Lo Loestrin Fe vs. Depo-Provera

See how Lo Loestrin Fe and Depo-Provera compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Lo Loestrin Fe is a daily pill with the lowest estrogen dose among FDA-approved oral contraceptives, while Depo-Provera is an injection given every three months.

  • Depo-Provera carries a boxed warning for bone density loss with long-term use, while Lo Loestrin Fe carries a boxed warning for cardiovascular risk in smokers over 35.

  • Both prevent pregnancy but do not protect against sexually transmitted infections, and their side effect profiles differ substantially in type and frequency.

Lo Loestrin Fe vs. Depo-Provera Drug Summary

Lo Loestrin Fe

Lo Loestrin Fe is a combination oral contraceptive containing the lowest dose of estrogen (10 mcg) among FDA-approved birth control pills. It combines norethindrone acetate, ethinyl estradiol, and iron, and is taken once daily in a 28-day pack to prevent pregnancy.

Depo-Provera

Depo-Provera is a progestin-only contraceptive given as an intramuscular injection once every three months. It contains no estrogen and works by suppressing ovulation, making it an option for people who cannot take estrogen-containing birth control.

Lo Loestrin Fe vs. Depo-Provera Side Effects

Lo Loestrin Fe

Most common
headache (up to 7%)
nausea/vomiting (up to 7%)
bleeding irregularities (up to 5%)
dysmenorrhea (up to 4%)

Depo-Provera

Most common
headache (up to 17%)
nervousness (up to 11%)
dizziness (up to 6%)
decreased libido (up to 5%)

Lo Loestrin Fe vs. Depo-Provera Dosage

Lo Loestrin Fe

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 1 mg/10 mcg once daily Days 1-24
Maximum dose 75 mg ferrous fumarate Days 27-28
Dose changes 2 increases As tolerated

Depo-Provera

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 150 mg IM injection At the start
Maximum dose 150 mg IM injection Same as starting
Dose changes None Fixed dose

Lo Loestrin Fe vs. Depo-Provera Indications

Lo Loestrin Fe

Lo Loestrin Fe is FDA-approved to prevent pregnancy in women who choose oral contraceptives. It is sometimes used off-label to help manage acne or other hormone-related symptoms.

  • Prevents pregnancy with a daily pill

  • Lowest estrogen dose of any FDA-approved oral contraceptive

  • Off-label use for acne or hormonal symptom management

  • Does not protect against sexually transmitted infections

Depo-Provera

Depo-Provera is FDA-approved to prevent pregnancy through a quarterly injection. It is not intended for long-term use beyond two years unless other contraceptive options are inadequate, due to the risk of bone loss.

  • Prevents pregnancy with a quarterly injection

  • Only FDA-approved use is pregnancy prevention

  • Not recommended beyond 2 years due to bone density risk

  • Does not protect against sexually transmitted infections

Lo Loestrin Fe vs. Depo-Provera Pros and Cons

Lo Loestrin Fe

Lo Loestrin Fe offers the lowest estrogen dose of any FDA-approved combination pill, which may reduce estrogen-related side effects for some users. It requires daily adherence and carries the class-wide cardiovascular risks associated with combination hormonal contraceptives, especially in smokers over 35.

Pros

  • Lowest daily estrogen dose among approved oral contraceptives

  • Shorter hormone-free interval may improve cycle regulation

  • Can be stopped at any time without a procedure

  • May help manage acne as an off-label benefit

Cons

  • Requires daily adherence with no missed doses

  • Boxed warning for cardiovascular risk in smokers over 35

  • Contraindicated with uncontrolled hypertension

  • Higher list price, roughly $171 to $1,017 per month, than Depo-Provera

Depo-Provera

Depo-Provera offers convenience with an injection needed only every three months, appealing to those who struggle with daily pill schedules. It carries a boxed warning for bone mineral density loss with prolonged use and is not recommended as a long-term method beyond two years.

Pros

  • Only requires an injection every 3 months

  • Progestin-only option for those who cannot take estrogen

  • No daily action needed, reducing user error

  • Substantially lower cost, roughly $20 to $45 per month equivalent, than Lo Loestrin Fe

Cons

  • Boxed warning for bone mineral density loss with prolonged use

  • Not recommended for use beyond 2 years

  • Nervousness reported in up to 11% of users

  • Dizziness reported in up to 6% of users

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