Comparison of Oral Contraceptives and Non-Oral Alternatives

Full update February 2020

Abbreviations: EE = ethinyl estradiol; IM = intramuscular; IUD = intrauterine device; IUS = intrauterine system.

ORAL CONTRACEPTIVES

Productsa,b

Manufacturer

Estrogen

Progestin

LOW-DOSE MONOPHASIC PILLS

Alessec,d
Alysenac,d
Avianec,d

Pfizer Canada
Apotex
Teva Canada

EE 20 mcg

Levonorgestrel 0.1 mg

Minestrin 1/20c

Allergan

EE 20 mcg

Norethindrone acetate 1 mg

Min-Ovralc
Ovimac
Portiac

Pfizer Canada
Apotex
Teva Canada

EE 30 mcg

Levonorgestrel 0.15 mg

Loestrin 1.5/30c

Allergan

EE 30 mcg

Norethindrone acetate 1.5 mg

Apric
Freyac
Marvelon
c
Mirvalac

Teva Canada
Mylan
Merck Canada
Apotex

EE 30 mcg

Desogestrel 0.15 mg

Yasminc,d

Bayer

EE 30 mcg

Drospirenone 3 mg

Cyclenc

Janssen

EE 35 mcg

Norgestimate 0.25 mg

Brevicon 0.5/35c

Pfizer Canada

EE 35 mcg

Norethindrone 0.5 mg

Brevicon 1/35c
Select 1/35c

Pfizer Canada
Pfizer Canada

EE 35 mcg

Norethindrone 1 mg

BIPHASIC PILLS

Synphasicc

Pfizer Canada

EE 35 mcg

Norethindrone 0.5 mg x 12 days, 1 mg x 9 days

Productsa,b

Manufacturer

Estrogen

Progestin

TRIPHASIC PILLS

Tricira Loc
Tri-Cyclen Loc

Apotex
Janssen

EE 25 mcg x 21 days

Norgestimate 0.18 mg x 7 days, 0.215 mg x 7 days, 0.25 mg x 7 days

Linessac

Aspen Pharmacare Canada

EE 25 mcg x 21 days

Desogestrel 0.1 mg x 7 days, 0.125 mg x 7 days, 0.15 mg x 7 days

Triquilarc

Bayer

EE 30 mcg x 6 days, 40 mcg x 5 days, 30 mcg x 10 days

Levonorgestrel 0.05 mg x 6 days, 0.075 mg x 5 days, 0.125 mg x 10 days

Tri-Cyclenc,d

Janssen

EE 35 mcg x 21 days

Norgestimate 0.18 mg x 7 days, 0.215 mg x 7 days, 0.25 mg x 7 days

EXTENDED-CYCLE PILLS

LoLo

Allergan

EE 10 mcg x 26 days

Norethindrone acetate 1 mg x 24 days

Indayo
Seasonale

Mylan
Teva Canada

EE 30 mcg x 84 days

Levonorgestrel 0.15 mg x 84 days

Seasonique

Teva Canada

EE 30 mcg x 84 days, 10 mcg x 7 days

Levonorgestrel 0.15 mg x 84 days

Yazd
Yaz Plus
d,e

Bayer
Bayer

EE 20 mcg x 24 days

Drospirenone 3 mg x 24 days

PROGESTIN-ONLY PILLS-“Mini-pill”

Jencycla
Micronor
Movisse

Sandoz Canada
Janssen
Mylan

None

Norethindrone 0.35 mg

EMERGENCY CONTRACEPTION

Ella

Actavis Specialty

None

Ulipristal 30 mg tablet (progesterone receptor modulator)

Backup Plan Onestep
Contingency One
Plan B

Apotex
Mylan
Paladin Labs

None

One tablet of levonorgestrel 1.5 mg taken as a single dose

HORMONAL ALTERNATIVES TO ORAL CONTRACEPTION

Productb

Manufacturer

Estrogen

Progestin

Depo-Provera Injection1,g
150 mg/mL

IM injection every three months

Pfizer Canada

None

Medroxyprogesterone acetate 150 mg

Evra4

Transdermal patch applied weekly for three weeks, followed by a patch-free week (i.e., week four)

Janssen

EE 35 mcg/day

Norelgestromin (active form of norgestimate) 200 mcg/day

Kyleena5
(IUS)

Bayer

None

Levonorgestrel
Average 9 mcg/day for up to five years

Mirena2,f

(IUS)

Bayer

None

Levonorgestrel
Average 15 mcg/day for up to five years

Nexplanon6,h

Implanted subdermally just under the skin at the inner side of the non-dominant arm.

Merck

None

Etonogestrel (active form of desogestrel): 60 to 70 mcg/day (after about 5 to 6 weeks), end of 1st year: about 35 to 45 mcg/day, end of 2nd year: about 30 to 40 mcg/day, end of 3rd year: about 25 to 30 mcg/day. Must be removed after 3 years.

NuvaRing3

Vaginal ring left in for three weeks, followed by a ring-free week (i.e., week four)

Merck Canada

EE 15 mcg/day

Etonogestrel (active form of desogestrel) 120 mcg/day

Nova-T
Flexi-T
Liberte
Mona Lisa

Bayer
Prosan
7-Med Industrie
Searchlight Pharma

Non-hormonal, copper IUDs
For more information, see our commentary, Intrauterine Contraceptives: IUDs.

  1. Products are grouped together based on hormone content. This grouping is not an indication of therapeutic equivalence for purposes of substitution.
  2. For information on which hormonal contraceptive to use, see our charts, Choosing a Hormonal Contraceptive and Contraception for Women With Chronic Medical Conditions.
  3. Available in 21- and 28-day packs. 28-day packs have 7 placebo pills.
  4. Health Canada-approved for contraception and acne.
  5. Yaz Plus contains levomefolate 451 mcg in each tablet of the 28-day regimen.
  6. Health Canada-approved for contraception and idiopathic menorrhagia.2
  7. Health Canada-approved for contraception and treatment of endometriosis.1
  8. Effectiveness has not been studied in women who are overweight (i.e., >130% of ideal body weight). Etonogestrel serum concentrations are inversely related to body weight and decrease over time; therefore, removal and replacement before three years should be considered in women who are overweight due to the potential for reduced efficacy.6

Project Leader in preparation of this clinical resource (360218): Annette Murray, BScPharm; last modified September 2020.

References

  1. Product monograph for Depo-Provera. Pfizer Canada. Kirkland, QC H9J 2M5. February 2018.
  2. Product monograph for Mirena. Bayer. Mississauga, ON L4W 5R6. June 2019.
  3. Product monograph for NuvaRing. Merck Canada. Kirkland, QC H9H 4M7. March 2018.
  4. Product monograph for Evra. Janssen. Toronto, ON M3C 1L9. June 2018.
  5. Product monograph for Kyleena. Bayer. Toronto, ON M9W 1G6. June 2019.
  6. Product monograph for Nexplanon. Merck Canada. Kirkland, QC H9H 4M7. May 2020.

Cite this document as follows: Clinical Resource, Comparison of Oral Contraceptives and Non-Oral Alternatives. Pharmacist’s Letter/Pharmacy Technician’s Letter. February 2020.

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