Mili and Estarylla are the same medication. Both contain exactly 0.25 mg of norgestimate and 0.035 mg of ethinyl estradiol per active tablet, and both follow a 28-day pack with 21 active pills and 7 inactive pills. The only differences are the manufacturer and pill appearance.
Why Two Names for the Same Drug
Mili and Estarylla are both generic versions of Ortho-Cyclen, a combination birth control pill that is no longer sold under its original brand name. When a brand-name drug loses patent protection, multiple pharmaceutical companies can manufacture their own versions. Each company gives its product a unique name, even though the formula inside is identical. Estarylla is made by Xiromed, while Mili is produced by a different generic manufacturer.
This is why you’ll find a long list of names that all refer to the same drug: Sprintec, Mono-Linyah, Previfem, Femynor, and Nymyo are additional generics with the same active ingredients and dosing schedule. Your pharmacy may switch you between any of these depending on what’s in stock or what your insurance covers.
What’s in Each Pill
Every active tablet in both Mili and Estarylla contains two hormones: a progestin (norgestimate) at 0.25 mg and an estrogen (ethinyl estradiol) at 0.035 mg. Because the hormone levels stay the same across all 21 active pills, these are classified as monophasic, meaning you get a consistent dose every day rather than a shifting one.
The remaining 7 tablets in each pack are placebo pills with no hormones. These are there to keep you in the habit of taking a pill daily. Your period typically starts during this placebo week.
Switching Between Mili and Estarylla
If your pharmacy substitutes one for the other, you don’t need to adjust anything. Take the new pack the same way you took the old one: one active pill per day for 21 days, then one placebo pill per day for 7 days. There’s no gap in protection and no need for backup contraception, since the hormones and doses are identical.
The inactive ingredients, like fillers, dyes, and coatings, can differ between manufacturers. In rare cases, someone may notice a minor difference in how they feel or tolerate a pill after switching generics. This is uncommon, but if you experience something unusual after a switch, it’s worth mentioning to your prescriber.
Missed Pill Guidelines
The instructions for missed pills are the same regardless of which brand name is on the pack. If you miss one active pill, take two pills the day you remember and then continue with one pill per day for the rest of the pack. If you miss two active pills in a row during the first or second week, take two pills per day for two consecutive days, then resume one pill daily. Missing pills in the third week or missing three or more pills at any point typically means you should start a new pack and use backup contraception for seven days.