Ortho Evra is a contraceptive skin patch containing a combination of female hormones (ethinyl estradiol and norelgestromin) that prevent ovulation (the release of an egg from an ovary). This medicine also causes changes in your cervical mucus and uterine lining, making it harder for sperm to reach the uterus and harder for a fertilized egg to attach to the uterus.
Ortho Evra skin patches are used as contraception to prevent pregnancy.
Ortho Evra may also be used for purposes not listed in this medication guide.
Before taking this medicine
Using Evra can increase your risk of blood clots, stroke, or heart attack. You are even more at risk if you have high blood pressure, diabetes, high cholesterol, or if you are overweight. Your risk of stroke or blood clot is highest during your first year of using birth control. Your risk is also high when you restart this medicine after not using for 4 weeks or longer.
Smoking can greatly increase your risk of blood clots, stroke, or heart attack. Your risk increases the older you are and the more you smoke. You should not use Ortho Evra if you smoke and are over 35 years old.
Usual Adult Dose for Contraception:
The initial dosage of Evra patches for contraception is the placement of one patch on the skin of the upper outer arm, or abdomen, or buttocks, weekly for 3 weeks (21 total days), which is to remain in place for 7 days, the fourth week is drug free.
A new Evra patch is placed on the skin one-week after the last patch was removed. Regardless of withdrawal bleed presence, the new transdermal patch is placed on the skin the same day (at any time) as it was done in the previous cycle.
If an Evra patch is partially or completed detached for less than 1 day (up to 24 hours), reapply it to the same place or replace it with a new patch immediately. No backup contraception is needed. If this event occurs for more than 1 day (24 hours or more), or if the woman is not sure how long the patch has been detached, she should stop the current contraceptive cycle and start a new cycle immediately by applying a new patch. Backup contraception, such as condoms, spermicide, or diaphragm, must be used for the first week of the new cycle.
In women switching from a combination oral contraceptive, begin use of the patch on the first day of withdrawal bleeding. If there is no withdrawal bleeding within 5 days of the last active (hormone-containing) tablet, pregnancy must be ruled out. If the patch is placed later than the first day of withdrawal bleeding, but within the 7 days from the last oral active tablet, a second method of contraception (non-hormonal) should be added for the first 7 days.
In women with a miscarriage or a complete first trimester abortion, begin use of the patch immediately. An additional method of contraception would not be needed if therapy is started immediately.
In women who choose not to breast-feed after childbirth, begin use of the Evra patch no sooner than 4 weeks after childbirth. Postpartum women who have not had a period should add a second method of contraception (non-hormonal) for the first 7 days of patch use.
What happens if I miss a dose?
If you forget to change your Ortho Evra patch at the end of the week, change it as soon as you remember. If it has been 24 hours or longer since your scheduled patch change, apply a new patch and start the cycle over (3 weeks wearing a weekly patch,1 week off). Do not use extra patches to make up the missed dose.
Missing a dose increases your risk of becoming pregnant and you may need to use back-up birth control. Follow the weekly patch schedule closely.
What should I avoid while using Evra?
Do not smoke while using Evra, especially if you are older than 35 years of age.
Grapefruit and grapefruit juice may interact with ethinyl estradiol and norelgestromin and lead to unwanted side effects. Discuss the use of grapefruit products with your doctor.
Avoid using creams, lotions, powders, or other medications on the skin where you apply the patch, or it may not stick to your skin.
Evra will not protect you from sexually transmitted diseases – including HIV and AIDS. Using a condom is the only way to protect yourself from these diseases.