Comprehensive medication guide to Nortrel 1/35 21 Day including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0 copay under ACA-compliant plans that cover FDA-approved contraceptives as preventive care; Tier 1–2 on most formularies; some plans require the specific preferred generic equivalent.
Estimated Cash Pricing
$60–$80 retail per 21-day pack at major pharmacy chains without insurance; as low as $20.92 with a GoodRx or SingleCare coupon for a 30-day supply.
Medfinder Findability Score
78/100
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Nortrel 1/35 21 Day is a combination oral contraceptive (birth control pill) manufactured by Teva Pharmaceuticals USA. Each active yellow tablet contains norethindrone 1 mg (a synthetic progestin) and ethinyl estradiol 0.035 mg (a synthetic estrogen). The "21 Day" format means the pack contains 21 active hormone tablets with no placebo pills — patients take one tablet daily for 21 days, followed by a 7-day pill-free interval.
Nortrel 1/35 is a monophasic pill, meaning each active tablet contains the same dose of hormones — unlike triphasic or biphasic pills where the hormone level changes throughout the cycle. It is FDA-approved for the prevention of pregnancy in women who elect to use this product as their method of contraception.
Multiple generic and brand equivalents exist with identical active ingredients, including Alyacen 1/35, Cyclafem 1/35, Dasetta 1/35, Pirmella 1/35, and Nylia 1/35. Nortrel 1/35 is not a controlled substance and can be prescribed by any licensed healthcare provider.
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Nortrel 1/35 21 Day prevents pregnancy through three complementary mechanisms. The primary mechanism is suppression of ovulation: the norethindrone and ethinyl estradiol components suppress gonadotropins (LH and FSH) from the pituitary gland, preventing the ovaries from releasing an egg. Without ovulation, fertilization cannot occur.
The norethindrone component also causes the cervical mucus to become thick and hostile to sperm, providing a secondary barrier that prevents sperm from reaching any egg. Additionally, both hormones alter the endometrial lining of the uterus, making it thinner and less receptive to implantation should fertilization somehow occur.
When taken correctly — one tablet daily for 21 consecutive days at the same time each day — Nortrel 1/35 21 Day is more than 99% effective at preventing pregnancy. The 7-day pill-free interval is carefully calibrated to allow withdrawal bleeding while preventing follicle development from reaching the point of ovulation.
norethindrone 1 mg / ethinyl estradiol 0.035 mg — tablet
21 active yellow tablets per pack. One tablet daily for 21 days, then 7-day pill-free interval.
Nortrel 1/35 21 Day is not on the FDA's official drug shortage list as of 2026. However, patients regularly report difficulty finding it at their local pharmacy. This happens for two main reasons: first, pharmacies stock only one or two of the many equivalent generics (Alyacen, Cyclafem, Dasetta, Pirmella, Nylia 1/35), and second, the 21-day pack format is less commonly stocked than the 28-day equivalent.
Most patients can resolve the access issue by asking their doctor to write a prescription for the generic name (norethindrone/ethinyl estradiol 1 mg/0.035 mg) with substitution permitted, which allows the pharmacist to dispense whichever equivalent is in stock. Trying different pharmacy chains — including independent pharmacies and grocery store pharmacies — often yields results.
If you're having trouble finding Nortrel 1/35 21 Day, medfinder can call pharmacies near you to find which ones have it in stock. Results are sent by text, saving you time and frustration.
Nortrel 1/35 21 Day is not a controlled substance, so it can be prescribed by any licensed prescriber without DEA registration requirements or special scheduling. Any provider who can write prescriptions can prescribe this medication.
OB/GYNs (obstetricians and gynecologists) — most common prescribers
Primary care physicians (family medicine, internal medicine)
Nurse practitioners (NPs) and physician assistants (PAs)
Certified nurse-midwives (CNMs)
Telehealth providers (Nurx, Hers, Wisp, Planned Parenthood Direct, and others)
Nortrel 1/35 21 Day is widely available via telehealth platforms in all 50 states, making it one of the most accessible prescription medications. Many platforms can issue a prescription after a brief online questionnaire, with same-day e-prescribing to your pharmacy.
