Opill: The First Over-The-Counter Birth Control Is Here

Ari Cofer Fact Checked
A photo of a hand holding birth control pills
© Marc Tran / Stocksy United

It’s finally here — an over-the-counter birth control pill option.

Opill is a once-daily tablet that is a safe, effective and convenient type of birth control. The drug itself isn’t new; in fact, it’s been available as a prescription contraception for decades. After nine years of review, the FDA approved Opill to be sold without a prescription in July 2023, and it will be coming to online and in-store retailers around the country in the next few months.   

Here’s what you need to know about this no-prescription-needed contraceptive. 

What you should know about taking Opill

Opill contains progestin, a synthetic form of the hormone progesterone.  

Progestin-only birth control is different from combination birth control pills, which include both progestin and estrogen. Combination pills stop your ovaries from releasing an egg each month (aka ovulation), whereas progestin-only pills prevent pregnancy by both preventing ovulation and thickening the cervical mucus and lining of the uterus, blocking sperm from getting to an egg. 

It’s important to take Opill at the same time every day. 

“Timing is very important when using this birth control because it has a shorter half-life than birth control pills that contain both estrogen and progestin,” says Dr. Sarah Prager, an OB-GYN and director of the Family Planning Division and Complex Family Planning Fellowship at UW Medicine.  

Simply put, progestin is eliminated by your body more quickly than some of the other hormonal contraceptives, so make sure you don’t delay or miss a pill, or it won’t be as effective in preventing pregnancy. 

Opill takes effect 48 hours from when you take the first pill, so use a backup method, such as a condom, for the first two days or if you forget to take a dose.  

Is Opill safe? 

Progestin-only pills have an extremely high safety profile, and drugs like Opill have been used to prevent pregnancy for nearly 50 years. Most people tolerate the medication well, but there’s always a chance of experiencing some side effects with any contraceptive.   

“Opill doesn’t have any additional risks than other contraceptives on the market, and it can have fewer side effects than combination pills,” says Prager. “It’s important for people to know that it’s safe — safer than ibuprofen or Tylenol.” 

Some people naturally have a higher risk of side effects with any birth control they take. For example, if you have or previously had breast cancer, Opill might not be for you. Talk to your doctor first to understand your individual risk. 

And remember: Oral birth control doesn’t protect you from HIV or other sexually transmitted infections (STIs), so make sure you’re still using protection if that’s a concern for you. 

Why it’s important to have accessible birth control 

Prager says there are many reasons why someone would need access to an over-the-counter birth control pill.  

“For example, if someone is traveling and forgets or runs out of their birth control pills, this availability can provide a way for people to substitute their regular pill with Opill and stay protected until they can get back to their usual birth control method,” says Prager. 

Opill has raised eyebrows for some parents because it doesn’t require a prescription, and there is no age restriction, meaning it’s available to teens, too.  

However, Prager says, “If the alternative is unsafe sex, using birth control is always the better option. If it’s not feasible to talk with a clinician or if there’s a long delay, we’d certainly prefer that anyone of reproductive age use this option.”

Of course, it’s still encouraged to talk with your doctor — and encourage your teen to talk with theirs — about starting any new medications.  

How much does Opill cost? 

If you’re considering heading to the store to get Opill, be prepared to pay $20 for a one-month supply. While it’s great that it’s available for anyone to purchase, it continues to highlight some barriers to widespread access to birth control medications. 

“Some people have more trouble getting into a clinic than others, and this over-the-counter option is a way to level the playing field,” says Prager. “While it’s the most effective over-the-counter option, it’s still expensive for many people.” 

If you have health insurance, birth control is typically covered without a co-pay thanks to the Affordable Care Act. While your insurance is unlikely to cover Opill since it’s over-the-counter, your plan might cover a wider range of birth control options, such as other birth control pills, intrauterine devices (IUDs) and vaginal rings.

To explore these different birth control options, schedule an appointment with an OB-GYN if it’s accessible to you. 

Ultimately, the availability of over-the-counter birth control is a win for birth control users everywhere and, hopefully, one step closer to making pregnancy prevention affordable and accessible for all who need it.