Head-to-head clinical analysis & difference comparison: details on mechanism of action, dosing, half-life, interactions, and maternal-fetal safety.
HAILEY FE 1/20 vs ALTAVERA
Clinician-reviewed, head-to-head comparison of mechanism, dosing, pharmacokinetics, and safety profiles.
Last clinically reviewed: July 2026 · OpiCalc Medical Review Team
Combination oral contraceptive containing ethinyl estradiol and norethindrone. Suppresses gonadotropin (FSH and LH) release via negative feedback on the hypothalamic-pituitary-ovarian axis, inhibiting ovulation. Also alters cervical mucus and endometrial lining to impair sperm penetration and implantation.
Combination of ethinyl estradiol and desogestrel: ethinyl estradiol suppresses gonadotropin release, inhibiting ovulation; desogestrel (progestin) causes cervical mucus thickening and endometrial atrophy, preventing implantation.
FDA-approved for prevention of pregnancy.
Prevention of pregnancy,Treatment of moderate acne vulgaris (in females ≥15 years with no contraindications)
One tablet orally once daily for 21 consecutive days followed by 7 days of placebo tablets.
1 tablet (ethinyl estradiol 0.03 mg / levonorgestrel 0.15 mg) orally once daily for 21 days, followed by 7 placebo days.
Ethinyl estradiol: approximately 17 ± 5 hours (terminal); Norethindrone: approximately 8 ± 2 hours (terminal). Clinical context: Steady-state reached within 7-10 days; once-daily dosing maintains effective concentrations for contraceptive efficacy.
Levonorgestrel: terminal elimination half-life 25±10 hours; ethinyl estradiol: 13±7 hours. Clinical context: steady-state concentrations achieved within 5-7 days; contraceptive efficacy requires consistent daily dosing.
Ethinyl estradiol is primarily metabolized via CYP3A4 hydroxylation and conjugation (glucuronidation/sulfation). Norethindrone is metabolized by reduction, hydroxylation, and conjugation, primarily via CYP3A4.
Ethinyl estradiol: primarily metabolized by CYP3A4; undergoes sulfation and glucuronidation. Desogestrel: rapidly converted to active metabolite etonogestrel via CYP2C9 and CYP2C19; further metabolism by CYP3A4.
Renal (approximately 50-60% as metabolites, including glucuronide conjugates of ethinyl estradiol and norethindrone, and about 20% as unchanged norethindrone); Fecal (approximately 30-40% as metabolites); Biliary (minor, with enterohepatic circulation of ethinyl estradiol conjugates).
Renal excretion of metabolites and unchanged drug: ~30% (levonorgestrel) and ~20% (ethinyl estradiol) in urine; biliary/fecal elimination: ~40-50% as conjugates and metabolites.
Ethinyl estradiol: approximately 97-98% bound to albumin (primarily) and sex hormone-binding globulin (SHBG); Norethindrone: approximately 93-95% bound to albumin and SHBG.
Levonorgestrel: 98-99% bound to sex hormone-binding globulin (SHBG) and albumin; ethinyl estradiol: 98% bound to albumin.
Ethinyl estradiol: approximately 2-4 L/kg; Norethindrone: approximately 4-6 L/kg. Clinical meaning: Extensive tissue distribution, with accumulation in adipose tissue and reproductive organs.
Levonorgestrel: Vd ~1.8 L/kg (suggesting extensive tissue distribution). Ethinyl estradiol: Vd ~2.4 L/kg.
Oral: Ethinyl estradiol ~40-45% (first-pass metabolism); Norethindrone ~60-65% (first-pass metabolism).
Oral bioavailability: levonorgestrel ~100% (nearly complete); ethinyl estradiol ~45-50% (first-pass hepatic metabolism).
No dose adjustment required for mild to moderate renal impairment. Contraindicated in severe renal impairment or acute renal failure due to risk of hyperkalemia.
No dose adjustment required for mild to moderate renal impairment. Contraindicated in severe renal disease or acute renal failure due to potential fluid retention.
Contraindicated in patients with active liver disease or Child-Pugh class B or C cirrhosis. For Child-Pugh class A, use with caution and monitor liver function.
Contraindicated in severe hepatic dysfunction (Child-Pugh class B or C). Use caution in mild to moderate impairment (Child-Pugh A); monitor liver enzymes.
Not indicated for use before menarche. For post-menarchal adolescents, same dosing as adults: one tablet orally once daily for 21 days, then 7 days of placebo.
Not indicated for use before menarche. For postmenarchal adolescents, same dosing as adults (1 tablet daily, 21/7 regimen) after evaluation of risks.
