Ortho Tri-Cyclen vs. Mirena
See how Ortho Tri-Cyclen and Mirena compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Ortho Tri-Cyclen is a daily pill that also treats moderate acne, while Mirena is a device placed once and left in for years.
Mirena requires a clinical insertion and removal procedure, while Ortho Tri-Cyclen relies on remembering a pill every day.
Both prevent pregnancy effectively, but Mirena additionally treats heavy menstrual bleeding for up to 5 years.
Ortho Tri-Cyclen vs. Mirena Drug Summary
Ortho Tri-Cyclen
Ortho Tri-Cyclen is a triphasic combination oral contraceptive containing norgestimate and ethinyl estradiol, taken once a day for 28 days (21 active tablets, 7 placebo). It prevents pregnancy and is also FDA approved to treat moderate acne in females 15 and older who want oral contraception.
Mirena
Mirena is a progestin-releasing intrauterine system placed inside the uterus by a clinician, where it releases levonorgestrel locally for up to 8 years. It prevents pregnancy and is also FDA approved to treat heavy menstrual bleeding for up to 5 years in women using it for contraception.
Ortho Tri-Cyclen vs. Mirena Side Effects
Ortho Tri-Cyclen
Mirena
Ortho Tri-Cyclen vs. Mirena Dosage
Ortho Tri-Cyclen
Mirena
| 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 |
| STAGE | DOSE | WHEN |
| Starting dose | ~21 mcg/day LNG release | Day 24 |
| Maximum dose | ~7 mcg/day LNG release | If needed |
| Dose changes | 2 increases | As tolerated |
Ortho Tri-Cyclen
| 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 |
Mirena
| STAGE | DOSE | WHEN |
| Starting dose | ~21 mcg/day LNG release | Day 24 |
| Maximum dose | ~7 mcg/day LNG release | If needed |
| Dose changes | 2 increases | As tolerated |
Ortho Tri-Cyclen vs. Mirena Indications
Ortho Tri-Cyclen
Ortho Tri-Cyclen is approved to prevent pregnancy and to treat moderate acne in females at least 15 years old who also want contraception. It is not approved as emergency contraception and is not recommended for women over 35 who smoke.
Prevention of pregnancy
Treatment of moderate acne in females 15 and older
Once-daily oral tablet
Requires daily adherence for full effectiveness
Mirena
Mirena is approved to prevent pregnancy for up to 8 years and to treat heavy menstrual bleeding for up to 5 years in women who choose it for contraception. It is not approved as emergency contraception and must not be used during pregnancy or active pelvic infection.
Prevention of pregnancy for up to 8 years
Treatment of heavy menstrual bleeding for up to 5 years
Placed once by a clinician
No daily dosing to remember
Ortho Tri-Cyclen vs. Mirena Pros and Cons
Ortho Tri-Cyclen
Ortho Tri-Cyclen offers dual benefit as a contraceptive and an acne treatment, and effects reverse quickly after stopping. Because it depends on daily use, its real-world effectiveness is more sensitive to missed pills than a long-acting device.
Pros
Also treats moderate acne, unlike Mirena
Effects stop quickly after discontinuing the pill
No insertion or removal procedure needed
Generic versions cost as little as $10 to $25 per month, far less than Mirena's $900 to $1,725 one-time device cost
Cons
Must be taken at the same time every day to stay effective
Contraindicated in women over 35 who smoke
Carries an increased risk of blood clots
Does not treat heavy menstrual bleeding
Mirena
Mirena removes the daily-adherence burden by delivering hormone locally for years at a time, and it is the only hormonal IUD approved to also treat heavy menstrual bleeding. That convenience comes with a clinical insertion procedure and device-specific risks not seen with a pill.
Pros
No daily pill to remember for up to 8 years
Also treats heavy menstrual bleeding for up to 5 years
Lower chance of user error than a daily pill
One placement lasts for years instead of monthly refills
Cons
Requires a clinician to insert and remove the device
Carries a risk of uterine perforation or device expulsion
Upfront cash cost of $900 to $1,725 per device before insurance
Does not treat acne
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