Azurette is a combination birth control pill that contains two hormones: a progestin called desogestrel and a synthetic estrogen called ethinyl estradiol. It’s a generic version of the brand-name pill Mircette (Kariva is another generic equivalent). What makes Azurette slightly unusual among birth control pills is its pill-free interval: instead of seven inactive placebo pills at the end of each pack, it includes only two placebos followed by five pills containing a low dose of estrogen. This design can reduce some of the symptoms that flare during the hormone-free week, like headaches and bloating.
What’s in the 28-Day Pack
Each Azurette pack contains three types of tablets, color-coded so you can tell them apart:
- 21 white tablets: The active pills. Each one contains 0.15 mg desogestrel and 0.02 mg ethinyl estradiol.
- 2 light-green tablets: Inert placebos with no active ingredients. These are spacers.
- 5 light-blue tablets: Each contains a very low dose of estrogen only, 0.01 mg ethinyl estradiol.
You take the pills in order, one per day, at the same time each day. After finishing all 28 tablets, you start a new pack the next day. Your period typically arrives during the two placebo days and the five low-dose estrogen days.
Those five light-blue pills at the end are the key feature that distinguishes Azurette from most other combination pills. By keeping a small amount of estrogen in your system during the “off” week, the pack shortens the total hormone-free window to just two days instead of seven. For some people, this reduces withdrawal symptoms like breakthrough headaches, mood dips, or pelvic pain that tend to show up when estrogen drops sharply.
How It Prevents Pregnancy
Azurette works the same way other combination pills do: it suppresses the hormonal signals your brain sends to your ovaries, preventing them from releasing an egg each month. That’s the primary mechanism. It also thickens cervical mucus, making it harder for sperm to reach the uterus, and thins the uterine lining, making implantation less likely. These backup effects add extra protection even if ovulation isn’t fully suppressed in a given cycle.
With perfect use (taking every pill on time, every day), combination pills like Azurette have a failure rate of less than 1% per year. With typical use, which accounts for real-life missed pills and late doses, the failure rate rises to about 7%. That gap highlights how much consistency matters with a daily pill.
Common Side Effects
Azurette shares the same side effect profile as other combination birth control pills. The most commonly reported effects include nausea, breast tenderness, spotting or breakthrough bleeding between periods, bloating, headaches, and changes in weight (up or down). Many of these are most noticeable in the first two to three months of use and often improve as your body adjusts.
Some people also experience mood changes, decreased sex drive, or changes in skin (acne can improve or worsen depending on the person). Contact lens wearers occasionally notice their lenses feel different because the hormones can slightly change the shape of the cornea. Less common but documented effects include skin darkening (melasma), especially with sun exposure, and vaginal yeast infections.
Blood Clot Risk
All combination birth control pills carry a small increased risk of blood clots, and Azurette deserves specific mention here because it contains desogestrel, a third-generation progestin. Research has consistently shown that pills with desogestrel carry a slightly higher clot risk compared to pills containing older progestins like levonorgestrel.
To put this in perspective: among women not using any hormonal birth control, about 2 out of every 10,000 develop a blood clot in a given year. For those on a levonorgestrel-based pill, that number rises to roughly 8 per 10,000. For those on a desogestrel-based pill like Azurette, estimates land around 10 to 15 per 10,000. A Cochrane review of 26 studies found that third-generation progestins increased the relative risk of clots by about 30% to 80% compared to levonorgestrel pills at the same estrogen dose.
That sounds alarming in relative terms, but the absolute risk remains very low for most people. The American Society for Reproductive Medicine notes that some of this difference could be explained by differences in the populations studied rather than the drugs themselves. Still, if you have a personal or strong family history of blood clots, or if you smoke (especially over age 35), this distinction matters and is worth discussing before starting Azurette specifically.
What to Do If You Miss a Pill
If you take a white (active) pill late but it’s been less than 24 hours since you should have taken it, just take it as soon as you remember and continue with the rest of the pack on your normal schedule. No backup contraception needed.
If you’ve missed one active pill by 24 to 48 hours, the same advice applies: take it right away, continue the pack, and you’re still protected. No condoms necessary, though you may want to consider emergency contraception if you also missed pills earlier in the cycle.
Missing two or more active pills in a row (48 hours or more since you should have taken one) is more serious. Take the most recent missed pill as soon as possible and discard any other missed ones. Continue the rest of the pack on schedule, but use condoms or avoid intercourse for the next seven days. If those missed pills happened during the last week of active tablets (roughly days 15 through 21), skip the placebo and low-dose pills entirely and start a new pack right away. If you had unprotected sex during the first week of the pack and missed pills, emergency contraception is worth considering.
Missing the light-green placebo tablets or the light-blue low-dose estrogen tablets does not affect your pregnancy protection, since those pills don’t contain the progestin that prevents ovulation.
How Azurette Compares to Other Pills
Azurette is chemically identical to Kariva, since both are generic versions of Mircette. The active ingredients, doses, and pill sequence are the same. Any differences between the two come down to inactive ingredients like binders and dyes, which can occasionally matter if you have a specific allergy but are otherwise irrelevant.
Compared to the broader landscape of combination pills, Azurette sits on the lower end of estrogen dosing at 0.02 mg (20 micrograms) of ethinyl estradiol. Many older pills contain 30 to 35 micrograms. Lower estrogen doses are generally associated with fewer estrogen-related side effects like bloating, nausea, and breast tenderness, though they may be slightly more likely to cause breakthrough bleeding, especially in the first few cycles. The shortened hormone-free interval (two days instead of seven) is designed to compensate for the lower estrogen dose by keeping hormone levels more stable throughout the month.