Apri (Generic Ethinyl Estradiol-Desogestrel): Complete Medication Guide
Key Takeaways
Apri is a combination birth control pill containing ethinyl estradiol and desogestrel, taken once daily to prevent pregnancy.
Common side effects include nausea, breast tenderness, and headaches, which often improve after the first few months.
Serious side effects are rare but may include blood clots, stroke, or heart attack, especially in people who smoke.
Drug interactions with antibiotics, antiseizure medications, and certain supplements can reduce effectiveness.
This information is educational and does not replace advice from your healthcare provider.
Apri Overview
Apri is a combination oral contraceptive (birth control pill) that contains two hormones: ethinyl estradiol (an estrogen) and desogestrel (a progestin). This medication prevents pregnancy by stopping ovulation, thickening cervical mucus, and altering the uterine lining. Apri belongs to the class of monophasic birth control pills, meaning each active tablet contains the same dose of hormones throughout the pill pack.
The pill works by mimicking natural hormone levels in the body, which signals to the ovaries that ovulation should not occur. By preventing the release of an egg, pregnancy cannot happen. Apri also makes it harder for sperm to reach the uterus and implantation of a fertilized egg less likely.
Apri is used primarily for pregnancy prevention and is highly effective when taken consistently. Beyond contraception, some people use combination pills like Apri to manage heavy periods, reduce menstrual cramps, or treat acne. If you're considering hormonal contraceptives, discuss your personal and family health history with your healthcare provider to find the option that works best for you. Learn more about serious side effects of drospirenone ethinyl estradiol if you're comparing birth control options.
Side Effects
Most people tolerate Apri well, especially after the first few months of use. Side effects can vary depending on individual sensitivity to hormones and how long you've been taking the pill.
Common Side Effects
Nausea: Often mild and may decrease after the first 1-3 months; taking the pill with food can help.
Breast tenderness: Soreness or swelling of the breasts is common in the first weeks; usually resolves on its own.
Headaches: Tension headaches or migraines may occur, though these often improve over time.
Bloating: Mild water retention or abdominal bloating may happen early in the cycle.
Mood changes: Some people report mood swings, anxiety, or mild depression, though this is not common.
Spotting or breakthrough bleeding: Light bleeding between periods may happen, especially in the first few months.
Serious Side Effects
Blood clots (thromboembolism): Rare but serious; risk increases in smokers and those with certain genetic clotting disorders.
Stroke or heart attack: Very uncommon; risk is higher in people over 35 who smoke or have high blood pressure.
Liver problems: Yellowing of skin or eyes, severe abdominal pain, or dark urine may signal liver issues.
Severe allergic reactions: Rash, difficulty breathing, or swelling of face, lips, or throat require immediate attention.
Vision changes: Sudden vision loss or eye pain may indicate a serious problem and should be evaluated immediately.
When to Seek Medical Attention
Contact your healthcare provider right away if you experience sudden chest pain, shortness of breath, severe leg pain or swelling, sudden vision changes, severe headache with weakness, or yellowing of your skin and eyes. These symptoms may indicate a serious condition that needs prompt evaluation.
If you notice milder side effects like nausea or headaches that don't improve after 2-3 months, or if you develop new symptoms while taking Apri, call your doctor. They can help determine whether the side effect will resolve on its own or if switching to a different contraceptive might be better for you.
Dosage
Dose Level or Form |
Dose |
Key Detail |
Active tablets |
30 mcg ethinyl estradiol + 150 mcg desogestrel |
Take 1 tablet daily for 21 days |
Inactive tablets |
No active hormones |
Take 1 tablet daily for 7 days; menstruation occurs during this week |
Starting |
1 tablet daily |
Begin on Day 1 of menstrual cycle or as directed by provider |
Timing |
Same time each day |
Improves effectiveness and reduces breakthrough bleeding |
Drug Interactions
Certain medications and substances can reduce the effectiveness of Apri or increase the risk of side effects. It's important to inform your healthcare provider about all medications, supplements, and herbal products you take.
