Comprehensive medication guide to Amethyst 28 Day including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0 copay for most patients with ACA-compliant insurance (contraceptives required to be covered without cost-sharing); $0–$30 copay on plans without full contraceptive mandate compliance; Tier 1–2 generic on most commercial formularies.
Estimated Cash Pricing
$58–$68 retail for a 28-day supply; as low as $20–$27 with GoodRx or SingleCare coupons for a 28-day pack (90 mcg levonorgestrel / 20 mcg ethinyl estradiol).
Medfinder Findability Score
78/100
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Amethyst 28 Day is a combination oral contraceptive containing levonorgestrel 90 mcg and ethinyl estradiol 20 mcg. Manufactured by Teva Pharmaceuticals, it is the generic equivalent of Lybrel — the first FDA-approved continuous-cycle oral contraceptive, which has since been discontinued as a brand.
What makes Amethyst 28 Day unique is that all 28 tablets are active hormone tablets — there are no placebo pills. Unlike standard 28-day packs that include 7 placebo pills followed by a withdrawal bleed, Amethyst 28 Day is taken continuously every day without interruption, eliminating scheduled monthly periods.
It is FDA-approved for the prevention of pregnancy and is available by prescription only. Amethyst 28 Day is not a controlled substance and can be prescribed by a wide range of healthcare providers including OB/GYNs, PCPs, nurse practitioners, and telehealth providers.
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Amethyst 28 Day prevents pregnancy through three complementary mechanisms. The primary mechanism is suppression of ovulation: the levonorgestrel and ethinyl estradiol suppress the release of FSH and LH from the pituitary gland, preventing the ovary from releasing an egg. Without an egg, fertilization cannot occur.
As secondary mechanisms, levonorgestrel thickens cervical mucus to impede sperm motility, and both hormones alter the endometrial lining to reduce the likelihood of implantation. Because Amethyst 28 Day delivers hormones continuously without a placebo week, hormone levels remain steady and the uterine lining stays in a suppressed state — which is why scheduled monthly bleeding does not occur.
Unscheduled spotting or breakthrough bleeding is common in the first 3–6 months as the endometrium adjusts to continuous hormone exposure. For most patients, this diminishes significantly over time. The pill must be taken at the same time each day without interruption to maintain its effectiveness.
90 mcg levonorgestrel / 20 mcg ethinyl estradiol — tablet
One tablet daily, continuous — all 28 tablets active, no placebo pills, no tablet-free interval
Amethyst 28 Day is not listed on the FDA Drug Shortage Database as of 2026 — it is still in active production and distribution. However, many patients report inconsistent availability at local pharmacies. This is because the continuous-cycle 90 mcg/20 mcg formulation occupies a niche in the oral contraceptive market, and chain pharmacies tend to stock it in smaller quantities than higher-turnover standard 28-day packs.
The discontinuation of its brand predecessor Lybrel, combined with the broad generic landscape for levonorgestrel/ethinyl estradiol products, means pharmacies and wholesalers sometimes shift inventory away from Amethyst 28 Day toward other formulations. Mail-order pharmacies tend to carry it more reliably than retail chains.
If you're having trouble locating Amethyst 28 Day at a pharmacy near you, medfinder contacts pharmacies in your area and texts you which ones have your medication in stock — no phone calls required on your end. Start your search today.
Because Amethyst 28 Day is not a controlled substance, it can be prescribed by any licensed prescriber in all 50 states. There are no DEA scheduling restrictions, no triplicate forms, and no mandatory in-person visit requirements specific to this medication. Prescriptions can be sent electronically, called in, or faxed by any authorized healthcare provider.
Common prescriber types include:
OB/GYNs (Obstetrician-Gynecologists): Most experienced with continuous-cycle OCP management and breakthrough bleeding
Primary Care Physicians (PCPs): Family medicine and internal medicine physicians routinely prescribe oral contraceptives
Nurse Practitioners (NPs) and Physician Assistants (PAs): Can prescribe in most states with full prescriptive authority
Certified Nurse-Midwives (CNMs): Often prescribe contraceptives as part of women's health services
Amethyst 28 Day is fully available via telehealth. Platforms including Nurx, Pandia Health, and Hims & Hers specialize in birth control prescriptions and can prescribe and deliver Amethyst 28 Day without an in-person visit in most states. General telehealth platforms (Teladoc, MDLive, Amazon Clinic) can also prescribe it. When using telehealth, specify you want the continuous-cycle formulation with no placebo week.
