Lactic Acid, Citric Acid, and Potassium Bitartrate Vaginal Contraceptive

PHEXXI is a hormone-free vaginal gel used right before sex to prevent pregnancy by keeping sperm from moving normally.

Brand name Phexxi
Drug classes ⓘ Acidifying Activity
Rx Route Vaginal
Dr. Brian Staiger, PharmD, BCPS
Reviewed by Last reviewed Jul 10, 2026 Content updated Oct 1, 2026

Built from the FDA-approved label, dated Nov 21, 2023 · How this page is built

✓No current FDA shortage listed · checked Oct 2, 2026
Dr. Brian Staiger, PharmD, BCPS
The Pharmacist’s Bottom LineWritten from the FDA label in plain language · reviewed by
PHEXXI is a hormone-free, on-demand vaginal gel that helps prevent pregnancy by slowing sperm — but it must be used before sex, not after. It's generally well-tolerated, though vaginal irritation and UTIs are the most common concerns. People with a history of recurrent UTIs should avoid it and discuss other options with their provider.
How you get itPrescription only
FDA label last updatedNov 21, 2023
FDA’s strongest warning (boxed)None on the label

⚡ Quick answers about Lactic Acid, Citric Acid, and Potassium Bitartrate Vaginal Contraceptive

Do I have to use PHEXXI every day, or only when I have sex?

Only when you have sex — that's the whole point of it being an on-demand contraceptive. You insert one applicator vaginally up to an hour before intercourse, and that's it. No daily routine needed.

Read the full answer →

Can I use PHEXXI with condoms or my birth control pill?

Yes, absolutely. PHEXXI is compatible with latex, polyurethane, and polyisoprene condoms, diaphragms, and hormonal contraceptives like the pill.

Read the full answer →

What side effects should I expect, and which ones mean I should call my doctor?

The most common side effects are vaginal burning and itching — about 1 in 5 people experience some burning, but it's usually mild and temporary. Yeast infections and UTIs have also been reported.

Read the full answer →

I get UTIs pretty often. Is PHEXXI safe for me?

That's actually really important to bring up with your doctor before using PHEXXI.

Read the full answer →
🧬 Where this information comes from Click to expand

The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 1 clinical label set within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →

How we combine label and product data →

📖 Lactic Acid, Citric Acid, and Potassium Bitartrate Vaginal Contraceptive: Patient Information Guide

A plain-language walkthrough of Lactic Acid, Citric Acid, and Potassium Bitartrate Vaginal Contraceptive — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.

What Lactic Acid, Citric Acid, and Potassium Bitartrate Vaginal Contraceptive is used for

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PHEXXI is used to prevent pregnancy on an as-needed basis. Main uses:

  • Prevention of pregnancy in people of reproductive age
  • On-demand contraception — used only when needed, not taken daily
  • Can be used alongside hormonal birth control, condoms, or diaphragms for added protection

Not effective if used after vaginal intercourse has already occurred.

How Lactic Acid, Citric Acid, and Potassium Bitartrate Vaginal Contraceptive works

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PHEXXI contains three ingredients — lactic acid, citric acid, and potassium bitartrate — that work together to keep the vagina at its naturally acidic pH level (3.5–4.5) even when semen is present. Semen is naturally alkaline, and sperm swim best in a less acidic environment. By maintaining that acidity, PHEXXI slows sperm motility (movement), making it harder for sperm to reach and fertilize an egg.

In clinical testing after intercourse, the majority of users had a vaginal pH below 5 and showed significantly reduced sperm movement.

How Lactic Acid, Citric Acid, and Potassium Bitartrate Vaginal Contraceptive is taken (dosage)

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PHEXXI is inserted vaginally using a pre-filled applicator shortly before sex.

  • Use one applicator immediately before or up to one hour before each act of vaginal intercourse
  • If you have sex more than once within a single hour, use an additional applicator each time
  • It can be used at any point in your menstrual cycle
  • It may be used as soon as it's safe to resume intercourse after childbirth, abortion, or miscarriage

Dosing details from the FDA-approved label

From the Lactic Acid, Citric Acid, and Potassium Bitartrate Vaginal Contraceptive prescribing information (“Dosage and Administration”). Doses are set by your prescriber for your product, condition, kidney function and age — never change a dose on your own.

