Comprehensive medication guide to Feirza 1/20 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 ACA-compliant private insurance plans under the contraceptive coverage mandate; minimal copay with Medicaid. Grandfathered or religiously-exempt plans may vary.
Estimated Cash Pricing
$22–$87 retail for a 28-day pack; as low as $8.40–$9.66 with SingleCare or GoodRx Gold coupons. With qualifying ACA-compliant insurance or Medicaid, coverage may be $0 copay.
Medfinder Findability Score
78/100
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Feirza 1/20 is a combination oral contraceptive (birth control pill) manufactured by Xiromed LLC, introduced to the U.S. market in January 2025 under FDA ANDA202772. Each 28-day pack contains 21 active white-to-off-white tablets — each containing norethindrone acetate 1 mg and ethinyl estradiol 20 mcg — plus 7 brown placebo tablets containing 75 mg ferrous fumarate (iron). The iron placebo tablets contain no hormones and serve only to help patients maintain a consistent daily pill-taking habit.
Feirza 1/20 is FDA-approved for two indications: prevention of pregnancy as a contraceptive, and treatment of moderate acne vulgaris in females 15 years and older who also want to use oral contraceptives. The "1/20" in the name refers to the 1 mg progestin and 20 mcg estrogen doses — making it a low-dose formulation with a well-established safety and efficacy profile.
Feirza 1/20 is therapeutically equivalent to other brands in the same generic class, including Junel Fe 1/20, Blisovi Fe 1/20, Larin Fe 1/20, Microgestin Fe 1/20, and Hailey Fe 1/20. It is not a controlled substance and can be prescribed by OB/GYNs, primary care providers, NPs, PAs, and telehealth platforms.
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Feirza 1/20 works through three layered mechanisms. The primary mechanism is suppression of gonadotropins (FSH and LH) from the pituitary gland, which prevents ovulation — no egg release means no fertilization. Norethindrone acetate is rapidly deacetylated to norethindrone after oral ingestion (bioavailability ~64%), and ethinyl estradiol has ~43% bioavailability after first-pass hepatic metabolism.
Secondary mechanisms include thickening the cervical mucus (making it difficult for sperm to penetrate) and altering the endometrial lining to reduce the likelihood of implantation. Together, these three mechanisms make Feirza 1/20 highly effective: with perfect use, the annual failure rate is approximately 0.1%; with typical use, approximately 7%.
For acne, ethinyl estradiol increases hepatic production of sex hormone-binding globulin (SHBG), which binds free testosterone in the blood and reduces androgenic stimulation of sebaceous glands. Less sebum production leads to fewer clogged pores and reduced acne inflammation over 3–6 months of consistent use.
Norethindrone acetate 1 mg / Ethinyl estradiol 20 mcg / Ferrous fumarate 75 mg — tablet
28-day pack: 21 active white-to-off-white hormone tablets + 7 brown ferrous fumarate placebo tablets. Take one tablet daily for 28 days with no break between packs.
As of 2026, Feirza 1/20 is generally available but not universally stocked at all pharmacies. The FDA has not declared a national shortage of Feirza 1/20 or the norethindrone acetate/ethinyl estradiol/ferrous fumarate drug class. However, because Feirza 1/20 entered the market in January 2025, it is still building its distribution footprint — not every pharmacy has incorporated it into their standard formulary ordering cycle.
Patients may find that their usual pharmacy carries Junel Fe 1/20 or Microgestin Fe 1/20 but not Feirza 1/20 specifically. The practical findability score for Feirza 1/20 reflects this — generally available in major metro areas through large pharmacy chains, but with localized gaps in smaller markets or at pharmacies that prefer established generic brands. Equivalent generics are typically easy to find even when Feirza 1/20 is not.
If you're having difficulty locating Feirza 1/20 at a pharmacy near you, medfinder can call pharmacies in your area to check which ones have it in stock and text you the results. medfinder covers all medications, not just shortage drugs.
Feirza 1/20 is not a controlled substance and has no DEA scheduling requirements. Any licensed prescriber with standard prescribing authority can write a prescription for Feirza 1/20, including physicians, nurse practitioners (NPs), physician assistants (PAs), and certified nurse-midwives (CNMs) with prescribing authority in their state.
Healthcare providers who commonly prescribe Feirza 1/20 include:
OB/GYN physicians — primary prescribers for women's reproductive health including contraception and acne management
Primary care physicians (family medicine, internal medicine)
Nurse practitioners (NPs) and physician assistants (PAs) — can prescribe in most states, including via telehealth
Certified nurse-midwives (CNMs) — in states where they hold prescribing authority
Reproductive health specialists at Planned Parenthood or Title X federally funded clinics
Telehealth prescribing is fully available for Feirza 1/20 in all 50 states, since it is not a controlled substance. Platforms including Nurx, Pandia Health, Hims & Hers, Wisp, and Hey Jane can evaluate patients online and send prescriptions to a local pharmacy, typically within the same day.