No. Amethyst 28 Day is not a controlled substance. It is not scheduled by the DEA and does not have the prescribing restrictions associated with controlled medications (such as no telephone refills, 30-day supply limits, or required in-person visits for every prescription).
Because it is non-controlled, Amethyst 28 Day can be prescribed via telehealth in all states, transferred between pharmacies without restriction, and dispensed in 90-day supplies. Prescriptions can be called in, faxed, or sent electronically by any licensed prescriber. There are no special triplicate forms or DEA reporting requirements associated with this medication.
The most common side effects include:
Unscheduled bleeding or spotting (most common — especially in first 3–6 months)
Nausea and vomiting
Headache
Breast tenderness or swelling
Mood changes, including depression or irritability
Decreased libido
Acne changes (improvement or worsening)
Weight changes due to fluid retention
Elevated blood pressure
Blood clots (DVT, pulmonary embolism): leg pain/swelling, chest pain, shortness of breath
Stroke: sudden weakness, vision changes, severe headache, confusion
Heart attack: chest pain, jaw/arm pain, sweating, nausea
Liver problems: jaundice, severe abdominal pain
Boxed Warning: Women who smoke and are over 35 years old should not use Amethyst 28 Day. Smoking increases the risk of serious cardiovascular events.
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Portia / Altavera / Kurvelo
Levonorgestrel 0.15 mg / ethinyl estradiol 0.03 mg — standard 28-day pack with placebo week; most widely stocked LNG/EE generic
Aviane / Falmina / Vienva
Levonorgestrel 0.1 mg / ethinyl estradiol 0.02 mg — lower dose LNG/EE; standard pack with placebo week
Seasonique / Jolessa
Extended-cycle LNG/EE: 84 active tablets + 7 low-dose EE; periods ~4 times per year instead of monthly — good alternative for period suppression
Sprintec / Tri-Sprintec
Norgestimate / ethinyl estradiol — different progestin, widely stocked, good tolerability; requires new prescription
Nexplanon (etonogestrel implant)
Long-acting reversible contraceptive; lasts up to 3 years; eliminates daily pill burden; many patients experience reduced or absent periods
Prefer Amethyst 28 Day? We can find it.
Carbamazepine (Tegretol)
majorStrong CYP3A4 inducer; significantly reduces levonorgestrel and ethinyl estradiol levels; may cause contraceptive failure
Phenytoin (Dilantin)
majorCYP450 enzyme inducer; reduces OCP effectiveness; use backup contraception
Rifampin / Rifampicin
majorPotent CYP3A4 inducer; greatly reduces hormonal contraceptive levels; backup contraception required during use and for 28 days after stopping
St. John's Wort (Hypericum perforatum)
majorCYP450 inducer and P-glycoprotein inducer; reduces levonorgestrel and ethinyl estradiol levels; may cause breakthrough bleeding and contraceptive failure
Viekira Pak (dasabuvir/ombitasvir/paritaprevir/ritonavir)
majorContraindicated — concurrent use can cause significant ALT elevations (liver toxicity); must stop Amethyst 28 Day before starting Viekira Pak
Lamotrigine (Lamictal)
moderateOCPs significantly reduce lamotrigine serum levels; may reduce seizure control; requires dose adjustment under neurologist supervision
Warfarin (Coumadin)
moderateOCPs may alter anticoagulation effect (increase or decrease INR); monitor closely when starting or stopping Amethyst 28 Day
Amethyst 28 Day is a uniquely formulated oral contraceptive that offers continuous hormone delivery without a placebo week, effectively eliminating scheduled monthly periods for most patients. It is the generic successor to the discontinued Lybrel and contains levonorgestrel 90 mcg and ethinyl estradiol 20 mcg in an all-active 28-tablet pack. It is not a controlled substance and can be prescribed by any licensed healthcare provider including via telehealth.
The most common challenge with Amethyst 28 Day is not safety or efficacy — it is finding it in stock. Because it is a niche formulation, many retail pharmacies stock limited quantities and frequently run out. Patients should refill early, request 90-day supplies, and consider mail-order pharmacies for more reliable access.
If you're struggling to find Amethyst 28 Day at a pharmacy near you, medfinder contacts pharmacies in your area and texts you the results — saving you hours of calling around. Enter your medication and location to get started.
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Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
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