Read the label’s full dosing text

2 DOSAGE AND ADMINISTRATION Administer one (1) pre-filled single-dose applicator of PHEXXI (5 grams) vaginally immediately before (or up to one hour before) each episode of vaginal intercourse ( 2.1 ) May use during any part of the menstrual cycle ( 2.2 ) 2.1 Recommended Dosage Administer one pre-filled applicator of PHEXXI (5 grams) vaginally immediately before or up to one hour before each act of vaginal intercourse. If more than one act of vaginal intercourse occurs within one hour, an additional dose must be applied. Five grams of PHEXXI contains 90 mg of lactic acid, 50 mg of citric acid, and 20 mg of potassium bitartrate. 2.2 Timing of PHEXXI Use May use PHEXXI during any part of the menstrual cycle. May use PHEXXI as soon as it is safe to resume vaginal intercourse after childbirth, abortion, or miscarriage. 2.3 Use of PHEXXI with Other Contraceptive Methods PHEXXI may be used concomitantly with hormonal contraceptives; latex, polyurethane, and polyisoprene condoms; and vaginal diaphragms. Avoid PHEXXI use with vaginal rings. 2.4 Use of PHEXXI with Other Vaginal Products PHEXXI may be used concomitantly with other products for vaginal infections including miconazole, metronidazole, and tioconazole.

Read the full Dosage and Administration section on DailyMed →

Lactic Acid, Citric Acid, and Potassium Bitartrate Vaginal Contraceptive side effects in detail

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Common side effects

  • Burning or stinging sensation in the vaginal area
  • Vaginal itching
  • Yeast infection (vaginal)
  • Urinary tract infection (UTI)
  • Vaginal discomfort or pain
  • Bacterial vaginosis (change in vaginal bacteria)
  • Unusual vaginal discharge
  • Pain or burning when urinating

When to get medical help

  • Call your doctor if you develop signs of a urinary tract or kidney infection: painful urination, frequent urges to urinate, fever, back or side pain, or chills.
  • Stop using PHEXXI and seek care if you have signs of an allergic reaction, such as rash, swelling, or difficulty breathing.
  • Tell your doctor right away if you develop a kidney infection (pyelonephritis) — this has required hospitalization in rare cases.

Most side effects with PHEXXI are local — meaning they affect the vaginal area — and tend to be mild. Common ones include:

  • Vaginal burning or stinging sensation (most common, reported by about 1 in 5 users)
  • Vaginal itching
  • Yeast infection
  • Urinary tract infection (UTI)
  • Vaginal discomfort or pain
  • Bacterial vaginosis
  • Unusual vaginal discharge
  • Pain or burning with urination

Serious reactions are rare but do occur: kidney infection (pyelonephritis) has been reported and in at least one case required hospitalization. Contact your doctor promptly if you develop fever, back or side pain, or severe urinary symptoms.

Lactic Acid, Citric Acid, and Potassium Bitartrate Vaginal Contraceptive warnings and precautions

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  • UTI and kidney infection risk: People with a history of recurrent UTIs or urinary tract abnormalities should avoid PHEXXI. In clinical trials, a small number of users developed serious kidney infections requiring hospitalization.
  • Not effective after sex: PHEXXI must be applied before intercourse — it offers no protection if used after.
  • Allergic reaction: At least one case of a suspected allergic reaction was reported. Stop using PHEXXI and seek care if you notice unusual or severe irritation, swelling, or rash.
  • Vaginal rings: Do not use PHEXXI at the same time as a vaginal ring, as the combination is not recommended.

Lactic Acid, Citric Acid, and Potassium Bitartrate Vaginal Contraceptive interactions: what it interacts with

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PHEXXI has a few important compatibility considerations with other vaginal products and contraceptive methods:

  • Vaginal rings — avoid: PHEXXI should not be used together with a vaginal ring.
  • Condoms — compatible: Safe to use with latex, polyurethane, and polyisoprene condoms.
  • Diaphragms — compatible: Can be used alongside a vaginal diaphragm.
  • Hormonal contraceptives — compatible: Can be combined with hormonal birth control methods.
  • Common vaginal treatments — compatible: Miconazole, metronidazole, and tioconazole (used for yeast or bacterial vaginal infections) do not interfere with PHEXXI's effectiveness or pH-buffering action.

