Oral contraceptives.

1. Contraceptive Reference Chart
KEY: EE=Ethinyl Estradiol; EV=Estradiol Valerate; Fe=Ferrous Fumarate; SD=subdermal;
TD=transdermal; LNG=levonorgestrel
Updated January 2020
Generics Brand Estrogen/Progestin Component Cost/30days*
MONOPHASIC 21/7 regimen
Afirmelle, Aubra, Aubra EQ,
Aviane, Delyla, Falmina, Larissia,
Lessina, levonorgestrel/EE,
Lutera, Orsythia, Sronyx, Vienva
Alesse
(not available)
EE 20 mcg/ levonorgestrel 0.1 mg $15
Apri, Cyred, Cyred EQ,
Desogestrel/EE, Emoquette,
Enskyce, Isibloom, Juleber,
Kalliga, Reclipsen
Ortho-Cept
(not available),
Desogen
(not available)
EE 30 mcg/ desogestrel 0.15 mg $17
Altavera, Ayuna, Chateal, Chateal
EQ, Kurvelo, Levonorgestrel/EE,
Levora, Lillow, Marlissa, Portia
Nordette
(not available)
EE 30 mcg/ levonorgestrel 0.15 mg $9
Cryselle, Elinest, Low-Ogestrel Lo/Ovral
(not available)
EE 30 mcg/ norgestrel 0.3 mg $13
Aurovela 1.5/30, Hailey 1.5/30,
Junel 1.5/30, Larin 1.5/30,
Microgestin 1.5/30,
Norethindrone/EE 1.5/30
Loestrin 1.5/30 EE 30 mcg/ norethindrone 1.5 mg $22
Aurovela Fe 1.5/30, Blisovi Fe
1.5/30, Junel Fe 1.5/30, Larin Fe
1.5/30, Microgestin Fe 1.5/30,
Nor/Est/FF 1.5/30
Loestrin Fe
1.5/30
EE 30 mcg/ norethindrone 1.5 mg/ Fe 75 mg $18 (Generic)
$261 (Brand)
Aurovela 1/20, Junel 1/20, Larin
1/20, Microgestin 1/20,
Norethindrone/EE 1/20
Loestrin 1/20 EE 20 mcg/ norethindrone 1 mg $14
Aurovela Fe 1/20, Blisovi Fe 1/20,
Junel Fe 1/20, Larin Fe 1/20,
Microgestin Fe 1/20,
Norethindrone/EE/Fe, Tarina Fe
1/20, Tarina Fe 1/20 EQ
Loestrin Fe 1/20 EE 20 mcg/ norethindrone 1 mg/Fe 75 mg $21
Estarylla, Femynor, Mili, Mono-
Linyah, MonoNessa,
Norgestimate/EE, Previfem,
Sprintec, Vylibra
Ortho-Cyclen
(not available)
EE 35 mcg/ norgestimate 0.25 mg $11 (Generic)
$51 (Brand)
Balziva, Briellyn, Philith,
Vyfemla
Ovcon-35
(not available)
EE 35 mcg/ norethindrone 0.4 mg $26
Nore/eth/fer, Wymzya Fe
(chew or swallow)
Femcon Fe
(not avaiable)
EE 35 mcg/ norethindrone 0.4 mg/Fe 75 mg $73 - $269
(AWP)
Necon 0.5/35, Nortrel 0.5/35,
Wera 0.5/35
Brevicon
(not available),
Modicon
(not available)
EE 35 mcg/ norethindrone 0.5 mg $15

2. Contraceptive Reference Chart
KEY: EE=Ethinyl Estradiol; EV=Estradiol Valerate; Fe=Ferrous Fumarate; SD=subdermal;
TD=transdermal; LNG=levonorgestrel
Updated January 2020
Generics Brand Estrogen/Progestin Component Cost/30days*
Alyacen 1/35, Cyclafem 1/35,
Dasetta 1/35, Nortrel 1/35,
Pirmella 1/35
Ortho-Novum
1/35
EE 35 mcg/ norethindrone 1 mg $14
Ethy eth est 1-35, Kelnor 1/35,
Zovia 1/35E
Demulen 1/35
(not available)
EE 35 mcg / ethynodiol diacetate 1 mg $22
None Ogestrel EE 50 mcg/ norgestrel 0.5 mg $36
Ethynodiol 1-50, Kelnor 1/50 Zovia 1/50E
(not available)
EE 50 mcg/ ethynodiol diacetate 1 mg $25
