Apri

(Desogestrel/Ethinyl Estradiol)

Apri contains desogestrel (a progestin) and ethinyl estradiol (an estrogen). It works mainly by preventing ovulation, and it also thickens cervical mucus and changes the uterine lining to reduce the chance of pregnancy.

Follow all directions given to you by your doctor and read all documents provided, including the full Prescribing Information, FDA-Approved Product Labeling, Instructions for Use, and Medication Guide before using Apri. However, the following is a synopsis of the general guidelines for the use of Apri:

Apri is taken by mouth once daily at approximately the same time every day.

Apri comes in a 21-day or 28-day regimen.

For the 21-day regimen, take one active pill daily for 21 days, then stop for 7 days, and start a new pack on Day 8.

For the 28-day regimen, take one active tablet daily for 21 days, then one inactive tablet daily for 7 days, and start a new pack on Day 8 without skipping any days.

You may start Apri on Day 1 of your menstrual cycle or on the first Sunday after your period begins.

A back-up method, such as latex condoms and spermicide, may be recommended for the first 7 days when starting Apri for the first time.

If vomiting occurs within 3 to 4 hours after taking a tablet, absorption may be reduced, and additional contraception may be needed.

If you miss a dose, follow the missed-dose instructions provided in the product information or ask your healthcare provider what to do.

Some mild or common side effects of Apri seen in clinical trials as compared to placebo include:

Nausea.

Breakthrough bleeding or spotting.

Breast tenderness.

Headache.

Changes in vaginal bleeding patterns.

Weight gain.

Some individuals may experience serious side effects while using Apri. These side effects may require immediate medical attention. If you experience any of the following, contact your healthcare provider or seek emergency medical help:

Signs of a heart attack include chest pain that radiates to the arm, shoulders, or neck, sweating, nausea, and shortness of breath.

Sudden partial or complete loss of vision.

New lumps, dimpling or sining of the skin, or nipple changes in your breasts.

Signs of a blood clot include swelling, pain, or warmth in one leg/ foot, or coughing up blood and sharp chest pain.

Unusual swelling of your extremities.

Signs of gallbladder disease include nausea, vomiting, stomach pain, and loss of appetite.

Yellowing of the eyes or skin, accompanied by fever and loss of appetite.

Signs of a stroke include sudden, severe headache, dizziness, vision or speech disturbances, and weakness or numbness on one side.

Signs of a vaginal infection include itching or unusual discharge.

Signs of an allergic reaction include swelling of the face, lips, or tongue, shortness of breath, or trouble breathing.

These are not all of the possible side effects of Apri. You should always seek medical advice from your healthcare provider for any questions or concerns about your medical condition or treatment. Read all patient information, medication guides, or drug information sheets that come with this medication. You can also report adverse effects to the Food and Drug Administration at www.fda.gov/medwatch or 1-800-FDA-1088.

Before starting Apri, it is crucial to discuss any existing health conditions with your healthcare provider. You should be sure that your healthcare provider is aware of all your medical conditions, including:

Smoking nicotine.

Obesity.

High blood pressure.

High cholesterol.

Diabetes or a family history of diabetes.

Family history of stroke, heart attack, or blood clots.

Heart disease.

Kidney problems.

History of seizures.

History of depression.

Cholestasis.

Cirrhosis or other liver problems.

Wear contact lenses.

Uterine fibroids.

Systemic lupus erythematosus (SLE).

Inflammatory bowel disease.

Hemolytic uremic syndrome.

Sickle cell disease.

Irregular heartbeat or heart valve disease.

Hereditary or acquired angioedema.

Porphyria.

Chloasma.

Allergy to desogestrel or ethinyl estradiol.

History of or risk factors for a blood clot.

History of a stroke or heart attack.

Coronary artery disease, including angina.

Heart valve disease with complications.

Migraine headaches with or without aura.

Uterine or breast cancer.

Liver disease.

Hepatitis C and taking ombitasvir/paritaprevir/ritonavir, with or without dasabuvir, or some other Hepatitis C drug combinations (such as glecaprevir/pibrentasvir).

Liver tumours.

History of or current jaundice.

Unusual and undiagnosed vaginal bleeding.

Pregnancy.

Pancreatitis and high triglycerides.

Loss of vision due to blood vessel disease of the eye.

Apri can begin preventing pregnancy once hormone levels are sufficient to suppress ovulation. A backup method may be needed during the first 7 days when starting for the first time, depending on when you begin the pack.

When Apri is taken with other prescription drugs, over-the-counter medications, vitamins, and supplements, it may change how they work or increase the frequency or severity of side effects. Make sure that you tell your healthcare professional about anything that you are taking to avoid any negative drug interactions, including:

Medications which decrease the levels of Apri, leading to reduced efficacy: antibiotics such as rifampin, nitrofurantoin, and sulfonamides; St. John’s Wort; anticonvulsants such as carbamazepine, felbamate, lamotrigine, oxcarbazepine, phenytoin, and topiramate; the antifungal griseofulvin; barbiturates; and bosentan.

Antivirals such as nelfinavir, ritonavir, nevirapine, and efavirenz may increase or decrease levels of Apri in the body.

Medications which may have increased side effects when combined with Apri include alcohol, clonidine, beta-blockers, caffeine, prednisone, cyclosporine, meperidine, reserpine, theophylline, benzodiazepines (lorazepam, diazepam), and clomipramine.

Medications that may have decreased efficacy when combined with Apri: anticoagulants, anticonvulsants, isoproterenol, clofibrate, antidiabetics, and vitamin B12.

Apri tablets contain:

Desogestrel 0.15 mg.

Ethinyl estradiol 0.03 mg.

Store Apri at room temperature and keep it out of the reach of children.

Apri is manufactured by Teva Canada Limited.

Yes, it is available from many manufacturers of generic drugs.

Do not stop Apri without guidance from your healthcare provider if you are using it for contraception. If you stop taking Apri, you may no longer be protected from pregnancy, and your menstrual cycle may change. If you want to stop or switch birth control pills, your healthcare provider can recommend an alternative option.

No. Apri should not be used during pregnancy.

Talk to your doctor if you are already breastfeeding or if you have any plans to breastfeed. They will know or recommend what is best for you.