Nextstellis is a brand-name oral tablet that’s prescribed for pregnancy prevention. Nextstellis contains the active drugs drospirenone and estetrol. It belongs to the hormonal birth control drug class.
Nextstellis is FDA-approved for pregnancy prevention in females of any age who can become pregnant.
Note: Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.
You’ll find key information about Nextstellis below.
- Drug form: oral tablet
- Generic available? no
- Prescription required? yes
- Controlled substance? no
- Year of FDA approval: 2021
The Food and Drug Administration (FDA) approves prescription drugs such as Nextstellis for certain uses.
Note: Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.
Nextstellis for birth control
Nextstellis may not be as effective in females with a body mass index (BMI) of 30 or more. (BMI is a measure of body size based on height and weight.) If your BMI is 30 or higher, talk with your doctor. They can recommend other birth control options that may be more effective in helping to prevent pregnancy.
Nextstellis and children
Nextstellis is approved to help prevent pregnancyin females of any age who can become pregnant. Females may be able to become pregnant after their first period. This often happens around 12 years of age.
Doctors may prescribe Nextstellis to help prevent pregnancy in adolescents.
Nextstellis can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Nextstellis. These lists do not include all possible side effects.
For more information about the possible side effects of Nextstellis, talk with your doctor or pharmacist. They can give you tips on how to manage any side effects that may be concerning or bothersome.
Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Nextstellis, you can do so through MedWatch.
Mild side effects
Below is a partial list of mild side effects of Nextstellis. To learn about other mild side effects, talk with your doctor or pharmacist or view the Nextstellis prescribing information.
Mild side effects of Nextstellis can include:
- breast-related side effects, including breast pain, swelling, or discomfort
- irregular vaginal bleeding, including stopped periods and spotting between periods
- low libido
- mood changes, such as feeling more agitated, anxious, or nervous
- pain during your period, including pelvic pain and menstrual cramps
- weight gain
- mild allergic reaction*
Most of these side effects may go away within a few days to a couple of weeks. However, if they become more severe or don’t go away, talk with your doctor or pharmacist.
* For more information about allergic reaction and Nextstellis, see “Allergic reaction” below.
Serious side effects
Serious side effects from Nextstellis aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.
Serious side effects and their symptoms can include:
- High blood pressure, which typically doesn’t cause symptoms unless it’s severely high. Symptoms of severely high blood pressure can include:
- chest pain
- Migraine episodes. Symptoms can include:
- sensitivity to light
- High blood potassium level. Symptoms can include:
- nausea and vomiting
- shortness of breath
- heart palpitations
- Depression. Symptoms can include:
- loss of interest in hobbies or activities
- changes in weight or appetite
- High levels of liver enzymes, which may be a sign of liver damage. Symptoms can include:
- Risk of serious cardiovascular events with cigarette smoking.*
- Severe allergic reaction.†
* Nextstellis has a boxed warning for this side effect. This is the most serious warning from the FDA. To learn more, see the “Nextstellis precautions” section below.
† For details about allergic reaction and Nextstellis, see “Allergic reaction” below.
Symptoms of a mild allergic reaction can include:
A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:
- swelling under your skin, typically in your eyelids, lips, hands, or feet
- swelling of your tongue, mouth, or throat
- trouble breathing
Call your doctor right away if you have an allergic reaction to Nextstellis, as the reaction could become severe. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.
Here are answers to some frequently asked questions about Nextstellis.
Can Nextstellis be prescribed for endometriosis or acne?
Possibly, but these uses for Nextstellis aren’t approved by the Food and Drug Administration (FDA).
If you’re interested in taking Nextstellis for endometriosis or acne, talk with your doctor. They’ll explain treatment options for these conditions and recommend the right one for you.
Does Nextstellis cause weight loss?
No, it isn’t likely. Weight loss wasn’t reported as a side effect in clinical trials of Nextstellis. However, weight gain was reported in the drug’s trials.
If you have concerns about unintentional weight loss while taking Nextstellis, talk with your doctor or pharmacist.
How does Nextstellis work?
Nextstellis works by helping to prevent ovulation, which is the release of an egg from an ovary. When ovulation doesn’t occur, there is no egg available for sperm to fertilize. In this way, Nextstellis helps prevent pregnancy.
If you have other questions about how Nextstellis works, talk with your doctor or pharmacist.
Other drugs are available that can help prevent pregnancy. Some may be a better fit for you than others. If you’re interested in finding an alternative to Nextstellis, talk with your doctor. They can tell you about other medications that may work well for you.
