Ultra-low-dose birth control pills with generics?
October 11, 2011 2:57 PM   Subscribe

Hormonal birth control question: Lo Loestrin Fe has no generic, and even with my crappy insurance is unaffordable for me. What are other ultra-low-dose birth control pills that DO have generics?

Special snowflake information: I don't tolerate HBC well, and this is sort of a last-ditch effort for me after my IUD insertion didn't go as planned (near uterine perforation, many days of pain, removal, sad face). I have been on Ortho Tri-Cyclen/OT-C Lo in the past (2000-2004) and it was horrible -- no sex drive, crazy moods, depression.

After the IUD insertion/removal, my dr. gave me a prescription and two months' samples of Lo Loestrin Fe with a manufacturer's $10 discount card (which wasn't supposed to expire till March 2012 but apparently has expired already). The first month of Lo Loestrin Fe was tough, but it seems to be evening out. So I go to fill my prescription and even WITH my insurance it comes to $74 a month, which I can't afford.

I'm currently trying to get an appointment to talk birth control at Planned Parenthood, but I'd like to know if there's a list somewhere of ultra-low-dose pills that have generics. There's so much advertising crap online that I'm having a hard time.

(To ward off derails: My boyfriend has offered to help out, and may for the next month, but that's untenable in the long run -- $74 is still a lot split between two, and I'd rather shoulder it myself. And I would love to get sterilized, but obviously I can't afford it. If you have some special knowledge of clinical trials of Essure in the Austin area, please let me know :] Or for that matter, trials of non-Paragard copper IUDs.)
posted by fiercecupcake to Health & Fitness (21 answers total) 3 users marked this as a favorite
I know this doesn't answer your question directly, but I hope it's helpful: I use a different brand of Loestrin and their prescription cards have always worked for me. There are a couple requirements, the most important one being that you have to get one month of prescription at a time - you can't get 90 days/3 months which is commonly prescribed by doctors. My pharmacy was happy to split up my prescriptions so I could use the card, but some might require your pharmacist to write a new prescription. Also, you could try calling up your doctor and asking for another card - they get loads and loads of them.
posted by muddgirl at 3:08 PM on October 11, 2011

my pharmacist has been the best source of information about drugs. they've helped me find generics, told me risks my doctor glossed over, noticed when i was paying too much. you might ask them.

this also might be worth a try. prescription discount cards save me about 100 bucks a month.
posted by nadawi at 3:10 PM on October 11, 2011

Yaz. Low dose and has generics.
and I also can't take Othro-tricyclen, and no issues with Yaz
posted by Neekee at 3:12 PM on October 11, 2011

Seconding asking your doctor for another discount card. You may need to register it online to get all the benefits.

The drug company really wants to give you the discount card, because it's only a discount for *you*, not for your insurance company, so they still end up making loads of money (the rest of the people in your health plan, not so much). They will give you the card if they think you'll use it. They want you to buy their drug. The $10 is not important to them.
posted by mskyle at 3:19 PM on October 11, 2011

Response by poster: Everyone has been helpful so far, and I will definitely check for discount cards from now on, but I'd like to add: the $10 off the $74 prescription still doesn't make it affordable. I'm talking $35 as the highest I can pay right now, and kind of what I was expecting to pay since I buy my own insurance and pay for prescription drug benefits.
posted by fiercecupcake at 3:24 PM on October 11, 2011

the link i posted suggests that with insurance you'd pay 24 bucks.
posted by nadawi at 3:29 PM on October 11, 2011

My apologies - for another type of Loestrin (Loestrin 24 FE), the discount card brings it down to $24 per month total and I assumed it was the same for Lo Loestrin.

nadawi - that's a different pill with a slightly higher dose of estrogen and progesterin.
posted by muddgirl at 3:31 PM on October 11, 2011 [1 favorite]

Talk to your doctor! You need them to get an Rx anyway- and I imagine someone at Planned Parenthood, if you get an appointment there, would be used to dealing with people who can't pay a ton for their BC. You might also check to see if your insurance has a website you can use to find out how much a given drug will cost you.

Or just call up the doctor who prescribed you the Loestrin- if it's within a year since your last exam, they can probably write you a new prescription based on a phone conversation.
posted by MadamM at 3:34 PM on October 11, 2011

Best answer: IANAPharmacist, but for reference, Lo-Loestrin FE is 1 mg norethindrone [a type of progestin] and 10mg EE [a type of estrogen] x 24, then two pills with only EE and two pills with only iron.

I don't know how new Lo-Loestrin is, but I have my Summer prescribing guide out because it has a really nice chart for OCPs and it's not in there. There's nothing particularly close, either.

(Yaz is 3mg/ 20mg, but it uses a different progestin called Drosperinone, and Orthro-Tri uses yet another one called Norgestimate, so 'low dose' .) Changing progestins may help, which is why some people do better on different pills.

