Norgestrel

OPILL

What it isProgestin used in combined and, at low dose, over-the-counter progestin-only contraception.

Why this oneThe first oral contraceptive available without prescription in the US.

What limits itThe progestin-only pill needs a narrow dosing window. Irregular bleeding.

Norgestrel prescription history

Animated chart of estimated U.S. prescriptions per year, Hormonal contraceptives (1960–2026). Norgestrel enters in 1973 (estimated).

Principal riskA narrow dosing window for the progestin-only pill

Therapeutic safety burden2 / 4

Overdose danger1 / 4

Weight-gain liability0 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk0 / 4

Legacy pregnancy categoryX

Defining liabilityVenous thromboembolism and hormone-related adverse effects; estrogen also lowers lamotrigine exposure.

NO BOXED WARNINGS

FDA dosing	Population	Start	Target	Max
Contraception	Females of reproductive potential	1 tablet QD	1 tablet QD, continuous (no pack break)

Renal Undefined

Hepatic Undefined

Take 1 tablet at the same time every day
Use a barrier method for the first 48 hours after starting the first pack
If >3 hours late or a dose is missed, take one immediately, resume usual schedule, and use backup for the next 48 hours
If vomiting or severe diarrhea within 4 hours of a dose, use backup for 48 hours
When a pack finishes, start the next the following day with no break

Available strengths

Pregnancy Undefined

Lactation Undefined

Norgestrel (OPILL)

What pharmacies pay · NADAC 9/30/26 · OTC

Strength		#/mo	generic $/mo	brand $/mo	CostPlus
0.075 mg	tab	30 qd	—	$16.46	not offered

Generic entry1999

CYP3A4 substrate

Which norgestrel enantiomer is active?
Levonorgestrel.
What timing issue matters with the norgestrel-only pill?
A narrow dosing window.