Everything you need to know about Opill, the new over-the-counter birth control pill

Opill, the new, long-awaited over-the-counter birth control pill, has hit the shelves! Here’s everything you need to know about it, including why you might want to choose it, how it works, where and how you can get it, and how to start taking it.

What is Opill?

Opill is a new progestin-only birth control pill (also called the mini-pill), that is available over the counter. That means you don’t need a prescription to get it. Opill is now available on Amazon, Opill’s website, and some drugstores, convenience stores, and grocery stores.

What is the difference between Opill and the mini-pill (the progestin-only birth control pill)?

Opill contains the same type of hormone and works the same way as other progestin-only birth control pills. The only difference between the over-the-counter birth control and prescription birth control is how you get it. Like all other versions of the mini-pill, Opill is estrogen-free and contains a single hormone, progestin. The main way progestin prevents pregnancy is by thickening cervical mucus, which makes it harder for sperm and egg to meet. To be effective at preventing pregnancy, Opill (like most mini-pills) should be taken as close as possible to the same time every day.

What is the difference between Opill and the combination birth control pill?

There are many different brands of birth control pills, but only two main categories of pill—the mini-pill (progestin-only pill) and the combination birth control pill. Both types of birth control pills contain hormones. The biggest difference between them is how you use them and which hormones they contain. The mini-pill only contains progestin. Combination birth control pills contain both estrogen and progestin. Opill is a brand of mini-pill.

If you use the progestin-only pill, or mini-pill, you have to be much more careful to take your pill at the same time every day. If you are more than 3 hours late taking the mini-pill (unless you’re using the brand Slynd, which offers more flexibility), you will need to use a backup method of birth control for the next 48 hours. With the combination pill, you just need to make sure to take a pill a day—the timing doesn’t matter.

Why would someone choose Opill over another type of birth control pill?

There are many reasons why someone might choose Opill––some have to do with the fact that Opill is a type of mini-pill, and some have to do with the fact that it’s available over the counter. The mini-pill is often prescribed if you’re sensitive to combination pills and having side effects or can’t take estrogen for some other reason.

Because Opill is available over the counter, unlike all of the other birth control pills, which require a prescription, you don’t need to talk to a health care provider to start taking it. That means it might be easier to get, more private, and maybe even less expensive than using other types of birth control pills.

Is Opill the same as emergency contraception (EC)? Is it the same as the abortion pill?

Nope. Opill is a birth control pill, meaning that you take it consistently to prevent pregnancy. EC allows you to prevent pregnancy AFTER having unprotected sex. The abortion pill ends a pregnancy that has already started.

How do I switch from another birth control method to Opill?

You can start taking Opill at any time in your cycle. You may or may not need to use a backup form of birth control, like condoms, when you switch to Opill––it depends on what kind of birth control you’ve been using (if any) and how consistently you’ve been using it.

If you are switching to Opill from a non-hormonal method of birth control, if you’re on a hormonal method but haven’t been using it consistently (you’ve missed pills or forgotten to change your ring or patch), or if you haven’t been using any type of birth control, you will need to use a backup method of birth control for 48 hours after starting Opill.

If you have been consistently using another method of hormonal birth control, including other brands of birth control pills, and you want to switch to Opill, you can start taking Opill the day you get it and stop using your old method right then, and you’ll be protected from pregnancy. You don’t need to use a backup method of birth control after starting on Opill. For example, if you’re using another brand of birth control pill, you can take your last pill from that pack one day and then the first pill from the new pack of Opill the next day. If you’re switching from a combination pill to Opill, make sure you switch during the time you are using the active pills. If you switch while you’re using the inactive pills at the end of the pack, you’ll need to use a backup method for 48 hours after starting Opill.

How quickly does Opill start to protect against pregnancy?

If you’re not on a hormonal method of birth control, or if you’re on a hormonal method, but you haven’t been using it consistently, when you start taking Opill, it will start being effective at preventing pregnancy after 48 hours. If you have sex during those first 48 hours, you’ll need to use a non-hormonal backup method of birth control to prevent pregnancy.

How do I take Opill?

