Twirla (levonorgestrel and ethinyl estradiol) prescription available online 

If you're interested in pregnancy prevention, Twirla (levonorgestrel and ethinyl estradiol) can help. Get a new prescription or refill of Twirla from a board-certified doctor online.*

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Weekly birth control patch

Available to women with a BMI less than 30*

Used to prevent pregnancy

*Prescriptions are provided at the doctor’s discretion. Learn more about our controlled substances policy and how you can save up to 80% with our prescription discount card.

About Twirla (levonorgestrel and ethinyl estradiol)

Twirla is a type of hormonal birth control that contains levonorgestrel and ethinyl estradiol. Unlike birth control pills, which are taken daily, Twirla is a birth control patch that you only need to apply once a week.

The Twirla patch is used to prevent pregnancy. Twirla is available only by prescription. It may be available in a generic formulation as levonorgestrel and ethinyl estradiol as well as under different brand names. It’s always important to follow the specific instructions on your prescription, as they can vary based on the formulation and dosage prescribed.

If you're prescribed Twirla, be sure to complete the full course of the transdermal patch unless your doctor specifically tells you to stop. If you don’t complete your prescription, the Twirla patch may not work as effectively to prevent pregnancy. 

Twirla uses

There are several FDA-approved uses for Twirla, but it may also be used off-label to treat other conditions. Your doctor may prescribe it for any of the following common reasons. It’s also possible that your health care provider may prescribe it for other reasons not listed here. If you have questions about why a medication is prescribed, ask your online doctor or pharmacist.

  • Pregnancy prevention (birth control)

    Twirla is FDA-approved to prevent pregnancy in women with a BMI (body mass index) less than 30. Similar to other forms of hormonal birth control, Twirla functions by blocking ovulation. Twirla may cause some people to stop having regular menstrual periods.

Twirla side effects

  • The side effects associated with taking Twirla are typically mild. Most Twirla side effects are associated with gastrointestinal discomfort. Twirla has some common side effects. The side effects of Twirla may include:

    • Nausea and upset stomach

    • Weight gain

    • Menstrual cramps

    • Skin reactions at the patch site

    Other side effects, which are less common but might be more severe, could include:

    • Signs of a blood clot (blurred vision, chest pain, shortness of blood)

    • High blood pressure

    • Severe migraine headaches

    You should call your doctor if you notice any of these side effects, or if you develop any other new or concerning symptoms. The use of Twirla is not recommended in children before menarche.

How to take Twirla

Your pharmacist will provide you with instructions on how to take your Twirla prescription. Be sure to read your prescription label and follow the instructions. Call your doctor or pharmacy if you have any questions.

Twirla can come in different forms and doses, so be sure to follow the specific instructions on your prescription. Apply a new birth control patch as soon as you remember and start a new cycle on that day. You should go three weeks while wearing a weekly patch and one week off the patch.

Make sure to use back-up birth control, such as condoms, during the first week of your new cycle. Like other forms of hormonal birth control, the birth control patch does not protect against sexually transmitted diseases or infections.

What to avoid while taking Twirla

Twirla has 436 drug interactions. Don’t change what you are taking without checking with your doctor or pharmacist. That includes other medications or supplements, as well as over-the-counter drugs. 

Possible drug interactions with the Twirla birth control patch include:

  • St. John's Wort

  • Acetaminophen

  • Antibiotic or antifungal medicines

  • Cholesterol medication

  • Seizure medicine

Ask your doctor for medical advice about side effects before drinking alcohol. Drinking alcohol may lead to an increased risk of liver damage.

Medication alternatives to Twirla

If your healthcare provider prefers to put you on another treatment altogether, they may suggest another birth control patch or other hormonal contraceptives in another drug class. Here are some common doctor-recommended alternatives based on your health issue:

Twirla prescription FAQs

  • How much does Twirla cost?

    Depending on your pharmacy, the Twirla patch costs around $211 for three films without insurance. Fortunately, most health insurance plans offer free or low-cost birth control. Our prescription discount card also helps members save up to 80% on prescriptions.

  • How long does it take for Twirla to be effective?

    The Twirla patch (levonorgestrel and ethinyl estradiol transdermal system) starts working within seven days to prevent pregnancy. Make sure to use back-up birth control for the first week of your new patch cycle.

  • Does the Twirla patch make you gain weight?

    Yes, weight gain is a possible side effect of Twirla.

  • Where is the best place to put a Twirla patch?

    You should apply the Twirla patch to your lower abdomen, buttock, or upper torso (excluding the breasts). Twirla should be applied to clean skin, and it should lay flat and smooth without any wrinkles or folds.

  • Can I skip my period with the Twirla patch?

    Yes, you can skip your period with the Twirla patch. Instead of going patch-free for a week, just apply a new patch every single week with no breaks. Talk to your doctor before skipping your period with the patch.

  • How can I refill my Twirla prescription?

    To refill your Twirla prescription, book a virtual appointment with one of our top rated board-certified doctors. After reviewing your medical history, your doctor can send an electronic prescription to your local pharmacy.

  • Who should not use Twirla?

    To make sure Twirla birth control is safe for you, tell your doctor if you have:

    • High blood pressure, heart disease, or a history of blood clots

    • Diabetes or gallbladder disease

    • A history of hormone-related cancer, such as breast cancer

    • If you're planning for a major surgery

    • Liver disease or liver tumors

    If you have underlying risk factors for cardiovascular disease, you may require regular laboratory and medical tests to make sure hormonal birth control is safe for you.

    Women who are 35 years or older and who smoke should not use hormonal birth control to prevent pregnancy. Ask your doctor for medical advice about non-hormonal birth control options.

  • What happens if I miss a dose of Twirla?

    If you forget to apply a birth control patch at the start of a new cycle, apply the patch as soon as you remember and start a new cycle on that day.

    If you forget to change your patch during your three-week wearing time, apply a new patch if it's been 48 hours since your scheduled patch change. Otherwise, apply a new patch and start a new cycle on that day.

  • What happens if I take too much Twirla?

    If you've taken too much Twirla, seek emergency medical attention or contact your local poison control center.

3 simple steps to request your Twirla prescription today 

Step 1: Book an appointment

Step 1

Book a Twirla prescription request appointment.

Book a same day appointment from anywhere.

Step 2: Visit with a doctor on your smartphone

Step 2

Talk to your medical provider regarding your Twirla prescription.

Visit with a doctor on your smartphone or computer.

Step 3: pick up at local pharmacy

Step 3

Pick up your Twirla prescription.

We can send prescriptions to any local pharmacy.

Twirla prescription pricing details

How pricing works

To get a new or refill on your Twirla prescription, join our monthly membership and get discounted visits.

Paying with insurance



First month free

First visit


For all visits

30 days of free membership

  • Same-day appointments 7 days a week

  • Unlimited messages with your Care Team

  • Prescription discount card to save up to 80%

  • Exclusive discounts on lab tests

  • Free memberships for your family

  • Cancel anytime

Visit price with insurance

Often the same as an office visit. Most patients with in-network insurance pay $30 or less!

  • We accept these insurance plans and many more:

    • Humana
    • Aetna
    • United Healthcare

Paying without insurance



First month free

First visit


Repeats only $99

30 days of free membership

  • Same-day appointments 7 days a week

  • Unlimited messages with your Care Team

  • Prescription discount card to save up to 80%

  • Exclusive discounts on lab tests

  • Free memberships for your family

  • Cancel anytime

Visit price without insurance

Initial visits are $129 and follow-ups are only $99 for active members.

Book an appointment

If we're unable to treat you, we'll provide a full refund.


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