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If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
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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What type of birth control pill is Apri?
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).
How do you use Apri birth control?
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.
What are the side effects of Apri?
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.
Who shouldn’t use combination oral contraceptives?
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).
Can Apri treat other medical conditions too?
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.
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.
- Berry-Bibee, E. N., Kim, M. J., Tepper, N. K., Riley, H. E., & Curtis, K. M. (2016). Co-administration of St. John’s Wort and Hormonal Contraceptives: A Systematic Review. Contraception, 94(6), 668–677. doi: 10.1016/j.contraception.2016.07.010. Retrieved from https://pubmed.ncbi.nlm.nih.gov/27444983/
- Evans, G., & Sutton, E. L. (2015). Oral Contraception. Medical Clinics of North America, 99(3), 479–503. doi: 10.1016/j.mcna.2015.01.004. Retrieved from https://pubmed.ncbi.nlm.nih.gov/25841596/
- Festin, M. P. R. (2020). Overview of Modern Contraception. Best Practice & Research Clinical Obstetrics & Gynaecology. doi:10.1016/j.bpobgyn.2020.03.004. Retrieved from https://pubmed.ncbi.nlm.nih.gov/32291177/
- NIH (U.S. U.S. National Institutes of Health): U.S. National Library of Medicine. (2020, Dec. 21). Apri 28 Day- Desogestrel and Ethinyl Estradiol Kit. DailyMed. Retrieved April 2, 2021 from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a9e08f9b-9862-4c2c-8302-53dc82d85126
- Schrager, S., Larson, M., Carlson, J., Ledford, K., & Ehrenthal, D. B. (2020). Beyond Birth Control: Noncontraceptive Benefits of Hormonal Methods and Their Key Role in the General Medical Care of Women. Journal of Women’s Health. doi:10.1089/jwh.2019.7731. Retrieved from https://pubmed.ncbi.nlm.nih.gov/32155101/
- Tinker, S. C., Broussard, C. S., Frey, M. T., & Gilboa, S. M. (2015). Prevalence of Prescription Medication Use Among Non-pregnant Women of Childbearing Age and Pregnant Women in the United States: NHANES, 1999-2006. Maternal and Child Health Journal, 19(5), 1097–1106. doi: 10.1007/s10995-014-1611-z. Retrieved from https://pubmed.ncbi.nlm.nih.gov/25287251/