Drovelis
Is It Right for You?
A complete guide to Drovelis — what it treats, how it works, dosages, side effects, and when a clinician may prescribe it following an online consultation.
What Is Drovelis?
Drovelis is a combined oral contraceptive pill containing estetrol (15 mg) — a naturally occurring oestrogen produced exclusively during human pregnancy by the foetal liver — and drospirenone (3 mg), a fourth-generation progestogen with anti-androgenic and anti-mineralocorticoid properties. It represents the first combined oral contraceptive to use estetrol as its oestrogenic component.
Estetrol acts as a selective oestrogen receptor modulator (SERM) with tissue-selective agonist and antagonist activity. Unlike ethinylestradiol, estetrol has minimal stimulatory activity at hepatic oestrogen receptors, which may translate to a more favourable metabolic and thrombotic risk profile. Drovelis is presented as a 28-day pack containing 24 active pink tablets and four white placebo tablets, providing a continuous daily pill-taking routine with a shorter hormone-free interval than traditional 21/7 formulations.
Drovelis is a prescription-only medication in the UK. A licensed clinician must assess your medical history, cardiovascular risk, and contraindications before it can be prescribed.
What Conditions Is Drovelis Used For?
Drovelis is indicated for:
highly effective prevention of pregnancy in women of reproductive age
Drovelis is licensed for the treatment of moderate acne in women who also require oral contraception; drospirenone's anti-androgenic activity reduces sebum production and acne lesions
Drovelis provides highly effective contraceptive protection but offers no barrier protection against sexually transmitted infections. Condom use remains necessary for STI prevention.
How Does Drovelis Work?
Drovelis exerts its contraceptive effect through three mechanisms:
Ovulation suppression — estetrol and drospirenone act synergistically on the hypothalamic-pituitary-ovarian axis to suppress gonadotrophin secretion and prevent the mid-cycle LH surge, thereby inhibiting ovulation. This is the primary contraceptive mechanism.
Cervical mucus thickening — drospirenone's progestogenic activity causes thickening of cervical mucus, reducing sperm penetration.
Endometrial transformation — continuous progestogenic stimulation induces endometrial atrophy, reducing receptivity to implantation.
Estetrol's tissue-selective oestrogenic activity differs importantly from ethinylestradiol: estetrol acts as a partial antagonist at hepatic oestrogen receptors while acting as a full agonist at hypothalamic and bone oestrogen receptors. This hepatic receptor selectivity is associated with reduced stimulation of hepatic clotting factor synthesis, potentially resulting in a lower VTE risk profile compared to ethinylestradiol-containing pills.
Drospirenone additionally blocks aldosterone receptors (anti-mineralocorticoid activity), which counteracts oestrogen-associated fluid retention, and androgen receptors (anti-androgenic activity), which reduces acne and excess hair growth.
Dosages & Administration
The correct dose depends on the type and severity of infection, age, weight, and kidney function. Always follow your clinician's instructions. The table below is for general reference only.
Administration Tips
Take one tablet at the same time each day — maintaining a consistent daily time maximises contraceptive efficacy and reduces breakthrough bleeding.
Begin on day one of your menstrual cycle for immediate contraceptive protection. Starting later in the cycle requires additional barrier contraception for seven days.
Take the placebo tablets (white tablets) during days 25–28 to maintain the daily pill-taking habit and reduce the risk of missed-pill errors. A withdrawal bleed typically occurs during this interval.
If you miss a pink (active) tablet, take it as soon as you remember. If more than 24 hours late, additional contraception is required for seven days. Follow your clinician's or pill leaflet's missed-pill guidance carefully.
Nausea — if nausea occurs, taking the tablet in the evening with food may help.
Side Effects of Drovelis
Most side effects are mild and resolve on their own. Serious side effects are rare but require immediate medical attention.
- Headache or migraine
- Breast tenderness
- Nausea
- Mood changes, including low mood or irritability
- Decreased libido
- Irregular bleeding or spotting (particularly during the first three cycles)
- Acne (may initially worsen before improving with drospirenone's anti-androgenic effect)
- Venous thromboembolism (VTE) — deep vein thrombosis or pulmonary embolism; leg swelling, pain, breathlessness, chest pain
- Arterial thrombosis — myocardial infarction or stroke; chest pain, sudden headache, facial droop, arm weakness, speech disturbance
- Hyperkalaemia — drospirenone's anti-mineralocorticoid activity can raise potassium levels, particularly in women with renal or adrenal insufficiency or those on potassium-sparing drugs
- Severe allergic reaction
- Severe hypertension
All combined oral contraceptives carry an increased risk of VTE compared to non-use. The absolute risk remains low in healthy women. Drovelis's estetrol component may be associated with a more favourable VTE risk profile than ethinylestradiol-containing pills, though long-term comparative data are still accumulating.
Drug Interactions
Always disclose all prescription drugs, over-the-counter medicines, vitamins, and supplements to your clinician or pharmacist before starting Drovelis
drospirenone's anti-mineralocorticoid activity may cause clinically significant hyperkalaemia when combined with these agents; monitor potassium levels.
combined oral contraceptives may reduce lamotrigine levels, potentially reducing seizure control..
certain agents reduce combined oral contraceptive efficacy; specialist review required.
no clinically significant interaction
Important Warnings
Drovelis is contraindicated in women with a personal or family history of VTE, known thrombophilia, or multiple arterial risk factors. The risk-benefit balance must be individually assessed.
Drovelis and all combined oral contraceptives are contraindicated in women who experience migraine with aura, due to an elevated risk of ischaemic stroke.
Women with renal impairment, adrenal insufficiency, or who are taking potassium-sparing medications should have potassium levels checked during the first cycle of Drovelis use.
Combined hormonal contraceptives are associated with a small increased risk of breast cancer, returning to baseline within ten years of stopping.
Speak to a Clinician About Treatment
Getting advice no longer means sitting in a waiting room. Through The GP Service, you can consult with a licensed clinician in minutes — from home, on your lunch break, or wherever works for you. If treatment is clinically appropriate, your clinician can issue a prescription during the consultation. A consultation does not guarantee a prescription.
The treatment you need, when you need it.
Drovelis FAQs
Drovelis is the first combined oral contraceptive to use estetrol, a naturally occurring oestrogen. Estetrol's selective oestrogen receptor activity may offer a more favourable safety profile compared to ethinylestradiol-containing pills, though long-term real-world data continue to accumulate.
Drovelis is licensed for the treatment of moderate acne in women also requiring contraception. Drospirenone's anti-androgenic activity reduces sebum production and acne severity. Improvement typically develops over three to six months of use.
The shorter four-day hormone-free interval reduces hormonal fluctuations and may reduce withdrawal symptoms such as headaches and breakthrough bleeding compared to traditional 21/7 pill formulations.
Drovelis is contraindicated in uncontrolled hypertension. Blood pressure should be monitored before and during treatment. Women with well-controlled hypertension should be assessed individually.
Clinical trials do not demonstrate a consistent causal relationship between Drovelis and weight gain. Drospirenone's anti-mineralocorticoid activity may counteract fluid retention associated with oestrogen.