Norelgestromin and Ethinyl Estradiol (Systemic)

Brand Names : Ortho Evra

Proper Use of This Medicine

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.

A paper with information for the patient will be given to you with your filled prescription, and will provide many details concerning the use of hormonal contraceptives. Read this paper carefully and ask your health care professional if you need additional information or explanation.

When you begin using norelgestromin and ethinyl estradiol, your body will require at least 7 days to adjust before a pregnancy will be prevented. Use a second form of contraception, such as a condom, spermicide, or diaphragm, for the first 7 days of your first cycle.

Keep each patch in the package until you are ready to use it. Apply the patch to clean, dry skin on the abdomen, 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 was 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 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 to using the patch, start the patch on the first day of your period. If you do not start your period after 5 days, you see your health care professional for a pregnancy test. If you start the patch later than the first day of your period, use a second method of birth control with the patch for the first 7 days.

If you have had a baby and are not breast-feeding, you should wait 4 weeks before you start this medicine. If you have not had a period after having your baby, you should make sure you are not pregnant before starting this medicine.

If you have a miscarriage or an abortion in the first trimester of your pregnancy, you may start norelgestromin/ethinyl estradiol 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 7 days. If you have a miscarriage or abortion after the first trimester, you should wait 4 weeks before starting this medicine

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 health care professional. If you do not have your period during the time the patch is off stay on your regular schedule and call your health care professional.

If the patch is uncomfortable or causing 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.

Dosing - Your health care professional may begin your patch on the first day of your menstrual period (called Day-1 start) or on 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, check with your health care professional about changing schedules.

• For transdermal dosage form (skin patch):
  • For contraception (to prevent pregnancy):
    • Adults - Apply 1 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.

Missed dose - Follow your doctor's orders or the directions on the label if you forget to change your patch. The following information includes only some of the ways to handle this. Your health care professional may want you to stop taking the medicine and use other birth control methods for the rest of the month until you have your menstrual period. Then your health care professional can tell you how to begin taking 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.

Storage - To store this medicine:

• Keep out of the reach of children.
• Store patches in their protective pouches.
• Do not refrigerate.
• Do not freeze.
• Do not keep outdated medicine or medicine no longer needed. Ask your health care professional how you should dispose of any medicine you do not use. Be sure that any discarded medicine is out of the reach of children.