Your Patients Can't Find Their Birth Control — Here's How to Help

When patients call your office frustrated that their pharmacy doesn't have Loestrin Fe 1/20 28 Day, it creates extra work for everyone — your staff, the patient, and often the pharmacy too. But with the right workflow and a few proactive strategies, you can significantly reduce the friction and help your patients stay on their contraception without interruption.

This guide walks you through the current availability landscape, explains why patients are struggling to find this medication, and gives you a concrete five-step action plan along with alternative options and workflow tips.

Current Availability of Loestrin Fe 1/20 28 Day

As of early 2026, brand-name Loestrin Fe 1/20 is discontinued. All prescriptions are filled with generic equivalents. The most common generics include:

• Junel Fe 1/20
• Microgestin Fe 1/20
• Blisovi Fe 1/20
• Larin Fe 1/20
• Gildess Fe 1/20
• Hailey Fe 1/20

All contain norethindrone acetate 1 mg / ethinyl estradiol 20 mcg / ferrous fumarate 75 mg and are AB-rated interchangeable generics. However, availability varies significantly by pharmacy, region, and wholesaler. Some pharmacies may have one generic in stock but not another.

Why Patients Can't Find It

Understanding the root causes helps you address patient concerns and make better prescribing decisions:

• Manufacturing consolidation: Fewer companies produce these generics, so production issues at one facility cause widespread shortages.
• Wholesaler allocation: Large chain pharmacies receive set allocations from their preferred wholesaler. When that wholesaler is short, the chain is short — even if other wholesalers have supply.
• Prescription specificity: If a prescription names a specific generic (e.g., "Junel Fe 1/20" DAW 0) and that specific product is unavailable, the pharmacist may not be able to substitute without contacting your office.
• Patient awareness: Many patients don't know that multiple generics exist and are interchangeable. They may assume their one pharmacy is the only option.

What Providers Can Do: 5 Steps

Step 1: Write Flexible Prescriptions

The single most impactful thing you can do is write prescriptions that give pharmacies maximum flexibility:

• Use the generic name: "norethindrone acetate/ethinyl estradiol 1 mg/20 mcg with ferrous fumarate"
• Allow generic substitution (DAW 0)
• Avoid specifying a manufacturer

This allows the pharmacist to fill with whichever AB-rated generic they have on the shelf.

Step 2: Direct Patients to Availability Tools

Rather than having your staff call pharmacies, direct patients to Medfinder. Patients can search by medication name and ZIP code to see which pharmacies near them currently have stock. This saves your office significant phone time.

Step 3: Maintain a Current Alternatives List

Keep a quick-reference list of therapeutic alternatives for when no norethindrone acetate/EE 1/20 product is available:

• Lo Loestrin Fe: Norethindrone acetate 1 mg / EE 10 mcg (lower estrogen, brand only, ~$150-$200/pack)
• Minastrin 24 Fe: Same hormones as Loestrin 24 Fe, chewable, 24/4 regimen
• Norethindrone acetate/EE 1.5/30 generics: Higher-dose option if 1/20 is unavailable
• Levonorgestrel/EE combinations: Different progestin class, widely available

Step 4: Use 90-Day Prescriptions When Possible

Encourage patients to use mail-order or 90-day fill options. Benefits include:

• Less frequent refill encounters (fewer chances to hit a stockout)
• Mail-order pharmacies generally maintain larger, more stable inventories
• Most insurance plans offer 90-day mail-order at the same or lower copay

Step 5: Proactively Communicate During Shortages

When you become aware of a shortage, proactively notify affected patients through your patient portal or messaging system. A brief message like "We're aware of supply issues with your birth control. Here are your options..." reduces inbound calls and patient anxiety.

Therapeutic Alternatives in Detail

When none of the AB-rated generics are available, a therapeutic switch may be necessary. Key considerations:

Lo Loestrin Fe

• Contains half the estrogen (10 mcg vs. 20 mcg EE)
• 26 active tablets + 2 EE-only tablets + 2 iron tablets
• May be preferred for patients with estrogen-sensitive side effects
• Brand only — check for manufacturer savings cards

Minastrin 24 Fe (Chewable)

• Norethindrone acetate 1 mg / EE 20 mcg, but 24 active + 4 iron (vs. 21/7)
• Chewable tablets — may improve adherence for some patients
• Generic versions available

Different Progestin Options

• If the patient has no specific clinical need for norethindrone acetate, levonorgestrel-containing COCs are widely available and may be easier to fill
• Drospirenone-containing pills (Yaz, Yasmin generics) offer different side-effect profiles

Workflow Tips for Your Practice

• Template your EHR: Create a smart phrase or order set for "norethindrone acetate/EE 1/20 with iron" that defaults to DAW 0 and allows generic substitution.
• Bookmark Medfinder for Providers: Front desk staff can quickly check availability when patients call about stockouts.
• Create a patient handout: Include a list of equivalent generics and instructions for using Medfinder. Share our patient guides: How to find Loestrin Fe 1/20 28 Day in stock and Alternatives to Loestrin Fe 1/20 28 Day.
• Flag charts: For patients on this medication, add a chart note about the shortage so any covering provider is aware.

Final Thoughts

Helping patients navigate the Loestrin Fe 1/20 28 Day shortage doesn't have to consume your day. By writing flexible prescriptions, maintaining a current alternatives list, and directing patients to tools like Medfinder, you can streamline the process and keep your patients on effective contraception.

For the clinical and supply chain context behind this shortage, see our companion briefing: Loestrin Fe 1/20 28 Day shortage — what providers need to know in 2026. For provider-focused cost guidance, see: How to help patients save money on Loestrin Fe 1/20 28 Day.