Antibiotics (Rifampin, Rifabutin)
These medications speed up the breakdown of hormones in Apri, making the pill less effective at preventing pregnancy. If you need these antibiotics, discuss backup contraception with your doctor and continue using it for at least 7 days after finishing the antibiotic course.
Antiseizure Medications (Phenytoin, Carbamazepine, Phenobarbital)
Antiseizure drugs increase hormone metabolism, potentially reducing Apri's contraceptive effectiveness. Your doctor may recommend a higher-dose pill or a non-hormonal backup method if you need seizure medications.
St. John's Wort (Herbal Supplement)
This popular herbal supplement for mood can reduce Apri's effectiveness by increasing hormone breakdown. Avoid taking St. John's Wort while on Apri, or use backup contraception if it's medically necessary.
Certain HIV and Hepatitis C Medications
Medications like protease inhibitors and some antivirals may reduce Apri's effectiveness or increase hormone side effects. Your healthcare provider can recommend the safest contraceptive option if you're taking these medications.
Acetaminophen and Ibuprofen
These over-the-counter pain relievers may slightly reduce Apri's effectiveness when used regularly, though occasional use is generally safe. If you use these medications frequently, discuss it with your provider.
Grapefruit Juice
Consuming large amounts of grapefruit juice may increase estrogen levels in your body, raising the risk of side effects. Occasional consumption is unlikely to cause problems, but regular intake should be discussed with your doctor.
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Pros and Cons
Pros
Highly effective at preventing pregnancy (over 99% when taken perfectly; about 91% with typical use).
Helps regulate menstrual cycles and may reduce period flow and cramping.
Can improve acne and reduce unwanted facial or body hair for some people.
Inexpensive and widely available with most insurance plans.
Reversible—fertility typically returns quickly after stopping the pill.
Cons
Requires daily adherence to be effective; missing doses increases pregnancy risk.
Does not protect against sexually transmitted infections (STIs); condoms are needed for protection.
May cause side effects like nausea, headaches, or mood changes in the first few months.
Carries a small increased risk of blood clots and cardiovascular events, especially in smokers.
May interact with other medications, reducing effectiveness or increasing side effect risk.
Frequently Asked Questions
Get answers to common questions about Apri.
Apri is over 99% effective when taken perfectly (at the same time every day without missing doses). With typical use, accounting for missed doses, effectiveness is about 91%. This means out of 100 people using Apri for one year with typical use, approximately 9 may become pregnant. Consistent daily use significantly improves effectiveness.
Apri can generally be used while breastfeeding since only tiny amounts of hormones pass into breast milk. However, some healthcare providers recommend waiting until breastfeeding is established (after 6 weeks) before starting hormonal contraceptives. Discuss timing and options with your doctor to ensure the safest choice for you and your baby.
If you miss one tablet, take it as soon as you remember, even if it means taking two tablets in one day. If you miss two or more tablets, use backup contraception and contact your healthcare provider. Missing multiple doses significantly increases pregnancy risk, so it's important to get guidance from your doctor on next steps.
Some people report slight weight changes while on Apri, though studies show minimal consistent weight gain. Any weight change is usually small and may be related to water retention or increased appetite rather than fat gain. If you notice significant weight changes, discuss them with your healthcare provider to determine if they're related to Apri or other factors.
Yes, most people can switch from one combination pill to Apri, though your healthcare provider should guide the transition. In many cases, you can start Apri immediately on the first day of your next period, or follow your doctor's specific instructions. Some people may need backup contraception for the first 7 days depending on their previous pill and when they switch.
The Bottom Line
Apri is a highly effective, affordable combination birth control pill containing ethinyl estradiol and desogestrel. It prevents pregnancy in over 99% of cases when taken consistently and may offer additional benefits like lighter, more regular periods and improved skin. Most side effects are mild and improve within a few months, though some people experience nausea, headaches, or breast tenderness early on. Serious side effects like blood clots are rare but more likely in smokers or people over 35. Understanding your personal risk factors and maintaining open communication with your healthcare provider ensures you get the best contraceptive choice for your needs.
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