No. Feirza 1/20 is not a controlled substance. It is not scheduled by the DEA under the Controlled Substances Act. This means there are no special DEA-number requirements for prescribers, no limits on the number of refills that can be authorized on a single prescription (except as imposed by state law or insurance plan rules), and no restrictions on prescribing via telehealth.
A standard prescription — written or electronic — from any licensed prescriber (physician, NP, PA, or CNM with prescribing authority) is sufficient to dispense Feirza 1/20. Most prescribers provide 3–12 months of refills on a single prescription. Patients can fill Feirza 1/20 at any licensed pharmacy in the United States.
Most common side effects, especially in the first 1–3 months, include:
Nausea (take with food or at bedtime to minimize)
Breast tenderness or swelling
Headaches
Breakthrough bleeding or spotting between periods
Lighter periods or amenorrhea (absent withdrawal bleed)
Mood changes or depression
Decreased libido
Mild weight changes or fluid retention
Chest pain, shortness of breath, or coughing blood (possible pulmonary embolism)
Leg pain, swelling, or warmth (possible DVT)
Sudden severe headache, vision changes, weakness or numbness (possible stroke)
Severe abdominal pain (possible liver problem)
Yellowing of skin or eyes — jaundice (possible liver toxicity)
Severe allergic reaction: hives, difficulty breathing, swelling of face or throat
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Junel Fe 1/20
Identical active ingredients (norethindrone acetate 1 mg / EE 20 mcg / ferrous fumarate 75 mg); one of the most widely distributed brands in this class
Blisovi Fe 1/20
Same active ingredients as Feirza 1/20; widely available at Walgreens and other major chains
Larin Fe 1/20
Therapeutically equivalent generic; manufactured by Mayne Pharma
Microgestin Fe 1/20
One of the original norethindrone acetate/EE 1/20 generics; widely available
Yaz (drospirenone 3 mg / EE 20 mcg)
Different progestin (drospirenone) at same 20 mcg estrogen dose; FDA-approved for contraception, acne, and PMDD; generic versions available
Sprintec (norgestimate 0.25 mg / EE 35 mcg)
Higher estrogen dose, different progestin (norgestimate); very widely available and inexpensive; good option if breakthrough bleeding is an issue on 1/20 formulations
Prefer Feirza 1/20 28 Day? We can find it.
Rifampin (rifampicin)
majorSignificantly increases metabolism of norethindrone and ethinyl estradiol, reducing contraceptive effectiveness. Use non-hormonal backup during therapy and for 28 days after stopping.
Ombitasvir/paritaprevir/ritonavir ± dasabuvir (HCV drugs)
majorContraindicated — combination causes significant ALT elevations indicating hepatotoxicity risk.
Phenytoin, phenobarbital, carbamazepine, oxcarbazepine, topiramate (anticonvulsants)
majorCYP3A4 inducers that reduce contraceptive effectiveness. Use non-hormonal or LARC contraception.
St. John's Wort (Hypericum perforatum)
majorHerbal CYP3A4/P-gp inducer that reduces oral contraceptive effectiveness; may lead to contraceptive failure.
Lamotrigine (Lamictal)
moderateEthinyl estradiol significantly reduces lamotrigine blood levels via increased glucuronidation; may reduce seizure control. Close monitoring and dose adjustment required.
Tranexamic acid (oral)
majorContraindicated with combination hormonal contraceptives — increases thrombotic risk via pharmacodynamic synergism.
Glecaprevir/pibrentasvir (Mavyret)
majorCo-administration not recommended due to potential ALT elevations.
Acitretin (oral retinoid)
majorMay decrease norethindrone effectiveness by unknown mechanism; contraceptive failure may result.
Feirza 1/20 is a low-dose combination oral contraceptive with a well-established safety profile in its drug class. Its 20 mcg estrogen formulation makes it one of the gentler options available, and its dual FDA approval for contraception and moderate acne makes it a versatile choice. Patients looking for maximum effectiveness should take it at the same time each day and start a new pack immediately after completing each 28-day cycle.
Cost is often minimal or zero for patients with ACA-compliant insurance, and significant savings are available through GoodRx (as low as $9.66) and SingleCare (as low as $8.40) for those paying cash. The most important concern for most patients is simply finding it in stock — as a newer generic brand, Feirza 1/20 is not yet universally stocked by every pharmacy.
If you have trouble finding Feirza 1/20 at a pharmacy near you, medfinder is a paid service that contacts pharmacies near you to find which ones can fill your prescription, then texts you the results — saving the time and frustration of calling pharmacies yourself. medfinder covers all medications, not just shortage drugs.
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