Comprehensive medication guide to Kariva 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 private insurance under the contraceptive mandate; Tier 1–2 on most commercial formularies; $0–$15 copay if not on a no-cost-share plan.
Estimated Cash Pricing
$55–$150 retail for a 28-tablet pack; as low as $9.54–$20 with GoodRx or SingleCare coupons at participating pharmacies for a 30-day supply.
Medfinder Findability Score
78/100
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Kariva 28 Day is a prescription biphasic combination oral contraceptive manufactured by Teva Pharmaceuticals. It contains two synthetic hormones — desogestrel (a third-generation progestin) and ethinyl estradiol (a synthetic estrogen) — and is FDA-approved for the prevention of pregnancy. Kariva is a generic equivalent of the discontinued brand-name pill Mircette.
The 28-day pack uses a biphasic design: days 1-21 contain 0.15 mg desogestrel and 0.02 mg ethinyl estradiol; days 22-23 are inert placebo tablets; and days 24-28 contain a uniquely low 0.01 mg dose of ethinyl estradiol only. This last phase is designed to minimize estrogen-withdrawal symptoms during the hormone-free interval.
Other FDA AB-equivalent branded generics of the same formulation include Azurette, Viorele, Pimtrea, Volnea, and Bekyree — all containing the same hormones at the same doses as Kariva. Kariva requires a prescription and is not a controlled substance.
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Kariva 28 Day prevents pregnancy through three complementary mechanisms. The primary mechanism is suppression of ovulation: the combination of ethinyl estradiol and desogestrel inhibits the hypothalamic-pituitary axis, preventing the surge of FSH and LH hormones that trigger egg release. Without ovulation, fertilization cannot occur.
The progestin component (desogestrel, which converts to etonogestrel in the body) also thickens the cervical mucus, creating a physical barrier that impedes sperm from reaching the uterus. Additionally, the hormonal combination keeps the uterine lining (endometrium) thin and unreceptive to implantation. These three layers of protection make Kariva approximately 99% effective with perfect use.
Desogestrel is a third-generation progestin notable for low androgenic activity compared to older progestins. This makes Kariva better tolerated by some patients who experience androgen-related side effects (acne, oily skin) on other pill formulations. It is metabolized by CYP3A4 liver enzymes, which is why enzyme-inducing drugs (like rifampin or carbamazepine) can significantly reduce Kariva's effectiveness.
0.15 mg / 0.02 mg (Days 1-21) — oral tablet (white)
0.15 mg desogestrel + 0.02 mg ethinyl estradiol — primary contraceptive phase
Inert (Days 22-23) — oral tablet (light-green)
Placebo tablets — no active hormones; allows withdrawal bleeding
0.01 mg (Days 24-28) — oral tablet (light-blue)
0.01 mg ethinyl estradiol only — low-dose estrogen bridge phase
As of 2026, Kariva 28 Day is not listed on the FDA's official drug shortage database, meaning national supply is adequate. However, patients regularly report difficulty filling Kariva at their usual pharmacy. This happens because Kariva is one of several branded generics of the discontinued Mircette — and pharmacies may stock Viorele or Azurette rather than Kariva specifically, creating apparent gaps even when the identical formulation is available nearby.
The findability score for Kariva 28 Day is 78/100 — generally available nationally, with intermittent local stocking gaps. Most patients can find it by calling 2-4 pharmacies, asking about equivalent generics, or switching to mail-order. The best immediate strategy for patients who cannot locate Kariva is to ask their prescriber to authorize substitution with an AB-equivalent (Azurette, Viorele, Pimtrea, or Volnea), which contain identical hormones and doses.
If you're struggling to find Kariva at pharmacies near you, medfinder can help. medfinder calls pharmacies in your area to find which ones have Kariva — or an equivalent — in stock and can fill your prescription. Results are sent to you by text.
Kariva 28 Day is not a controlled substance, so there are no DEA scheduling restrictions on who can prescribe it. Any licensed prescriber in good standing can write a prescription for Kariva 28 Day for appropriate patients.
OB/GYNs (Obstetricians/Gynecologists)
Primary Care Physicians (Family Medicine, Internal Medicine)
Nurse Practitioners (NPs) — authorized to prescribe in all 50 states
Physician Assistants (PAs) — under collaborative practice agreements
Certified Nurse Midwives (CNMs)
Kariva 28 Day is widely available through telehealth. Platforms like Nurx, Hers, and Planned Parenthood Direct can prescribe Kariva or an equivalent after a brief online health consultation and ship the medication directly to your home, available in most U.S. states.