drospirenone/EE, Ocella, Syeda,
Zarah, Zumandimine
Yasmin EE 30 mcg/ drospirenone 3 mg $34 (Generic)
$130 (Brand)
Dros/eth est tab levomefo,
Tydemy
Safyral EE 30 mcg/ drospirenone 3 mg/
levomefolate calcium 0.451 mg
$154 generic
$240 brand
None Taytulla EE 20 mcg/ norethindrone 1 mg/Fe 75 mg $203
BIPHASIC
Azurette, Bekyree,
desogestrel/EE, Kariva, Pimtrea,
Simliya, Viorele
Mircette EE 20, 10 mcg / desogestrel 0.15 mg
 Active tablet (EE 20 mcg): 21 days
 Inactive tablet: 2 days
 Active EE only (10 mcg): 5 days
$31
TRIPHASIC
Tilia Fe, Tri-Legest Fe Estrostep Fe EE 20, 30, 35 mcg/ norethindrone 1 mg/ Fe
75 mg
 Active tablet (EE 20 mcg): 5 days
 Active tablet (EE 30 mcg): 7 days
 Active tablet (EE 35 mcg): 9 days
 Inactive tablet (Fe only): 7 days
$56
Enpresse, Levonest, levonor/ethi,
Myzilra, Trivora
Tri-Levlen
(not available)
EE 30, 40 mcg/ levonorgestrel 0.05, 0.075,
0.125mg
 Active tablet (EE 30, lev 0.05): 6 days
 Active tablet (EE 40, lev 0.075): 5 days
 Active tablet (EE 30, lev 0.125): 10 days
 Inactive tablet: 7 days
$19
Norgestimate/EE, Tri Femynor,
Tri-Estaryll, Tri-Lynyah, Tri-Mili,
Tri-Previfem, Tri-Sprintec, Tri-
Vylibra
Ortho Tri-
Cyclen
(not-available)
EE 35 mcg/ norgestimate 0.18, 0.215, 0.25
mg
 Active tablet (nor 0.18): 7 days
 Active tablet (nor 0.215): 7 days
 Active tablet (nor 0.25): 7 days
 Inactive tablet: 7 days
$11

3. Contraceptive Reference Chart
KEY: EE=Ethinyl Estradiol; EV=Estradiol Valerate; Fe=Ferrous Fumarate; SD=subdermal;
TD=transdermal; LNG=levonorgestrel
Updated January 2020
Generics Brand Estrogen/Progestin Component Cost/30days*
Norgestimate/EE, Tri-Lo-
Estarylla, Tri-Lo-Marzia, Tri-Lo-
Mili, Tri-Lo-Sprintec, Tri-Vylibra
Lo, Trinessa Lo
Ortho Tri-
Cyclen LO
EE 25 mcg/ norgestimate 0.18, 0.215, 0.25
mg
 Active tablet (nor 0.18): 7 days
 Active tablet (nor 0.215): 7 days
 Active tablet (nor 0.25): 7 days
 Inactive tablet: 7 days
$15
Aranelle, Leena Tri-Norinyl
(not available)
EE 35 mcg/ norethindrone 0.5, 1 mg
 Active tablet (nor 0.5): 7 days
 Active tablet (nor 1): 9 days
 Active tablet (nor 0.5): 5 days
 Inactive tablet: 7 days
$25
Caziant, Velivet Cyclessa EE 25 mcg/ desogestrel 100, 125, 150 mcg
 Active tablet (des 100): 7 days
 Active tablet (des 125): 7 days
 Active tablet (des 150): 7 days
 Inactive tablet: 7 days
$24
Alyacen 7/7/7, Cyclafem 7/7/7,
Dasetta 7/7/7, Nortrel 7/7/7,
Pirmella 777
Ortho-Novum
7/7/7
EE 35 mcg/ norethindrone 0.5, 0.75, 1 mg
 Active tablet (nor 0.5): 7 days
 Active tablet (nor 0.75): 7 days
 Active tablet (nor 1): 7 days
 Inactive tablet: 7 days
$21
FOUR-PHASIC
None Natazia EV 3, 2, 1 mg/ dienogest 2, 3 mg
 Active estrogen only (EV 3 mg): 2 days
 Active tab (EV 2mg, di 2mg): 5 days