The lowest dose of anything I can find that isn't just a minipill (which are progestin only) is Kariva, which is the generic for Mircette. Again, it's a different progestin, so it's hard to tell how you'd react to each without trials, which can be really hard sometimes.
posted by cobaltnine at 3:35 PM on October 11, 2011 [1 favorite]

Isn't Junel the generic version of Lo Estrin FE? That's what I take and it is covered by my insurance.
posted by WorkingMyWayHome at 3:37 PM on October 11, 2011

I used to be on Loestrin -- sorry, I don't remember which one -- and now I am on a generic called Gildess 1.5/30. It says: "Each tablet contains 1.5 mg norethindrone acetate and 0.03 ethinyl estradiol."
posted by BlahLaLa at 3:43 PM on October 11, 2011

Best answer: I'm not a doctor, but I do know a bit about oral contraceptives. Lo Loestrin Fe has a couple features that may be the key for you -- the type of progestin (norethindrone acetate) and the administration of a constant dose of 10 mcg of ethinyl estradiol all the time (even in the normal "placebo" or pill-free week). I think it's less likely that the low dose of 10 mcg of ethinyl estradiol (versus, say, 20 mcg or 30 mcg) is the thing that's making the difference for you.

So, I'd suggest calling your doctor and asking if you can first try a generic OC with norethindrone acetate. See how that works for a couple months. If you find you have annoying symptoms during or around the pill-free week, then ask your doctor if you can try taking that same OC continuously or with a break only every 3-4 months (ie, skipping the pill free week for 2-4 packs in a row). If your doctor is up-to-date on OC literature, he/she should be willing to work with you on this.

The last option is to try a progestin you haven't tried before (drospirenone, norgestimate, etc).

(On preview, Junel Fe is a generic with 21 days of norethindrone acetate/20 mcg EE and 7 days of placebo. So it has the same progestin as Lo Loestrin Fe, but it has 20 mcg of EE for 21 days and 7 pill-free days, instead of 10 mcg of EE all the time. So that might be one to try first, and if you have trouble with the pill-free week, ask your doctor if you can just take it continuously for 3-4 packs at a time.)
posted by pitseleh at 3:46 PM on October 11, 2011 [1 favorite]

Whoops, I edited out part of my answer. It should read 'So 'low dose' is kind of hard to define between different types of progestins.'
posted by cobaltnine at 3:46 PM on October 11, 2011

Oh, correction -- I see that Lo Loestrin Fe has 2 days fully hormone-free. That doesn't really change my advice, though -- it's probably either the norethindrone acetate that your body likes, and/or the near-continuous estrogen administration. You can definitely get both of those in a generic if you and your doctor are OK with skipping the pill-free week.
posted by pitseleh at 4:10 PM on October 11, 2011

If you're relying on the pharmacy to get your copay correct, you may want to double check their work. Despite it being mostly automated, they've priced some scrips very wrongly for me. $35 is the most I should pay for any covered drug and they wanted me to give them $74 for a freakin' generic I should have been paying $15 for! They also tried to charge me full price for (my SO's) OTC-Lo when they were out of the generic, even though our insurance covers non-generics, just with a higher copay.

Oh, and my copay is also $15 for name brands if no generic is available, and they once tried to get me to pay $115 for some brand name antibiotic.
posted by wierdo at 4:18 PM on October 11, 2011

No generic foe loestrin fe but there is for loestrin (junel is one) call your dr/nurse line/pharmacy on what the exact difference is.

You may want to ask the dr for samples since a drug rep may be behind the prescription.
posted by Bun Surnt at 4:32 PM on October 11, 2011

** also go to the mfg website for the med and see if they offer a copayment card. Which when taken to the pharmacy will reduce your copayment. If no luck online call the mfg and see if they have a of assist program that can work for you (even if you have insurance )
posted by Bun Surnt at 4:34 PM on October 11, 2011

My doc once gave me 6 months of free samples of Loestrin FE 24. Most won't give you more than a few but always ask for samples when you're getting a name brand or new drug.
posted by Bunglegirl at 4:46 PM on October 11, 2011

My insurance didn't want to cover continuous bc pills. There may be specific hoops a doctor has to jump to get it done.
posted by Salamandrous at 5:25 AM on October 12, 2011

Response by poster: Lots of good advice in this thread! Thanks so much. I finally got through to PP and have an appointment this afternoon. I'll let you know what happens.

I somehow put in the magic search string and found this this morning:
MPR - Oral Contraceptives

Which is everything I was looking for, but without the invaluable breaking-it-down from cobaltnine and pitseleh. So thanks again :]
posted by fiercecupcake at 9:49 AM on October 12, 2011 [1 favorite]

Have you checked to see if your insurance covers getting your tubes tied (since you say you would love to get sterilized?)

My POS insurance fully covers sterilization, but barely covers birth control. Which as a mid 20s woman who just wants to delay having children and not swipe it off the table completely..i think its complete fuckery
posted by WeekendJen at 12:01 PM on October 12, 2011

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