Not indicated for use in postmenopausal women. No specific geriatric dosing adjustments; consider increased risk of thromboembolic events and cardiovascular disease.
Not indicated for postmenopausal women. No specific geriatric dosing; consider increased risk of thromboembolism, cardiovascular disease, and metabolic effects in older women of reproductive age.
Cigarette smoking increases risk of serious cardiovascular events (e.g., stroke, myocardial infarction, thromboembolism) from combination oral contraceptives. Risk increases with age (>35 years) and heavy smoking (≥15 cigarettes/day). Women who are >35 years old and smoke should not use this product.
Cigarette smoking increases risk of serious cardiovascular events from combined oral contraceptives. Risk increases with age (especially >35 years) and with number of cigarettes smoked. Women who use combined hormonal contraceptives should be strongly advised not to smoke.
Increased risk of thrombotic disorders including venous thromboembolism, stroke, and myocardial infarction.,Discontinue if sudden partial or complete loss of vision or onset of proptosis, diplopia, migraine.,Elevated blood pressure; use caution in hypertension.,Gallbladder disease; increased risk of gallstones.,Carbohydrate and lipid metabolism effects; use caution in diabetes and hyperlipidemia.,Hepatic neoplasia; discontinue if jaundice or liver dysfunction.,Chloasma; avoid sun or UV exposure.,Bleeding irregularities; may cause breakthrough bleeding and spotting.,Possible decreased efficacy with concomitant enzyme-inducing drugs.
Thrombotic disorders: risk of venous thromboembolism (VTE), stroke, myocardial infarction; discontinue if thrombotic event occurs.,Hepatic disease: discontinue if jaundice or liver function abnormalities develop.,Hypertension: monitor blood pressure; discontinue if uncontrolled.,Carbohydrate metabolism: may affect glucose tolerance; monitor diabetic patients.,Depression: discontinue if significant depression occurs.,Gallbladder disease: increased risk of cholelithiasis.
Thrombophlebitis or thromboembolic disorders (current or history).,Cerebrovascular or coronary artery disease (current or history).,Known or suspected breast carcinoma or estrogen-dependent neoplasia.,Undiagnosed abnormal genital bleeding.,Pregnancy (known or suspected).,Benign or malignant liver tumor (active or history).,Active liver disease with abnormal liver function.,Hypersensitivity to any component.,Age >35 years with cigarette smoking.
Thrombophlebitis or thromboembolic disorders (current or history),Cerebrovascular or coronary artery disease (current or history),Known or suspected breast carcinoma,Estrogen-dependent neoplasia (known or suspected),Undiagnosed abnormal genital bleeding,Cholestatic jaundice of pregnancy or jaundice with prior pill use,Hepatic adenoma or carcinoma (known or suspected),Pregnancy (known or suspected),Hypersensitivity to any component
No specific food interactions. Grapefruit juice may increase estrogen levels; avoid excessive consumption. St. John's Wort may reduce efficacy. Consistent intake with or without food is recommended to maintain steady-state levels.
No significant food interactions. Alcohol does not affect efficacy but may increase risk of adverse effects such as nausea. Grapefruit juice has no known interaction. Avoid excessive alcohol consumption due to potential hepatotoxicity.
First trimester: No increased risk of major birth defects in large epidemiological studies. Second and third trimesters: Use is not recommended due to potential adverse effects on fetal development, including possible estrogenic effects and association with congenital anomalies in animal studies. Fetal risk cannot be ruled out.
ALTAVERA contains ethinyl estradiol and levonorgestrel. First trimester: Inadvertent exposure during organogenesis is associated with a very low absolute risk of cardiovascular defects (relative risk 1.2-1.4) and no consistent increase in other major malformations. Second and third trimesters: No known teratogenic effects, but theoretical risks from estrogenic effects (e.g., feminization of male fetus). Postnatal: No increased risk of long-term developmental effects from pregnancy exposure.
Excreted in breast milk in small amounts. Estrogen and progestin levels may affect milk composition and reduce milk production. M/P ratio not reported; use caution, especially in the immediate postpartum period. Avoid use in breastfeeding women if possible.
Combined oral contraceptives may reduce milk production and quality, especially in early lactation. Ethinyl estradiol transfers into breast milk at low levels (M/P ratio approximately 0.1-0.2), excluding clinical effects in term infants. Levonorgestrel transfer is minimal (M/P ratio ~0.2-0.4). Use is generally avoided in breastfeeding women, especially during the first 6 weeks postpartum. Progestin-only methods are preferred.
No dose adjustment established; use is contraindicated during pregnancy. If inadvertent exposure occurs, discontinue immediately. Pharmacokinetic changes in pregnancy (increased clearance, volume of distribution) do not warrant dose adjustment because the drug is contraindicated.