Not a complete list. The label covers the interactions the manufacturer studied or reported, and our own interaction database does not cover every medicine either. Bring your full medication list, including vitamins and herbal products, to your pharmacist.

Before taking Lactic Acid, Citric Acid, and Potassium Bitartrate Vaginal Contraceptive

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  • Recurrent UTIs or urinary tract abnormalities: Avoid PHEXXI — you are at higher risk for serious urinary infections.
  • Known or suspected allergy to any PHEXXI ingredient: Do not use it.
  • Pregnancy: Discontinue PHEXXI if you become pregnant — there is no use for it during pregnancy.
  • Breastfeeding: Data on effects in breastfed infants are not available; discuss with your provider.
  • Pre-menarche (before first period): PHEXXI is not indicated for use before menstruation begins.
  • Adolescents after first period: Expected to work the same as in adults 17 and older.

Pharmacokinetics: how your body processes Lactic Acid, Citric Acid, and Potassium Bitartrate Vaginal Contraceptive

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Formal pharmacokinetic studies (looking at how the body absorbs and processes this medication) have not been performed in humans. However, the levels of lactic acid, citric acid, and potassium bitartrate that enter the body after vaginal use are not expected to raise any safety concerns. The drug acts locally in the vagina rather than being absorbed into the bloodstream in meaningful amounts.

How to store Lactic Acid, Citric Acid, and Potassium Bitartrate Vaginal Contraceptive

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Store in the original foil pack at room temperature 20°C to 25°C (68°F to 77°F); excursion permitted between 15°C to 30°C (59°F to 86°F) .

📄 Written from Lactic Acid, Citric Acid, and Potassium Bitartrate Vaginal Contraceptive’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →

33

Supplements & herbs that interact with Lactic Acid, Citric Acid, and Potassium Bitartrate Vaginal Contraceptive

33 supplements and herbal products have documented interactions with Lactic Acid, Citric Acid, and Potassium Bitartrate Vaginal Contraceptive in the licensed clinical database we use. Most are manageable — but your pharmacist should know about everything you take, including vitamins and herbals.

Severity mix
  • Major · 1
  • Moderate · 21
  • Minor · 11
Every supplement checked against Lactic Acid, Citric Acid, and Potassium Bitartrate Vaginal Contraceptive — ranked by severity The full interaction hub: 1 major · 21 moderate · 11 minor · every one linked to its full report. Check Lactic Acid, Citric Acid, and Potassium Bitartrate Vaginal Contraceptive against your exact supplements

Educational information from a licensed clinical database (Natural Medicines) — see our data sources & update cadence. Not medical advice: an interaction being documented does not mean it will happen to you; do not start or stop medications or supplements without professional guidance.

2

Nutrient depletion considerations

Lactic Acid, Citric Acid, and Potassium Bitartrate Vaginal Contraceptive has been associated with lower levels of 2 nutrients in the clinical literature. This does not mean a deficiency will occur — it means these may be worth discussing with your pharmacist or healthcare provider, especially with long-term use.

See the full Lactic Acid, Citric Acid, and Potassium Bitartrate Vaginal Contraceptive nutrient depletion report

Educational information from a licensed clinical database (Natural Medicines) — not medical advice. Do not start or stop medications or supplements without professional guidance.

🩺 Lactic Acid, Citric Acid, and Potassium Bitartrate Vaginal Contraceptive: pharmacist answers to common questions

Quick, plain-English answers to the questions patients ask most about Lactic Acid, Citric Acid, and Potassium Bitartrate Vaginal Contraceptive — the kind of thing our pharmacy team would talk through with you at the counter.

Do I have to use PHEXXI every day, or only when I have sex?

▾
Only when you have sex — that's the whole point of it being an on-demand contraceptive. You insert one applicator vaginally up to an hour before intercourse, and that's it. No daily routine needed. Just remember: if you have sex more than once within that same hour, you'll need to use a second applicator.

Can I use PHEXXI with condoms or my birth control pill?

▾
Yes, absolutely. PHEXXI is compatible with latex, polyurethane, and polyisoprene condoms, diaphragms, and hormonal contraceptives like the pill. The one thing to avoid is using it at the same time as a vaginal ring — those two don't mix. Using PHEXXI alongside another method can give you added peace of mind.

