What Is Ethinyl Estradiol/Levonorgestrel? Uses, Dosage, and What You Need to Know in 2026

Ethinyl estradiol/levonorgestrel is a combination hormonal contraceptive that has been used by millions of women for over 50 years. It is one of the most prescribed medications in the United States and exists under more than 30 brand and generic names. If you've been prescribed Aviane, Levora, Kurvelo, Seasonique, Altavera, or a similar pill, you're taking a formulation of ethinyl estradiol/levonorgestrel.

This guide explains what it is, what it's used for, how to take it correctly, and what you need to know to use it safely and effectively.

What Is Ethinyl Estradiol/Levonorgestrel?

Ethinyl estradiol/levonorgestrel is a combination oral contraceptive (COC) — commonly called "the pill" — that contains two synthetic hormones:

Ethinyl estradiol (EE): A synthetic form of estrogen, one of the primary female sex hormones

Levonorgestrel (LNG): A synthetic progestin (a form of progesterone), used in many contraceptive products including hormonal IUDs and emergency contraception (Plan B)

Together, these two hormones work to prevent pregnancy through multiple complementary mechanisms. The combination has been in use since the 1960s and represents one of the most extensively studied medications in history.

What Is It Used For?

The primary FDA-approved use is:

Contraception: Prevention of pregnancy in females of reproductive potential. When taken correctly (one pill daily at the same time each day), EE/LNG is over 99% effective.

Common off-label uses include:

Heavy or irregular periods: The pill regulates the menstrual cycle and can significantly reduce heavy bleeding (menorrhagia) and cramping.

Endometriosis: Suppressing the menstrual cycle can reduce endometriosis pain and progression. Continuous-dosing regimens are sometimes used for this purpose.

Acne: Some combination pills reduce androgens, which can improve hormonal acne. While other specific combination pills are FDA-approved for acne, EE/LNG is sometimes prescribed off-label for this purpose.

What Brand Names Does It Come In?

EE/LNG is available under more than 30 branded and generic names in the U.S. Some of the most commonly prescribed include:

28-day monophasic: Aviane, Altavera, Aubra, Chateal, Falmina, Kurvelo, Larissia, Lessina, Levora, Lutera, Marlissa, Orsythia, Portia, Sronyx, Vienva

91-day extended-cycle: Seasonique, Seasonale, Jolessa, Camrese, Daysee, Introvale, Quasense, Setlakin, Simpesse, LoSeasonique, Amethia

Triphasic (varying doses): Trivora, Enpresse, Myzilra

Dosage Forms and How to Take It

EE/LNG is primarily taken as an oral tablet once daily. The key dosing rules are:

Take one tablet every day at the same time — birth control pills work best when taken within 24 hours of the previous dose

For 28-day packs: take 21 active tablets, then 7 inactive (placebo) tablets, then start the next pack immediately

For 91-day packs: take 84 active tablets continuously, then 7 low-dose estrogen or placebo tablets

Start on the first day of your period (Day 1 start) or on the first Sunday after your period begins (Sunday start) — use backup contraception for the first 7 days with Sunday start

If you vomit within 3-4 hours of taking your pill, treat it as a missed dose

Who Should NOT Take It?

EE/LNG is contraindicated in patients who:

Are over 35 and smoke cigarettes

Have a history of blood clots (DVT, pulmonary embolism)

Have uncontrolled high blood pressure

Have migraines with aura (especially over age 35)

Have active liver disease or liver tumors

Are pregnant or suspect pregnancy

Have estrogen-dependent tumors (e.g., certain types of breast cancer)

Are taking certain hepatitis C medications (ombitasvir/paritaprevir/ritonavir)

Is It Covered by Insurance?

Under the ACA, most non-grandfathered private insurance plans cover FDA-approved contraceptives with no cost-sharing. This means no copay, no deductible, no coinsurance for generic EE/LNG. Without insurance, cash prices start around $23–$80+ depending on the brand and formulation, with discount cards like GoodRx bringing costs down significantly for generic versions.

Learn More

Want to understand how EE/LNG works at the hormonal level? See how ethinyl estradiol/levonorgestrel works. For a detailed breakdown of possible side effects, read our guide to EE/LNG side effects and when to call your doctor.