What Is Altavera 28 Day? Uses, Dosage, and What You Need to Know in 2026

Altavera 28 Day is one of the most widely prescribed oral contraceptives in the United States. Whether you're starting it for the first time or switching from another pill, this guide covers everything you need to know: what's in it, how to take it, how effective it is, and what to watch out for.

What Is Altavera 28 Day?

Altavera 28 Day is a combination oral contraceptive (COC) containing two synthetic hormones: levonorgestrel (0.15 mg) and ethinyl estradiol (0.03 mg). It is manufactured by Xiromed LLC in Florham Park, NJ (produced by Laboratorios Leon Farma in Spain) and is a generic version of the discontinued brand Nordette. Like all generics, it contains the same active ingredients in the same amounts as its brand-name predecessor.

Each Altavera 28-day dispenser contains 21 active peach tablets (containing the hormones) and 7 white inert placebo tablets (reminder pills with no hormones). The pack is designed to be taken in order over a 28-day cycle.

What Is Altavera Used For?

Altavera is FDA-approved for one indication:

Prevention of pregnancy in females of reproductive potential

Combination oral contraceptives like Altavera are also commonly used off-label to help regulate menstrual cycles and reduce menstrual cramps (dysmenorrhea), though these are not FDA-approved indications. Altavera does not protect against HIV or sexually transmitted infections.

How Effective Is Altavera?

Based on clinical studies, about 1 to 5 out of 100 women may become pregnant during the first year of using Altavera — meaning its typical-use failure rate is approximately 1–5%. With perfect use (taking the pill at the same time every day, never missing), the failure rate is closer to 0.1–0.3%. Altavera is one of the most effective reversible contraceptive methods available in pill form.

How to Take Altavera 28 Day

Choose a time to take your pill each day — consistency is the most important factor for effectiveness

Start on the first day of your period (Day 1 start) or on the first Sunday after your period begins (Sunday start)

Take 1 active pill daily for 21 days, followed by 1 white placebo pill daily for 7 days

Start the next pack the day after finishing the current one — never skip a day

For Sunday starts, use backup contraception for the first 7 days; Day 1 starts do not require backup

What If You Miss a Pill?

If you miss one active pill, take it as soon as you remember — even if that means taking two pills in one day. Then continue with your regular schedule. If you miss two or more active pills, use backup contraception for the next 7 days and consider taking a pregnancy test if you miss your period. If you have vomiting or diarrhea for more than 1 day, your pill may not absorb properly — treat missed doses accordingly and use backup contraception.

Who Should NOT Take Altavera?

Altavera is contraindicated (not safe) for women who:

Smoke and are over 35 years old

Have a history of blood clots, stroke, or heart disease

Have uncontrolled high blood pressure

Have known or suspected breast cancer or other estrogen-dependent cancers

Have active liver disease or liver tumors

Are pregnant or suspect pregnancy

Are breastfeeding (COCs can reduce milk supply)

Is Altavera a Controlled Substance?

No. Altavera is not a controlled substance and has no DEA scheduling. It requires a prescription but has no restrictions on early refills or quantity limits imposed by the DEA. Many states allow pharmacists to prescribe hormonal contraceptives directly under standing orders.

To learn more, see our posts on how Altavera works and Altavera side effects.