Comprehensive medication guide to Opill 28 Day including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0 if your provider writes a prescription and your insurance covers it under the ACA contraceptive mandate; some CVS Caremark plans cover OTC Opill at $0 without a prescription. Without coverage, retail OTC price applies at $15–$20/month.
Estimated Cash Pricing
$19.99 retail for a 28-tablet (1-month) pack; as low as $15/month when purchasing the 6-month (168-tablet) pack for $89.99 at opill.com or GoodRx. Walmart sells the 28-pack for approximately $18.97.
Medfinder Findability Score
82/100
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Opill 28 Day (norgestrel 0.075 mg) is the first FDA-approved over-the-counter daily oral contraceptive in the United States. Manufactured by Perrigo, it became available on pharmacy shelves nationwide in March 2024 after receiving FDA OTC approval on July 13, 2023. No prescription is required, and there is no age restriction to purchase it.
Opill is a progestin-only pill (POP), sometimes called a minipill, because it contains only one hormone — norgestrel — with no estrogen. Each pack contains 28 active tablets with no placebo pills. It has a well-established safety record spanning over 50 years, as norgestrel was first approved as a prescription contraceptive in 1973.
Opill is available at CVS, Walgreens, Walmart, Target, Kroger, and other major retailers, as well as online at opill.com, Amazon, and GoodRx. It is not a controlled substance and requires no special documentation to purchase.
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Opill 28 Day works primarily by thickening the cervical mucus — the natural secretion produced by the cervix. Norgestrel keeps this mucus in a thick, sticky state throughout the month, creating a physical barrier that makes it very difficult for sperm to penetrate the cervix and reach an egg. This cervical mucus thickening is the primary and most consistent mechanism of action.
As a secondary mechanism, norgestrel thins the endometrial lining (the uterine lining), making it less receptive to implantation in the unlikely event that fertilization occurs. Additionally, Opill partially suppresses ovulation in approximately 50% of cycles — though this effect is inconsistent and varies by individual, unlike combination birth control pills which reliably suppress ovulation in nearly all cycles.
Because Opill's protection depends primarily on maintaining consistent norgestrel blood levels, strict daily timing is critical. Opill must be taken within the same 3-hour window every day. If taken more than 3 hours late, backup contraception should be used for 48 hours. With perfect use, Opill is approximately 98% effective at preventing pregnancy.
0.075 mg — tablet
One tablet taken orally once daily at the same time each day. Each 28-day pack contains 28 active tablets — no placebo pills.
Opill 28 Day is not in a national FDA drug shortage as of 2026. It is manufactured by Perrigo and broadly available at major pharmacy chains (CVS, Walgreens), big-box retailers (Walmart, Target), grocery stores, and online (opill.com, Amazon, GoodRx). For most patients, especially those willing to order online, Opill is readily accessible.
However, localized stockouts do occur — particularly in rural areas, at smaller-format stores, or during periods of increased demand. Some stores also keep Opill in locked security cases or behind the pharmacy counter, where it may not be immediately visible on an open shelf. A 2024 KFF survey found that only 26% of women ages 18-49 had even heard of Opill, suggesting the product is still building retail distribution in some markets.
If you're having trouble finding Opill in stock near you, medfinder is a service that calls pharmacies near you to check real-time availability and texts you results — saving you from making calls yourself.
Opill 28 Day does not require a prescription — it is a fully OTC medication available to anyone without a doctor's visit or DEA registration. However, obtaining a prescription for Opill (even though it is OTC) may allow patients to have it covered by health insurance under the ACA contraceptive mandate.
Any licensed prescriber can write a prescription for norgestrel 0.075 mg (Opill), including:
OB/GYNs (obstetricians and gynecologists)
Primary care physicians (PCPs) — family medicine and internal medicine
Nurse practitioners (NPs) — prescribing authority in all 50 states
Physician assistants (PAs) — prescribing authority in all 50 states
Certified nurse midwives (CNMs)
Telehealth platforms such as Planned Parenthood Direct, Hey Jane, Nurx, and PRJKT RUBY can prescribe Opill quickly — often same-day — after a brief health history review conducted online. Since Opill is not a controlled substance, there are no telehealth prescribing restrictions that apply.
