Microgestin vs. Apri

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

Key Takeaways

  • Both Microgestin and Apri are combination oral contraceptives that prevent pregnancy by pairing estrogen with a progestin, but the progestins differ and carry different side effect profiles.

  • Microgestin uses norethindrone acetate and comes in two strengths with several pack-length options, while Apri uses desogestrel in a single, standardized 28-day regimen.

  • Microgestin's FDA label lists specific side effect rates from clinical trials, while Apri's label does not quantify exact rates for its most common reactions like nausea and headache.

Microgestin vs. Apri Drug Summary

Microgestin

Microgestin is a combination oral contraceptive that pairs norethindrone acetate with ethinyl estradiol to prevent pregnancy. It is taken once daily, in either a 21-day pack or a 28-day pack that adds a week of iron tablets.

Apri

Apri is a combination oral contraceptive that pairs desogestrel with ethinyl estradiol to prevent pregnancy. It is taken once daily in a 28-day pack with 21 active tablets followed by 7 inert tablets.

Microgestin vs. Apri Side Effects

Microgestin

Most common
Headache (up to 6.3%)
Nausea (up to 4.6%)
Vaginal candidiasis (up to 6.1%)
Menstrual cramps (up to 4.4%)

Apri

Most common
Headache (rate n/a)
Nausea (rate n/a)
Breakthrough bleeding (rate n/a)
Breast tenderness (rate n/a)

Microgestin vs. Apri Dosage

Microgestin

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 1 mg/20 mcg once daily Days 1-21
Maximum dose 75 mg ferrous fumarate/day Days 22-28
Dose changes 2 increases Every 21 days

Apri

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 1 active tablet daily Days 1-21
Maximum dose 1 inert tablet daily Days 22-28
Dose changes 1 increase Every 21 days

Microgestin vs. Apri Indications

Microgestin

Microgestin is FDA-approved to prevent pregnancy in women who choose oral contraceptives. It combines a synthetic progestin, norethindrone acetate, with ethinyl estradiol to suppress ovulation. It is not approved to prevent sexually transmitted infections, including HIV.

  • Prevents pregnancy through combined hormonal contraception

  • Available in 21-day, 28-day, and 24-day iron-supplemented (Fe) packs

  • Two dose strengths (1 mg/20 mcg and 1.5 mg/30 mcg) for flexible dosing

  • Does not protect against sexually transmitted infections

Apri

Apri is FDA-approved to prevent pregnancy in women who choose oral contraceptives. It combines desogestrel, a low-androgenic progestin, with ethinyl estradiol to suppress ovulation. It does not protect against HIV or other sexually transmitted infections.

  • Prevents pregnancy through combined hormonal contraception

  • Taken as a 28-day pack with 21 active and 7 inert tablets

  • Generic equivalent of the brand-name pill Ortho-Cept

  • Does not protect against sexually transmitted infections

Microgestin vs. Apri Pros and Cons

Microgestin

Microgestin has been available since 1968, giving it one of the longest safety track records among oral contraceptives. It comes in two estrogen doses and several pack lengths, letting clinicians tailor the regimen to individual patients.

Pros

  • Over 50 years of clinical use and accumulated safety data

  • Available in two strengths (1/20, 1.5/30) and multiple pack lengths

  • Generally less expensive: about $20 to $50 per month without insurance, versus $30 to $99 for Apri

Cons

  • Norethindrone has more androgenic activity, which may worsen acne in some users

  • Requires attention to which pack variant (21-day vs 24 Fe) is prescribed

  • Higher documented rate of vaginal candidiasis in clinical trials

Apri

Apri has been available since 1999 and uses desogestrel, a progestin with lower androgenic activity than norethindrone. It follows a single, standardized 28-day dosing schedule without alternate strength options.

Pros

  • Desogestrel's low androgenic activity may mean fewer acne or hair-growth effects

  • Single consistent dosing regimen simplifies pill-pack instructions

  • Well-established generic equivalent with a long market history

Cons

  • Typically costs more out-of-pocket: roughly $30 to $99 per month without insurance, compared with $20 to $50 for Microgestin

  • FDA labeling does not quantify exact side effect rates, making comparison less precise

  • Only one standard formulation, without alternative strengths like Microgestin's 1.5/30

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