Updated: January 11, 2026
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What Is Feirza 1/20? Uses, Dosage, and What You Need to Know in 2026
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Overview
New to Feirza 1/20? This comprehensive guide covers what it is, what it treats, how to take it correctly, and everything else you need to know in 2026.
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Feirza 1/20 is a combination oral contraceptive pill manufactured by Xiromed LLC and introduced to the U.S. market in January 2025. If you've been prescribed Feirza 1/20 — or are considering it — this guide covers everything you need to know: what's in it, what it treats, exactly how to take it, and what to watch for.
What Is Feirza 1/20?
Feirza 1/20 ("1/20" refers to 1 mg norethindrone acetate / 20 mcg ethinyl estradiol) is a low-dose combination oral contraceptive — commonly called a "birth control pill" or "the pill." It is a 28-day pack containing:
21 active tablets (white to off-white): each containing norethindrone acetate 1 mg + ethinyl estradiol 20 mcg
7 placebo tablets (brown): containing 75 mg ferrous fumarate (iron) — present only to maintain the daily pill habit; contain no hormones and provide no therapeutic benefit
Norethindrone acetate is a progestin (synthetic progesterone), and ethinyl estradiol is a synthetic estrogen. Together they form the "combination" in combination oral contraceptive.
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What Is Feirza 1/20 Used For?
Feirza 1/20 has two FDA-approved indications:
Prevention of pregnancy (contraception) — Feirza 1/20 is a highly effective contraceptive when taken correctly. With perfect use, fewer than 1 in 100 women (0.1%) experience an unintended pregnancy per year. With typical use (including occasional missed pills), the rate is approximately 7 in 100 women.
Treatment of moderate acne vulgaris — Approved for females 15 years and older who want to use oral contraceptives and who have started menstruating. By raising sex hormone-binding globulin (SHBG) and reducing free testosterone, Feirza 1/20 can reduce the androgen-driven sebum production that causes acne.
How Do You Take Feirza 1/20?
Feirza 1/20 is taken orally (by mouth), one tablet per day, at the same time every day, in the order directed on the blister pack. The 28-day pack has no "off days" — you take one pill every single day with no break between packs.
There are two start options:
Sunday Start: Take the first active pill on the first Sunday after your period starts. Use backup contraception for 7 days.
Day 1 Start: Take the first active pill on Day 1 of your menstrual period. No backup contraception needed with Day 1 start.
Take Feirza 1/20 at the same time each day. Setting a daily alarm helps. You can take it with food to reduce nausea.
What If You Miss a Pill?
Missing active hormone pills reduces contraceptive protection. Here is what to do:
Missed 1 active pill: Take it as soon as you remember. Take the next pill at the regular time (even if two pills are taken in one day). Continue the rest of the pack normally.
Missed 2+ consecutive active pills: Take the most recently missed pill, discard others, continue taking 1 pill/day. Use backup contraception for 7 days. If unprotected sex occurred, consider emergency contraception.
Missed brown placebo pills: These contain no hormones. Missing them has no effect on contraceptive protection. Discard missed brown pills and continue normally.
Who Should NOT Take Feirza 1/20?
Feirza 1/20 is contraindicated in people with the following conditions:
History of blood clots (DVT, pulmonary embolism) or clotting disorders
History of stroke or heart attack
Breast cancer or other hormone-sensitive cancers
Liver disease or history of jaundice with oral contraceptive use
Women over 35 years of age who smoke — the boxed warning explicitly contraindicates this combination
Undiagnosed abnormal uterine bleeding
Pregnancy
Receiving HCV drugs containing ombitasvir/paritaprevir/ritonavir ± dasabuvir (risk of ALT elevation)
Important Storage Information
Store Feirza 1/20 at 68–77°F (20–25°C). Short excursions to 59–86°F are acceptable. Keep inside the blister pouch; remove individual tablets only immediately before taking. Keep out of reach of children. Do not use after the expiration date.
50K+Found
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Does Feirza 1/20 Protect Against STIs?
No. Feirza 1/20 does not protect against sexually transmitted infections (STIs), including HIV. If you are at risk for STIs, use barrier protection (condoms) in addition to the pill.
The Bottom Line
Feirza 1/20 is a well-established low-dose combination oral contraceptive that is effective for pregnancy prevention and moderate acne. Taking it at the same time each day is the most important factor in its effectiveness. For a deeper look at how the pill works, see our article on how Feirza 1/20 works. If you have trouble finding it at your pharmacy, medfinder can help you locate it near you.
Frequently Asked Questions
Feirza 1/20 is FDA-approved for two uses: (1) prevention of pregnancy as a contraceptive, and (2) treatment of moderate acne vulgaris in females 15 years and older who also want to use oral contraceptives. It contains norethindrone acetate 1 mg and ethinyl estradiol 20 mcg as active hormones.
With a Sunday Start, Feirza 1/20 may not provide full contraceptive protection for 7 days — use backup contraception during this period. With a Day 1 Start (first day of your period), protection begins immediately. Acne improvement may take 3–6 months of consistent use to become noticeable.
Feirza 1/20 is a brand-name generic drug manufactured by Xiromed LLC. It is not the brand-name originator, but rather a generic version of the norethindrone acetate/ethinyl estradiol/ferrous fumarate formulation. Other generic brands with the same active ingredients include Junel Fe 1/20, Blisovi Fe 1/20, and Microgestin Fe 1/20.
The 21 white-to-off-white tablets are the active hormone pills containing norethindrone acetate 1 mg and ethinyl estradiol 20 mcg. The 7 brown tablets are placebo pills containing only 75 mg of ferrous fumarate (iron) — they have no hormones and no therapeutic purpose. They are included to help you maintain the daily pill-taking habit during the hormone-free week.
Combination oral contraceptives like Feirza 1/20 are generally not recommended while breastfeeding because estrogen can reduce milk supply. If you are breastfeeding, discuss alternative options with your provider — progestin-only pills (minipills), IUDs, or implants are typically preferred as they don't affect milk production.
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