Birth control is something that needs to be effective. In choosing their oral contraceptives, women have a large array of medications to choose from. Is choosing a generic contraceptive as good as choosing a brand name?

The FDA has different rules for generic drugs than for the originals. When first introduced to the market, drugs have to undergo a series of tests to make sure that they not only do what they allege, but also to make sure that they don't have unpleasant or dangerous side effects. Generic drugs do not undergo such stringent testing procedures.

The FDA requires that generic drugs prove that they are therapeutically equivalent to the originator drug. This means that generic drugs have to prove pharmaceutical equivalency and bioequivalency. Pharmaceutical equivalency means that the drugs have the same active ingredient, in the same dosages, and delivered in the same way. Bioequivalency means that it is not absorbed at a different rate or strength than the originator drug. To prove pharmaceutical equivalency and bioequivalency, often a study is carried out with only 20 or 30 women.

Bioequivalency requires that the generic drug be absorbed at least 80% of the strength of the originator drug. The generic drug must also be absorbed almost at the same rate as well. For most drugs, this is not a problem. However, for low-dose pills, this can cause the pills to be not efficient.

With low-dose oral contraceptives (ones that have only 20 micrograms of ethinyl estradiol), the effectiveness of generic drugs is not adequately tested by the FDA. Brand name drugs have to be within 10% effectiveness, and so a brand name low-dose pill would still prevent pregnancy. However, with a generic low-dose pill, the pill could theoretically have a low as 14.4 micrograms of ethinyl estradiol and still be considered suitable by FDA guidelines. A dosage this low will not prevent contraception. This means that if you are choosing a low-dose contraceptive, as many women are, you are better to choose a brand name alternative.

With other oral contraceptives, ones that have 25 micrograms of ethinyl estradiol and above, you can typically choose to use generic brands with no worries about effectiveness. This can be a more cost-effective way to prevent pregnancies.

In every state, pharmacists are allowed to (and sometimes legislated to) give generic equivalents for brand name drugs. This is very helpful for most types of drugs, but with low-dose birth control, it can be disastrous. The FDA has considered mandating against the substitution of generic birth control for brand name birth control. As of yet, it is still up to you, your doctor, and your pharmacist to determine what brand (or no-name) birth control you get.

If you are using other types of prescription contraception, such as the injection, patch or vaginal ring, there are no generic equivalencies available currently. The brand names available for the progestin injection are Depo-Provera and Depo-subQ Provera, the patch is Ortho Evra, and the vaginal ring is NuvaRing.

Talk with your doctor or pharmacist about your oral contraceptive prescription to see if you have a generic or brand name pill, and to reassure yourself that you are getting the protection you need.
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For more information about birth control options, visit The Guide to Birth Control.