Nextstellis (drospirenone/estetrol) Tablets

Nextstellis is a prescription birth control pill that contains drospirenone and estetrol to help prevent pregnancy. This page explains how the medication works, what the pack contains, and practical safety points to review with a healthcare professional. BorderFreeHealth supports access for cash-pay patients without insurance with US shipping from Canada where permitted.

What Nextstellis Is and How It Works

This medicine is a combined oral contraceptive (a pill with an estrogen and a progestin). Prescriptions are confirmed with the prescriber before dispensing. The hormones help prevent pregnancy mainly by stopping ovulation (release of an egg). They also thicken cervical mucus, which can make it harder for sperm to reach an egg, and they can change the uterine lining.

Estetrol is an estrogen (a hormone similar to natural body estrogen), and drospirenone is a progestin (a progesterone-like hormone). Drospirenone also has antimineralocorticoid activity (affects salt-and-water balance), which is one reason certain medical conditions and interacting medicines matter. Like other hormonal contraceptives, this treatment does not protect against sexually transmitted infections; barrier methods are often discussed for STI risk reduction.

Who It’s For

This product is used for contraception in people who can become pregnant. It is not intended for use during pregnancy, and it should not be started if pregnancy is known or suspected. For broader browsing across methods and related prescriptions, see the Contraception Options Hub or the Women’s Health Category for other women’s health therapies.

Combined hormonal contraception is not appropriate for everyone. Clinicians typically screen for a history of blood clots, stroke, certain heart conditions, uncontrolled high blood pressure, migraines with aura, liver disease or liver tumors, and hormone-sensitive cancers such as breast cancer. Smoking cigarettes while over age 35 is a major safety concern with combined pills. Conditions that raise potassium (for example, kidney or adrenal problems) can be especially relevant with drospirenone. If polycystic ovary syndrome is part of the medical history, the PCOS Symptoms Guide can help organize questions for a visit. For STI awareness alongside contraception planning, the HIV Symptoms In Women resource provides plain-language context.

Dosage and Usage

Nextstellis is generally taken as one tablet by mouth at the same time each day, following the order in the blister pack. Many packs include a set of active hormone tablets followed by placebo (non-hormonal) tablets to keep the daily habit consistent. The prescribing information describes how to start (for example, starting on day 1 of a period versus another start method) and when back-up contraception may be needed during the first days of use.

Consistency matters with all daily pills. Try to avoid missed doses, and keep the blister card as a visual reminder of where you are in the pack. If vomiting or severe diarrhea occurs soon after taking a tablet, absorption may be reduced, and the label provides guidance on how to respond. A clinician can also advise on what to do when other medicines may interfere with hormone levels.

Missed Tablets and Back-Up Contraception

If a tablet is missed, the correct next step depends on where you are in the pack and how many pills were missed. Some situations call for taking a missed tablet as soon as it is remembered and continuing the next tablet at the usual time, even if that means two tablets in one day. Other situations may require temporary back-up contraception for a set number of days. The product label includes a decision pathway designed to reduce pregnancy risk and to manage breakthrough bleeding. When there is uncertainty, contacting a pharmacist or prescriber is the safest way to confirm the plan.

Why it matters: The chance of ovulation can rise when hormone doses are missed.

Strengths and Forms

This contraceptive is supplied as oral tablets in a blister-style pack. The active tablets contain drospirenone 3 mg and estetrol 14.2 mg, and the placebo tablets contain no hormones. Tablet color and markings can vary by market and manufacturer packaging, so the dispensing pharmacy’s labeling should be used as the primary reference.

Packs are commonly arranged as a 28-day cycle to support a steady routine. The sequence helps users track active versus placebo days and can make it easier to notice a missed pill. If a replacement pack is needed due to loss or damage, pharmacists typically advise starting the new pack in a way that preserves continuous coverage, using the official instructions as the guide.

Storage and Travel Basics

Store tablets at controlled room temperature and keep them in the original blister until use to protect from moisture. Avoid leaving the pack in places with sustained heat (such as a parked car) or high humidity (such as a steamy bathroom). Check the pharmacy label for any additional storage directions, and keep medicines out of reach of children and pets.

Travel can introduce missed doses because of time-zone changes and busy schedules. Packing the blister card in carry-on luggage helps prevent temperature swings and reduces the chance of lost bags disrupting a dosing routine. If a schedule change is needed, clinicians often recommend keeping the interval between tablets as close to 24 hours as practical. For life-stage context that may overlap with contraception planning discussions, the Menopause And Beyond Guide is a helpful overview, and the Women’s Health Articles hub collects related topics.

