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Ortho Evra

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Drug Uses

Ortho Evra is a contraceptive (birth control) skin patch used to prevent pregnancy. It is a combination hormonal contraceptive because it contains two hormones, estrogen and progestin. It does not protect against HIV infection (AIDS) and other sexually transmitted diseases.

How Taken

This birth control method uses a 28-day (four-week) cycle. One topical patch is applied and kept in place for one week. A new topical patch is applied each week for three weeks in a row (21 total days). You should not apply a patch during the fourth week (a one-week break). During the one-week break, you should have your menstrual period. Every new patch should be applied on the same day of the week; this will be your 'Patch Change Day'. Follow your healthcare provider's instructions regarding when to start using Ortho Evra and whether back-up contraception is needed temporarily. Clean and dry the area of skin where the patch will be applied. The patch can be placed on the buttock, abdomen, upper outer arm, or upper torso in a place where it won't be rubbed by tight clothing. Never put the patch on the breasts. To avoid skin irritation, apply each new patch to a different place on the skin. Do not apply the patches to skin that are red, irritated or cut. Do not use creams, oils, powder, or makeup on the skin where you will put a patch or near a patch your are wearing. It may cause the patch to become loose. If a patch causes irritation, it can be removed and a new patch may be applied to a new location until the next 'Patch Change Day'. Only one patch should be worn at a time.

Warnings/Precautions

The risks associated with using Ortho Evra increase significantly if you: smoke, have high blood pressure, diabetes, or high cholesterol, have or have had clotting disorders, heart attack, stroke, chest pain (angina pectoris), and cancer of the breast or reproductive organs, jaundice, or malignant or benign liver tumors. Ortho Evra may be less effective in women weighing more than 198 lbs. (90 kg). Do not use Ortho Evra without first talking to your doctor if you weigh more than 198 lbs. (90 kg). Ortho Evra is in the FDA pregnancy category X. This means that Ortho Evra is known to cause birth defects in an unborn baby. Do not use Ortho Evra if you are pregnant. Ortho Evra may decrease milk flow and have other effects on milk composition. Do not use Ortho Evra without first talking to your doctor if you are breast-feeding a baby.

Missed Dose

If you forget to change your patch:
-at the start of any patch cycle,
Week one (Day 1): If you forget to apply your patch, YOU COULD BECOME PREGNANT - you must use back-up contraception for one week. Apply the first patch of your new cycle as soon as you remember. You now have a new Patch Change Day and new Day 1.
-in the middle of your patch cycle,
Week two or week three: If you forget to change your patch for one or two days, apply a new patch as soon as you remember. Apply your next patch on your normal Patch Change Day. No back-up contraception is needed.
Week two or week three: If you forget to change your patch for more than two days, YOU COULD BECOME PREGNANT start a new four week cycle as soon as you remember by putting on a new patch. You now have a different Patch Change Day and a new Day 1. You must use back-up contraception for the first week of your new cycle.
-at the end of your patch cycle,
Week four: If you forget to remove your patch, take it off as soon as you remember. Start your next cycle on your normal Patch Change Day the day after Day 28. No back-up contraception is needed.
-at the start of your next patch cycle,
Day 1 (week one): If you forget to apply your patch, YOU COULD BECOME PREGNANT. Apply the first patch of your new cycle as soon as you remember. You now have a new Patch Change Day and new Day. You must use back-up contraception for the first week of your new cycle.

Possible Side Effects

Some common side effects with combination hormonal contraceptives like Ortho Evra are:
-breast tenderness and enlargement
-headache
-nausea
-menstrual changes
-abdominal cramps and bloating
-vaginal discharge.

Storage

Store at 25°C (77°F); excursions permitted to 15-30°C (59-86°F). Store patches in their protective pouches. Apply immediately upon removal from the protective pouch. Do not store in the refrigerator or freezer. Used patches still contain some active hormones. Each patch should be carefully folded in half so that it sticks to itself before safely disposing of it in the trash. Used patches should not be flushed down the toilet.

Overdose

Ortho Evra is unlikely to cause an overdose because the patch releases a steady amount of the hormones. Do not use more than one patch at a time. Serious ill effects have not been reported when young children accidentally took large doses of oral contraceptives. Over dosage may cause nausea and vomiting. Vaginal bleeding may occur in females. In case of over dosage, contact your health care professional or pharmacist.

More Information

Your health care professional will take a medical and family history before prescribing Ortho Evra and will examine you. You should be reexamined at least once a year. Be sure to inform your health care professional if there is a family history of any of the conditions listed previously in this leaflet. Be sure to keep all appointments with your health care professional, because this is a time to determine if there are early signs of side effects of hormonal contraceptive use. Do not use the drug for any condition other than the one for which it was prescribed. This drug has been prescribed specifically for you; do not give it to others who may want birth control. If you want more information about Ortho Evra, ask your health care professional or pharmacist.

Disclaimer

This drug information is for your information purposes only, it is not intended that this information covers all uses, directions, drug interactions, precautions, or adverse effects of your medication. This is only general information, and should not be relied on for any purpose. It should not be construed as containing specific instructions for any particular patient. We disclaim all responsibility for the accuracy and reliability of this information, and/or any consequences arising from the use of this information, including damage or adverse consequences to persons or property, however such damages or consequences arise. No warranty, either expressed or implied, is made in regards to this information. Ethinyl estradiol is a form of estrogen and norelgestromin is a form of progesterone. These are both female hormones involved in conception. The ethinyl estradiol and norelgestromin topical patch releases estrogen and progesterone that are absorbed directly through the skin. HOW TO USE: Review the Patient Information Leaflet. Follow all instructions on how to use this medication patch and also the best time (during your menstrual cycle) to start using the patch. If any of the information is unclear, consult your doctor or pharmacist. Open the patch container and apply one patch to an area of clean, dry skin on the buttock, abdomen, upper outer arm, or upper body (torso) exactly as directed by your doctor. The patch is worn for 7 days. Do not apply the patch to the breast(s), the area around the breast(s); to red, cut, or irritated skin; or over other topical products (e.g., make-up, creams, lotions, powders). After 7 days, remove the old patch and apply a new patch. Repeat this weekly cycle for 3 weeks (3 patches equal 1 cycle). After your third patch is removed, you will have one week without using the patch. Your menstrual cycle (period) usually should start during the week when you do not use the patch. If your menstrual cycle (period) does not begin during this week, consult your doctor. After your 4th week, begin a new patch cycle, even if you still are experiencing some bleeding (still having your period). Do not go longer than 7 days without a patch. Doing so may make this medication less effective. If the medication patch accidentally comes off, is removed, or if it becomes detached, apply a new patch.

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