You simply take one pill a day around the same time. To be effective at preventing pregnancy, Opill needs to be taken every day within a three-hour window. For example, you could take Opill daily between 10:00 am and 1:00 pm, though it will be easier not to accidentally go outside the three-hour window if you plan to take it at the same time every day. Some people set an alarm or take their pill at the same time that they do something else every day.

If you take your pill at any time during that three-hour window, you’re good to go! Opill is 98% effective at preventing pregnancy when taken at the same time daily.

What happens if I miss a pill or I’m late taking it?

Anytime you are more than three hours late taking Opill, you will need to use a backup method, like condoms, for the next 48 hours.

If you miss taking Opill during that three-hour window (which will mean that it’s been more than 27 hours since your last pill), take the missed pill as soon as you remember and then go back to your normal time the next day. Even if it means taking two pills in one day, that’s okay. Use a backup method for 48 hours while continuing to take Opill every day.

Can I start Opill right after using emergency contraception pills?

EC pills are birth control you take after sex to prevent pregnancy before it starts. Over-the-counter EC pills, like Plan B, also contain progestin, the same hormone in Opill. You can start Opill right after using EC (although you may want to wait until the next day to reduce nausea), but you’ll need to use a backup method to prevent pregnancy for 48 hours after starting Opill. If you use prescription EC pills (which have the brand name ella), you’ll need to wait 5 days after taking EC to start Opill to avoid making your EC pill less effective.

Can I start Opill right after having an abortion?

It depends on what type of abortion you have. If you have an abortion procedure, it’s totally safe (and often convenient!) to start birth control on the same day as your abortion. That means you can start using Opill (or another brand of pill) that same day.

If you have a medication abortion (sometimes called “the abortion pill”), you’ll be able to start Opill or another hormonal method of birth control immediately after your abortion is complete (that is, as soon as you’ve finished the heavier bleeding that starts after the last pills).

Can I start Opill right after giving birth?

Yes! All brands of the mini-pill are safe to use immediately after giving birth, including if you’re breastfeeding.

Is there anyone who shouldn’t use Opill?

Opill is safe for almost everyone who can get pregnant. You shouldn’t use Opill or any other brand of mini-pill if you currently have breast cancer. Talk to a health care provider before using the mini-pill if you have a history of cancer, have vaginal bleeding and don’t know why, have liver disease or a liver tumor, have a history of stroke, have had bariatric surgery, or have lupus or heart disease. Also talk to your provider about whether the mini-pill is safe for you if you are taking anticonvulsant medications, like seizure medications.

What are the possible side effects of Opill?

Opill, like other brands of the mini-pill, may have side effects for some people. They may include headaches, bleeding changes, sore breasts, nausea, acne, and a change in your sex drive.

Can I still talk to my doctor about birth control if I’m using Opill?

Absolutely. Health care providers, including doctors, nurse practitioners, and pharmacists, can be great resources to talk to about your birth control and other sexual health needs, even when you’re using birth control you get without a prescription, like Opill or condoms. And if you have questions about Opill, they should be able to answer those too.

Where can I get Opill and how much is it?

Opill is now available on Amazon, Opill’s website, and some drugstores, convenience stores, and grocery stores. There is a suggested retail price of $19.99 for a one-month supply and $49.99 for a three-month supply in stores. Each retailer or store can set their own price, so it may be different based on where you’re getting it and/or where you live. A six-month supply is also available for $89.99 at Opill.com.

Do I have to talk to a pharmacist when I’m buying Opill or can I check out at any register?

Opill is approved by the FDA for over-the-counter use for people of all ages and gender identities without a prescription and without having to talk to a pharmacist or other health care provider. There are no limits on who can buy Opill, and no one should ask for your ID to buy it. However, individual stores and retailers may choose to lock up Opill, meaning you may have to talk to someone who works there to have it unlocked.

I can’t remember to take the pill every day. Is there another method I can use?

Taking a birth control pill every day works great for some people, but for others, it just isn’t a good fit. Check out our Method Explorer for all the information you need about methods of birth control you don’t have to use every day, from condoms you only use when you have sex, to the ring, which you only have to think about twice a month, to IUDs and implants that are effective for years.