Drug information provided by: IBM Micromedex
To make using hormonal contraceptives as safe and reliable as possible, you should understand how and when to use them and what effects may be expected.
This medicine comes with patient instructions. Read and follow these instructions carefully. Ask your doctor if you have questions.
This transdermal patch system is to be used for 28 days (four-week) cycle. A new patch is applied each week for 3 weeks (21 days), and week four is patch-free.
When you begin using norelgestromin and ethinyl estradiol combination transdermal, your body will require at least 7 days to adjust before a pregnancy will be prevented. Use a second form of contraception (eg, condoms, spermicides, diaphragms) for the first 7 days of your first patch cycle.
To use this patch:
Keep each patch in the package until you are ready to use it.
Wash your hands with soap and water before and after applying a patch.
Apply the patch to clean, dry, and intact skin on the abdomen or stomach, upper body, the upper outside part of the arm, or the buttocks. Avoid touching the sticky surface of the patch.
Make sure there is no lotion, powder, cream, or make-up on the skin.
Apply the patch and then press it with the palm of your hand for 10 seconds to make sure it sticks.
Change the location of the patch each time you apply a new one. Do not apply a patch to skin that is injured, broken, or cut. Do not apply a patch to your breasts. Check the patch every day to make sure it is in place.
If the patch comes off partly or all the way, try to apply it again or apply a new patch. If it becomes loose less than 24 hours, no other form of birth control is needed. If the patch has peeled away for more than 24 hours, apply a new patch and start a new cycle. A second form of birth control should also be used.
If the patch is not sticky or has stuck to material or itself, remove it and apply a new patch. Do not hold the patch in place with tape or wraps.
If you are switching from a contraceptive pill or vaginal ring to using the patch, start the patch on the first day of your period for Ortho Evra® or on the day that you would usually use your next pill or vaginal ring for Xulane®. If your period does not start after 5 days for Ortho Evra® or 1 week for Xulane®, you should see your doctor for a pregnancy test. If you start the patch later than the first day of your period for Ortho Evra® or if you apply Xulane® more than 1 week after using your last pill or vaginal ring, use a second method of birth control with the patch for the first 7 days.
If you have a miscarriage or an abortion in the first trimester of your pregnancy, you may start norelgestromin and ethinyl estradiol combination transdermal right away. You do not need a second form of birth control. If you start this medicine 5 days or more after the miscarriage or abortion, you should use a second form of birth control with the patch for the first 24 hours during the start of your menstrual period or for the first 7 days on the first Sunday of your menstruation. If you have a miscarriage or abortion after the first trimester, you should wait for 4 weeks before starting this medicine.
If you use this patch after giving birth and choose not to breastfeed, you may start after 4 weeks to prevent the risk of having blood clots.
If you have bleeding with the patch in place, continue to use the patches as usual. If the bleeding continues for 2–3 cycles, call your doctor. If you do not have your period during the time the patch is off, stay on your regular schedule and call your doctor.
If the patch is uncomfortable or causes irritation, change to a new patch in a new location. Change the patch again on your regular schedule. Do not use more than one patch at a time.
When you remove a patch, carefully fold it in half so that it sticks to itself and throw it away. There will still be some hormones on the patch. Do not touch the inside of the patch.
Do not eat grapefruit or drink grapefruit juice while you are using this medicine. Grapefruit and grapefruit juice may change the amount of this medicine that is absorbed in the body.
The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
Your doctor may begin your patch on the first day of your menstrual period (called Day-1 start) or on a Sunday (called Sunday start). When you begin on a certain day it is important that you follow that schedule, even if you forget to change a patch. Do not change your schedule on your own. If the schedule that you have been put on is not convenient, talk to your doctor about changing schedules.
For transdermal dosage form (skin patch):
For contraception (to prevent pregnancy):
Adults—Apply one patch to the skin and keep it in place for 1 week. Apply a new patch at the beginning of week 2 and again at week 3. Always change the patch on the same day of the week. Do not use a patch during week 4. This is when you will have your period. Start a new patch 7 days after the last patch was removed.
Children—Use and dose must be determined by your doctor.
Call your doctor or pharmacist for instructions.
Follow your doctor's orders or the directions on the label if you forget to change your patch. This includes only some of the ways to handle this medicine. Your doctor may want you to stop using this medicine and use other birth control methods for the rest of the month until you have your menstrual period. Then your doctor can tell you how to begin using your medicine again.
If you forget to apply your patch during the 1st week, apply it as soon as possible and start a new cycle. Use a second form of birth control for the first week of the new cycle. You will now have a new patch start day.
If you forget to change your patch in the 2nd or 3rd week for one or two days, change it as soon as you remember. No other form of birth control is needed. If you forget to change your patch in the 2nd or 3rd week for more than two days, change to a new patch and start a new cycle. Use a second form of birth control for the first week of the new cycle. If you forget to remove your patch at the end of the 3rd week, remove it as soon as possible and then start a new patch on your regular start day. You should never have the patch off for more than 7 days in a row.
Store the patches at room temperature in a closed container, away from heat, moisture, and direct light.
Keep out of the reach of children.
Do not keep outdated medicine or medicine no longer needed.
Ask your healthcare professional how you should dispose of any medicine you do not use.
After removing a used patch, fold the patch in half with the sticky sides together. Place it in a child-resistant container or a sealed bag. Make sure to dispose of it out of the reach of children and pets.