Tajana Kundacina, DO, an OB/GYN with Valley Women’s Healthcare in Auburn discusses the recent FDA approval of over-the-counter birth control pills, who will benefit from having access to these pills, and how it is different from what is currently available by prescription. Watch the video below or read the transcript at the bottom of the page.
What can you tell us about the recent FDA approval about over-the-counter birth control pills and why is it significant?
Yes, this is super exciting! We’re joining the ranks of hundreds of other countries and offering a birth control pill over the counter in the United States. It will help increase access to birth control without having a prescription or having a doctor’s visit or provider visit to get that prescription, which is really, really great. The pill that they approved over the counter was called Opill and the generic form of that is norgestrel. It’s a medication that’s been around since the 1970s. Originally, it’s one of the first-generation progesterone-only pills so it has been around for a really long time, and we know it has good safety data.
When will we expect to see the pills in pharmacies?
That’s not entirely clear yet. From what I can gather from my own research, we’re thinking sometime in 2024, from what the manufacturer has listed on their website. The details surrounding that are a little unclear in terms of whether or not you can use your insurance to purchase the medication without a prescription. So, we’ll see more of what comes out of that once the federal government gives us a little bit more information on those topics.
Who will most benefit from having access to these over-the-counter pills?
What’s great about this being a progesterone-only pill is that a lot of patients can take it safely. It’s going to be great for those people who may have just moved recently or don’t have an OB/GYN or provider that prescribes birth control, and they need to just get by, or they forgot their medication on vacation. It’s also going to help in those areas where people don’t have as good access to care or provider care with a physician or a nurse practitioner who can prescribe birth control. Having that available more commercially in your pharmacy can be really helpful. You can just say, ‘I need to start some birth control. I’m going to see if I can go pick this up at my local pharmacy.’ So, it’s really about increasing that access to care.
How is this pill different than what is currently available by prescription?
It’s very similar to the other progesterone-only pills that we have available for birth control. However, this is an older, first-generation progesterone, which isn’t necessarily a bad thing. When we talk about different types and generations of birth control pills, some of them can have different benefits than others. The newer generations of pills out there that are progesterone-only do have other benefits for patients who have, say, PCOS, who have acne, and maybe increased hair growth – and this pill may not be as good of an option for them in that regard. However, that would be an off-label use of this medication. In terms of being a safe, over-the-counter contraceptive, it is a really great option for a lot of people.
What are the considerations to be aware of for taking this kind of progesterone-only pill?
What’s great about progesterone-only pills is that there aren’t a lot of harmful side effects. The biggest things I would watch out for, and counsel patients to talk to a physician or a provider about, would be if they have any sort of liver disease or breast cancer. Those would be the big ones to talk about. If you’re really not sure, and you’re at the grocery store, you can ask a pharmacist. They’re really helpful with certain things like that, but they may also steer you towards a provider if they have concerns. The other thing we want to talk about too is what other medications are you taking? There are certain medications that can actually decrease the efficacy of birth control pills. That might be something the pharmacist can help with, or you may want to talk to your provider about that as well. But, in the reverse, birth control pills can sometimes have an effect on other medications that you take. So, if you’re worried and you’re on a lot of medications, that would be a good thing to review with someone. But overall, they’re very safe to use for patients who have even had a history of cardiovascular disease, or diabetes, high blood pressure, smokers. So again, it helps increase that access to a larger population of people for a very safe birth control pill option.
Is there anything else to know about taking this pill once it becomes available?
If you’ve decided that this is something that you want to try out and take, the biggest thing is knowing that in order for this to work effectively and prevent pregnancy, you have to take this medication at the same time every day. Within three hours is what we consider the same time. If you go past that, take your pill as soon as you remember, and then use some form of backup contraception for the next 48 hours. That’s the biggest thing I would say about this medication. If you’re not good at taking pills every day, it might not be a great option. I always tell my patients that birth control and finding the right fit is kind of like dating or figuring out what your favorite flavor of ice cream is, you need to try a bunch of different things sometimes to find the right fit. So, even if this doesn’t work for you, come talk to your provider, come talk to an OB/GYN like myself, and we can help figure out what will work best for you, and try different things.
