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Frequently Asked Questions About Opill® and Contraception Access

Side Effects and Interactions

What are the most common side effects with Opill®?
The most common side effects are related to changes in bleeding pattern. Some people may find their period becomes less or more frequent, shorter or longer, lighter or heavier than before starting Opill®. Some people may also have some spotting or bleeding between periods or stop having periods while taking Opill®. Less common side effects include headaches, dizziness, nausea, increased appetite, abdominal pain, cramps or bloating. Most side effects are mild and often resolve on their own [1]. However, if the side effects are severe or persistent, it is important to talk to a doctor.
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Is it normal to have spotting between periods or miss/stop having periods while on Opill®?
Yes, it is completely normal to experience changes in your menstrual bleeding pattern while taking Opill®. This may include spotting between periods as well as the potential for missed or stopped periods.
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Will I experience an increase in negative mood changes or depression while taking Opill®?
A systematic review of the published literature found that the preponderance of evidence does not support an association between progestin-only contraception and depression. [2]
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What should I do if I experience abdominal pain?
If you are experiencing severe and ongoing pain in your lower abdomen, especially on one side, seek medical help right away. This type of pain could be a sign of an ectopic pregnancy, where a fertilized egg implants in the wrong place. Ectopic pregnancies are uncommon, occurring in approximately 2% of all pregnancies in the U.S. [3] While ectopic pregnancies are rare, they are also a serious medical event that requires medical attention. [4]

Severe persistent belly pain may occur for a few other reasons also and should be assessed right away for proper care and treatment as necessary.
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What do I do if I experience migraine symptoms?
Opill® is safe to use by people who experience migraines. If you start having migraines with aura (headaches that start with changes in vision) or your migraine headaches get worse, talk to a doctor but continue taking Opill® every day.
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Does Opill® cause weight gain?
No, progestin-only pills like Opill® have not been shown to cause weight gain. [5]
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What if I vomit or have diarrhea within 4 hours after taking Opill®?
If you vomit or have diarrhea within 4 hours of taking Opill®, it's possible that your body didn't fully absorb the medicine. To be safe, use a condom or another type of barrier method for the next 2 days (48 hours) every time you have sex. The next day, take your daily tablet at your usual time.
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Are there any allergies I should be aware of when taking Opill®?
Do not take Opill® if you are allergic to this product or any of its ingredients, including FD&C yellow No.5 (also known as tartrazine). If you have an allergy to aspirin, you might also be allergic to tartrazine. Allergic reactions can lead to symptoms like hives, facial swelling, asthma (wheezing), shock, skin reddening, rash and blisters. If you experience any allergic reactions, stop using Opill® and seek medical help right away.
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What if I have taken an emergency contraceptive (morning after pill) before starting Opill®?
Talk to a doctor or pharmacist if you have taken an emergency contraceptive in the past 5 days.

Opill® should not be used for 5 days after using the emergency contraceptive ella® which contains ulipristal acetate. This might reduce the ability of both Opill® and ella® to prevent pregnancy. Also, use a condom (or another barrier method) every time you have sex until your next period.
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Should I still consult with a doctor before getting Opill® from a pharmacy or online?
Opill® is approved for OTC use by the FDA and therefore, most* people don’t have to consult with a doctor before getting Opill®.

However, you should talk to a doctor prior to use if you:
  • currently have vaginal bleeding between periods and have not already talked to a doctor
  • have liver tumors or liver disease
  • have or have ever had any cancer
  • are taking or starting to take any of the following medications, as these may make Opill® less effective:
    • barbiturates, carbamazepine, oxcarbazepine, phenytoin, topiramate, primidone (to treat Seizures)
    • rifampin, rifabutin (to treat Tuberculosis, or TB)
    • bosentan (to treat Pulmonary hypertension, a type of high blood pressure that affects the arteries in the lungs and the right side of the heart)
    • efavirenz (to treat HIV/AIDS)
    • St John’s Wort (or any herbal products containing hypericum perforatum)
    • ulipristal acetate (an emergency contraceptive, or morning after pill) in the past 5 days
*Do not use Opill® if you have or ever had breast cancer. See Opill® label for list of warnings.
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Are there any interactions with other medicinal products that could affect Opill®?
Talk to a doctor or pharmacist if you are taking or start to take any of the following medications, as these may make Opill® less effective:
  • Certain drugs to treat
    • Seizures (barbiturates, carbamazepine, oxcarbazepine, phenytoin, topiramate, primidone)
    • Tuberculosis (rifampin, rifabutin)
    • Pulmonary hypertension (bosentan)
    • HIV/AIDS (efavirenz)
  • St John's Wort (or any herbal products containing hypericum perforatum)

Your doctor or pharmacist may advise you to use another form of contraception.
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More information by topic


What is Opill®
Buying Opill®
Taking Opill®
Stopping Opill®
Opill® and your health



References

[1] U.S. Food and Drug Administration. (2023, July 14). Opill (0.075mg Oral Norgestrel Tablet) Information. https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-andproviders/opill-0075mg-oral-norgestrel-tablet-information

[2] Worly BL, Gur TL, Schaffir J. The relationship between progestin hormonal contraception and depression: a systematic review. Contraception. 2018 Jun;97(6):478-489. doi: 10.1016/j.contraception.2018.01.010. Epub 2018 Feb 26. PMID: 29496297.

[3] Lee IT, Barnhart KT. What Is an Ectopic Pregnancy? JAMA. 2023;329(5):434. doi:10.1001/jama.2022.22941

[4] Planned Parenthood. What is ectopic pregnancy?: Definition and treatment. Ectopic Pregnancy.Retrieved November 17, 2023, from https://www.plannedparenthood.org/learn/pregnancy/ectopic-pregnancy.

[5] Lopez LM, Ramesh S, Chen M, Edelman A, Otterness C, Trussell J, Helmerhorst FM. Progestin-only contraceptives: effects on weight. Cochrane Database Syst Rev. 2016 Aug 28;2016(8):CD008815. doi:10.1002/14651858.CD008815.pub4. PMID: 27567593; PMCID: PMC5034734.

[6] Graham CA, Ramos R, Bancroft J, Maglaya C, Farley TM. The effects of steroidal contraceptives on the well-being and sexuality of women: a double-blind, placebo-controlled, two-centre study of combined and progestogen-only methods. Contraception. 1995 Dec;52(6):363-9. doi:10.1016/0010-7824(95)00226-x. PMID: 8749600.

[7] Curtis KM et al. U.S. Medical Eligibility Criteria for Contraceptive Use, 2016. MMWR Recomm Rep 2016;65(No. RR-3):1–104. DOI: http://dx.doi.org/10.15585/mmwr.rr6503a1Curtis KM et al. U.S. Medical Eligibility Criteria for Contraceptive Use, 2016. MMWR Recomm Rep 2016;65(No. RR-3):1–104. doi:http://dx.doi.org/10.15585/mmwr.rr6503a1-8-