The following drugs are similar to Nextstellis:
As with all medications, the cost of Nextstellis can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.
Drug coupons. You can visit Optum Perks* for price estimates of Nextstellis. These estimates are based on the use of Optum Perks coupons. Note: Optum Perks coupons cannot be used with any insurance copays or benefits.
Financial and insurance assistance. If you need financial support to pay for Nextstellis, or if you need help understanding your insurance coverage, help is available.
A savings card is available for Nextstellis. For more information and to find out whether you’re eligible for support, visit the manufacturer’s website.
To learn more about saving money on prescriptions, check out this article.
Generic version. Nextstellis is not available in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Generics tend to cost less than brand-name drugs.
* Optum Perks is a sister site of Medical News Today.
If you can become pregnant, consider the following information about pregnancy and breastfeeding.
Nextstellis and pregnancy
Nextstellis is prescribed for pregnancy prevention. The drug should not be taken during pregnancy.
If you think you’ve become pregnant while taking Nextstellis, talk with your doctor right away. They’ll likely order a pregnancy test. If the test shows you’re pregnant, your doctor can recommend whether it’s safe to continue the pregnancy.
Nextstellis and breastfeeding
In general, Nextstellis is considered safe to take while breastfeeding. However, the drug may reduce the amount of breast milk your body makes.
For this reason, it’s important to talk with your doctor before taking Nextstellis while breastfeeding. They can recommend other birth control options that are less likely to affect breastfeeding. Or, they can suggest other ways to feed your child while taking Nextstellis.
The following information describes dosages that are commonly prescribed or recommended. However, be sure to follow the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.
Drug forms and strengths
Nextstellis comes as an oral tablet. It comes in a blister pack, with the following strengths in each pack:
- 24 pink tablets containing these active ingredients:
- 4 white tablets containing inactive ingredients*
* Tablets with inactive ingredients are taken so that you have a period. This helps confirm that the drug is working for pregnancy prevention. It also helps to keep you in the habit of taking doses.
Dosage for pregnancy prevention
The recommended dosage of Nextstellis is one tablet per day. You should take the tablet around the same time every day in the order provided on the blister pack labeling.
Nextstellis is approved to help prevent pregnancy in females* of any age who can become pregnant. Females may be able to become pregnant after their first period, which often happens around 12 years of age.
The recommended dosage of Nextstellis is one tablet per day. It should be taken at the same time every day in the order provided on the blister pack labeling.
* Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.
About taking Nextstellis
Below you’ll find information about key dosage issues.
When to take. You should take Nextstellis once per day, at any time of day. Taking the medication around the same time of day helps keep a steady level of the drug in your body. This helps Nextstellis work effectively.
When you’ll start taking Nextstellis depends on certain factors. These include whether you’ve recently:
- had an abortion or experienced pregnancy loss
- given birth
- started your period
- taken a different hormonal birth control
In general, you can start taking Nextstellis on or after the first day of your period. Your doctor will recommend the best time to start taking Nextstellis.
If you miss a dose. What you’ll do about a missed dose of Nextstellis depends on certain factors. These include whether you’ve missed a pink (active) tablet or a white (inactive) tablet and how many doses you’ve missed.
Below are instructions for missed doses of Nextstellis:
- If you miss one pink tablet at any time during treatment. Take your missed dose as soon as you remember, then take your next dose at the regular time. You may need to take two doses in one day. Continue taking one tablet per day until you finish the blister pack.
- If you miss two or more pink tablets during the first or second week of treatment. Take one missed dose as soon as you remember, then take another dose at the regular time. This could mean taking two doses in one day. Discard the other doses you’ve missed and continue taking one tablet per day until you finish the blister pack.*
- If you miss two pink tablets in the third week of treatment. Take one missed dose as soon as you remember, then take another dose at the regular time. This could mean taking two doses in one day. Discard the other doses you’ve missed and continue taking one tablet per day until you finish the blister pack. Then discard the white tablets from your current blister pack and start taking one pink tablet per day from a new blister pack.*
- If you miss one or more white tablets in the fourth week of treatment. Skip the missed dose and take one tablet per day until you finish the blister pack.
If you have questions about what to do if you miss a dose of Nextstellis, talk with your doctor or pharmacist.
* Be sure to use a hormone-free method of birth control (such as condoms) during sexual activity for at least 7 days after taking your missed tablets. Using another method will help prevent pregnancy during this time.
Taking Nextstellis with food. You can take Nextstellis with food or without it.
