What’s Opill® birth control?

In case you missed it, the first over-the-counter (OTC) birth control pill on the market. Opill®, which was approved by the FDA in July 2023, is available for purchase without a prescription — a major win for birth control accessibility. Learn more about Opill®, how it works, its side effects, and how it (ever so slightly) differs from other birth control methods.

What is Opill®? How does it work?

Opill® is a progestin-only daily oral contraceptive that is available for purchase without a prescription. This daily 0.075mg norgestrel pill prevents pregnancy by thickening cervical mucus to prevent sperm from reaching an egg. In some cases, it can also suppress ovulation.

When do I take it? What if I miss a dose?

Just like other birth control pills, timing is key. Opill® should be taken orally every day at the same time. Setting an alarm can help you stay on top of your timing.

Missing a pill by more than 3 hours is considered a “missed dose,” which can significantly reduce its effectiveness. (Another way to think of it – taking a pill more than 27 hours after the previous pill is considered a missed dose.) If you miss a pill and you’re outside the 3-hour window, you should still take the pill anyway and use a backup birth control barrier method, like condoms, for the next two days. If you have sex in the 48 hours following a missed dose, you should also consider using a morning-after pill (like Julie’s) just to be safe. If vomiting or severe diarrhea occurs within three hours of taking your daily Opill®, the progestin's absorption may be affected. If this happens, use a backup method until two days after the symptoms subside.

Progesterone vs. Progestin

If you’ve read up on reproductive health and birth control, you might be familiar with progesterone and progestin. Progesterone is a naturally-occurring female hormone produced in the ovaries that prepares the uterus lining for pregnancy. Meanwhile, progestin is a synthetic form of progesterone with a similar function and is commonly used in several contraceptive medications like the Opill®.

The two main types of birth control pills contain varying levels of progestin. Combination birth control pills contain both progestin and estrogen. Progestin-only pills, like the Opill® or “mini pill,” contain progestin at a lower dose than combination pills.

Opill® effectiveness

Opill® effectiveness sets it apart from other over-the-counter (OTC) birth control options, like condoms and spermicides, because of its low failure rate.

Typical OTC birth control methods, like condoms and spermicides have a 13 to 27% failure rate. On the other hand, the Opill® failure rate is expected to be only 7% per year, according to data from HRA Pharma. The FDA reports a slightly higher failure rate, estimating that nine out of 100 women who use progestin-only pills over the course of a year may become pregnant.

Opill® side effects

All medications, including birth control and the morning-after pill, have potential side effects. The same is true for Opill®.

Potential side effects include:

• irregular bleeding
• headaches
• dizziness
• nausea
• cramps
• sore breasts or breast discomfort

Acne and weight gain are also potential side effects. And just like other birth control pills, Opill® does not protect against STIs.

Is it safe?

Norgestrel, the compound used in Opill®, was first approved for prescription use by the FDA in 1973. Many different progestin-only derivatives are currently available by prescription, like Camila, Errin, and Nora-BE.

As a progestin-only birth control option, it has fewer contraindications (reasons not to use the pill). According to the FDA, when HRA Pharma applied to convert norgestrel from a prescription to an OTC product, they had to demonstrate that consumers could use the product safely and effectively by relying on the instructions and information given on the label and without any guidance from a healthcare professional. HRA’s studies showed that consumers’ comprehension and understanding of Opill® directions and information was high overall, supporting the notion that the pill can be appropriately used without professional guidance.

Long story short: Opill® is safe and effective, according to HRA. Nonetheless, you should always consult a healthcare professional before starting any kind of medication to ensure it's right for you.

Where can I get Opill®?

Opill® is available at most pharmacies and online. Start by heading to the sexual wellness aisle and, if you don’t see it there, check with the pharmacist (sometimes they keep it behind the counter). You can also order it online for home delivery (and here’s a tip – it’s cheapest to buy a 3-month supply from the Opill® website).

How much does Opill® cost?

Prices vary depending on the retailer, but the average cost of a month of pills is around $20, and there are usually discounts for buying more packs at a time. Many people with insurance can get their birth control for free or for a reduced rate.

The Julie Morning After Pill™ is already OTC

Because of the precise 3-hour time window for taking Opill®, it’s a good idea to have a backup form of contraception on hand, like condoms or the Julie Morning After Pill. The Julie Morning After Pill™ is available OTC at Target, CVS, Walmart and Amazon or get it delivered now through GoPuff, UberEats, Instacart and Doordash. No ID, prescription, parent, or insurance is required to purchase. Want to learn more about emergency contraception? Check out our article here.

While we love to share useful and helpful information, the above shouldn’t replace the advice of your healthcare professional. For questions about birth control and other women’s health issues, please talk to your doctor.