Comprehensive medication guide to Incassia 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 commercial and ACA marketplace plans (covered as preventive care under the Affordable Care Act); $0–$10 copay on some plans; Medicaid covers it in all states at no cost to the patient.
Estimated Cash Pricing
$50–$65 retail for a 28-tablet pack (1-month supply); as low as $17.87 with a GoodRx coupon, or approximately $24 for a 3-month supply with GoodRx.
Medfinder Findability Score
78/100
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Incassia 28 Day is a prescription progestin-only oral contraceptive — commonly called a "mini-pill" — containing 0.35 mg of norethindrone. It is manufactured by Aurobindo Pharma and comes in blister packs of 28 tablets, all of which are active (no placebo pills). It is taken once daily at the same time every day, continuously with no break between packs.
Unlike combined oral contraceptives, Incassia contains no estrogen — making it an important option for patients who cannot use estrogen-containing birth control. It is FDA-approved for the prevention of pregnancy and is one of more than 10 brand names for the same active ingredient, norethindrone 0.35 mg, which also includes Camila, Errin, Heather, Jencycla, and several others.
When taken with perfect use — one pill at the exact same time each day — Incassia has a first-year failure rate of 0.5%. With typical use, the failure rate is approximately 5%. The critical rule: if a dose is taken more than 3 hours late, backup contraception must be used for 48 hours.
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Incassia prevents pregnancy through four simultaneous mechanisms. Its primary action is thickening cervical mucus — within 2–4 hours of each dose, norethindrone causes the cervical mucus to become thick and viscous, creating a physical barrier that blocks sperm from reaching an egg. This mucus effect begins to diminish by 24 hours, which is why strict daily timing is so critical.
Secondarily, norethindrone suppresses ovulation in approximately 50% of menstrual cycles by lowering the mid-cycle LH and FSH surges that trigger egg release. It also slows the movement of the egg through the fallopian tubes and thins the uterine lining (endometrium), making implantation less likely.
Norethindrone is rapidly absorbed with peak plasma concentrations within 1–2 hours. Its half-life is approximately 8 hours, and it is extensively metabolized in the liver and excreted in both urine and feces. Fertility returns quickly after stopping — often within days.
0.35 mg — tablet
One tablet taken orally once daily at the same time each day, continuously — no break between packs. All 28 tablets in each pack are active.
Incassia 28 Day is not currently listed on the FDA's official drug shortage database. However, patients regularly report localized difficulty finding it at retail pharmacies. This is largely a reflection of how pharmacies stock generic medications: they typically carry only 1–2 norethindrone 0.35 mg brands at a time, and when their preferred brand is backordered or unavailable, patients perceive a shortage even when other equivalent brands are readily available.
The most efficient way to find Incassia — or any of its equivalent brands — is to use medfinder, which calls pharmacies near you to check which ones can fill your prescription. Results are sent to you by text.
When searching for Incassia, always ask pharmacies for "norethindrone 0.35 mg" by generic name and specify that you'll accept any brand. This approach — combined with checking multiple pharmacies — resolves the availability issue for most patients within a day.
Incassia 28 Day is not a controlled substance, so no special DEA licensing is required to prescribe it. Any licensed prescriber with general prescribing authority can write a prescription for norethindrone 0.35 mg.
OB/GYN physicians (most common prescribers for contraceptives)
Primary care physicians (family medicine, internal medicine)
Nurse practitioners (NPs) and physician assistants (PAs)
Certified nurse-midwives (CNMs)
Pharmacists (in states where pharmacist prescribing of contraceptives is permitted — including California, Colorado, New Mexico, and others)
Telehealth services are an excellent way to obtain or renew a norethindrone prescription without an in-person visit. Platforms including Nurx, The Pill Club, Hims/Hers, and Planned Parenthood Direct commonly prescribe Incassia and equivalent brands, often the same day, with prescriptions sent to a local pharmacy or shipped directly to your home.
No. Incassia 28 Day (norethindrone 0.35 mg) is not a controlled substance and is not scheduled by the DEA. It requires a valid prescription from a licensed prescriber in the United States, but there are no DEA Schedule restrictions, no refill quantity limits based on controlled substance scheduling, and no special requirements for early refills or prescription transfers.
