When Your Pharmacy Can't Fill Your Xulane Prescription

If your pharmacy has told you that Xulane is out of stock or on backorder, you're probably wondering what your options are. Going without birth control isn't one of them — and fortunately, you have several good alternatives to consider.

In this article, we'll explain what Xulane is and how it works, then walk through the best alternatives available in 2026. All of these are real medications you can discuss with your healthcare provider. For background on why Xulane can be hard to find, check out our article on why Xulane is so hard to find.

What Is Xulane?

Xulane is a prescription birth control patch that sticks to your skin and delivers two hormones — Norelgestromin (a progestin) and Ethinyl Estradiol (an estrogen) — through your skin over the course of a week. It's the generic version of the discontinued brand Ortho Evra and is made by Mylan Pharmaceuticals (a Viatris company).

You apply a new patch once a week for three weeks, then go patch-free for the fourth week. During that patch-free week, you'll usually get your period. For a deeper explanation, see our article on what Xulane is, its uses, and dosage.

How Does Xulane Work?

Xulane prevents pregnancy in three ways:

1. Suppresses ovulation: The hormones stop your ovaries from releasing an egg each month.
2. Thickens cervical mucus: This makes it harder for sperm to reach an egg.
3. Thins the uterine lining: This reduces the chance of a fertilized egg implanting.

This is the same mechanism used by most combined hormonal contraceptives, including birth control pills and the vaginal ring. For more detail, read how Xulane works: mechanism of action explained.

Alternative 1: Twirla (Levonorgestrel / Ethinyl Estradiol Patch)

Twirla is the other FDA-approved birth control patch currently available in the U.S. Like Xulane, it's a weekly patch that you wear for three weeks with one patch-free week. However, there are some key differences:

• Different progestin: Twirla contains Levonorgestrel instead of Norelgestromin.
• Lower hormone dose: Twirla delivers 120 mcg of Levonorgestrel and 30 mcg of Ethinyl Estradiol per day — a lower estrogen dose than Xulane's 35 mcg.
• Different size: Twirla is a larger, round patch (28 cm²) compared to Xulane's smaller, square patch (14 cm²).
• BMI considerations: Like Xulane, Twirla may be less effective in women with a higher BMI. Talk to your doctor about whether your weight affects the choice.

Twirla is a brand-name medication with no generic available yet, so it may cost more than Xulane. Check with your insurance or use a discount card to compare prices.

Alternative 2: Zafemy (Norelgestromin / Ethinyl Estradiol Patch)

Zafemy is another generic version of Ortho Evra — the same original brand that Xulane is based on. It contains the same active ingredients as Xulane (Norelgestromin and Ethinyl Estradiol) and works the same way.

• Slightly smaller patch: Zafemy's patch is 12.5 cm² compared to Xulane's 14 cm².
• Same hormones, same schedule: Weekly application for 3 weeks, 1 week off.
• May have different availability: Because it's made by a different manufacturer, Zafemy may be in stock when Xulane isn't — and vice versa.

If your pharmacy is out of Xulane, ask if they carry Zafemy. Your doctor may only need to adjust your prescription slightly.

Alternative 3: NuvaRing (Etonogestrel / Ethinyl Estradiol Vaginal Ring)

If you like the idea of a non-daily contraceptive but patches aren't working out, the NuvaRing is worth considering. It's a small, flexible ring that you insert into your vagina once a month.

• Monthly dosing: Insert the ring, leave it in for 3 weeks, remove for 1 week. Similar schedule to the patch.
• Different delivery method: Hormones are absorbed through the vaginal lining instead of the skin.
• Generic available: Generic versions of NuvaRing (Etonogestrel/Ethinyl Estradiol ring) are available and may be more affordable.
• No patch-related skin irritation: If you've experienced skin reactions from Xulane, the ring avoids that issue entirely.

Alternative 4: Combined Oral Contraceptive Pills

If you're open to a daily option, combined oral contraceptive pills (often just called "the pill") are the most widely available form of hormonal birth control. There are dozens of brands and generics available, which means supply issues are rare.

• Daily dosing: You take one pill at the same time every day.
• Many options: Brands like Yaz, Lo Loestrin Fe, Sprintec, and many generics are widely stocked at nearly every pharmacy.
• Affordable: Generic birth control pills are often available for $0 with insurance or as low as $9-$20 per month without insurance using discount cards.
• Drawback: You have to remember to take it every day. If you chose Xulane because you didn't want a daily pill, this may not be ideal.

How to Switch to an Alternative

Switching birth control methods should always be done with guidance from your healthcare provider. Here's what to do:

1. Contact your prescriber. Let them know you can't find Xulane and ask about alternatives.
2. Discuss your needs. Think about what matters most to you: weekly vs. daily dosing, patch vs. ring vs. pill, hormone levels, and any past side effects.
3. Ask about overlap. Your doctor will tell you whether you need backup contraception (like condoms) during the transition between methods.
4. Check availability first. Before your doctor writes a new prescription, use Medfinder or call pharmacies to make sure the alternative is in stock.

If you need help finding a prescriber, see our guide on how to find a doctor who can prescribe Xulane near you — they can also prescribe alternatives.

Final Thoughts

Not being able to find Xulane is stressful, but it's not a dead end. Twirla, Zafemy, the NuvaRing, and oral contraceptive pills are all legitimate alternatives that your doctor can help you transition to safely. The most important thing is not to go without birth control while you figure things out — talk to your provider and explore your options.

And before you give up on Xulane entirely, try using Medfinder to check if another pharmacy near you has it in stock. You might find it's available just a short drive away. For more tips, read our guide on how to find Xulane in stock near you.