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Twirla (Levonogestrel and Ethinyl Estradiol)

Prescription medicineOnly Available By Prescription

Top brand choice

Strength Pack Size Qty
Pack Size

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What if I find a lower price with another pharmacy?

We guarantee the lowest price on all of our prescription products. If you find your medications cheaper at any other recognized licensed mail order pharmacy, we will not only match their price, we will beat it by 25% of the difference. It is our 125% price match guarantee!

Example: If you find a product on Canada Drugs Direct for $50.00 and find the same product for $40.00 at another mail order pharmacy, we will provide you with a $12.50 discount, bringing your total to $37.50.

To get the discount please make sure to mention the price match to the customer service team when they call to collect payment for your order. Or call toll free at 1-888-904-8467 to place the order through the phone.

Terms & Conditions of Program

  • Guaranteed lowest price is only valid at the time of sale.
  • We will only match the current advertised price.
  • Products must be identical and in stock at the time of placing an order with a licensed mail order pharmacy. They must be an online Canadian pharmacy with an address in Canada.
  • Products must be authentic in brand and size (same manufacturer, same country of manufacture, same pack size, same strength and same quantity).
  • Products must be new. We cannot match the price of any used, short expiry or expired product.
  • Price match can only be issued over the phone with our customer service team. Please note at this time we cannot offer price matching for the products Ozempic or Saxenda.
What is a Generic Drug?

A generic drug is a copy of the brand-name drug with the same dosage, safety, strength, quality, consumption method, performance, and intended use. Before generics become available on the market, the generic company must prove it has the same active ingredients as the brand-name drug and works in the same way and in the same amount of time in the body.

The only differences between generics and their brand-name counterparts is that generics are less expensive and may look slightly different (eg. different shape or color), as trademarks laws prevent a generic from looking exactly like the brand-name drug.

Generics are less expensive because generic manufacturers don't have to invest large sums of money to develop a drug. When the brand-name patent expires, generic companies can manufacture a copy of the brand-name and sell it at a substantial discount.


Twirla contains a progestin, levonorgestrel, and an estrogen, ethinyl estradiol, to prevent pregnancy in women who have a body mass index (BMI) that is less than 30 kg/m2.

Fact Table


C21H28O2, C20H24O2




38% - 48%

Legal status


Chemical Name

Levonogestrel and Ethinyl Estradiol

Elimination half-life

7–36 hours

Dosage (Strength)






Protein binding


PubChem CID

13109, 5991


a610021, a604032


6443, 4903

ATC code

G03AC03, G03CA01




D00950, D00554

Routes of administration



Twirla comes as a transdermal patch for application to the skin only. Apply the patch per the instructions that come with your prescription. Talk to your doctor or pharmacist about any questions or concerns you may have.

One patch should be applied to clean, dry, and intact skin of the abdomen, buttock, or upper torso every week for three consecutive weeks. 

Avoid applying the patch to the breasts. Avoid cutting the patch. You should not wear a patch during the fourth week.

120 mcg/day of levonorgestrel and 30 mcg/day of ethinyl estradiol are provided in each patch.


Levonorgestrel and Ethinyl Estradiol are the active ingredients in Twirla.



  • TWIRLA is contraindicated in women over 35 years old who smoke. Cigarette smoking increases the risk of serious cardiovascular events from combined hormonal contraceptive (CHC) use.
  • TWIRLA is contraindicated in women with a BMI = 30 kg/m2. Compared to women with a lower BMI, women with a BMI = 30 kg/m2 had reduced effectiveness and may have a higher risk for venous thromboembolic events.
  • Avoid the use of Twirla if you currently have or have a history of blood clots, a heart attack, or a stroke, uncontrolled high blood pressure, certain heart valve problems, a condition that makes your blood clot more than normal, or if you smoke and are older than 35 years old.
  • Avoid the use of Twirla if your BMI is 30 kg/m2 or more.
  • Avoid the use of Twirla if you currently have or have a history of breast cancer or other hormonally-sensitive cancer.
  • Avoid the use of Twirla if you have liver tumors, acute viral hepatitis, or decompensated liver cirrhosis. 
  • Avoid the use of Twirla if you have migraines with aura, if you are older than 35 years old and have migraines with or without aura, or if you have headaches with focal neurological symptoms.
  • Avoid the use of Twirla if you have undiagnosed irregular vaginal bleeding.
  • Avoid the use of Twirla if you are pregnant.
  • Avoid the use of Twirla if you are allergic to levonorgestrel, ethinyl estradiol, or any of the other ingredients contained in the patch.
  • Avoid the use of Twirla if you take hepatitis C drugs that contain ombitasvir/paritaprevir/ritonavir, with or without dasabuvir.


  • Before you start using Twirla transdermal system, talk to your doctor:
    • About all the prescription and nonprescription medications you take, as well as vitamins and herbal supplements
    • About any allergies you may have
    • About your medical problems
    • About any scheduled or planned surgeries 
    • About your pregnancy status. Tell your doctor if you are pregnant or plan to become pregnant.
    • About your breastfeeding status. Tell your doctor if you are planning to breastfeed.
  • Your risk for blood clots, a heart attack, or a stroke may be increased with the use of Twirla. Cardiovascular risk factors should be evaluated before starting Twirla.
  • Liver problems may occur with the use of Twirla. 
  • High blood pressure may occur with the use of Twirla. Monitor your blood pressure periodically while using Twirla.
  • Gallbladder disease may worsen or occur with the use of Twirla.
  • Glucose intolerance may decrease in women who are prediabetic or diabetic and are using Twirla.
  • Triglyceride levels may increase with the use of Twirla. Increased triglyceride levels can lead to pancreatitis.
  • Severe or persistent headaches may occur with the use of Twirla.
  • Irregular vaginal bleeding or no menstruation may occur with the use of Twirla.

Side Effects

Twirla can cause side effects such as application site reactions, nausea, headache, abnormal vaginal bleeding, and weight gain.

Immediately tell your doctor if you experience side effects that bother you or continue.


Twirla. Grand Rapids, MI: Corium International, Inc.; 2020.

IMPORTANT NOTE: The above information is intended to increase awareness of health information and does not suggest treatment or diagnosis. This information is not a substitute for individual medical attention and should not be construed to indicate that use of the drug is safe, appropriate, or effective for you. See your health care professional for medical advice and treatment.

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