 Active tab (EV 2mg, di 3mg): 17 days
 Active estrogen only (EV 1mg): 2 days
 Inactive tablet: 2 days
$378
MONOPHASIC 24/4 regimen
Kaitlib Fe, Layolis Fe,
norethindrone/EE/Fe
Generess Fe
(chewable only)
* Non-formulary
EE 25 mcg/ norethindrone 0.8 mg/ Fe 75mg
 Active tablet: 24 days
 Inactive tablet: 4 days
$86
Aurovela 24 Fe, Blisovi 24 Fe,
Hailey 24 Fe, Junel Fe 24, Larin
24 Fe, Norethindrone/EE/Fe,
Tarina 24 Fe
Loestrin 24 Fe
(not available)
EE 20 mcg/ norethindrone 1 mg/ Fe 75 mg
 Active tablet: 24 days
 Inactive tablet: 4 days
$90 - $269
(AWP)

4. Contraceptive Reference Chart
KEY: EE=Ethinyl Estradiol; EV=Estradiol Valerate; Fe=Ferrous Fumarate; SD=subdermal;
TD=transdermal; LNG=levonorgestrel
Updated January 2020
Generics Brand Estrogen/Progestin Component Cost/30days*
Melodetta 24 Fe (chewable),
Mibelas 24 Fe (chewable),
noreth/ethin Fe (chewable)
Minastrin 24 Fe
(chewable)
EE 20 mcg/ norethindrone 1 mg/ Fe 75 mg
 Active tablet: 24 days
 Inactive tablet: 4 days
$134
Drospire/eth tab estr/lev Beyaz
*Non-formulary
EE 20 mcg/ drospirenone 3 mg/
levomefolate calcium 0.451 mg
 Active tablet: 24 days
 Inactive tablet: 4 days
$113 (Generic)
$200 (Brand)
drospirenone/EE, Gianvi, Jasmiel,
Loryna, Lo-Zumandimi, Nikki
Yaz EE 20 mcg/ drospirenone 3 mg
 Active tablet: 24 days
 Inactive tablet: 4 days
$46
None Lo Loestrin Fe
*Non-formulary
EE 10 mcg/ norethindrone 1 mg/ Fe 75mg
 Active tablet: 24 days
 Active EE only: 2 days
Inactive tablet: 2 days
$157
MONOPHASIC (EXTENDED-CYCLE, 84 days)
Introvale, Jolessa,
levonorgestrel/EE, Setlakin
Seasonale
(not available)
EE 30 mcg/ levonorgestrel 0.15 mg
Extended Cycle:
 Active tablet: 84 days
 Inactive tablet: 7 days
$20
MULTIPHASIC (EXTENDED-CYCLE, 84 days)
Amethia, Ashlyna, Camrese,
Daysee, levonorgestrel/EE,
Simpesse
Seasonique EE 30, 10 mcg/ levonorgestrel 0.15 mg
Extended Cycle:
 Active tablet: 84 days
 Active EE only (10 mcg): 7 days
$54
Amethia Lo, Camrese Lo,
levonorgestrel/EE
LoSeasonique EE 20, 10 mcg/ levonorgestrel 0.1 mg
Extended Cycle:
 Active tablet: 84 days
 Active EE only (10 mcg): 7 days
$47
Fayosim, Rivelsa Quartette
*Non-
formulary
EE 20, 25, 30, 10 mcg/ levonorgestrel 0.15 mg
Extended Cycle
 Active tablet (EE 20 mcg): 42 days
 Active tablet (EE 25 mcg): 21 days
 Active tablet (EE 30 mcg): 21 days
 Active EE only (10 mcg): 7 days
$416 - $831
(AWP)

5. Contraceptive Reference Chart
KEY: EE=Ethinyl Estradiol; EV=Estradiol Valerate; Fe=Ferrous Fumarate; SD=subdermal;
TD=transdermal; LNG=levonorgestrel
Updated January 2020
Non-Oral Contraceptive Alternatives
Generic Name Brand Name EE Progestin Route Cost/30
days*
Medroxyprogesterone
acetate
Depo-Provera None medroxyprogesterone acetate
150mg *every 3 months; no > 2 yrs.