No. Kariva 28 Day is not a controlled substance and is not scheduled under the DEA's Controlled Substances Act. There are no refill restrictions based on controlled substance scheduling. Prescribers can write up to 12 months of refills, and the prescription can be sent electronically or called in by any licensed prescriber without special DEA authorization.
Kariva does require a prescription from a licensed healthcare provider — it is not available over the counter. Any licensed prescriber (MD, DO, NP, PA, CNM) can write a prescription for Kariva. Telehealth services operating in your state can also prescribe Kariva or an equivalent without an in-person visit.
Most patients tolerate Kariva 28 Day well. Common side effects that typically improve after 2-3 cycles include:
Nausea (take with food to reduce)
Breast tenderness or swelling
Breakthrough bleeding or spotting
Headache
Weight changes (usually minor fluid retention)
Mood changes or decreased libido
Dark skin patches (melasma)
Blood clots (DVT, PE): leg pain/swelling, shortness of breath, chest pain — call 911
Stroke: sudden face drooping, arm weakness, speech difficulty — call 911
Heart attack: chest tightness, radiating arm/jaw pain — call 911
New or worsening migraines with aura — contact your prescriber immediately
Liver problems: jaundice, dark urine, right upper abdominal pain
Severe depression or worsening mood
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Azurette (28 Day)
FDA AB-equivalent generic of Mircette; identical active ingredients and doses to Kariva. Often interchangeable with prescriber authorization.
Viorele (28 Day)
Another Mircette-equivalent generic; same biphasic desogestrel/ethinyl estradiol formulation as Kariva.
Pimtrea (28 Day)
Identical formulation to Kariva; one of several branded generics of the discontinued Mircette.
Apri (28 Day)
Monophasic desogestrel/ethinyl estradiol pill (0.15 mg / 0.03 mg); same progestin as Kariva but constant dose and slightly higher estrogen.
Sprintec (28 Day)
Widely available monophasic COC containing norgestimate 0.25 mg + ethinyl estradiol 0.035 mg; different progestin than Kariva.
Prefer Kariva 28 Day? We can find it.
Rifampin (Rifadin)
majorPotent CYP3A4 inducer; significantly reduces Kariva hormone levels and contraceptive efficacy. Use backup contraception during and 28 days after rifampin.
Carbamazepine (Tegretol)
majorAnticonvulsant; induces CYP3A4 and reduces Kariva plasma levels. Consider non-hormonal or longer-acting contraception.
Phenytoin (Dilantin)
majorAnticonvulsant; enzyme inducer that reduces Kariva effectiveness. Backup contraception recommended.
Lamotrigine (Lamictal)
majorKariva significantly reduces lamotrigine plasma levels, potentially reducing seizure control. Monitor levels when starting or stopping Kariva.
Ombitasvir/paritaprevir/ritonavir (Viekira Pak)
majorContraindicated — risk of severe ALT elevation (>5x ULN). Discontinue Kariva before starting; restart ~2 weeks after completing HCV therapy.
St. John's Wort
moderateHerbal enzyme inducer; reduces Kariva hormone levels and contraceptive efficacy. Avoid or use backup contraception.
Glecaprevir/pibrentasvir (Mavyret)
moderateNot recommended — risk of ALT elevation. Discuss alternative contraception during HCV treatment.
Grapefruit juice
minorMay modestly increase ethinyl estradiol plasma concentrations. Occasional consumption unlikely to be clinically significant.
Kariva 28 Day is a well-established, low-dose biphasic oral contraceptive with a strong safety and efficacy record. Its unique biphasic design — with a low-dose estrogen phase at the end of the pack — makes it a preferred option for patients who experience estrogen-withdrawal symptoms on traditional 21/7 pill regimens. The drug is not in a national FDA shortage, but localized pharmacy stock gaps are common given the fragmented generic market.
For most patients with private insurance, Kariva is covered at $0 under the ACA contraceptive mandate. For uninsured patients, discount programs like GoodRx bring the cost to under $20 per pack. Several AB-equivalent generics (Azurette, Viorele, Pimtrea) offer identical protection and may be more readily available or cheaper at your pharmacy — ask your prescriber about substitution authorization.
If you've had trouble finding Kariva at your pharmacy, medfinder can locate pharmacies near you that have it in stock — saving you the time and frustration of calling around. medfinder contacts pharmacies on your behalf and texts you the results.
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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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