Apri vs. Kyleena

See how Apri and Kyleena compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Apri is a daily oral contraceptive pill, while Kyleena is a long-acting IUD placed once and left in for up to 5 years.

  • Apri requires consistent daily dosing to stay effective, while Kyleena works continuously without any daily action once placed.

  • Both prevent pregnancy but through different mechanisms: Apri combines estrogen and progestin taken by mouth, while Kyleena releases a low, mostly local dose of progestin only.

Apri vs. Kyleena Drug Summary

Apri

Apri is a combination oral contraceptive containing desogestrel and ethinyl estradiol, used to prevent pregnancy. It comes as a 28-day pack of 21 active tablets and 7 inactive tablets, taken once daily at the same time. It has been FDA approved since 1999.

Kyleena

Kyleena is a levonorgestrel-releasing intrauterine device used to prevent pregnancy for up to 5 years. It is a single device placed in the uterus by a clinician and releases a low, mostly local hormone dose. It has been FDA approved since 2016.

Apri vs. Kyleena Side Effects

Apri

Most common
Headache (up to 20%)
Nausea (up to 14%)
Breast tenderness (up to 11%)
Dysmenorrhea (up to 10%)

Kyleena

Most common
Vulvovaginitis (up to 24%)
Ovarian cysts (up to 22%)
Abdominal/pelvic pain (up to 21%)
Headache/migraine (up to 15%)

Apri vs. Kyleena Dosage

Apri

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 1 tablet once daily At the start
Maximum dose 1 tablet once daily Same as starting
Dose changes None Fixed dose

Kyleena

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 19.5 mg IUS, one device At the start
Maximum dose 19.5 mg IUS, one device Same as starting
Dose changes None Fixed dose

Apri vs. Kyleena Indications

Apri

Apri is a combination birth control pill that prevents pregnancy by suppressing ovulation and thickening cervical mucus. It combines desogestrel and ethinyl estradiol in a daily tablet. It is not approved to protect against HIV or other sexually transmitted infections.

  • Prevention of pregnancy in women who choose oral contraceptives

  • Not approved for prevention of HIV or STIs

  • Requires daily dosing for effectiveness

  • Reversible quickly after stopping the pill

Kyleena

Kyleena is a hormonal IUD that releases a low, mostly local dose of levonorgestrel to prevent pregnancy for up to 5 years. It thickens cervical mucus and thins the uterine lining, with minimal hormone reaching the rest of the body. It is not approved for emergency contraception or use before a first period.

  • Prevention of pregnancy for up to 5 years per device

  • Not approved for emergency contraception

  • Not approved for use before first menstrual period

  • Inserted once by a clinician, no daily action needed

Apri vs. Kyleena Pros and Cons

Apri

Apri offers flexible, reversible contraception without any procedure, but effectiveness depends on taking a pill at the same time every day. Its desogestrel component has minimal androgenic activity, which may be gentler on skin than some other progestins. As a monthly prescription, costs and pharmacy visits recur over time.

Pros

  • No clinical procedure needed to start or stop

  • Desogestrel has minimal androgenic activity, may help acne

  • Widely covered by insurance as a standard pill

  • Fertility typically returns quickly after stopping

Cons

  • Must be taken at the same time every day to work well

  • Increased clot risk, especially with smoking after 35

  • Monthly refills mean ongoing cost and pharmacy visits

  • Higher monthly cost than Kyleena's average ($30-$99 vs $20-$24)

Kyleena

Kyleena removes the need for daily action once it's placed, delivering a low, mostly local hormone dose for up to 5 years. It requires a clinical insertion and removal, and irregular bleeding is common at first. Because one device lasts years, its average monthly cost tends to work out lower than a pill filled every month.

Pros

  • One placement lasts up to 5 years, no daily action needed

  • Averages to a lower monthly cost over time ($20-$24 vs $30-$99)

  • Hormone acts mostly locally, limiting systemic exposure

  • No risk of missed doses affecting effectiveness

Cons

  • Requires an in-clinic insertion and removal procedure

  • Small risk of uterine perforation during insertion

  • Irregular bleeding or spotting common in early months

  • Small risk of expulsion or device displacement

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