Comprehensive medication guide to Ethinyl Estradiol/Levonorgestrel 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 on ACA-compliant insurance plans under the preventive care mandate. Medicaid covers with $0–$3 cost-sharing in most states. Tier 1 generic on most commercial formularies.
Estimated Cash Pricing
$50–$90 retail per 28-day generic pack; as low as $23 with GoodRx or SingleCare coupons. Extended-cycle 91-day packs retail $180–$240, available for $27–$50 with discount cards.
Medfinder Findability Score
88/100
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Ethinyl estradiol/levonorgestrel is a combination hormonal oral contraceptive — one of the most prescribed medications in the United States. It contains two synthetic hormones: ethinyl estradiol (a synthetic estrogen) and levonorgestrel (a synthetic progestin). Together, these hormones work primarily by suppressing ovulation to prevent pregnancy.
Available in more than 30 branded and generic formulations, this medication is sold under names including Aviane, Altavera, Levora, Kurvelo, Portia, Lessina, Lutera, Seasonique, Jolessa, Camrese, Trivora, Enpresse, and many others. Formulations include standard 28-day monophasic packs, triphasic packs with varying hormone doses, and extended 91-day cycle packs designed to reduce the frequency of withdrawal bleeding to 4 times per year.
The medication is FDA-approved for prevention of pregnancy in females of reproductive potential. It is also used off-label for management of heavy or irregular menstruation and endometriosis. Ethinyl estradiol/levonorgestrel is not a controlled substance and requires a prescription in the United States (with the exception of the over-the-counter progestin-only pill Opill, which is a separate product).
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Ethinyl estradiol/levonorgestrel prevents pregnancy through three complementary mechanisms. The primary mechanism is suppression of ovulation: by maintaining steady blood levels of synthetic estrogen and progestin, the medication suppresses the mid-cycle surge in luteinizing hormone (LH) that triggers egg release from the ovaries. Without ovulation, fertilization cannot occur.
The levonorgestrel (progestin) component also thickens cervical mucus, creating a physical barrier that impedes sperm movement toward any egg that might be released. Additionally, the medication alters the endometrial lining, making implantation less hospitable. These secondary mechanisms provide additional layers of pregnancy prevention.
After oral ingestion, ethinyl estradiol reaches peak blood concentration in approximately 1-2 hours; levonorgestrel peaks in about 1 hour. Levonorgestrel has a half-life of approximately 36 hours, while ethinyl estradiol's half-life is approximately 18 hours — both long enough that once-daily dosing maintains effective blood levels throughout the cycle. Both hormones are metabolized primarily in the liver and excreted in urine and feces.
0.1 mg / 0.02 mg — tablet (28-day pack)
Monophasic: 21 active + 7 placebo. Brands: Aviane, Aubra, Falmina, Larissia, Lessina, Lutera, Orsythia, Sronyx, Vienva
0.15 mg / 0.03 mg — tablet (28-day pack)
Monophasic: 21 active + 7 placebo. Brands: Altavera, Chateal, Kurvelo, Levora, Marlissa, Portia
0.15 mg / 0.03 mg → 0.01 mg EE — tablet (91-day extended cycle)
84 active + 7 low-dose EE. Brands: Seasonique, Jolessa, Camrese, Daysee, Introvale, Quasense, Setlakin, Simpesse
Triphasic (varying) — tablet (28-day pack)
Three phases with varying LNG doses. Brands: Trivora, Enpresse, Myzilra
Ethinyl estradiol/levonorgestrel is generally widely available across the United States. There is no active FDA shortage as of 2026, and more than a dozen manufacturers supply the market, including Teva, Lupin, Amneal, Glenmark, Hetero Labs, Dr. Reddy's, and Xiromed. The medication earns a high findability score as a result of this robust supply base.
That said, individual patients may still encounter localized access challenges. With more than 30 branded and generic formulations on the market, pharmacies stock a subset based on local demand. Your specific brand or dose may be available at one pharmacy but not another just a few miles away. Insurance formulary restrictions, refill timing policies, and rural pharmacy limitations can create additional barriers for some patients.
If you're having trouble filling your prescription, medfinder calls pharmacies near you to find which ones can fill your specific prescription — then texts you the results so you can get your medication without the runaround.
Ethinyl estradiol/levonorgestrel is not a controlled substance and carries no DEA scheduling restrictions. Any licensed healthcare provider with prescribing authority can write a prescription. This broad prescribing access is one reason this medication is widely available across many healthcare settings.
OB/GYNs: The most common prescribers; manage contraception alongside reproductive and gynecological health
Primary care physicians (family medicine, internal medicine): Routinely prescribe oral contraceptives as part of preventive care
Nurse practitioners (NPs) and physician assistants (PAs): Full prescribing authority in most states for this non-controlled medication
Certified nurse-midwives (CNMs): Prescribe contraceptives as part of comprehensive women's health care
Pharmacists (in 30+ states): Can prescribe hormonal contraceptives directly at the pharmacy counter in states with pharmacist-prescribing authority
Telehealth platforms — including Nurx, The Pill Club, Planned Parenthood Direct, and PRJKT RUBY — allow patients to receive prescriptions from licensed providers via video or questionnaire-based visits, with medication shipped directly to their home or sent to a local pharmacy. This has dramatically expanded access to oral contraceptives, particularly for patients in rural areas or contraceptive deserts.