IM $28
Medroxyprogesterone
acetate
Depo-SubQ
Provera 104
None medroxyprogesterone acetate
104mg *every 3 months; no > 2 yrs.
SubQ $280
(AWP)
None Nexplanon None etonogestrel 68 mg
*remove or replace by 3rd
year
SD
implant
$1120
per IUD
None Liletta None levonorgestrel 52 mg
 Initial release of 18.6 mcg/day
then decreases to:
Year 1: LNG 16.3 mcg/day
Year 2: LNG 14.3 mcg/day
Year 3: LNG 12.6 mcg/day
*Remove or replace by 3rd
year
IUD $944 per
IUD
None Kyleena None levonorgestrel 19.5 mg
 Initial release of 17.5 mcg/day
*Remove or replace by 5th
year
IUD $1,144
per IUD
None Mirena None levonorgestrel 52 mg
 Initial release of 20 mcg/day
*Remove or replace by 5th
year
IUD $1,144
per IUD
Generics Brand Estrogen/Progestin Component Cost/30days*
CONTINUOUS CYCLE (no hormone-free interval)
Levo-eth est Amethyst EE 20 mcg/ levonorgestrel 90 mcg
 Take daily
$40
PROGESTIN-ONLY PILLS
None Slynd drospirenone 4 mg $233 (AWP)
Camila, Deblitane, Errin, Heather,
Incassia, Jencycla, Lyza, Nora-
BE, norethindrone, Norlyda,
Norlyroc, Sharobel, Tulana
Nor-QD
(not available),
Ortho-Micron
norethindrone 0.35 mg $5
EMERGENCY CONTRACEPTIVES
Aftera, Econtra EZ, Econtra OS,
levonorgestrel 1.5 mg, My Choice,
My Way, New Day, Next Choice
One Dose, Opcicon, Option 2,
React, Take Action
Plan B One-
Step
levonorgestrel 1.5 mg (1 pill) $28
None Ella ulipristal 30 mg $58

6. Contraceptive Reference Chart
KEY: EE=Ethinyl Estradiol; EV=Estradiol Valerate; Fe=Ferrous Fumarate; SD=subdermal;
TD=transdermal; LNG=levonorgestrel
Updated January 2020
Generic Name Brand Name EE Progestin Route Cost/30
days*
None Skyla None levonorgestrel 13.5 mg
 Initial release of 14 mcg/day
after the 1st
24 days
*Remove or replace by 3rd
year
IUD $952
per IUD
None ParaGard
T380A
Copper: Non-hormonal
*Remove or replace on or before 10 years
IUD $1,061
per IUD
None Annovera 13
mcg/day
Segesterone acetate/EE
l 0.15/0.013 mg/day
Insert for 21 days, remove for 7
vaginal
ring
$2400
per ring
(lasts 1
year)
Eluryng, etonogrestre
mis ethy est
NuvaRing 15
mcg/day
etonogestrel 12 mcg/day
*leave in for 3 continuous weeks,
then 1-week ring-free interval
vaginal
ring
$190
Xulane Ortho Evra
(not available)
35
mcg/day
norelgestromin 200 mcg/day
*apply weekly for 3 weeks, then
week 4 is patch-free
TD
patch
$150/mo
(3
patches)