What is Apri? Uses, warnings & side effects

Read and follow the instructions included in the carton.

Take one tablet per day at the same time every day. Do not miss a dose.

There are 21 rose-colored tablets containing hormones and seven inert white tablets without hormones. Take all the tablets in the blister pack, including the inert tablets.

Take the first tablet (number 1) on the first day of menstruation or the first Sunday after menstruation starts. 

When switching from another type of hormonal birth control, take the first pill the day you would have started a new blister pack of a previous birth control pill, replaced a vaginal ring or patch, or the day an implant or IUD is removed.

Each tablet has a number assigned to it on the blister pack. Take each tablet in order.

Take the first rose-colored pill from a new pack the day after the last white pill is taken from the old pack. 

Start each new pack on the same day of the week each cycle.

Swallow the tablet whole with a drink of water.

• Do not crush, break, or chew it.

• Tablets can be taken with or without food. 

If you vomit or have diarrhea, use backup birth control until you can talk to the prescriber. 

Store Apri at room temperature in the original carton.

Missed doses increase the risk of pregnancy. 

• It may be necessary to use backup birth control for at least seven days if a dose is missed.

If a rose-colored pill is missed:

• Take it as soon as possible. 

• Take the next tablet at its regular time.

• Two doses can be taken on the same day to make up for a missed dose. 

• Missing one pill does not increase the risk of pregnancy. Backup birth control is not necessary.

If you miss two rose-colored pills in a row in the first two weeks:

• Take two doses on the day you remember and two doses the next day.

• Return to the regular dosing schedule.

• Two consecutive missed doses increase the risk of pregnancy. Use backup birth control for at least seven days.

If you miss two rose-colored pills in a row in the third week: 

• Start over with a new Apri blister pack.

• Day 1 starters should throw out the current pill pack and start over with a new one.

• Sunday starters should continue to take rose-colored pills from the old pack and then start a new pack on Sunday.

• Missing two pills in the third week increases the risk of pregnancy. Use backup birth control for the first seven days after starting a new blister pack.

If you miss three or more rose-colored pills in a row in any week:

• Start over with a new Apri blister pack. 

• Day 1 starters should throw out the current pack and start over with a new one.

• Sunday starters should continue to take rose-colored pills from the old pack and then start a new one on Sunday.

• Use backup birth control for seven days after starting the new pack.

If you’re not sure about a missed pill, use backup birth control.

While oral contraceptives are safe for most women, they are not safe for some women. 

Do not use Apri if you are pregnant, older than 35, and smoke, or have:

• Unusual vaginal bleeding that has not been checked by a healthcare provider

• A history of heart attack or stroke

• A history of blood clots in the legs

• Current blood clots in the legs, lungs, or eyes

• Chest pain

• High blood pressure that is not corrected by medicine

• Current or past coronary artery disease or blood vessel problems in the brain

• Valvular heart disease with complications

• Diabetes with kidney, eye, nerve, or blood vessel damage

• Migraine headaches with focal neurological symptoms

• Hormone-sensitive cancers such as breast cancer, uterine cancer, cervical cancer, or vaginal cancer

• Liver tumor

• Any history of jaundice when pregnant or on birth control pills

• Major surgery requiring prolonged immobilization

Tell all other healthcare providers treating you that you are using birth control pills, especially before medical or dental procedures. 

• Apri should not be used four weeks before or two weeks after major surgery.

• Birth control pills can alter the results of several important blood tests. 

The prescriber may need to perform regular lab tests to monitor the effects of this medicine. Keep all appointments.

Immediately tell the prescriber if you become pregnant, think you’re pregnant, or miss two periods in a row. 

Before starting Apri, tell the prescriber if you smoke, are breastfeeding, or have:

• Recently given birth

• Heart or blood vessel disease

• High blood pressure

• High cholesterol or triglycerides

• Breast nodules

• Fibrocystic disease of the breasts

• An abnormal mammogram or breast X-ray

• Diabetes

• Migraines

• Kidney problems

• Liver problems

• Gallbladder disease

• Depression

• A history of light periods

Apri can cause serious side effects, including: 

• Increased risk of blood clots, heart attack, and stroke

• Increased risk of breast or cervical cancer

• High blood pressure

• High cholesterol

• Liver problems

• Gallbladder problems

• Severe, persistent, or worsening headaches

• Increased risk of ectopic pregnancy

Apri can cause a spotty darkening of the skin, particularly on the face. Wear sunscreen and avoid tanning beds or tanning lights.

Apri can change the shape of the cornea. Women wearing contact lenses should immediately talk to the prescriber if they experience vision changes or are unable to wear the lenses. 

This medicine will not protect women from HIV/AIDS or other sexually transmitted diseases.

Do not take Apri with any hepatitis C drug containing ombitasvir/paritaprevir/ritonavir.

Apri has numerous drug interactions. Tell the prescribing healthcare provider about all prescription drugs, over-the-counter medicines, and supplements regularly used, especially:

• Other birth control pills

• Barbiturates

• Macrolide antibiotics

• Drugs that treat fungal infections 

• Drugs that treat seizures

• Antiviral drugs that treat hepatitis C or HIV/AIDS

• Thyroid hormones

• St. John’s wort

• Acetaminophen, aprepitant, ascorbic acid, atorvastatin, bosentan, clofibric acid, cyclosporine, felbamate, prednisolone, rifabutin, rifampicin, rosuvastatin, rufinamide, theophylline, tizanidine

Avoid grapefruit and grapefruit juice when taking Apri.

Women taking colesevelam should take Apri four hours before or four hours after a colesevelam dose. 

Tell other healthcare providers you are using this medicine before they prescribe new medications.