Contraindicated in pregnancy. No dose adjustment recommended because use is discontinued upon confirmed or suspected pregnancy. Pharmacokinetic changes in pregnancy (e.g., increased hepatic clearance, altered binding proteins) are not relevant for this indication.
Contains ethinyl estradiol 20 mcg and norethindrone 1 mg. Consider lower estrogen dose for patients with estrogen-sensitive migraines or history of thromboembolism. Monitor for breakthrough bleeding, especially in first 3 cycles. CYP3A4 inducers like rifampin may reduce efficacy. Check pregnancy test before initiating if delayed menses. Use with caution in patients with hypertriglyceridemia.
ALTAVERA is a combined oral contraceptive (COC) containing ethinylestradiol and levonorgestrel. It inhibits ovulation via suppression of gonadotropins. Counsel patients to take at the same time daily to maintain efficacy. Missed pill management: if missed within 12 hours, take immediately; if >12 hours, take last missed pill and use backup contraception for 7 days. Be aware of increased VTE risk, especially in smokers over 35. May reduce effectiveness of lamotrigine; monitor seizure control. Initiate on the first day of menses or first Sunday after onset.
Take one tablet daily at the same time, in the order listed on the pack.,If you miss a dose, take it as soon as remembered; if more than 24 hours late, use backup contraception.,Common side effects: nausea, breast tenderness, spotting, and headache.,Report signs of blood clots: sudden leg pain, chest pain, or shortness of breath.,Smoking increases risk of serious cardiovascular side effects, especially if over 35 years old.,Antibiotics (except rifampin) do not reduce effectiveness; inform your provider about all medications.
Take one tablet daily at the same time each day, with or without food.,If you miss a pill by less than 12 hours, take it as soon as you remember. If more than 12 hours, take the missed pill and use a backup method (e.g., condoms) for the next 7 days.,Smoking increases your risk of serious cardiovascular side effects, especially if you are over 35 years old. Do not smoke while taking this medication.,Seek immediate medical attention if you experience sudden severe headache, chest pain, leg pain/swelling, or vision changes (symptoms of blood clots).,This medication does not protect against HIV or other sexually transmitted infections.,If you are taking lamotrigine or other anticonvulsants, tell your doctor; your seizure medication may be less effective.,Store at room temperature away from moisture and heat.
No interactions on record
No interactions on record
Explore head-to-head clinical comparisons of other medications in the same therapeutic classes.
Common clinical questions about HAILEY FE 1/20 vs ALTAVERA, answered by our medical review team.
HAILEY FE 1/20 is a Oral Contraceptive that works by Combination oral contraceptive containing ethinyl estradiol and norethindrone. Suppresses gonadotropin (FSH and LH) release via negative feedback on the hypothalamic-pituitary-ovarian axis, inhibiting ovulation. Also alters cervical mucus and endometrial lining to impair sperm penetration and implantation.. ALTAVERA is a Combined Oral Contraceptive that works by Combination of ethinyl estradiol and desogestrel: ethinyl estradiol suppresses gonadotropin release, inhibiting ovulation; desogestrel (progestin) causes cervical mucus thickening and endometrial atrophy, preventing implantation.. They differ in pharmacokinetic profiles, FDA-approved indications, and side effect profiles.
Potency comparisons between HAILEY FE 1/20 and ALTAVERA depend on the specific clinical indication. These are agents from distinct pharmacological classes and are not directly interchangeable by dose. A physician or clinical pharmacist should guide any therapeutic switching decisions.
The standard adult dose of HAILEY FE 1/20 is: One tablet orally once daily for 21 consecutive days followed by 7 days of placebo tablets.. The standard adult dose of ALTAVERA is: 1 tablet (ethinyl estradiol 0.03 mg / levonorgestrel 0.15 mg) orally once daily for 21 days, followed by 7 placebo days.. Dosing should always be individualized based on indication, renal and hepatic function, age, and other patient factors.
No direct drug-drug interaction has been formally documented between HAILEY FE 1/20 and ALTAVERA in current clinical databases. However, individual patient risk factors including other medications, organ function, and comorbidities should always be evaluated by a qualified healthcare provider.
The maternal-fetal safety profiles differ. HAILEY FE 1/20 is classified as Category C. First trimester: No increased risk of major birth defects in large epidemiological studies. Second and third trimesters: Use is not recommended due to potential adverse effects on . ALTAVERA is classified as Category C. ALTAVERA contains ethinyl estradiol and levonorgestrel. First trimester: Inadvertent exposure during organogenesis is associated with a very low absolute risk of cardiovascular def. Always consult a maternal-fetal medicine specialist before taking either drug during pregnancy or lactation.