Ortho Evra contains the hormones estrogen and progestin. It is a combination hormonal contraceptive (birth control) skin patch. The patch cannot be used for protection against HIV infection (AIDS) and other sexually transmitted diseases.
Ortho Evra is administered in the form 28-day (four-week)cycle patches. Each patch is applied and kept in place for one week. Every week a new patch is applied for three weeks in a row (21 days in total), followed by one patch-free week. Your period should come during the patch-free week. The ‘Patch Change Day’ is the day when a new patch is applied for that week. It should be the same day every week. With respect to the initial use of Ortho Evra and temporary back-up contraceptive methods, consult your doctor. Clean and dry the skin area for patch application. The patch can be placed on the buttocks, abdomen, upper outer arm, or upper torso. It should be put in a place where tight clothing will not cause constant rubbing. Never apply the patch on the breasts. Apply each new patch to a different place in order to avoid skin irritation. Do not apply the patch red, irritated or cut skin. Do not use creams, oils, powder, or makeup on the skin where you will put a patch or near a patch your are using as it may loosen up the patch. If a patch causes irritation, it can be removed. In such cases apply a new patch to a new location and keep in place until the next ‘Patch Change Day’. Wear only one patch at a time.
Warnings Precautions
Ortho Evra belongs to the X FDA pregnancy category, meaning that it causes birth defects in the fetus. It may also decrease lactation and affect milk composition. Do not use Ortho Evra if you are pregnant or if you are breast-feeding without consulting your doctor first.
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, the possible harmful side effects of Ortho Evra are much more likely to occur. The effect of Ortho Evra is reduced in women weighing more than 198 lbs. (90 kg). If you weigh more than 198 lbs. (90 kg), consult your doctor first before taking Ortho Evra.
Missing a 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 might become pregnant and a back-up contraception method must be used for at least a 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. You need not apply a back-up contraceptive method.
Week two or week three: If you forget to change your patch for more than two days, you might become pregnant. Put on a new patch and start a new four week cycle as soon as you remember. You now have a different Patch Change Day and a new Day 1. A back-up contraceptive method must be used during 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 might 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. A back-up contraceptive method must be used during the first week of your new cycle.
Possible Side Effects
Breast tenderness and enlargement, headache, nausea, menstrual changes, abdominal cramps and bloating, vaginal discharge are among some of the common side effects of hormonal contraceptives.
Storage
Store at 25?°C (77?°F). Variations in temperature of between 15 and 30?°C (59-86?°F) are permitted. Store patches in the original pouches. Apply immediately upon removal from the protective pouch. Do not store in the refrigerator or freezer. Fold the patches in half and dispose of them carefully as used patches still contain some active hormones. Do not flush down the toilet.
Overdose
Cases of an Ortho Evra have been rarely reported since the patch releases hormones evenly. Never apply two patches at the same time. In the case of ingestion of large doses of contraceptives by small children, serious side effects have been reported. Nausea and vomiting are among the symptoms of an Ortho Evra overdose. Vaginal bleeding may also occur. If you suspect an overdose, contact your doctor immediately.
More Information
Before prescribing Ortho Evra, your doctor will take a record of your medical and family history and examine you. Reexaminations must be performed at least once a year. If you have a family history of any of the previously listed conditions, notify your doctor. The side effects of hormonal contraceptive use will be identified during visits to your doctor and the appointment schedule must be followed strictly. Do not use Ortho Evra for any other purpose besides contraception. The prescription is personal and should not be passed onto other people. For further clarifications on Ortho Evra, consult your doctor.
Ortho Evra resources:
http://www.wellesley.edu/Health/ortho.html
http://www.youngwomenshealth.org/patch.html
http://www.fda.gov/cder/consumerinfo/druginfo/orthoevra.HTM
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