In 2023, the Food and Drug Administration approved Opill, the first birth control pill in the United States that doesn’t require a prescription. This means that anyone can access birth control pills, even if they lack insurance or cannot see a health care provider.
Read on to learn how Opill works, who can take it, how much it costs, and more.
What is Opill, and how does it work?
Opill, also called a mini pill, is an over-the-counter daily birth control pill.
“Its availability increases access to effective birth control methods to people who cannot go to a clinic to receive prescription birth control,” says Dr. Melissa A. Simon, professor of obstetrics and gynecology at Northwestern’s Feinberg School of Medicine. “This increased access is especially important in rural areas where there are fewer clinics from which to obtain birth control, in states where there is no Medicaid expansion, and where there are stricter laws prohibiting access to reproductive health care, including abortion.”
Unlike most prescription birth control pills, which contain a combination of the hormones estrogen and progestin, Opill is a progestin-only pill that prevents pregnancy by:
- Thinning the lining of the uterus to prevent fertilized eggs from attaching to it.
- Thickening cervical mucus, making it harder for sperm to enter the uterus.
- Preventing ovulation, or stopping the ovaries from releasing eggs.
Both combination birth control pills and progestin-only pills are effective at preventing pregnancy; however, progestin-only pills are slightly less effective, since they are not as efficient at stopping ovulation.
Who can take Opill?
Most people who can become pregnant can take Opill, and anyone of any age can purchase it over the counter.
“Opill should not be used by those who are pregnant, or have breast cancer or a history of breast cancer,” Simon says. “Individuals who are taking anti-seizure medications, antibiotics, and over-the-counter supplements should consult with their clinicians before using progestin-only pills to make sure there are no [drug] interactions.”
Do not take Opill if you are currently using another birth control pill, vaginal ring, patch, implant, injection, or intrauterine device. You also should not take it for five days after taking the emergency contraception pill ella, as this could inhibit both Opill and ella from preventing pregnancy.
How effective is Opill at preventing pregnancy?
When taken at the same time every day, Opill is 98 percent effective at preventing pregnancy. Progestin-only pills take effect within 48 hours.
Since no form of birth control is 100 percent effective, Opill and other birth control pills work best when they are consistently used in combination with other forms of birth control, like condoms, which also protect against sexually transmitted infections.
What are the side effects?
The most commonly reported side effect is changes in menstrual cycle length and flow. You may also experience spotting or bleeding between periods or stop having periods. Less common side effects may include headaches, nausea, dizziness, cramping, bloating, and increased appetite, and these side effects typically resolve on their own.
Talk to your health care provider if you experience severe or persistent side effects while taking Opill.
Where is Opill available, and how much does it cost?
Opill is available at major retailers nationwide. Find a store near you that carries it using this search tool. You can also purchase it online through the manufacturer’s website.
A one-month supply costs around $20. You may be able to purchase Opill at no cost if your insurance plan has added it to its Preventive Medications List. Call your insurance provider to find out if Opill is covered by your plan.
Opill also offers a Cost Assistance Program for those who may struggle to afford birth control pills.
For more information about whether Opill is right for you, talk to your health care provider.