Your Patients Are Struggling to Find Enpresse 28 Day — Here's How to Help

When patients call your office saying they can't fill their Enpresse 28 Day prescription, it creates a real clinical concern. Oral contraceptive gaps — even short ones — increase the risk of unintended pregnancy. As a prescriber, you're in a unique position to help patients navigate availability challenges while maintaining contraceptive continuity.

This guide provides a practical, step-by-step approach to helping patients locate Enpresse 28 Day or transition to an appropriate alternative.

Current Availability: What You Need to Know

Enpresse 28 Day (Levonorgestrel/Ethinyl Estradiol triphasic, manufactured by Teva Pharmaceuticals) has been largely discontinued as a brand. Key facts:

• The Enpresse brand name is no longer actively produced
• Generic equivalents (same triphasic Levonorgestrel/Ethinyl Estradiol formulation) remain available from other manufacturers
• No formal FDA or ASHP shortage is listed for this formulation
• Real-world availability varies significantly by pharmacy and region
• Chain pharmacies are less likely to stock lower-demand triphasic generics

Why Patients Can't Find It

Understanding the root causes helps you counsel patients effectively:

1. Brand discontinuation — Pharmacies searching for "Enpresse" in their ordering system may get no results
2. NDC-specific ordering — Chain pharmacies often order by specific NDC codes, and if their system lists only the discontinued Enpresse NDC, it shows as unavailable even when equivalent generics exist
3. Low stocking priority — Triphasic oral contraceptives represent a smaller market share than monophasic pills, leading some pharmacies to deprioritize them
4. Regional supply variation — Some wholesalers have more reliable access than others depending on geography

What Providers Can Do: 5 Practical Steps

Step 1: Prescribe by Generic Name with Substitution Allowed

Write prescriptions as "Levonorgestrel/Ethinyl Estradiol 0.050-0.030/0.075-0.040/0.125-0.030 mg triphasic 28-day" rather than "Enpresse." Ensure the prescription allows generic substitution. This gives the dispensing pharmacy maximum flexibility to fill with whatever manufacturer's version they have in stock.

Step 2: Direct Patients to Medfinder

Medfinder for Providers is a real-time pharmacy availability tool. You can:

• Search for Enpresse 28 Day availability in the patient's area
• Share the Medfinder link with patients so they can search on their own
• Identify which pharmacies near your practice reliably stock this formulation

Consider adding the Medfinder link to your patient handouts or post-visit instructions for patients on hard-to-find medications.

Step 3: Recommend Independent Pharmacies

Independent pharmacies typically have:

• Access to multiple wholesalers (not just one contracted distributor)
• Greater willingness to special-order specific generics
• More personalized service and follow-up

If you have a relationship with a local independent pharmacy, consider reaching out directly to confirm they can source the medication before sending patients there.

Step 4: Have a Ready List of Alternatives

When the specific formulation truly isn't available, be prepared to switch patients efficiently. Keep these alternatives in mind:

• Trivora-28: Identical active ingredients and triphasic regimen — the most seamless substitution
• Tri-Sprintec / Tri-Previfem: Triphasic Norgestimate/Ethinyl Estradiol — widely available, well-established safety profile
• Ortho Tri-Cyclen: Another triphasic Norgestimate/Ethinyl Estradiol option with decades of use
• Levora / Altavera: Monophasic Levonorgestrel/Ethinyl Estradiol — same hormones, simplified once-daily dosing

For a detailed comparison, see our alternatives guide.

Step 5: Consider Telehealth and Mail-Order Pathways

For patients who face persistent local availability issues:

• Mail-order pharmacies often have broader generic inventory and can ship directly to patients
• Telehealth contraceptive services (Nurx, SimpleHealth, Wisp) handle prescribing and dispensing, bypassing local pharmacy stocking issues entirely
• Cost Plus Drugs carries generic Levonorgestrel/Ethinyl Estradiol triphasic tablets at transparent pricing

Workflow Tips for Your Practice

To reduce the burden of medication access issues on your staff and patients:

• Standardize prescribing language — Update templates to use generic names with substitution permitted
• Create a "hard to find" medication reference sheet — Include Enpresse 28 Day and other frequently reported access issues, along with alternatives and patient resources
• Prescribe 90-day supplies when possible to reduce refill frequency and the chance of running into stock issues
• Flag patients on this medication in your EHR so staff can proactively address availability at prescription renewal time
• Train front-desk and nursing staff to direct patients to Medfinder when they call reporting fill difficulties

Final Thoughts

The Enpresse 28 Day access challenge is a practical problem with practical solutions. By prescribing generically, leveraging tools like Medfinder, maintaining a ready list of alternatives, and considering mail-order pathways, you can help patients maintain uninterrupted contraceptive coverage — even when their specific brand isn't on the shelf.

For a patient-friendly version of this information, direct patients to our posts on finding Enpresse 28 Day in stock and the current shortage update.