What side effects should I expect, and which ones mean I should call my doctor?

▾
The most common side effects are vaginal burning and itching — about 1 in 5 people experience some burning, but it's usually mild and temporary. Yeast infections and UTIs have also been reported. You should call your doctor if you develop signs of a urinary or kidney infection — things like painful urination, fever, or back and side pain. Those need prompt attention.

I get UTIs pretty often. Is PHEXXI safe for me?

▾
That's actually really important to bring up with your doctor before using PHEXXI. People with a history of frequent UTIs or any urinary tract abnormalities are advised to avoid this product, because it can increase the risk of UTIs — including more serious kidney infections. Your provider can help you find a birth control option that's a better fit.

What happens if I forget to use it before sex and try to use it after?

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Unfortunately, PHEXXI won't work if you use it after intercourse — it has to be in place beforehand to do its job. If you had unprotected sex and are worried about pregnancy, talk to a pharmacist or provider about emergency contraception options.

Can I use PHEXXI while breastfeeding or if I'm pregnant?

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PHEXXI should be stopped if you become pregnant — there's no reason to use a contraceptive during pregnancy. If you're breastfeeding, there isn't enough data yet to say for certain how it affects breast milk or your baby, so it's worth talking to your provider to decide if it's the right choice for you right now.

Is Lactic Acid, Citric Acid, and Potassium Bitartrate Vaginal Contraceptive available over the counter?

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Lactic Acid, Citric Acid, and Potassium Bitartrate Vaginal Contraceptive is dispensed by prescription according to its FDA labeling, so it isn't sold over the counter. Your prescriber and pharmacist will determine if it's appropriate for you.

💬 Answers drafted from Lactic Acid, Citric Acid, and Potassium Bitartrate Vaginal Contraceptive’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →

🧰 More about Lactic Acid, Citric Acid, and Potassium Bitartrate Vaginal Contraceptive on HelloPharmacist

🏷️ Lactic Acid, Citric Acid, and Potassium Bitartrate Vaginal Contraceptive brand names

Lactic Acid, Citric Acid, and Potassium Bitartrate Vaginal Contraceptive is sold under one brand name in the FDA directory — Phexxi. A brand and its generic contain the same active ingredient; the brand name belongs to one company's product.

Phexxi

Lactic Acid, Citric Acid, and Potassium Bitartrate Vaginal Contraceptive drug class (RxNorm)

Lactic Acid, Citric Acid, and Potassium Bitartrate Vaginal Contraceptive belongs to the Organic acids class.

Drug family (ATC) Organic acids
How it works Acidifying Activity

Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.

🔬 Sources for this Lactic Acid, Citric Acid, and Potassium Bitartrate Vaginal Contraceptive page

Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.

📄
FDA-filed drug labels (SPL) Uses, dosing, warnings & side effects from SPL records retrieved through openFDA; the linked representative set can be verified on DailyMed. ✓ Linked label effective Nov 21, 2023
🏭
Forms, brands & labelersAggregated from ingredient-matched FDA National Drug Code Directory product records for Lactic Acid, Citric Acid, and Potassium Bitartrate Vaginal Contraceptive.
📈
Real-world reportsThe FDA Adverse Event Reporting System (FAERS), served through openFDA.
🚨
Recalls & shortagesopenFDA drug-enforcement reports and the FDA drug-shortage database.
🧾 Clinical label set — FDA-filed SPL labels retained for Lactic Acid, Citric Acid, and Potassium Bitartrate Vaginal Contraceptive after exact ingredient or ingredient-combination matching and applicable route/form matching
Clinical labels in scope
1
Linked representative label ⓘ
Evofem, Inc.
Linked label effective
Nov 21, 2023
Composite sections available
19
Linked SPL Set ID
173ff411-7227-47b0-94dc-844e1ebaf14e
Linked SPL Document ID
11e3cfeb-3ae2-4e97-88f9-3e4cdf770659
Open the linked representative label on DailyMed ↗

How we combine label and product data

HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 1 FDA-filed SPL label set within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.

For canonical ingredient pages, bounded product-attributed indication and administration excerpts may be added to the AI evidence, and the generator is instructed to preserve available product, brand, route, and form qualifiers instead of treating one label as universal. Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. Evofem, Inc. is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.

This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.