Understanding Apri 28 Day Side Effects

Starting a new medication always comes with questions, and birth control is no exception. Apri 28 Day (Desogestrel 0.15 mg / Ethinyl Estradiol 0.03 mg) is a combined oral contraceptive made by Teva Pharmaceuticals. Like all hormonal birth control, it has potential side effects — most are mild and temporary, but some require immediate medical attention.

This guide breaks down what's normal, what's not, and when you need to pick up the phone.

What Is Apri 28 Day?

Apri 28 Day is a monophasic combined oral contraceptive containing two synthetic hormones: desogestrel (a progestin) and ethinyl estradiol (an estrogen). Each 28-day pack contains 21 active rose-colored tablets and 7 white placebo tablets. For a deeper look at how it works, see our guide on how Apri 28 Day works.

Common Side Effects

Most side effects of Apri 28 Day are mild and tend to improve within the first 2-3 months as your body adjusts to the hormones. The most frequently reported include:

• Nausea — Often the most common complaint in the first few weeks. Taking your pill with food or at bedtime can help.
• Headache — Mild headaches are common, especially during the first cycle. They usually decrease over time.
• Breast tenderness — Your breasts may feel swollen or sore, particularly in the first month or two.
• Breakthrough bleeding or spotting — Light bleeding between periods is very common in the first 1-3 months. It does not mean the pill isn't working.
• Bloating — Mild water retention and bloating may occur, usually during the first few cycles.
• Weight changes — Some people notice minor weight fluctuations (usually 1-3 pounds), often from water retention rather than actual fat gain.
• Mood changes — Some people experience mood swings, irritability, or mild depressive symptoms.
• Decreased libido — A reduction in sex drive is reported by some users.
• Dizziness — Occasional lightheadedness, particularly when starting the medication.

These side effects are generally not dangerous and often resolve on their own. If they persist beyond 3 months or significantly affect your daily life, talk to your provider about whether a different formulation might be a better fit. Our alternatives guide covers similar options.

Serious Side Effects — When to Call Your Doctor Immediately

While rare, combined oral contraceptives like Apri 28 Day can cause serious side effects that require immediate medical attention. The most important to know about are related to blood clots.

Blood Clots and Cardiovascular Risks

Apri 28 Day carries an FDA boxed warning about cardiovascular risks:

"Cigarette smoking increases the risk of serious cardiovascular side effects from oral contraceptive use. This risk increases with age and with heavy smoking (15 or more cigarettes per day) and is quite marked in women over 35 years of age."

Serious side effects include:

• Deep vein thrombosis (DVT) — A blood clot in the leg. Symptoms: pain, swelling, warmth, or redness in one leg.
• Pulmonary embolism (PE) — A blood clot in the lung. Symptoms: sudden shortness of breath, chest pain, coughing up blood.
• Stroke — Symptoms: sudden severe headache, vision changes, difficulty speaking, weakness or numbness on one side of the body.
• Heart attack — Symptoms: chest pain or pressure, pain radiating to the arm or jaw, shortness of breath, cold sweats.

Use the memory aid ACHES to remember warning signs:

• A — Abdominal pain (severe)
• C — Chest pain or shortness of breath
• H — Headache (severe, sudden, or different from usual)
• E — Eye problems (blurred vision, vision loss, flashing lights)
• S — Severe leg pain or swelling

If you experience any of these symptoms, seek emergency medical care immediately.

Other Serious Side Effects

• Liver tumors (rare) — Signs include severe abdominal pain, an abdominal mass, or jaundice.
• Gallbladder disease — Symptoms: pain in the upper right abdomen, nausea, vomiting.
• High blood pressure — Usually detected during routine monitoring. Your provider should check your blood pressure at follow-up visits.
• Jaundice — Yellowing of the skin or whites of the eyes. Stop taking Apri 28 Day and contact your doctor immediately.
• Severe allergic reactions — Hives, swelling of the face or throat, difficulty breathing. Seek emergency care.

Specific Populations and Risk Factors

Certain people have a higher risk of side effects with Apri 28 Day:

• Smokers over 35 — Should NOT take combined oral contraceptives due to significantly increased cardiovascular risk.
• People with a history of blood clots — Apri 28 Day is contraindicated.
• People with migraines with aura — Increased stroke risk. A progestin-only method may be safer.
• Postpartum patients — Wait at least 4 weeks after delivery before starting (if not breastfeeding). Breastfeeding patients should discuss options with their provider, as estrogen may affect milk production.
• People with depression — Monitor mood closely, as hormonal contraceptives may worsen symptoms in some people.
• Patients with diabetes, high cholesterol, or high blood pressure — May need closer monitoring while on Apri 28 Day.

How to Manage Common Side Effects

Here are practical tips for dealing with the most common issues:

• For nausea — Take your pill with food or right before bed. If nausea persists after a few weeks, talk to your provider.
• For breakthrough bleeding — Take your pill at the same time every day. Consistency is key. Spotting usually stops after 2-3 months.
• For headaches — Over-the-counter pain relievers like acetaminophen or ibuprofen can help. If headaches are severe or come with visual changes, call your doctor immediately.
• For breast tenderness — A supportive bra and reducing caffeine intake may provide relief.
• For mood changes — Track your moods in a journal or app. If depression or anxiety worsens, discuss alternative contraceptive options with your provider.
• For bloating — Reducing sodium intake and staying hydrated can help. Symptoms typically improve after the first few cycles.

If side effects are making you consider stopping Apri 28 Day, talk to your provider first. They may recommend a different pill formulation with a different progestin or estrogen dose. Stopping suddenly without a backup plan can result in unintended pregnancy.

Final Thoughts

Most people who take Apri 28 Day experience mild, temporary side effects that resolve within a few months. Serious side effects are rare but important to recognize. The key takeaways:

• Common side effects like nausea, spotting, and headaches are normal and usually temporary.
• Remember ACHES — the warning signs that need immediate medical attention.
• Don't smoke while taking Apri 28 Day, especially if you're over 35.
• Talk to your provider before stopping — they can help you find a better option if needed.

For more about this medication, check out our full overview: What Is Apri 28 Day? If you need to fill your prescription, visit Medfinder to find it in stock near you.