Woman looking up and to the side on a geometric background.
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, and/or 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, and/or bloating. Most side effects are mild and may resolve on their own[1]. However, if the side effects are severe or persistent, it is important to talk to a doctor.

›

What will my period be like after starting Opill®?

After starting Opill®, you may experience changes in menstrual bleeding, including breakthrough bleeding and spotting between menstrual periods.*,1 Breakthrough bleeding and spotting is considered any vaginal bleeding which does not have the characteristics of your menstrual period.1-3 It can happen with any type of hormonal birth control and does not mean that the birth control is ineffective.+,2 About half of women who take Opill® experience changes to their period including breakthrough bleeding and/or spotting.1 Some women stop having periods while taking Opill®.1

Bleeding between periods is usually temporary and does not mean there is a problem.+,1 However, call your healthcare provider if you repeatedly have vaginal bleeding after sex or if you start having menstrual periods that last more than 8 days, or are unusually heavy. 1

›

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.

›

How will my period change after I’ve already been on Opill® for a while?

While taking Opill®, you may experience some irregularities regarding your menstrual period.

Progestin-only pills, like Opill®, should be taken at the same time each day*. With consistent use, breakthrough bleeding and spotting with progestin-only pills may improve.1,3-6 For some women who take Opill®, periods stop altogether.1

›

What will the long-term changes in my period be like while taking Opill®?

In a survey of women who used Opill® for up to six months, most (80%) found the frequency and amount of bleeding they experienced to be acceptable or felt neutral about it. †,6 In the same survey, more than half (58%) of women who had used hormonal birth control in the month before found the bleeding they experienced on Opill® was similar or better. †,6

By the end of one cycle, about 6% of participants in Opill® studies stopped having a period (amenorrhea) and almost one third of all study participants stopped having their period during the studies.1 Just one in 10 Opill® users (9.94%) discontinued due to bleeding patterns.1 6.4% of study participants discontinued due to breakthrough bleeding and 2.7% due to amenorrhea.1

›

Will I experience an increase in negative mood changes or depression while taking Opill®?

It is not likely; 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]

›

What should I do if I experience sudden or severe persistent abdominal pain and am sexually active while taking Opill®?

If you are experiencing severe and ongoing pain in your lower abdomen while taking Opill®, 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 and unlikely if you are taking Opill® as directed, 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.

›

What do I do if I experience migraine symptoms while taking Opill®?

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.

›

Does Opill® cause weight gain?

No, progestin-only pills like Opill® have not been shown to cause weight gain.[5]

›

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.

›

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.
›

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.
›

Should I still consult with a doctor before getting Opill® from a pharmacy or online?

Opill® is approved for over the counter (OTC) use by the FDA and therefore, most* people don’t have to consult with a doctor before purchasing Opill® from a retailer or online.

<

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, because some cancers are sensitive to hormones like the one in Opill®
  • 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.

›

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.
›

More information by topic


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



References

*Read all label information and use as directed.

+Contact your healthcare provider if you repeatedly have vaginal bleeding after sex or if you start having menstrual periods that last more than 8 days or are unusually heavy.

†Based on a follow-up survey of 665 Opill users from the self-selection and actual use trial.

References:
1. U.S. Food and Drug Administration. Opill® Tablets (norgestrel tablets). 2017. Accessed May 2026. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/017031s035s036lbl.pdf

2. French V. What you should know about breakthrough bleeding with birth control. American College of Obstetricians and Gynecologists. Published January 2021. Last reviewed April 2025. Accessed May 2026. https://www.acog.org/womens-health/experts-and-stories/the-latest/what-you-should-know-about-breakthrough-bleeding-with-birth-control

3. Edelman A, Kaneshiro B. Evaluation and management of unscheduled bleeding in individuals using hormonal contraception. UpToDate. Updated January 8, 2026. Accessed May 2026. https://www.uptodate.com/contents/evaluation-and-management-of-unscheduled-bleeding-in-individuals-using-hormonal-contraception

4. U.S. Food and Drug Administration. Opill® (0.075 mg oral norgestrel tablet) information. FDA website.https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/opill-0075mg-oral-norgestrel-tablet-information

5. Source: U.S. Food and Drug Administration. Decisional memorandum: new drug application 017031, supplement 41-application for full prescription-to-nonprescription switch of norgestrel tablets 0.075 mg. FDA website. July 13, 2023. https://www.accessdata.fda.gov/drugsatfda_docs/nda/2023/017031Orig1s041SumR.pdf

6. Grindlay K, Key K, Zuniga C, et al. Experience using a progestin-only pill in an over-the-counter environment in the United States: a cross-sectional survey. 2023;49:27-34. doi:10.1136/bmjsrh-2022-201637. https://srh.bmj.com/content/49/1/27