Any licensed prescriber with prescribing authority — including physicians, nurse practitioners, physician assistants, certified nurse-midwives, and pharmacists in states where pharmacist prescribing of contraceptives is permitted — can write a prescription for Incassia 28 Day without any special DEA registration or licensing.
Irregular bleeding or spotting (most common; typically improves after 2-3 months)
Headache
Breast tenderness
Nausea
Dizziness
Acne (rare — due to mild androgenic properties of norethindrone)
Weight changes (rare; usually minor and transient)
Severe sudden lower abdominal pain (possible ectopic pregnancy)
New or worsening severe headache or migraine (especially with visual changes)
Two consecutive missed menstrual periods (rule out pregnancy)
Jaundice (yellowing of skin or eyes — possible liver problem)
Persistent pelvic pain or fullness (possible ovarian cyst)
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Camila 28 Day
FDA-equivalent norethindrone 0.35 mg brand. Identical active ingredient, dose, and mechanism. Most seamless substitution — pharmacist can typically switch without a new prescription.
Errin 28 Day
Another norethindrone 0.35 mg generic equivalent. Widely stocked at major chains. Same dosing, same 3-hour missed-pill window.
Slynd (drospirenone 4 mg)
Progestin-only pill with a different progestin. Suppresses ovulation more reliably (>95% vs ~50% for norethindrone) and has a 24-hour missed-pill window. Requires a new prescription. Significantly more expensive without insurance (~$150–$200/month).
Nexplanon (etonogestrel implant)
Long-acting subdermal implant lasting 3 years; >99% effective; estrogen-free. No daily pills required. Requires office visit for insertion and removal.
Mirena / Kyleena (levonorgestrel IUD)
Hormonal IUD lasting 3–8 years; >99% effective; estrogen-free. May reduce or eliminate periods. Requires in-office insertion procedure.
Prefer Incassia 28 Day? We can find it.
St. John's Wort
majorPotent inducer of CYP3A4 liver enzymes; significantly reduces norethindrone blood levels and contraceptive effectiveness. Avoid while using Incassia.
Rifampin (rifampicin)
majorAntibiotic used for tuberculosis; one of the strongest reducers of hormonal contraceptive blood levels. Use alternative contraception if rifampin treatment is required.
Phenobarbital / Primidone
majorBarbiturate anticonvulsants that induce liver enzymes, reducing norethindrone levels. Discuss alternative contraception with your provider.
Carbamazepine (Tegretol)
majorAnti-seizure medication; enzyme inducer that accelerates norethindrone metabolism, reducing effectiveness.
Ulipristal (Ella)
majorEmergency contraceptive progesterone receptor modulator; may counteract norethindrone's effects. Use backup contraception for 7 days after taking ulipristal.
Topiramate (Topamax)
moderateAnti-seizure/migraine medication; may reduce hormonal contraceptive efficacy at higher doses.
Griseofulvin
moderateAntifungal; may reduce hormonal contraceptive effectiveness. Use backup contraception during treatment.
Ritonavir / Lopinavir
moderateHIV protease inhibitors; may alter norethindrone metabolism. Consult HIV specialist about contraceptive choices.
Incassia 28 Day (norethindrone 0.35 mg) is a proven, estrogen-free contraceptive with decades of safety data. Its most important features — and the ones patients most need to understand — are its strict 3-hour missed-dose window, its continuous 28-day active-pill format with no break between packs, and the availability of more than 10 equivalent generic brands that make finding a supply much easier.
For most patients with insurance, it should cost nothing out of pocket under the ACA contraceptive mandate. For those paying cash, GoodRx brings the cost down to under $20/month — or around $24 for a 3-month supply. If you're struggling to find Incassia at your pharmacy, always ask for norethindrone 0.35 mg by generic name and accept any equivalent brand.
Need help finding Incassia in stock near you? medfinder calls pharmacies near you to identify which ones can fill your prescription, so you don't have to spend time on hold.
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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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