Updated: January 25, 2026

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

Author

Peter Daggett

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What Is Kariva 28 Day?
What Is Kariva 28 Day Used For?
How Do You Take Kariva 28 Day?
What Happens If I Miss a Dose?
Who Should Not Take Kariva 28 Day?

Kariva 28 Day is a biphasic combination birth control pill containing desogestrel and ethinyl estradiol. Here's everything you need to know about its uses, dosage, and how to take it.

Kariva 28 Day is a prescription oral contraceptive used to prevent pregnancy. It belongs to the class of drugs known as combination hormonal contraceptives (CHCs) or combined oral contraceptives (COCs). If you've just been prescribed Kariva or are researching birth control options, this guide covers everything you need to know.

What Is Kariva 28 Day?

Kariva 28 Day is manufactured by Teva Pharmaceuticals and is a generic equivalent of the discontinued brand-name contraceptive Mircette (originally made by Organon). It is a biphasic oral contraceptive, meaning the hormonal content of the active tablets changes at one point during the 28-day cycle.

The 28-day pack contains three distinct tablet types:

Days 1-21 (white tablets): 0.15 mg desogestrel + 0.02 mg (20 mcg) ethinyl estradiol — these are the primary contraceptive tablets

Days 22-23 (light-green tablets): Inert (placebo) tablets — no active hormones; allow for withdrawal bleeding to occur

Days 24-28 (light-blue tablets): 0.01 mg (10 mcg) ethinyl estradiol only — a very low dose of estrogen with no progestin; this is a unique feature of the Mircette/Kariva formulation

The addition of low-dose ethinyl estradiol in the final 5 days is designed to reduce the hormonal drop that can cause headaches or symptoms for some patients during the hormone-free interval of traditional 21/7 pill regimens.

What Is Kariva 28 Day Used For?

The FDA-approved indication for Kariva 28 Day is prevention of pregnancy. When taken correctly (one tablet daily at the same time each day), it is approximately 99% effective with perfect use, and about 91% effective with typical use.

Providers may also prescribe Kariva and similar COCs off-label for:

Dysmenorrhea (painful periods)

Dysfunctional uterine bleeding / irregular periods

Endometriosis management

Polycystic ovarian syndrome (PCOS) — menstrual regulation and androgen reduction

Premenstrual syndrome (PMS) symptom management

How Do You Take Kariva 28 Day?

Take one tablet every day at the same time, in the exact order specified on the blister pack. Do not skip tablets, take them out of order, or skip placebo days. Key instructions:

Starting the pack: Begin on the first Sunday after your period starts (Sunday start), or on the first day of your period (Day 1 start). Use backup contraception for the first 7 days if starting on Sunday.

Daily timing: Take Kariva at the same time each day — within 24 hours of the previous dose. Setting a phone alarm can help.

With food: Taking Kariva with food can reduce nausea, especially when first starting.

New pack timing: Start a new pack the day after taking your last (light-blue) tablet. Do not wait.

What Happens If I Miss a Dose?

Missed 1 active (white) tablet: Take it as soon as you remember, even if that means taking 2 tablets in one day.

Missed 2 consecutive active tablets (Weeks 1-2): Take 2 tablets the day you remember and 2 the next day. Use backup contraception for 7 days.

Missed 2 tablets in Week 3 or 3+ tablets anytime: Continue taking 1 white tablet daily until the next Sunday. Then start a new pack. Use backup contraception for 7 days.

Missed light-green or light-blue tablets: These are placebo or very low-dose; missing them has no contraceptive significance. Discard and continue.

Who Should Not Take Kariva 28 Day?

Kariva is contraindicated in people who:

Are over 35 and smoke (boxed warning)

Have or have had breast cancer

Have a history of blood clots (DVT, PE, stroke, or heart attack)

Have active liver disease or liver tumors

Have uncontrolled high blood pressure

Experience migraines with aura

Are pregnant or suspect pregnancy

For a full breakdown of what to watch for while taking Kariva, see our article on Kariva 28 Day side effects.

Frequently Asked Questions

Kariva 28 Day is FDA-approved for the prevention of pregnancy. It contains desogestrel and ethinyl estradiol and works by preventing ovulation, thickening cervical mucus, and altering the uterine lining. It may also be prescribed off-label for dysmenorrhea, PCOS, endometriosis, and menstrual irregularities.

Kariva is a generic equivalent of the discontinued brand Mircette. Both contain the same active ingredients (desogestrel and ethinyl estradiol) in the same biphasic dosing pattern. Mircette is no longer manufactured; Kariva and other generics (Azurette, Viorele, Pimtrea) are the currently available versions.

With perfect use (taking one pill at the same time every day without missing any), Kariva is approximately 99% effective — about 1 in 100 women per year may become pregnant. With typical use (accounting for occasional missed pills), effectiveness is about 91%. Kariva does not protect against sexually transmitted infections.

Kariva 28 Day contains desogestrel (a progestin) and ethinyl estradiol (an estrogen). Days 1-21 contain 0.15 mg desogestrel and 0.02 mg ethinyl estradiol. Days 22-23 are inactive placebo tablets. Days 24-28 contain 0.01 mg ethinyl estradiol only, with no progestin.

Yes. Safety and efficacy of Kariva have been established in women of reproductive age, including postpubertal adolescents. Use is not indicated before the onset of menstruation (menarche). Teens with specific health conditions (such as hypertension, migraines with aura, or a clotting disorder history) should have these evaluated before starting any COC.

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