Ortho Tri-Cyclen vs. Depo-Provera

See how Ortho Tri-Cyclen and Depo-Provera compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Ortho Tri-Cyclen is a daily combination pill that also treats moderate acne, while Depo-Provera is a progestin-only shot given every three months.

  • Depo-Provera carries a boxed warning for bone density loss with long-term use, a risk not listed for Ortho Tri-Cyclen.

  • Choosing between them often comes down to whether you prefer daily control with a pill or infrequent dosing with an injection.

Ortho Tri-Cyclen vs. Depo-Provera Drug Summary

Ortho Tri-Cyclen

Ortho Tri-Cyclen is a triphasic combination oral contraceptive containing norgestimate and ethinyl estradiol. It is taken once daily in a 28-day cycle of 21 active tablets followed by 7 placebo tablets, and it is also FDA-approved to treat moderate acne in women who want oral contraception.

Depo-Provera

Depo-Provera is a progestin-only contraceptive containing medroxyprogesterone acetate. It is given as an intramuscular injection once every three months instead of a daily pill, and it is approved only for preventing pregnancy.

Ortho Tri-Cyclen vs. Depo-Provera Side Effects

Ortho Tri-Cyclen

Most common
Abdominal pain (n/a)
Headache (n/a)
Breast pain (n/a)
Vaginal infection (n/a)

Depo-Provera

Most common
Abdominal pain (up to 11%)
Headache (up to 17%)
Menstrual changes (up to 57%)
Weight gain (up to 38%)

Ortho Tri-Cyclen vs. Depo-Provera Dosage

Ortho Tri-Cyclen

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 0.180 mg/0.035 mg daily Days 1-7
Maximum dose Placebo tablet daily Days 22-28
Dose changes 3 increases Every 7 days

Depo-Provera

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 150 mg every 3 months At the start
Maximum dose 150 mg every 3 months Same as starting
Dose changes None Fixed dose

Ortho Tri-Cyclen vs. Depo-Provera Indications

Ortho Tri-Cyclen

Ortho Tri-Cyclen prevents pregnancy through a combination of estrogen and progestin taken daily. It is also approved to treat moderate acne in females 15 and older who want oral contraception. It is not approved for women over 35 who smoke or for use as emergency contraception.

  • Prevents pregnancy when taken daily as directed

  • Treats moderate acne in women 15 and older who want birth control

  • Not approved for women over 35 who smoke

  • Not used as emergency contraception

Depo-Provera

Depo-Provera prevents pregnancy through a progestin-only injection given every three months. It has no other FDA-approved use, and it is not recommended as a long-term method beyond two years unless other options are inadequate.

  • Prevents pregnancy with an injection every 3 months

  • Not approved for any use besides contraception

  • Not recommended long-term (over 2 years) unless needed

  • Not started before the first menstrual period

Ortho Tri-Cyclen vs. Depo-Provera Pros and Cons

Ortho Tri-Cyclen

Ortho Tri-Cyclen offers a well-established combination option that is also FDA-approved for acne, and multiple generic versions are widely available. Its estrogen component means clot risk and smoking restrictions apply, and missed pills quickly raise pregnancy risk.

Pros

  • Also treats moderate acne, not just contraception

  • Gives daily control you can stop anytime

  • No needles or injections required

  • Widely available in low-cost generic versions

Cons

  • Requires remembering a pill every day

  • Not recommended for smokers over 35

  • Estrogen component adds clot risk

  • Missed doses quickly raise pregnancy risk

Depo-Provera

Depo-Provera offers convenient dosing every three months without a daily pill, using only a progestin. Its boxed warning for bone loss and high rate of menstrual changes are the main trade-offs for that convenience.

Pros

  • Only needs an injection every 3 months

  • No daily pill to remember or miss

  • Long real-world track record since the 1990s

  • Progestin-only, an option when estrogen is not suitable

Cons

  • Carries a boxed warning for bone density loss

  • Not recommended past 2 years unless needed

  • Menstrual irregularities are very common

  • Effects can't be reversed once injected

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