Crushing, splitting, or chewing Nextstellis. The manufacturer of Nextstellis hasn’t stated whether the tablets can be crushed, split, or chewed. If you have difficulty swallowing tablets, talk with your doctor or pharmacist. You can also read suggestions for swallowing tablets in this article.
Length of use. Nextstellis can be taken as a long-term option for pregnancy prevention. If you and your doctor determine that Nextstellis is safe and effective for you, you may take it long term.
Taking more than the recommended dose of Nextstellis can lead to serious side effects. Do not take more Nextstellis than your doctor recommends.
Symptoms of an overdose can include:
What to do in case of overdose
If you think you’ve taken too much of this drug, call your doctor. You can also call America’s Poison Centers at 800-222-1222 or use its online tool. However, if your symptoms are severe, call 911 or your local emergency number or go to the nearest emergency room right away.
Nextstellis can interact with several other medications and certain supplements.
Before taking Nextstellis, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also, tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.
Interactions with medications, foods, and supplements
Below is a list of medications and supplements that can interact with Nextstellis. This list does not contain all drugs that may interact with Nextstellis. If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
|Medications that can interact with Nextstellis||• certain antifungals, such as fluconazole (Diflucan) and itraconazole (Sporanox, Tolsura)|
• certain antibiotics, such as rifampin (Rifadin, Rimactane) and rifabutin (Mycobutin)
• certain HIV drugs, such as ritonavir (Norvir) and nelfinavir (Viracept)
• certain seizure drugs, such as phenytoin (Dilantin, Phenytek) and carbamazepine (Carbatrol, Tegretol, others)
• certain diuretics, such as spironolactone (Carospir, Aldactone) and eplerenone (Inspra)
• corticosteroids, such as prednisone (Rayos) and dexamethasone (Hemady)
• bile acid sequestrants, such as colesevelam (Welchol) and cholestyramine (LoCholest, Prevalite)
• diabetes drugs, such as metformin (Fortamet, Glumetza) and insulin
• bosentan (Tracleer)
|Supplements that can interact with Nextstellis||• St. John’s wort|
• potassium supplements
|Lab tests that can interact with Nextstellis||• thyroid-binding globulin blood test|
• cortisol-binding globulin test
• sex hormone-binding globulin concentration blood test
Alcohol is not known to interact with Nextstellis. It’s likely safe to consume alcohol while taking Nextstellis. If you have questions about how much alcohol is safe to drink while taking Nextstellis, talk with your doctor or pharmacist.
This drug comes with several precautions.
FDA warning: Risk of serious cardiovascular events with cigarette smoking
This drug has a boxed warning. This is the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.
Risk of serious cardiovascular events with cigarette smoking. Taking Nextstellis increases the risk of serious cardiovascular events, including blood clots, heart attack, and stroke.These side effects weren’t reported in clinical trials of Nextstellis. However, cardiovascular events are a known risk of hormonal birth control. (Nextstellis is a hormonal birth control.)
This risk is especially high in people ages 35 years and older who smoke cigarettes. Due to this risk, doctors typically won’t prescribe the drug for people who smoke and are over age 35 years.
Some symptoms of cardiovascular events include:
- Blood clots. Symptoms can include:
- swelling or pain in the affected area
- skin discoloration or warmth
- difficulty breathing
- Heart attack. Symptoms can include:
- shortness of breath
- pain in your shoulder, neck, chest, or arm
- Stroke. Symptoms can include:
- slurred speech
- weakness or numbness on one side of the body or face
If you have symptoms of a blood clot while taking Nextstellis, contact your doctor right away. But if your symptoms seem life threatening or related to a heart attack or stroke, you or a bystander should call 911 or a local emergency number immediately.
Before taking Nextstellis, discuss your health history with your doctor. Nextstellis may not be right for you if you have certain medical conditions or other factors affecting your health. Be sure to talk with your doctor if any of the following apply to you:
- any cancer that is sensitive to hormones, such as breast cancer or cervical cancer
- any condition that increases the risk of a high blood potassium level, such as kidney failure or adrenal insufficiency
- current or past blood clots in a lung or deep vein, or having a genetic (inherited) condition that increases this risk
- liver tumors or liver disease
- high triglyceride or cholesterol levels
- high blood pressure
- cerebrovascular disease
- coronary artery disease
- gallbladder disease
- melasma during pregnancy
- unexplained vaginal bleeding
- migraine episodes with aura
- past allergic reaction to this or a similar drug
Note: For more information about the potential negative effects of Nextstellis, see the “Nextstellis side effects” section above.
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.