Provider Briefing: Camrese 91 Day Supply Disruptions in 2026

If your patients on Camrese 91 Day (Levonorgestrel 0.15 mg/Ethinyl Estradiol 0.03 mg extended-cycle) are reporting difficulty filling prescriptions, this briefing will help you understand the current landscape and guide clinical decision-making.

Extended-cycle oral contraceptives have faced intermittent supply disruptions since 2022, and the situation remains fluid in 2026. Here's what you need to know to keep your patients covered.

Shortage Timeline and Current Status

The supply challenges affecting Camrese and its generic equivalents began around 2022 and have been driven by:

• Manufacturing consolidation — fewer producers of extended-cycle Levonorgestrel/Ethinyl Estradiol formulations
• API sourcing constraints — intermittent shortages of pharmaceutical-grade Levonorgestrel and Ethinyl Estradiol
• Demand growth — increased patient preference for extended-cycle regimens, outpacing production capacity
• Distribution inequities — supply reaching some regions and pharmacy chains inconsistently

As of early 2026, the FDA Drug Shortage Database has listed extended-cycle Levonorgestrel/Ethinyl Estradiol products intermittently. The shortage is not continuous but recurrent, with availability varying by pharmacy, region, and whether brand or generic is sought.

Prescribing Implications

Generic Substitution

Camrese 91 Day has several AB-rated generic equivalents:

• Amethia (Levonorgestrel 0.15 mg/Ethinyl Estradiol 0.03 mg × 84 + Ethinyl Estradiol 0.01 mg × 7)
• Daysee (same formulation)
• Jaimiess (same formulation)

Prescribing generically ("Levonorgestrel/Ethinyl Estradiol extended-cycle 91-day") rather than by brand name gives pharmacists maximum flexibility to dispense whichever product is available. Consider updating existing prescriptions to allow generic substitution if they currently specify brand-only.

Therapeutic Alternatives

When no extended-cycle product is available, consider:

• Continuous use of a monophasic 28-day OC — Prescribe a standard monophasic Levonorgestrel/Ethinyl Estradiol pill (e.g., Levlen, Nordette generics) and instruct the patient to skip placebo pills, starting a new active pack immediately. This effectively creates an extended-cycle regimen from widely available 28-day packs.
• Seasonique/Seasonale — Brand-name equivalents that may be stocked differently
• Camrese Lo/Amethia Lo — Lower-dose extended-cycle option (Levonorgestrel 0.1 mg/Ethinyl Estradiol 0.02 mg) for patients who may benefit from reduced estrogen exposure
• NuvaRing (Etonogestrel/Ethinyl Estradiol ring) — Can be used in extended fashion (continuous ring use with monthly replacement, no ring-free week)

Clinical Considerations When Switching

• Patients switching between AB-rated generics require no washout period and can transition pack-to-pack
• When switching to a different hormonal method, start the new method the day after the last active pill of the current pack
• Advise 7 days of backup contraception when switching to a non-equivalent formulation
• Document the reason for the switch (medication shortage) in the patient chart for insurance purposes

Availability Picture

The availability situation in 2026 is best described as "patchy." Key observations:

• Independent pharmacies and mail-order services tend to have better access than large chain pharmacies
• Generic versions (particularly Amethia) are generally more available than brand-name Camrese
• Supply tends to be better at the start of manufacturing cycles and may dip mid-quarter
• Some regions are affected more than others, with no clear geographic pattern

Medfinder for Providers offers real-time pharmacy availability data that can help your practice direct patients to pharmacies with stock. Consider integrating this tool into your prescription workflow.

Cost and Access Considerations

Under the ACA contraceptive mandate, most insurance plans cover Camrese and its generics at $0 copay. However, patients may encounter issues when:

• Their usual pharmacy is out of stock and they must fill at an out-of-network location
• Insurance requires a specific generic and that particular product is unavailable
• They lack insurance — cash prices range from $30-$90 (generic) to $150-$300 (brand)

For uninsured patients, direct them to:

• Discount cards (GoodRx, SingleCare, RxSaver) — can bring generic cost to $30-$60
• Teva Cares Foundation — patient assistance program for eligible uninsured patients
• Title X clinics and Planned Parenthood — provide contraceptives at reduced or no cost
• 340B pharmacies — if your practice participates, patients may access discounted pricing

Tools and Resources for Your Practice

• Medfinder for Providers — real-time medication availability search to help patients locate stock
• FDA Drug Shortage Database — official shortage tracking at accessdata.fda.gov
• ASHP Drug Shortage Resource Center — clinical guidance during shortages
• State pharmacy boards — some states have enacted emergency dispensing provisions during shortages

Looking Ahead

The extended-cycle OC market is expected to stabilize as generic manufacturers increase capacity, but the timeline remains uncertain. In the interim:

• Prescribe generically when possible to maximize dispensing flexibility
• Proactively discuss backup plans with patients at each visit
• Consider adding continuous-use instructions to standard OC prescriptions as a fallback option
• Encourage patients to start seeking refills 2-3 weeks before their current pack runs out

Final Thoughts

The Camrese 91 Day shortage requires a proactive approach from prescribers. By prescribing flexibly, maintaining awareness of the current supply landscape, and leveraging tools like Medfinder for Providers, you can help ensure your patients maintain uninterrupted contraceptive coverage.

For patient-facing resources to share with your patients, see:

• Camrese 91 Day Shortage Update for Patients
• Alternatives to Camrese 91 Day
• How to Save Money on Camrese 91 Day