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Generic name: drospirenone and estetrol
Dosage form: tablets
Drug class: Contraceptives

Medically reviewed by Judith Stewart, BPharm. Last updated on Aug 22, 2023.

What is Nextstellis?

Important information

Do not use Nextstellis if you smoke cigarettes and are over 35 years old. Smoking increases your risk of serious cardiovascular side effects (heart and blood vessel problems) from birth control pills, including death from heart attack, blood clots or stroke. The risk increases with age and the number of cigarettes you  smoke.

How does Nextstellis work for contraception?

Your chance of getting pregnant depends on how well you follow the directions for taking your birth control pills. The better you follow the directions, the less chance you have of getting pregnant.
Based on the results of one clinical study of a regimen of drospirenone 3 mg and estetrol 14.2 mg tablets, about 2 out of 100 females may get pregnant within the first year they use Nextstellis.

Who should not take Nextstellis?

Do not take Nextstellis if you:

If any of these conditions happen while you are taking Nextstellis, stop taking Nextstellis right away and talk to your healthcare provider. Use non-hormonal contraception when you stop taking Nextstellis.

Before taking Nextstellis

Before taking Nextstellis, tell your healthcare provider about all of your medical conditions, including if you:

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. If you are currently on daily, long-term treatment for a chronic condition with any of the following medicines, you should talk to your healthcare provider before taking Nextstellis:

Nextstellis may affect the way other medicines work, and other medicines may affect how well Nextstellis works.

Know the medicines you take. Keep a list of them to show your healthcare provider and pharmacist when you get a new

How should I take Nextstellis?

Nextstellis side effects

Call your healthcare provider or go to a hospital emergency room right away if you have:

Other serious side effects include:

The most common side effects include:

These are not all of the possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Do birth control pills cause cancer?

Birth control pills do not seem to cause breast cancer. However, if you have breast cancer now, or have had it in the past, do not use birth control pills because  some breast cancers are sensitive to hormones.
Females who use birth control pills may have a slightly higher chance of getting cervical cancer. However, this may be due to other reasons such as having more sexual partners.

What if I want to become pregnant?

You may stop taking the pill whenever you wish. Consider a visit with your healthcare provider for a pre-pregnancy checkup before you stop taking the pill.

What should I know about my period when taking Nextstellis?

Irregular vaginal bleeding or spotting may happen while you are taking Nextstellis, especially during the first 4 months of use. If the irregular vaginal bleeding or spotting continues or happens again after you have had regular menstrual cycles, call your healthcare provider. It is important to continue taking your pills on a regular schedule to prevent a pregnancy.

What if I miss my scheduled period when taking Nextstellis?

Some females miss periods on hormonal birth control, even when they are not pregnant. However, if you go 2 or more months in a row without a period, or you miss your period after a month where you did not take all of your Nextstellis correctly, call you healthcare provider because you may be pregnant. Also call your healthcare provider if you have symptoms of pregnancy such as morning sickness or unusual breast tenderness. Stop taking Nextstellis if you are pregnant.

What else should I know about taking Nextstellis?

What other drugs will affect Nextstellis?

Tell your doctor about all your current medicines. Many drugs can interact with drospirenone and estetrol, especially:

This list is not complete and many other drugs may interact with drospirenone and estetrol. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

How should I store Nextstellis?

General information about the safe and effective use of Nextstellis.

Medicines are sometimes prescribed for purposes other than those listed in a Patient Information leaflet. Do not use Nextstellis for a condition for which it was not prescribed. Do not give Nextstellis to other people, even if they have the same symptoms that you have. It may harm them.
You can ask your pharmacist or healthcare provider for information about Nextstellis that is written for health professionals.

What are the ingredients in Nextstellis?

Active ingredient: Pink tablets: drospirenone and estetrol
Inactive ingredients:


Important Information about taking Nextstellis

Before you start taking Nextstellis

When should I start taking Nextstellis?

If you start taking Nextstellis and you have not used a hormonal birth control method before:

You do not need a back-up non-hormonal birth control method.

If you start taking Nextstellis and you are switching from another birth control pill:

If you start taking Nextstellis and previously used a vaginal ring or transdermal patch:

If you start taking Nextstellis and you are switching from a progestin-only method such as an implant or injection:

If you start taking Nextstellis and you are switching from an intrauterine device or system (IUD or IUS):

If you start taking Nextstellis after you have given birth and you were more than 20 weeks pregnant:

If you start taking Nextstellis after an abortion or miscarriage and you were 14 weeks pregnant or less:

If you start taking Nextstellis after an abortion or miscarriage and you were more than 14 weeks pregnant but 20 weeks pregnant or less:

Keep a calendar to track your menstrual period. If this is the first time you are taking birth control pills, read, When should I start taking Nextstellis? above and follow these instructions.

Before you start taking your pills

When to start the first pack of pills
Start on the first day (Day 1) of your natural menstrual period (Day 1 start). Pick a time of day which will be easy to remember.

Day 1 Start:

  1. Pick the day label strip that starts with the first day of your period.
  2. Place this day label strip on the pill dispenser over the area that says: “Place enclosed day label here”.
  3. Take the first active pink pill of the first pack during the first 24 hours of your period. Take 1 pill every day in the order of the blister pack, at the same time each day, for 28 days.
  4. The day after taking the last pill on Day 28 from the blister pack, start taking the first pill from the new pack, on the same day of the week as the first pack. Take the first pill in the new pack whether or not you are having your period.

What should I do if I miss any Nextstellis pills?

If you miss 1 pink active pill in Weeks 1, 2 or 3, follow these steps:

If you miss 2 or more pink active pills in Week 1 or Week 2 of your pack, follow these steps:

If you miss 2 pink active pills in a row in week 3 of your pack, follow these steps:

If you miss 1 or more white inactive pills, follow these steps:

If you have any questions or are unsure about the information in this leaflet, call your healthcare provider. They have a more technical leaflet called the Professional Labeling which you may read.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.