No. Opill 28 Day (norgestrel 0.075 mg) is not a controlled substance. It is not listed on any DEA schedule and requires no special prescription, DEA registration, or government documentation to purchase or dispense.
As an FDA-approved OTC medication, Opill can be purchased by anyone of any age without a prescription or ID at pharmacies, grocery stores, and big-box retailers. There are no refill restrictions, quantity limits on purchases, or monitoring programs associated with Opill. It can also be ordered online and shipped discreetly to your home without a prescription.
Most Opill side effects are mild and tend to improve after 2–3 months as your body adjusts to the hormone. Common side effects include:
Irregular menstrual bleeding, spotting, or missed periods (most common)
Headaches (usually mild)
Dizziness
Nausea (taking with food or at bedtime may help)
Increased appetite
Abdominal pain, cramps, or bloating
Breast tenderness (usually resolves within 1–2 months)
Mild mood changes
Severe or one-sided lower abdominal pain: May indicate ectopic pregnancy — a medical emergency
Liver problems: Jaundice, dark urine, severe upper right abdominal pain
Severe allergic reaction: Hives, facial swelling, difficulty breathing (Opill contains FD&C Yellow No. 5)
Importantly, Opill does NOT increase the risk of blood clots, stroke, or high blood pressure — unlike estrogen-containing combination birth control pills.
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Norethindrone (Errin, Camila, Heather)
Prescription progestin-only pill with same 3-hour timing window; $10–$30/month cash, often $0 with insurance under ACA mandate. Very similar clinical profile to Opill.
Slynd (Drospirenone 4 mg)
Prescription progestin-only pill with a forgiving 24-hour missed-pill window; suppresses ovulation more consistently; $30–$60/month for generic. Anti-androgenic properties.
Nexplanon (Etonogestrel Implant)
Long-acting reversible contraceptive implant lasting up to 3 years; over 99% effective; requires office visit for insertion/removal; not affected by drug interactions that reduce pill effectiveness.
Hormonal IUD (Mirena, Liletta, Kyleena)
Progestin-releasing intrauterine device lasting 5–8 years; over 99% effective; local hormone delivery with minimal systemic exposure; office visit required for insertion.
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Carbamazepine (Tegretol)
majorCYP3A4 inducer — significantly reduces norgestrel blood levels, may cause contraceptive failure. Use non-hormonal or long-acting alternative contraception.
Phenytoin (Dilantin)
majorCYP3A4 inducer — reduces norgestrel effectiveness. Do not rely on Opill as primary contraception while taking phenytoin.
Rifampin (Rifadin)
majorPotent CYP3A4 inducer — dramatically reduces norgestrel levels. Use non-hormonal contraception during rifampin treatment and for 28 days after stopping.
St. John's Wort
moderateCYP3A4 inducer — reduces norgestrel blood levels over time. Use backup contraception consistently if taking St. John's Wort.
Ulipristal Acetate (ella)
majorDo not start Opill within 5 days of taking ella emergency contraceptive — reduces efficacy of both agents.
GLP-1 Receptor Agonists (Semaglutide, Orforglipron)
moderateDelayed gastric emptying may reduce Opill absorption. Use backup contraception for 4 weeks after initiating GLP-1 therapy.
Efavirenz (Sustiva)
majorCYP3A4 inducer used for HIV — reduces norgestrel levels. Discuss alternative contraception with provider.
Opill 28 Day represents a major advance in contraceptive access in the United States. As the first OTC daily birth control pill, it removes prescription barriers for millions of people — particularly adolescents, uninsured patients, and those in areas with limited access to reproductive healthcare. With a 50-year safety record and 98% perfect-use effectiveness, it is a clinically proven contraceptive option.
Cost remains a challenge for some patients. At $19.99/month OTC without insurance, it can cost $240/year — more than some prescription alternatives covered at $0 by insurance. Getting a provider to write a prescription for Opill, using HSA/FSA funds, or accessing the Perrigo donation program through a participating clinic are the best options for reducing cost.
If you're having trouble locating Opill near you, medfinder is a service that contacts pharmacies in your area to check real-time stock and texts you results. Whether you're looking for Opill or any other medication, medfinder helps you find what you need without making calls yourself.
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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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