Two medicines, side by side
Drospirenone/ethinyl estradiol vs ethinyl estradiol/levonorgestrel
Drospirenone/ethinyl estradiol and ethinyl estradiol/levonorgestrel are both labeled for birth control. Drugs@FDA records approvals of drospirenone/ethinyl estradiol since 2001 and of ethinyl estradiol/levonorgestrel since 1982. Pharmacies paid $0.151 per drospirenone-ee 3-0.03 mg tablet and $0.154 per falmina-28 tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like.
Check it at the source: the drospirenone/ethinyl estradiol FDA label on DailyMed (effective May 29, 2025); the ethinyl estradiol/levonorgestrel FDA label on DailyMed (effective August 27, 2026).
Highlights of the drospirenone and ethinyl estradiol record
Drospirenone and ethinyl estradiol (Yaz) · label of May 29, 2025
CIGARETTE SMOKING AND SERIOUS CARDIOVASCULAR EVENTS Cigarette smoking increases the risk of serious cardiovascular events from combination oral contraceptives (COC) use. This risk increases with age, particularly in women over 35 years of age, and with the number of cigarettes smoked. For this reason, COCs should not be used by women who are over 35 years of age and smoke [see Contraindications ( 4 )].
Used for
From the label: indicationsYaz is a combination of drospirenone, a progestin, and ethinyl estradiol, an estrogen, indicated for use by females of reproductive potential to: • Prevent pregnancy. ( 1.1 ) • Treat symptoms of premenstrual dysphoric disorder (PMDD) for females of reproductive potential who choose to use an oral contraceptive for contraception. […]
On the market
- Earliest approval on file
- May 11, 2001
- Generic labelers
- 15 labelers
- Pharmacy cost
- $0.151 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 0
Highlights of the ethinyl estradiol and levonorgestrel record
Ethinyl estradiol and levonorgestrel (Twirla) · label of August 27, 2026
CIGARETTE SMOKING AND SERIOUS CARDIOVASCULAR EVENTS Cigarette smoking increases the risk of serious cardiovascular events from combined hormonal contraceptive (CHC) use. This risk increases with age, particularly in women over 35 years of age, and with the number of cigarettes smoked.
Used for
From the label: indicationsTYBLUME is indicated for use by females of reproductive potential to prevent pregnancy. TYBLUME (levonorgestrel and ethinyl estradiol tablets) is a combination of levonorgestrel, a progestin, and ethinyl estradiol, an estrogen, indicated for use by females of reproductive potential to prevent pregnancy.
On the market
- Earliest approval on file
- May 10, 1982
- Generic labelers
- 19 labelers
- Pharmacy cost
- $0.154 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 9
Source: FDA drug labels via openFDA (Drospirenone/ethinyl estradiol label of May 29, 2025, Ethinyl estradiol/levonorgestrel label of August 27, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do drospirenone/ethinyl estradiol and ethinyl estradiol/levonorgestrel differ on the record?
How each works, in its label's words: Drospirenone/ethinyl estradiol, “COCs lower the risk of becoming pregnant primarily by suppressing ovulation.”; Ethinyl estradiol/levonorgestrel, “CHCs lower the risk of becoming pregnant primarily by suppressing ovulation.”
Half-life, in each label's words: Drospirenone/ethinyl estradiol, “Excretion DRSP serum concentrations are characterized by a terminal disposition phase half-life of approximately 30 …”; Ethinyl estradiol/levonorgestrel, “Excretion The elimination half-life for levonorgestrel is approximately 36 ± 13 hours at steady state.”
Both labels carry a boxed warning; the records quote them.
Generics: drospirenone/ethinyl estradiol since 2008; ethinyl estradiol/levonorgestrel since 1993 (Drugs@FDA).
| Drospirenone/ethinyl estradiol | Ethinyl estradiol/levonorgestrel | |
|---|---|---|
| Labeled for | Acne, Birth control | Birth control |
| Pharmacologic class | n/a | Estrogen, Progestin, Progestin-containing Intrauterine System |
| How it works (label) | COCs lower the risk of becoming pregnant primarily by suppressing ovulation. | CHCs lower the risk of becoming pregnant primarily by suppressing ovulation. |
| Half-life (label) | Excretion DRSP serum concentrations are characterized by a terminal disposition phase half-life of approximately 30 hours after both single and multiple dose regimens. | Excretion The elimination half-life for levonorgestrel is approximately 36 ± 13 hours at steady state. |
| Earliest approval on file (Drugs@FDA) | May 11, 2001 | May 10, 1982 |
| First generic approved | May 9, 2008 | December 13, 1993 |
| Generic labelers (NDC) | 15 labelers | 19 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.151 per tablet (Drospirenone-ee 3-0.03 mg tablet) | $0.154 per tablet (Falmina-28 tablet) |
| 12-month price change | -5% | -2% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 0 | 9 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 44,288 | 3,159 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What next?
- Alternatives to drospirenone/ethinyl estradiol
- every medicine labeled for the same conditions