Apri (Desogestrel and Ethinyl Estradiol)

Apri is a combination birth control pill, meaning that it prevents pregnancy by altering the body’s levels of estrogen and progestin — two naturally-occurring hormones that help regulate the reproductive cycle. Apri prevents the ovaries from releasing an egg, making fertilization impossible. The two hormones can also thicken the cervical mucus to block sperm from entering the uterus and they can thin the lining of the uterine wall making implantation of a fertilized egg less likely.

Like other combination pills, Apri is over 99% effective when used exactly as prescribed. Even when factoring in user error, Apri is still extremely effective: for every 100 women who take it over the course of a year, fewer than 2 will get pregnant.

Each pack of Apri contains 28 pills: 21 pink hormone-containing pills and 7 white placebo pills. The hormone-containing pills should all be taken consecutively, followed by the 7 hormone-free placebo pills. Even though the placebo pills contain no hormones, you will continue to be protected.

Apri’s packs are designed to be started one of two ways: on a Sunday or on the first day of your period. There’s no “right” way to start taking Apri, but it’s important to remember that, unless you start taking Apri on the first day of your period, you’ll need to use another form of birth control such as condoms for 7 days after you begin taking Apri in order to ensure that your body has the time it needs to adjust to the new levels of hormones.

The likelihood of pregnancy increases with every missed dose (a gap of 24 hours or more between pills) of Apri. If you miss an active pill dose, take it as soon as possible, and then resume your regular schedule. It won't cause any harm to take two active pills in one day, though you may feel some nausea as a result. If you miss taking an active pill and want to prevent pregnancy, it's important to use a back-up form of birth control for one week after, along with the skipped pills.

As with any form of hormonal birth control, some women may experience side effects when taking Apri. Most of these side effects are generally rare, and those that do appear tend to weaken or go away after several months of continuous usage. Still, it’s important for you to know what you might potentially notice once you start taking Apri:

• Headaches.
• Breast tenderness.
• Nausea and vomiting.
• Weight gain or loss.
• Fluid retention.
• Vaginal bleeding between periods.
• Bloating.
• Raised blood pressure.

In addition, there are a number of other drugs that, when taken in combination in Apri, increase your risk of becoming pregnant, including:

• Certain seizure medications
• HIV drugs
• Barbiturates
• St. John’s Wort
• Rifampin or rifabutin
• Modafinil
• Griseofulvin

Always consult with your doctor first regarding the interactions that your existing medications may have with your birth control.

In very rare cases, Apri can have an impact on a woman’s blood flow, increasing the chance of blood clots, heart attacks, or stroke. While only a small fraction of women are at risk of these things occurring, women who are advised to avoid estrogen should not take Apri. In particular, women who are over the age of 35 and smoke should look for forms of birth control that do not contain estrogen, such as the shot or the minipill.

Nurx offers over 100 different birth control brands and methods for women to choose from. While it’s great to have that much choice at your disposal, it can also be overwhelming to try and distinguish between all of your options. If you’re hoping to find a new method of birth control but don’t know where to start, answer some questions from a Nurx provider to get recommendations customized to you.