No. Ethinyl estradiol/levonorgestrel is not a controlled substance. It has no DEA scheduling and does not require any special DEA registration by prescribers or pharmacists. Any licensed prescriber — including physicians, nurse practitioners, physician assistants, certified nurse-midwives, and pharmacists in the more than 30 states with pharmacist-prescribing authority — can prescribe this medication.
Because it is not a controlled substance, prescriptions for ethinyl estradiol/levonorgestrel can be called, faxed, or electronically submitted to any pharmacy. Refills can be written for up to one year at a time in most states, and many states now require insurers to dispense up to a 12-month supply. There are no limits on the number of prescriptions a provider can write, and no prescription monitoring program requirements apply.
Patients should be aware that while ethinyl estradiol/levonorgestrel itself is not controlled, it does require a prescription in most formulations. The only daily oral contraceptive pill available over the counter in the U.S. as of 2026 is Opill (norgestrel 0.075 mg), which is a progestin-only pill — a different medication class.
Most common side effects, which often resolve after 2-3 cycles:
Headaches
Nausea and vomiting (take with food or at bedtime to reduce)
Irregular or breakthrough bleeding (especially in first 1-3 cycles)
Breast tenderness or pain
Mood changes, anxiety, or depression
Acne (may improve or worsen initially)
Weight changes (often due to water retention)
Blood clots (deep vein thrombosis, pulmonary embolism) — symptoms: leg pain/swelling, chest pain, shortness of breath
Stroke — symptoms: sudden severe headache, vision changes, weakness, slurred speech
Heart attack — symptoms: chest pain or pressure, shortness of breath
Significant blood pressure elevation
Liver problems (jaundice, severe abdominal pain)
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Norgestimate/Ethinyl Estradiol (Sprintec, Tri-Sprintec)
Different progestin with low androgenic activity; widely stocked and covered at Tier 1 on most formularies
Drospirenone/Ethinyl Estradiol (Yaz, Yasmin, Syeda)
Anti-androgenic progestin with mild diuretic properties; FDA-approved for acne and PMDD in addition to contraception
Norethindrone/Ethinyl Estradiol (Junel Fe, Lo Loestrin Fe)
Often formulated with iron supplement; good for patients with anemia or heavy periods
Progestin-only pill / Opill (norgestrel)
Estrogen-free option for patients who cannot take combination pills; Opill available OTC since 2024
Etonogestrel/Ethinyl Estradiol ring (NuvaRing)
Monthly vaginal ring; eliminates daily pill requirement for patients who prefer fewer touchpoints
Prefer Ethinyl Estradiol/Levonorgestrel? We can find it.
Rifampin (Rifadin)
majorPotent CYP3A4 inducer that significantly reduces EE/LNG blood levels and contraceptive effectiveness. Use non-hormonal backup contraception during and 4 weeks after rifampin.
Carbamazepine, Phenytoin, Phenobarbital (enzyme-inducing AEDs)
majorCYP3A4 enzyme inducers that reduce EE/LNG effectiveness. Alternative or additional contraception required.
St. John's Wort
majorPotent CYP3A4 inducer; documented to cause breakthrough bleeding and contraceptive failure. Avoid combination.
Ombitasvir/paritaprevir/ritonavir ± dasabuvir (Viekira Pak)
majorContraindicated — causes significant ALT elevations (>5x ULN). Discontinue EE/LNG before starting this hepatitis C regimen.
Tranexamic acid oral (Lysteda)
majorContraindicated — combination significantly increases thrombotic risk.
Fezolinetant (Veozah)
majorContraindicated — EE inhibits CYP1A2 metabolism of fezolinetant, causing significantly elevated fezolinetant levels.
Grapefruit juice
moderateInhibits intestinal CYP3A4, modestly increasing EE blood levels. Not contraindicated but worth discussing with prescriber if consumed regularly.
Atorvastatin, Rosuvastatin
moderateIncrease EE AUC by approximately 20-25%. Usually not clinically significant but may increase estrogen-related effects.
Azole antifungals (fluconazole, itraconazole)
moderateCYP3A4 inhibitors that increase systemic EE exposure. Usually not significant for short-course treatment.
Topiramate (Topamax) >200 mg/day
moderateEnzyme-inducing at higher doses; may reduce contraceptive effectiveness. Use backup contraception.
Ethinyl estradiol/levonorgestrel is one of the most studied, widely used, and well-established contraceptive medications in the world. Its combination of synthetic estrogen and progestin provides highly effective pregnancy prevention — more than 99% with perfect use — along with off-label benefits for menstrual regulation and endometriosis management. The broad availability of generics has made it one of the most affordable prescription medications in the country.
While no national shortage exists in 2026, individual access challenges — from local pharmacy stock gaps to insurance formulary barriers — remain real for many patients. The key strategies for maintaining uninterrupted access include requesting 90-day supplies, knowing acceptable generic equivalents, and being prepared to check multiple pharmacies if needed.
If you're struggling to find your birth control in stock, medfinder can call local pharmacies on your behalf and text you the results — saving you the time and frustration of making those calls yourself. Finding your medication shouldn't be a barrier to using it consistently.
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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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