Comprehensive medication guide to Zafemy 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 insured patients under the ACA contraceptive mandate; some grandfathered or religious-exemption plans may charge a copay. Prior authorization occasionally required.
Estimated Cash Pricing
Retail price averages $132 for a 3-patch (one-month) supply; as low as $46.97 with a GoodRx coupon at participating pharmacies for a 30-day supply.
Medfinder Findability Score
72/100
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Zafemy is a generic prescription birth control patch that delivers two synthetic hormones through your skin once a week. It contains norelgestromin (a progestin) and ethinyl estradiol (a synthetic estrogen) — the same active ingredients that were in the original brand-name patch Ortho Evra, which is no longer manufactured. Zafemy is made by Amneal Pharmaceuticals LLC and was FDA-approved in 2021.
Zafemy belongs to the drug class of combination hormonal contraceptives (CHCs). Each patch is 12.5 cm² and delivers 150 mcg/day norelgestromin and 35 mcg/day ethinyl estradiol. It is FDA-approved for the prevention of pregnancy in females with a BMI under 30 kg/m² for whom combined hormonal contraception is appropriate. When used correctly, Zafemy is approximately 99% effective at preventing pregnancy.
Xulane is the only other generic birth control patch on the U.S. market. It contains the same hormones as Zafemy at the same daily dose but in a slightly larger patch (14 cm²). The FDA considers Zafemy and Xulane therapeutically equivalent (AB-rated).
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Zafemy prevents pregnancy through three complementary mechanisms. The primary mechanism is suppression of ovulation: the progestin (norelgestromin) reduces pituitary release of LH (luteinizing hormone) and FSH (follicle-stimulating hormone), preventing the ovary from releasing an egg. Without an egg, fertilization cannot occur.
As secondary mechanisms, Zafemy thickens cervical mucus (making it harder for sperm to reach any egg that might be released) and alters the uterine lining (endometrium), making it less receptive to implantation. Together, these three mechanisms provide highly effective contraception when the patch is changed correctly each week.
Hormones are delivered via a matrix-based transdermal system embedded in the 12.5 cm² patch. Because delivery bypasses the liver's first-pass metabolism, the total estrogen exposure (AUC) is approximately 60% higher than with a 35-mcg oral contraceptive pill — an important pharmacokinetic distinction that affects side effect and risk profiles.
150 mcg norelgestromin / 35 mcg ethinyl estradiol per day — transdermal patch
One 12.5 cm² patch worn for 7 days; changed weekly for 3 weeks, then 1 patch-free week. Comes in boxes of 3 patches (one month supply).
Zafemy is not listed on the FDA Drug Shortage Database as of 2026 and is not in a national shortage. However, localized availability gaps are common. Zafemy is manufactured solely by Amneal Pharmaceuticals, which means its distribution is more limited than that of Xulane (the competing generic patch made by Viatris, with a wider distribution network). Some chain pharmacies preferentially stock Xulane, and low local demand can lead individual pharmacies to not carry Zafemy at all.
Patients who have trouble finding Zafemy at their usual pharmacy should try calling independent pharmacies (which can often place special orders within 1–3 days), checking mail-order services like Amazon Pharmacy, or asking their prescriber to switch to the bioequivalent Xulane if availability is persistently poor in their area.
The fastest way to find Zafemy in stock is to use medfinder — a paid service that calls pharmacies near you and texts you which ones have your medication ready to fill. This eliminates the need to call pharmacy after pharmacy on your own.
Zafemy is not a controlled substance and has no DEA scheduling requirements. Any licensed healthcare provider authorized to prescribe medications in their state can write a Zafemy prescription. Prescribers will review the patient's medical history for contraindications (BMI, smoking status, cardiovascular risk factors, liver disease) before prescribing.
OB/GYNs (obstetricians/gynecologists) — most common prescribers with deepest contraceptive counseling expertise
Primary care physicians (family medicine, internal medicine)
Nurse practitioners (NPs) and physician assistants (PAs) — licensed to prescribe in all 50 states
Certified nurse-midwives (CNMs)
Zafemy can also be prescribed via telehealth in all states, with no in-person visit requirement. Services such as Nurx, The Pill Club, and Planned Parenthood Direct offer online contraceptive consultations and can send the prescription directly to your pharmacy or mail the patch to your home.
