Apri vs. Skyla

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

Key Takeaways

  • Apri is a pill you take every day, while Skyla is a hormonal IUD placed once by a clinician and left in for up to three years.

  • Apri's effects reverse as soon as you stop taking it, while Skyla requires an in-office removal before fertility returns.

  • Neither Apri nor Skyla protects against HIV or other sexually transmitted infections, so barrier methods are still needed for that.

Apri vs. Skyla Drug Summary

Apri

Apri is a combination oral contraceptive containing desogestrel and ethinyl estradiol, used to prevent pregnancy. It comes in a 28-day pack of 21 active tablets and 7 inert ones, taken by mouth once a day at the same time.

Skyla

Skyla is a levonorgestrel-releasing intrauterine system used to prevent pregnancy for up to three years. It is placed once by a clinician directly in the uterus and needs no daily attention afterward.

Apri vs. Skyla Side Effects

Apri

Most common
breakthrough bleeding (up to 14%)
nausea (up to 5%)
headache (up to 5%)
breast tenderness (up to 3%)

Skyla

Most common
vulvovaginitis (up to 20%)
abdominal/pelvic pain (up to 19%)
acne/seborrhea (up to 15%)
ovarian cyst (up to 13%)

Apri vs. Skyla 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

Skyla

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 13.5 mg IUS, one insertion At the start
Maximum dose 13.5 mg IUS, one insertion Same as starting
Dose changes None Fixed dose

Apri vs. Skyla Indications

Apri

Apri is approved to prevent pregnancy in women who choose an oral contraceptive. It works by combining an estrogen and a progestin to suppress ovulation, and it is taken as one tablet a day for a full 28-day cycle. It is not intended to protect against sexually transmitted infections.

  • Prevents pregnancy in women choosing oral contraceptives

  • Taken once daily, same time each day, for cycle control

  • Not approved for prevention of HIV or other STIs

  • Suited to women who want control over starting or stopping

Skyla

Skyla is approved to prevent pregnancy for up to three years after a single insertion. It releases a low dose of levonorgestrel directly into the uterus, so there is nothing to remember day to day. It is not intended for emergency contraception or STI prevention.

  • Prevents pregnancy for up to 3 years after insertion

  • Single insertion procedure, no daily action needed

  • Not approved for emergency contraception or before menarche

  • Not approved for prevention of HIV or other STIs

Apri vs. Skyla Pros and Cons

Apri

Apri gives users direct, day-to-day control over their contraception, and its effects wear off quickly once tablets are stopped. As a long-available generic combination pill, it has a well-established safety record, though it depends on the user remembering a daily dose and carries some clot-related risks.

Pros

  • Effects reverse quickly after stopping the pill

  • No insertion procedure or in-office visit required

  • Desogestrel has minimal androgenic activity, less acne risk

  • Easy to adjust or discontinue without a clinician

Cons

  • Requires daily adherence; missed doses lower effectiveness

  • Contraindicated in women over 35 who smoke

  • Small increased risk of blood clots and stroke

  • Higher real-world failure rate than long-acting methods

Skyla

Skyla removes the need for daily action, protecting against pregnancy for up to three years from one insertion. It has a very low user-error failure rate, but placement and removal require a clinical visit, and it carries device-specific risks not seen with pills.

Pros

  • One insertion covers up to 3 years, no daily routine

  • Very low user-error failure rate compared to a daily pill

  • Efficacy data specifically studied in nulliparous women

  • Smallest, lowest-dose hormonal IUD currently available

Cons

  • Requires an in-office procedure for insertion and removal

  • Small risk of uterine perforation or device displacement

  • Small risk of ectopic pregnancy if pregnancy occurs with device in place

  • Shortest approved duration among levonorgestrel IUS options

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