No. Nortrel 1/35 21 Day is not a controlled substance. It is not scheduled by the DEA and carries no Schedule II, III, IV, or V classification. Nortrel 1/35 21 Day is a prescription medication that can be prescribed by any licensed healthcare provider — including OB/GYNs, primary care physicians, nurse practitioners, physician assistants, and telehealth providers — in all 50 states.
Because it is not a controlled substance, there are no special refill restrictions, no DEA monitoring requirements, and no limits on early refills beyond standard pharmacy and insurance policies. Prescriptions can be written for up to a 12-month supply at a time in many states, and the medication can be prescribed via telehealth without in-person examination in most states.
Most side effects are mild and often resolve after the first 2–3 months of use:
Nausea (especially in the first weeks; take with food or at bedtime)
Breast tenderness or swelling
Spotting or breakthrough bleeding between periods
Headache
Mood changes or decreased libido
Bloating or mild fluid retention
Skin darkening (chloasma) in sun-exposed areas
Blood clots (DVT or pulmonary embolism): leg pain/swelling, chest pain, shortness of breath
Stroke: sudden weakness/numbness, severe headache, vision changes, confusion
Heart attack: chest pain, jaw or arm pain, sweating, shortness of breath
Jaundice (yellowing of skin/eyes): may signal liver problems
Severe abdominal pain: possible gallbladder or liver issue
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Dasetta 1/35
Identical generic — norethindrone 1 mg / ethinyl estradiol 0.035 mg, 28-day pack. Widely stocked at major pharmacy chains.
Alyacen 1/35
Identical generic — same active ingredients, 28-day format. FDA-rated therapeutically equivalent to Nortrel 1/35.
Sprintec
Norgestimate 0.25 mg / ethinyl estradiol 0.035 mg. Different progestin (norgestimate) with lower androgenic activity; widely available.
Junel 1/20
Norethindrone acetate 1 mg / ethinyl estradiol 0.02 mg. Same progestin class, lower estrogen dose; good for estrogen-sensitive patients.
Slynd
Drospirenone 4 mg progestin-only pill. Good for patients with estrogen contraindications; larger missed-dose window than traditional minipills.
Prefer Nortrel 1/35 21 Day? We can find it.
Rifampin (rifampicin)
majorStrong enzyme inducer — significantly reduces norethindrone and ethinyl estradiol blood levels, potentially reducing contraceptive efficacy. Use backup contraception.
Ombitasvir/paritaprevir/ritonavir (Viekira Pak)
majorContraindicated — concurrent use causes significant ALT elevations. Switch to non-estrogen-containing contraceptive during Hepatitis C treatment.
Phenytoin, carbamazepine, phenobarbital, topiramate
majorAntiepileptic enzyme inducers — reduce OCP hormone levels, potentially reducing effectiveness. Use backup contraception; consider alternative AEDs or non-hormonal contraception.
St. John's Wort
moderateHerbal enzyme inducer — reduces hormone levels and contraceptive effectiveness. Avoid concurrent use.
Lamotrigine (Lamictal)
moderateOCPs significantly reduce lamotrigine plasma levels; stopping OCPs can cause lamotrigine levels to spike. Requires close monitoring with neurologist.
Aromatase inhibitors (anastrozole, exemestane)
majorEstrogen in OCPs counteracts aromatase inhibitor effects used in breast cancer treatment. Combination generally contraindicated.
Nortrel 1/35 21 Day is a safe, effective, and widely used combination oral contraceptive. While it is not in an official FDA shortage, patients may encounter difficulty finding it at their specific pharmacy due to the fragmented generic birth control market and the lower stocking rate of 21-day pack formats. The good news: multiple identical generic equivalents exist, and working with your provider to allow generic substitution solves most access problems quickly.
For cost savings, ACA coverage provides $0 out-of-pocket for most insured patients. GoodRx coupons bring the price as low as $20.92 for those without coverage. And for those who repeatedly struggle with access, a pharmacist or telehealth provider consultation about a 28-day equivalent pack or a long-acting contraceptive may be the right next step.
If you need help finding Nortrel 1/35 21 Day in stock at a pharmacy near you, medfinder calls pharmacies on your behalf and texts you the results — so you know exactly where to go without sitting 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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