Quick tip: Set a daily alarm before a trip starts.

Side Effects and Safety

Many people tolerate combined hormonal pills well, but side effects can occur, especially during the first few cycles. Common effects may include nausea, headache, breast tenderness, mood changes, and irregular or breakthrough bleeding. Gastrointestinal upset can also happen, and changes in appetite or fluid retention may be noticed. Experiences vary, and symptom patterns are worth tracking so a prescriber can determine whether a different formulation is a better fit.

More serious risks are uncommon but important to recognize. Nextstellis, like other combined hormonal contraceptives, can increase the risk of blood clots, which may lead to deep vein thrombosis, pulmonary embolism, stroke, or heart attack. Seek urgent care for symptoms such as chest pain, sudden shortness of breath, leg swelling or pain on one side, severe headache unlike usual, weakness on one side, or vision changes. Medications are supplied through licensed Canadian partner pharmacies. Because drospirenone can raise potassium in some situations, clinicians may consider potassium monitoring for patients with relevant conditions or interacting drugs. If mental health symptoms worsen, the Prozac Side Effects Guide can support a more structured conversation about mood-related symptoms.

• Common: nausea or headache
• Cycle changes: spotting or no withdrawal bleed
• Urgent: clot warning symptoms
• Monitoring: potassium in select cases

Drug Interactions and Cautions

Some medicines can lower contraceptive hormone levels, which may reduce reliability and increase breakthrough bleeding. This includes certain seizure medicines, rifampin-like antibiotics, and some HIV or hepatitis C therapies. Herbal products can matter too; St. John’s wort is a well-known example that can affect hormone metabolism. If a new prescription is started, it is reasonable to ask whether back-up contraception is recommended during that course and for a period after it ends.

Drospirenone can interact with drugs that increase potassium, such as certain blood pressure medicines (for example ACE inhibitors or ARBs), potassium supplements, some diuretics, and other agents that affect kidney handling of electrolytes. Nonprescription pain relievers in the NSAID class may also be discussed in higher-risk settings. Keep a current medication list, including supplements, and share it with the dispensing pharmacist so potential conflicts are flagged early. Avoid stopping or starting any prescription medication without prescriber direction.

• Enzyme inducers: may reduce hormone levels
• Potassium-raising drugs: added caution
• Herbals: St. John’s wort risk
• New meds: confirm back-up needs

Compare With Alternatives

When comparing options, it helps to separate the delivery method (daily pill, ring, patch, injection, implant, or IUD) from the hormone ingredients. Nextstellis uses estetrol as the estrogen component rather than ethinyl estradiol, which is found in many other combined pills. Some people consider this difference when discussing tolerability, medical history, or personal preferences with a clinician.

Other drospirenone-containing combined pills include Yaz Tablets and Yasmin Tablets, which use ethinyl estradiol as the estrogen. Non-pill methods (such as a vaginal ring or a levonorgestrel IUD) can be useful when daily adherence is difficult or when menstrual goals differ. A prescriber can review contraindications, bleeding patterns, and drug interactions to help select an appropriate method.

Pricing and Access

Coverage and out-of-pocket amounts vary widely by plan and by region, and some people compare cash-pay pricing when insurance coverage is limited. Nextstellis may require a valid prescription, and the dispensing pharmacy will follow jurisdiction rules about what can be supplied. If coverage questions come up, it may help to check the plan formulary and ask whether a prior authorization is required.

For those managing contraception expenses without insurance, BorderFreeHealth may support access using a cash-pay model rather than billing a plan. Cash-pay access is available when insurance coverage is limited. When available, site-wide programs are listed on the Current Promotions page. If a switch is being considered for medical reasons, discussing alternatives and contraindications with the prescriber is important, since “similar pill” does not always mean “similar risk.”

Authoritative Sources

For the most complete and current details, review the official labeling and clinical guidance alongside a pharmacist or prescriber. Nextstellis prescribing information is the best source for contraindications, missed-pill instructions, and monitoring recommendations for higher-risk situations. Reporting new or severe symptoms promptly can help clinicians assess whether continued use is appropriate.

These sources provide label-based and public health guidance:

• FDA Prescribing Information (PDF)
• CDC Contraception Guidance

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This content is for informational purposes only and is not a substitute for professional medical advice.