Generic Birth Control Explained

When filling birth control requests, the Nurx medical team usually prescribes equivalent substitutions.  These are commonly known as generics, the term you are most familiar with.  Why do we do this?  It is for a number of reasons.  It all comes down to what is most affordable for you, whether you are paying cash or using insurance.  From a medical perspective, the original patented pill, the equivalent substitute from a different manufacturer, and the chemical name generic are all exactly the same thing.  We get a lot of questions and complaints about this, so let’s talk about it in detail. 

What’s up with generic birth control?

Birth control pills are different from other medications.  Usually there is  an original, patented BRAND name pill and then the generic name is its chemical name.  For example there is a brand named antiviral medication called Valtrex for preventing herpes and its generic name is valacyclovir.  But with birth control, no one can remember what the first of its type is called and no one can remember the chemical names of birth control pills and there are many manufacturers for these equivalents.  So marketing people came up with specific names and packaging to help you be loyal to your pill:  Whether it is a brand or generic equivalent. 

What’s different about generic birth control? 

The short answer is “nothing important”.  The Food and Drug Administration requires that generics contain the exact same dose of the exact same hormones as the originally patented brand name version of the medication.  Drug manufacturers have quality controls, and are well-regulated by the FDA.  So all equivalents are the same, whether a chemical generic or a generic with a brand name.  We know that this can be frustrating for you if you are used to certain packaging or a specific name.  But  often the choice of equivalent is dictated by your insurance company.  They refer to these specific medication equivalents as “preferred” on their formulary.

Is there any reason not to take a generic equivalent version?

In rare cases an inactive ingredient in a particular equivalent can cause an allergy or reaction, so if that’s true for you, make sure your medical provider knows. One of the most common ingredients to cause a reaction is a yellow dye called tartrazine. Pill manufacturers use this or other colors to make the pills look pretty, or to distinguish the active pills from the placebo pills. 

If you have an allergy or known reaction to something,  tell your medical provider or pharmacist. But even if you have a reaction to a particular generic, that doesn’t usually mean you’d have to take a name-brand version. There are multiple equivalent versions of birth control pills, so you can likely find another version of that same birth control.

Are there some pills that don’t have a generic equivalent version, that might be worth the extra money?

There is Lo Loestrin, the pill with the lowest estrogen dose available in the US and  there is Slynd, a progestin-only pill that contains drospirenone.  Some people have tried samples and have done well on them and their insurance covers the cost with an affordable co-pay.  There are also some chewable pills and some capsules that are patented brand name options that patients prefer.  You have to decide if they are worth the extra money to you because these patented original brand name options are usually far more expensive.  It is exceedingly rare that there would be a medical reason for any one specific pill like these.

What should a patient do if they think the generic pill they’re taking is causing unpleasant side effects?

Keep track of what you’re experiencing, perhaps by using a calendar app that allows you to record bleeding days and specific symptoms. Work together with your medical provider (whether at Nurx or elsewhere) so you can determine whether the inactive ingredients in your equivalent pill are causing the side effects. It’s very rare that this would be the case. When a patient thinks they’re reacting to an inactive ingredient in a specific pill and that they need a different formulation, it’s usually a “reverse placebo effect”.  For example, a patient starts a new, different equivalent pill and starts experiencing headaches and thinks it’s the pill.  In fact,  the headaches are actually caused by stress or poor sleep or something else entirely and that only comes to light later on.  We want to work as a team and figure out what’s causing your symptoms before rushing to a new pill, especially if the new pill is going to cost you more and isn’t medically necessary.

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