Twirla^®

Twirla® is a birth control patch that gives off hormones that prevent your ovaries from releasing eggs. Twirla® contains a different mix of hormones than the original birth control patch, Xulane. Just like there are many birth control pill formulas that contain different mixes of hormones, now there's a second patch option. For some people, the patch is a great option since it does not need to be taken every day like a pill to be effective — you simply change your patch every week for three weeks, then have a patch-free week at the end of the month when you have a period.

It is not recommended to use any patch continuously to skip periods beyond 3 periods in a row. The reason is that patches contain one of the highest doses of estrogen available, and after 3 months of continuous use the level of estrogen in your body increases to a point that the risk of adverse effects like blood clots and stroke increase.

The side effects of the patch are the same as those of other combined hormone option (those with include both estrogen and progestin). Common side effects include irregular bleeding, nausea, headaches, breast tenderness, and bloating. These typically resolve by the third month of use. One side effect specific to the patch is that the adhesive may cause irritation, redness, or a rash. Uncommon but severe side effects include blood clots that could cause a heart attack or stroke.

It's important to tell your provider if you are taking any other medications or if you have any allergies. Interactions are possible with certain drugs, and you may need a dose adjustment to safely take both medications. If you start using a new medication, check with your provider before stopping or starting any of your current medicines. This includes over-the-counter medications.

Twirla® contains a different type of progestin than Xulane, and since everyone responds differently to hormones, some people may feel better with the change of hormone combination.

Twirla® is beige and round and a little larger than Xulane, which is square and peach-toned patch.

For more information about how Twirla® compares with Xulane, click here.

Any weight gain you experience when starting this medication is likely due to fluid retention, and should decrease after your body adjusts. If you experience significant weight gain or loss after starting a new contraceptive, it's important to let your healthcare provider know.

While not originally intended to treat acne, studies have found that some birth control medications can reduce breakouts and inflammation. If you're interested in learning more about what birth control might help your acne symptoms, visit our Birth Control for Acne page to get started.

Your Nurx medical provider will partner with you to find the best care for your symptoms and medical concerns. As medically appropriate, a Nurx provider may prescribe birth control to help manage symptoms associated with PMS (Premenstrual syndrome) and/or PMDD (Premenstrual dysphoric disorder), or to help with cycle control (delayed period). In some cases, birth control may also be used to help manage symptoms of endometriosis and/or PCOS (Polycystic ovary syndrome), to assist with improving acne. While the use of birth control is considered “off-label” for these listed purposes, a licensed Nurx clinician may prescribe birth control if they deem doing so medically appropriate.

Consultation
Anyone who requests a birth control prescription will be charged a $28 consultation fee. Please note that at this time, we do not submit claims to insurance for the medical consult fee.

Medication
For those with health insurance, your prescription will be free in most cases if it is covered by your health insurance, and we accept your plan. Insurance companies set the “copay” for prescriptions and depending on your plan and the prescription, this will usually be $0. Please connect with your insurance company if you would like to learn more about your copay. If you do have a copay, Nurx will authorize a $30 hold at checkout. If your copay is over $30, you will receive a notification to approve the updated amount.

Support Fee
Nurx will charge a flat $3 support fee each month one or more of your orders are processed. This fee covers your unlimited, on-demand access to our customer care team as well as certain processing fees. This fee will only be charged once in any month, even if you have multiple orders processed that month. This fee applies whether the order is filled through Nurx or at your local pharmacy. If your order is filled via Nurx, the support fee is billed at the time of fulfillment. If your prescription is sent to a local pharmacy, a support fee will be applied at that time. In the future, the support fee will be applied on a cadence that matches your medication refill cadence.

Yes, we accept most forms of private health insurance for medications. If you’d like to know if we accept your health insurance plan, please connect with our team at [email protected]. Please note that at this time, we do not submit claims to insurance for the medical consult fee.
Nurx does not accept any federal or state government insurance plans, such as Medicare, Medicaid, Tricare, or any of their affiliated managed care plans, nor can Nurx service such patients. We recommend that you find a local provider in your community that participates in your government payer program.