy
Some people who became pregnant while taking progestin-only birth control like Opill (norgestrel) have had an ectopic pregnancy (a pregnancy outside the womb). If you have severe pain in your lower stomach, contact your OB-GYN right away. They can examine you to see whether it's an ectopic pregnancy and whether you need closer monitoring during pregnancy.
Ovarian cyst
Sometimes, ovarian cysts (small fluid-filled sacs in the ovary) can develop after taking Opill (norgestrel). These cysts rarely cause problems and tend to go away on their own. But some might lead to mild stomach pain and, in rare cases, require surgery. If you have severe stomach pain, contact your primary care provider so they can check for an ovarian cyst.
Irregular vaginal bleeding
Irregular vaginal bleeding is a common side effect of Opill (norgestrel). In clinical studies, about 50% of people taking this medication experienced changes in their period, including breakthrough bleeding and spotting. Some people also stopped having a period while taking the medication. In some rare cases, these changes could be a sign of a serious condition, such as an infection or cancer. If you're concerned about irregular bleeding, talk with your healthcare professional. If you miss a period while you're taking Opill (norgestrel) and you've recently had sex, consider taking a pregnancy test.
Liver damage
Although rare, progestins like Opill (norgestrel) can cause liver damage, usually from high doses. Signs of liver problems include stomach pain, yellowing of the skin or whites of the eyes, dark-colored urine, and feeling tired. If you experience these symptoms, contact your primary care provider so they can check your liver health.
Migraines
If you start having new or worsening migraines or develop severe, frequent, or persistent headaches while taking Opill (norgestrel), talk to your healthcare provider. Migraines can raise your risk of stroke, so it's important to find out the cause of your symptoms.
Interactions with other medications
Some medications can make Opill (norgestrel) work less well at preventing pregnancy. They include seizure medications, like phenytoin (Dilantin) and carbamazepine (Tegretol), and the tuberculosis (TB) medication rifampin. Certain antibiotics, human immunodeficiency virus (HIV) medications, and herbal supplements like St. John's wort can speed up the breakdown of Opill (norgestrel), making it less effective and increasing the chance of breakthrough bleeding. Additionally, don't use Opill (norgestrel) within 5 days of taking an emergency contraceptive pill called Ella (ulipristal). Tell your primary care provider or pharmacist about all the medications and supplements you're taking before starting Opill (norgestrel).
Allergic reaction
Risk factors: Allergy to FD&C Yellow No. 5
Opill (norgestrel) contains a dye called FD&C Yellow No. 5 (tartrazine). This dye can cause some people to experience allergic reactions, such as hives or breathing problems. Talk to your primary care provider before taking Opill (norgestrel) if you're allergic to FD&C Yellow No. 5.
Opill (norgestrel) dosage forms
Typical dosing for Opill (norgestrel)
Each tablet contains 0.075 mg of norgestrel.
The typical dose is 1 tablet by mouth every day, at the same time each day.
Opill (norgestrel) contraindications
Currently pregnant
Using other hormonal birth control or IUD (intrauterine device)
Allergic to Yellow No. 5 dye
Male
History of breast cancer or other progestin-sensitive cancer
Have liver tumor, either benign or cancerous
Have bleeding between your periods that hasn't been diagnosed by your OB-GYN provider or HCP
Acute (sudden) liver disease
What are alternatives to Opill (norgestrel)?
Prevent pregnancy for up to 8 years
Relieve heavy menstrual periods for up to 5 years
What is the latest news about Opill (norgestrel)?
Opill (norgestrel) images
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References
Best studies we foundNational Institute of Diabetes and Digestive and Kidney Diseases. (2020). Progestins. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury.
Perrigo Company plc. (2017). Opill® tablets. U.S. Food and Drug Administration.
Perrigo Company plc. (2023). Opill norgestrel tablets 0.075 mg daily oral contraceptive [package insert]. DailyMed.
Perrigo Company plc. (2023). Perrigo announces U.S. FDA approval for Opill® OTC daily oral contraceptive. PRNewswire.
U.S. Food and Drug Administration. (2023). FDA approves first nonprescription daily oral contraceptive.
U.S. Food and Drug Administration. (2023). How safe are color additives?
You and Your Hormones. (2021). Progesterone.
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