Phexxi
Phexxi is a prescription vaginal gel used as a type of birth control to prevent pregnancy. It’s hormone-free, so it doesn’t contain any hormones. Instead, it has three active ingredients: lactic acid, citric acid, and potassium bitartrate. Though it’s not a spermicide, it’s used the same way — by inserting it into the vagina before sex, as needed. Common side effects include vaginal burning, vaginal itching, and yeast infections.
What is Phexxi?
What is Phexxi used for?
- To prevent pregnancy
How Phexxi works
Phexxi is a vaginal pH regulator. It works by changing the pH of the vagina during sex, making the vaginal environment more acidic during sex. This makes it harder for sperm to move up to where the egg is, which lowers your risk of pregnancy.
Drug facts
Side effects of Phexxi
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
- Vaginal burning (18%)
- Vaginal itching (15%)
- Vaginal yeast infection (9%)
- Urinary tract infection (UTI) (9%)
- Vaginal discomfort (9%)
- Vaginal bacterial infection (8%)
- Vaginal discharge (6%)
Less Common Side Effects
- Genital discomfort
- Painful urination
- Vaginal pain
Phexxi serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Urinary tract infection: pain or burning during urination, cloudy urine, pain in the pelvis, back pain
The following Phexxi 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
- Genital yeast infection—redness, swelling, pain, or itchiness, odor, thick or lumpy discharge
- Urinary tract infection (UTI)—burning when passing urine, passing frequent small amounts of urine, bloody or cloudy urine, pain in the lower back or sides
- Unusual vaginal discharge, itching, or odor
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Vaginal irritation at application site
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Pros and cons of Phexxi
Pros
- A hormone-free birth control option
- Can be used as needed right before (or up to 1 hour before) vaginal sex
- Can be used anytime even during your period
Cons
- Must be prescribed by a healthcare professional
- Can cause vaginal burning, itching, or discomfort
- Doesn't work as well to prevent pregnancy as some other birth control methods
Pharmacist tips for Phexxi
- You can use Phexxi even if you have a vaginal infection. It’s also safe to use with vaginal medications like miconazole (Monistat), metronidazole (Vandazole), and tioconazole (Vagistat-1).
- Use Phexxi right before or up to 1 hour before vaginal sex. Since this medication is used to prevent pregnancy, stop using it if you become pregnant, as it’s no longer needed.
- You can use Phexxi at any time, including while you’re on your period. Just make sure you use a new single dose applicator each time you have vaginal sex with your partner.
- It’s okay to use Phexxi as soon as your OB-GYN provider says it's safe to have vaginal sex after childbirth, abortion, or miscarriage.
- Phexxi doesn’t protect you against HIV and other sexually transmitted infections (STIs). Talk to your prescriber if you have questions about ways to protect yourself from these infections.
- If you're allergic to any ingredients in Phexxi (lactic acid, citric acid, or potassium bitartrate), you might also be allergic to the medication itself. Mild side effects like local burning, itching, and pain can occur, and your partner might experience these too. Let your prescriber know if these symptoms become bothersome.
How to use Phexxi:
- It’s important to read the Instructions For Use before using Phexxi to make sure you use it correctly.
- Take the applicator and plunger out of the foil wrapper. Insert the plunger into the end of the applicator and slowly push until they connect. Once connected, remove the pink cap.
- Gently insert the applicator into your vagina. Then, using your index finger, push the plunger down until it stops to make sure all the gel is inserted. Remove the applicator and plunger, and throw them away.
Common questions about Phexxi
In a clinical study, Phexxi was 86% effective at preventing pregnancy, similar to condoms, which are 85% effective. Though Phexxi doesn't work as well as other birth control methods, like an intrauterine device (IUD) or the pill, it's more effective than spermicides. Speak with your OB-GYN provider about the different birth control options available to you.
Phexxi lasts about 1 hour before you have vaginal sex. So if you don’t have vaginal sex within an hour after using the gel, you’ll need to insert a new applicator before having sex. Also, if you have vaginal sex more than once within an hour, use a new applicator each time. Basically, you'll need to use a new Phexxi applicator each time you have vaginal sex.
It can. About 9% of people who used Phexxi had a yeast infection in clinical studies. If you notice symptoms such as vaginal itching, yellowish discharge, and pain, let your OB-GYN provider know.
Yes, Phexxi can expire. Look for the expiration date written on the box. Each application can only be used one time as well. Throw away the medication and ask for a refill or new prescription if it's past the expiration date. Expired medication might not work as well to prevent pregnancy.
Weight gain isn't a side effect reported by people who used Phexxi in clinical trials. Speak with your OB-GYN provider if you have questions about weight gain and this medication.
Yes. Phexxi can be used alone or with other birth control methods. Using it with other options can further lower your chances of getting pregnant. Though it's okay to use Phexxi with the pill, condoms, and vaginal diaphragms, avoid using it with a vaginal ring like the NuvaRing (etonogestrel / ethinyl estradiol) or Annovera (segesterone acetate / ethinyl estradiol). Speak to your OB-GYN provider to discuss the best pregnancy prevention for you.
No. Phexxi is only available as a brand-name medication.
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Risks and warnings for Phexxi
Phexxi 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.
Urinary tract infections (UTI)
- Risk factors: Repeated urinary tract infections (UTI) | Other urinary tract conditions
Phexxi can raise your risk for urinary tract infections (UTI), including bladder infection (cystitis) and a kidney infection (pyelonephritis). Your risk is higher if you have a history of UTIs or other urinary tract conditions. Even though UTIs are common, they can be serious if left untreated. If you experience symptoms like pain or burning during urination, cloudy urine, pain in the pelvis, or back pain, let your prescriber know or speak to another healthcare professional as you might need antibiotics to treat the UTI.
Phexxi dosage
Box| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| twelve 5g applicators of 1.8%/1%/0.4% | 1 box | $353.24 | $353.24 |
Typical dosage for Phexxi
Phexxi comes in pre-filled single dose applicators. Each applicator contains 5 grams of gel.
The typical dose is one pre-filled applicator placed into your vagina right before (or up to 1 hour before) vaginal sex.
How much does Phexxi cost?
$353.24
What are alternatives to Phexxi?