No. Zafemy is not a controlled substance and is not scheduled by the DEA. It is a prescription medication, but it carries no special prescribing restrictions based on controlled substance scheduling. Any licensed prescriber — including physicians, nurse practitioners, physician assistants, and certified nurse-midwives — can write a prescription for Zafemy without any DEA registration or controlled substance-specific requirements.
Because Zafemy is not a controlled substance, it can also be prescribed via telehealth in all states without the in-person visit requirement that applies to controlled substances (like those regulated under the Ryan Haight Act). Patients can obtain a Zafemy prescription from telehealth services like Nurx, The Pill Club, or Planned Parenthood Direct without seeing a provider in person.
The following side effects were reported in 5% or more of patients in clinical trials. Most are mild to moderate and often improve after the first 1–3 cycles:
Breast symptoms (tenderness, discomfort, enlargement)
Nausea and/or vomiting
Headache
Application site reactions (skin irritation, redness at patch site)
Abdominal pain or cramping
Dysmenorrhea (painful periods during patch-free week)
Irregular vaginal bleeding or spotting (common in first 1–3 cycles)
Mood changes, anxiety, or affect disorders
Venous thromboembolism (DVT, pulmonary embolism) — leg pain/swelling, shortness of breath, chest pain
Stroke — sudden severe headache, one-sided weakness, trouble speaking, vision changes
Heart attack — chest pain, jaw pain, arm pain, sweating
Liver tumors or liver disease — jaundice, dark urine, severe abdominal pain
New-onset migraines with aura after starting Zafemy
Significant rise in blood pressure
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Xulane
FDA bioequivalent generic patch; same hormones (norelgestromin 150 mcg/day + EE 35 mcg/day) in a slightly larger 14 cm² patch. More widely stocked at chain pharmacies.
Twirla
Birth control patch with levonorgestrel and lower-dose ethinyl estradiol (30 mcg/day). Different progestin with a lower estrogen dose; also BMI-restricted.
NuvaRing / EluRyng
Monthly vaginal ring releasing etonogestrel and ethinyl estradiol. Similar hormone class to Zafemy; changed once monthly instead of weekly.
Combined oral contraceptives
Daily pills in many formulations. Widely available generics (e.g., Sprintec, norgestimate/EE) are inexpensive and universally stocked. Require daily adherence.
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Rifampin
majorPotent CYP3A4 inducer; significantly reduces Zafemy hormone levels and contraceptive effectiveness. Use alternative contraception during and for 28 days after rifampin.
Phenytoin / Carbamazepine / Topiramate (high dose)
majorAnticonvulsants that induce CYP3A4; may reduce contraceptive effectiveness. Use backup contraception. Consider non-hormonal methods for epilepsy patients.
Ombitasvir/paritaprevir/ritonavir (Hepatitis C regimen)
majorContraindicated with Zafemy. Coadministration can cause ALT elevations >5–20x ULN. Discontinue Zafemy before starting this HCV regimen; restart 2 weeks after completion.
St. John's Wort (Hypericum perforatum)
majorPotent CYP3A4 inducer herbal supplement. Can reduce Zafemy hormone levels and cause breakthrough bleeding or reduced contraceptive protection.
Lamotrigine (Lamictal)
moderateZafemy (combined hormonal contraceptives) significantly reduces lamotrigine blood levels, potentially causing breakthrough seizures. Neurologist must monitor and adjust lamotrigine dose.
HIV antiretrovirals (ritonavir-boosted regimens, efavirenz)
moderateVariable interactions; many reduce contraceptive hormone levels. Consult HIV specialist and OB/GYN before using Zafemy with ART. Consider long-acting reversible contraception.
Zafemy is a safe and effective generic birth control patch for eligible patients. It provides 99% effectiveness with perfect use, requires only a weekly patch change rather than a daily pill, and is covered at $0 by most insurance plans under the ACA. Its main limitations are the BMI restriction (contraindicated for BMI ≥ 30), the smoking/age restriction (contraindicated for women over 35 who smoke), and the slightly higher estrogen exposure compared to oral contraceptives.
Availability can be inconsistent at some pharmacies due to limited distribution through a single manufacturer. Patients who have difficulty filling Zafemy should ask about special ordering, consider mail-order pharmacy, or discuss switching to the bioequivalent Xulane with their prescriber.
If you're struggling to find Zafemy in stock near you, medfinder can call pharmacies in your area and text you which ones have your prescription ready to fill — saving you time and keeping your contraception uninterrupted.
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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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