Apri birth control: uses, side effects, and more

Birth control pills are one of the most common forms of pregnancy prevention in the United States.

That’s why there are so many options for oral contraceptives on the market. One type of pill is Apri, which is used to prevent pregnancy and help manage conditions including acne, endometriosis, and heavy menstrual bleeding (Tinker, 2015). Here’s what you need to know about Apri birth control.

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Birth control pills contain progestin alone or progestin and estrogen together. Apri is a combination oral contraceptive, meaning it contains both estrogen and progestin. (NIH, 2020).

Apri works mainly by preventing ovulation. In other words, it stops the body from releasing an egg from the ovaries during each menstrual cycle. Apri also causes other changes in the body. It alters cervical mucus to prevent sperm from reaching an egg and thins the lining of the uterus to help stop a fertilized egg from implanting and developing (NIH, 2020). 

Oral contraceptives are popular because it’s a discrete method that, when used correctly, prevents pregnancy without planning when to have sex. Unlike other birth control methods like intrauterine devices (IUDs) and hormonal implants, you can stop taking the pill any time without help from a medical professional.

It’s important to remember that Apri prevents pregnancy—but doesn’t protect against sexually transmitted infections (STIs).

Apri comes as six packets of 28 pills. Each packet provides pills for about a month. 

To use the pills, take one per day. Birth control works best when taken around the same time each day, so try to be consistent about when you take it (NIH, 2020).

If you forget a pill, take the missed one as soon as you remember. If you miss two pills in a row, you need to use another method of birth control, like condoms or spermicide, to prevent pregnancy for the next seven days. What to do if you miss three or more pills in a row depends on when you started the pills, so check Apri’s package insert if this happens to you (NIH, 2020). 

Certain medications can make Apri less effective at preventing pregnancy. Rifampin, rifabutin, and rifapentine are antibiotics known to decrease the effectiveness of oral hormonal contraceptives. 

Some drugs used to treat epilepsy can interact with birth control. These medications include barbiturates, carbamazepine, phenytoin, primidone, oxcarbazepine, and topiramate (Evans, 2015). 

Certain drugs used to treat HIV and hepatitis C should not be used with Apri. Lastly, the over-the-counter herbal supplement St. John’s Wort can make birth control pills less effective (Berry-Bibee, 2016). 

Other medications and supplements can interact with hormonal birth control like Apri, so be sure to tell your healthcare provider about any drugs you're taking before you start. 

Nausea, vomiting, and breast tenderness are common side effects of combination birth control pills like Apri. 

Vaginal bleeding between menstrual periods, also known as breakthrough bleeding, can also occur when using hormonal birth control pills. Although some people who use hormonal contraceptives are concerned about weight gain, there is little evidence that birth control pills cause weight gain (Evans, 2015).

Uncommon but serious side effects include blood clots, heart attack, stroke, high blood pressure, gallbladder disease, and benign liver tumors. People with depression or high cholesterol should be monitored closely to ensure these conditions don’t get worse while taking oral contraceptives. 

If you experience jaundice, swelling, or visual changes (for those who wear contact lenses), talk to a healthcare provider immediately as these may be signs of a more serious condition (NIH, 2020).

While rare, all medications that contain estrogen increase the risk of developing blood clots. Signs of a blood clot include severe leg pain, redness or swelling, or trouble breathing.

Although combined oral contraceptives like Apri are considered very safe, some people shouldn’t take them. Here’s who should avoid this type of birth control (Evans, 2015):

• People with a history of blood clots or clotting disorders

• Those who have high blood pressure

• Individuals with risk factors for heart disease, such as high blood pressure, high cholesterol, and diabetes

• People with liver disease

• Those who’ve experienced breast cancer or have a history of breast cancer

• People breastfeeding or who are within 30 days of giving birth

There is an increased risk of blood clots and heart attack among people who smoke and are over 35. For this reason, people older than 35 who smoke cigarettes shouldn’t use combined oral contraceptives, including Apri (NIH, 2020).

Combination oral contraceptives like Apri have many uses other than for preventing pregnancy. Apri is also often used to treat (Schrager, 2020):

• Endometriosis a painful condition characterized by growth of the uterine lining outside of the uterus.

• Uterine fibroids a condition characterized by muscular growths in the uterus that can cause bleeding.

• Heavy menstrual periods

• Polycystic ovarian syndrome a condition that can cause hormone imbalances, irregular periods, and fertility problems, among other things.

• Acne

• Migraines

This type of birth control may also have cancer-related benefits. Research has found that taken either short- or long-term, combined oral contraceptives help reduce the risk of endometrial and ovarian cancers. There’s some evidence that these pills may decrease the risk of other forms of cancer as well (Schrager, 2020). 

There are many benefits to using combination oral contraceptives like Apri. Speak with your healthcare provider to discuss any risks, drug interactions, or other options available when it comes to birth control.

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Current version

June 15, 2021

Written by

Chelsea Boyd

Fact checked by

Yael Cooperman, MD

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About the medical reviewer

Yael Cooperman, MD, Ro

Yael Cooperman is a physician and works as a Senior Manager, Medical Content & Education at Ro.