Provider Briefing: Enpresse 28 Day Supply Status in 2026

If your patients have been reporting difficulty filling prescriptions for Enpresse 28 Day (Levonorgestrel/Ethinyl Estradiol triphasic), they're not mistaken. The brand has been largely discontinued by Teva Pharmaceuticals, and while generic equivalents remain available, real-world pharmacy availability has been inconsistent.

This post provides a concise, evidence-based overview of the supply situation, prescribing considerations, and tools you can use to help your patients maintain uninterrupted contraceptive coverage.

Timeline: How We Got Here

The Enpresse supply disruption is not a sudden event — it's the result of several converging factors over the past few years:

• 2022: Teva Pharmaceuticals closed its manufacturing facility in Irvine, California, affecting production capacity for multiple generic products
• 2023: Teva announced strategic shifts away from low-margin generic production toward branded products, further reducing its generic portfolio
• 2024-2025: The Enpresse brand name was effectively discontinued, though Teva and other manufacturers continued to produce AB-rated generic equivalents
• 2026: No formal FDA or ASHP shortage is listed for Levonorgestrel/Ethinyl Estradiol triphasic tablets, but brand-name Enpresse is no longer reliably stocked at most pharmacies

Prescribing Implications

For providers, the key clinical considerations include:

Generic Substitution

Enpresse 28 Day is itself a generic product (manufactured by Teva under the Enpresse brand name). AB-rated equivalents — most notably Trivora-28 — contain identical active ingredients in the same triphasic dosing regimen. In most states, pharmacists can substitute these at the point of dispensing without requiring a new prescription.

If you're writing prescriptions, consider specifying the generic name (Levonorgestrel/Ethinyl Estradiol 0.050-0.030/0.075-0.040/0.125-0.030 mg triphasic 28-day) rather than the Enpresse brand to give pharmacies maximum flexibility in sourcing.

Therapeutic Alternatives

If the triphasic Levonorgestrel/Ethinyl Estradiol formulation is unavailable, the following represent clinically appropriate alternatives:

• Trivora-28: Same active ingredients, same triphasic dosing — the most direct substitution
• Tri-Sprintec / Tri-Previfem: Triphasic Norgestimate/Ethinyl Estradiol — widely available, well-tolerated, also FDA-approved for acne
• Ortho Tri-Cyclen: Brand-name triphasic Norgestimate/Ethinyl Estradiol with decades of safety data
• Levora / Altavera: Monophasic Levonorgestrel/Ethinyl Estradiol — same hormones, simplified dosing

When switching progestins (e.g., from Levonorgestrel to Norgestimate), counsel patients about potential adjustment symptoms including breakthrough bleeding, mood changes, or headaches in the first 1-3 cycles.

Contraceptive Continuity

Any gap in oral contraceptive use increases pregnancy risk. When patients report difficulty filling their prescription, prioritize maintaining continuity:

• Authorize generic substitution explicitly on the prescription
• Consider prescribing a 90-day supply to reduce refill frequency
• Provide a bridge prescription for an available alternative if the primary is out of stock

Current Availability Picture

As of early 2026:

• Brand Enpresse: Largely discontinued — not reliably available at most pharmacies
• Generic Levonorgestrel/Ethinyl Estradiol triphasic: Available from multiple manufacturers, but stocking varies by pharmacy and region
• No formal shortage listed on FDA or ASHP databases for this formulation

Availability tends to be better at independent pharmacies and mail-order services than at large chain pharmacies, which may not stock lower-demand triphasic generics.

Cost and Access Considerations

Under the ACA contraceptive coverage mandate, most commercial insurance plans cover generic oral contraceptives with $0 copay. Key cost points:

• Insured patients: Typically $0 copay for generic; may require step therapy to generic if brand is requested
• Uninsured patients: Cash price ranges from $29-$75 per pack; discount cards (GoodRx, SingleCare) bring it to $11-$30
• Cost Plus Drugs: Carries generic Levonorgestrel/Ethinyl Estradiol triphasic at transparent pricing
• Patient assistance: Title X clinics, Planned Parenthood, and state Medicaid programs provide low-cost or free oral contraceptives for qualifying patients

Tools and Resources for Your Practice

Several tools can streamline medication access for your patients:

• Medfinder for Providers: Search real-time pharmacy availability to help patients locate their medication. Share the link directly with patients so they can check availability themselves.
• Electronic prescribing: Use the generic name and allow substitution to maximize fill rates
• Telehealth platforms: Services like Nurx and SimpleHealth can prescribe and ship oral contraceptives directly, bypassing local pharmacy stocking issues
• Discount card referrals: Direct uninsured patients to GoodRx or SingleCare for significant savings on generic oral contraceptives

Looking Ahead

The oral contraceptive market continues to evolve:

• Opill (Norgestrel) is now available over the counter as the first FDA-approved nonprescription daily oral contraceptive. While it's progestin-only (not a combination triphasic), it expands access for patients who face barriers to prescription contraception.
• Generic manufacturers continue to produce triphasic Levonorgestrel/Ethinyl Estradiol formulations, and supply is expected to stabilize as pharmacy stocking adjusts to the Enpresse discontinuation.
• Telehealth contraceptive prescribing is expanding, providing another access pathway for patients in areas with limited pharmacy availability.

Final Thoughts

The Enpresse 28 Day situation represents a common pattern in generic drug markets: brand discontinuation creates temporary confusion and access gaps, even when the underlying medication remains available. By prescribing generically, authorizing substitution, and directing patients to tools like Medfinder, providers can help ensure contraceptive continuity during this transition.

For a patient-facing version of this information, see our Enpresse 28 Day shortage update for patients.