New Opill OTC Birth Control

March 4, 2024

photo of Opill package and pill packs

Over-the-Counter Birth Control Pills Available Soon

Opill* is the first daily birth control pill that has been approved by the FDA for over-the-counter access, and will soon be available in the U.S. – meaning you don’t need a medical appointment or prescription to get it! You should be able to buy it right off the shelf at pharmacies or other stores, just like aspirin or condoms, and it will even be available online.

NOTE: the information below is very general, and meant to provide basic facts regarding this newly-available birth control method. If you have specific questions, concerns, or want to discuss whether this option may be right for you, talk to a KBFPC provider. Appointments are available in-person or via telehealth, and you may qualify for low- or no-cost services according to our sliding fee discount program. Call 907-235-3436 or text 907-435-7505 to learn more!

What’s the deal?

Opill is a progestin-only birth control pill (also known as the “mini pill”). It does not contain estrogen, unlike most other types of birth control pills. It prevents pregnancy by thickening your cervical mucus, which helps block sperm from reaching the egg. It may also prevent your ovaries from releasing eggs on some menstrual cycles. To be effective it must be taken as close as possible to the same time every day.

Opill is not emergency contraception (“morning after pill”) so it won’t prevent pregnancy when used after sex without a condom or other birth control method. It will not end or harm an existing pregnancy, but it should not be taken when pregnant. It does not protect against HIV or other sexually transmitted infections (STIs).

Who can use it?

Progestin-only birth control pills like Opill can be taken by most people who can get pregnant, but if you currently have or have previously had breast cancer you should not take Opill. (There are some other medical reasons someone shouldn’t take Opill, so be sure to read all the information that comes with the medication.) Since it contains only one hormone, progestin, and is estrogen-free, Opill is suitable for people who have medical conditions that prevent them from taking estrogen-based contraceptives and for people who are breastfeeding/chestfeeding. There is no age restriction, so Opill can be used by anyone who has started menstruating, at any age. Opill should work as well for people of any weight, but any concerns about effectiveness should be discussed with your healthcare provider.

Why would I choose it?

The best birth control method for you is the one that you prefer: one that works for your body and your lifestyle, that you can access, and that you can commit to using consistently. If you are looking for an estrogen-free birth control pill or a contraceptive method that is available without an appointment, and are able to swallow a pill at the same time every day, Opill may be a good choice.

Progestin-only pills like Opill have been considered a safe method of contraception for 50 years. Opill is prescription-strength, with a low dose of a progestin hormone called norgestrel, and is 98% effective at preventing pregnancy when used as directed. With “typical use,” meaning the way most people actually use it in real life, progestin-only pills are closer to 91% effective, which is still pretty good!

Using a progestin-only method like Opill may change your menstrual cycle while taking it: your periods may become lighter, more frequent, or may stop altogether, and you may get spotting between periods. Taking Opill will not affect your future fertility – all reversible methods of birth control, including progestin-only pills, will not affect your ability to get pregnant if you want to in the future.

How do I use it?

Set a reminder and swallow one pill at the same time every day. It might be helpful to set an alarm on your phone, or plan to take your pill when you do something else at the same time every day. Progestin-only pills like Opill only work for 24 hours which is why it’s important to take your pill as close as possible to the same time every day to prevent pregnancy. Unlike combined-hormone pills or other methods including estrogen (like the patch or vaginal ring) you should continue to take Opill at the same time every day, all month. There is no “week off” or placebo/sugar pills with progestin-only pills.

You can start taking Opill on any day of your cycle, and it will start working within 48 hours after you take your first pill. Depending on the type of birth control you were using previously, you may need to use a backup method of birth control, like condoms, every time you have sex during the first 48 hours to prevent pregnancy while continuing to take Opill at the same time every day. If you have been:

  • using a non-hormonal method like condoms or spermicide,
  • on a hormonal method but haven’t been using it consistently (missed pills, or forgot to change your ring or patch), or
  • not using any method of birth control,

you should use a backup method of birth control for 48 hours after starting Opill.

If you have been:

  • consistently using another method of hormonal birth control like pills, patch, or ring as directed,

you can start taking Opill the day after you stop your previous method, and you don’t need to use a backup birth control method after starting on Opill. (BUT: if you are switching to Opill from a combination pill, make sure to switch during the time you are using the active pills. If you switch while you’re using the inactive “placebo” pills at the end of the month, you will need to use a backup method of birth control for 48 hours after starting Opill.)

And remember, barrier methods like condoms are the only type of birth control that also prevents sexually transmitted infections (STIs).

What if  I miss a pill?

If you are more than 3 hours late taking your pill, meaning it’s been more than 27 hours since your last pill, take the missed pill as soon as you remember and then go back to your normal time the next day. It’s okay even if it means taking two pills in one day, but make sure to use a backup method of birth control like condoms every time you have sex during the next 48 hours to prevent pregnancy while continuing to take Opill at the same time every day. If you vomit or have diarrhea within 4 hours of taking your pill, it may not work so you should use a back-up method of birth control for 48 hours.

What will it cost?

As of March 4, 2024, the Opill manufacturer Perrigo has suggested pricing of $19.99 for a one-month supply and $49.99 for a three-month supply, but the final cost can be set by individual retailers or stores, so it may be different based on where you live and which stores carry it. If you have health insurance, your flexible spending or health savings accounts may be able to pay or reimburse for Opill, according to Perrigo. Under the Affordable Care Act (also known as “Obama Care”) prescription birth control must be covered by your insurance, but it’s not yet known how insurance coverage will apply to this new birth control pill available without a prescription. Perrigo has also said they will have a cost assistance program available for qualified low-income and uninsured people, which will be available in the coming weeks.

What if I have more questions?

You can learn more about Opill at the official site, from the FDA, or from reproductive health resources like Bedsider.

You can also always schedule a consult with an expert KBFPC provider to discuss your questions, no matter what birth control method you’re considering. Appointments are available in-person or via telehealth, and you may qualify for low- or no-cost services according to our sliding fee discount program. Call 907-235-3436 or text 907-435-7505 to learn more!

*Opill is a Registered Trademark