Ortho Evra instructions

Brand Name: Ortho Evra patch

Generic Name: Ethinyl estradiol and norgestimate

The following product information is not a substitute for physician's or manufacturer's instructions.

Ortho Evra Medical Uses:
The Ortho Evra birth control patch is a highly effective, weekly hormonal birth control patch that is worn on the skin to prevent pregnancy. The patch is worn for one week and replaced on the same day of the week for three consecutive weeks, with the fourth week "patch-free." Ortho Evra combines the efficacy of the birth control pill with once-a-week dosing. The Ortho Evra birth control patch is 99 percent effective when used correctly.

How to Use Ortho Evra:
Ortho Evra uses a 28-day, or four-week cycle. You should apply a new patch on the same day of the week for three consecutive weeks, for a total of 21 days. You should not apply a patch during the fourth week. Your menstrual period should start during this "patch-free" week. Every new patch should be applied on the same day of each week. This day will be your "Patch Change Day." You should wear only one birth control patch at a time. On the day after week four ends, you should begin a new four-week cycle by applying a new birth control patch. You must use non-hormonal back-up contraception, such as a condom, spermicide or diaphragm for the first week of your first cycle. 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. Wear the patch continuously for seven days (one week). On Day 8 (the "Patch Change Day"), remove the used birth control patch, discard it and apply a new one immediately to one of the four areas described above. Apply a new patch for week two (on Day 8) and week three (on Day 15), on your "Patch Change Day." To avoid irritation, do not apply the new patch to the same exact place on your skin. Do not wear a patch on week four (Day 22 through Day 28). Your period should start during this week. Begin your next four week cycle by applying a new patch on your normal "Patch Change Day," the day after Day 28—no matter when your period begins or ends. First Day Start: Apply your first birth control patch during the first 24 hours of your menstrual period. This is considered the "Patch Change Day" (if the patch is not applied within the first 24 hours of your period, you must use non-hormonal back-up contraception for the first seven days of patch use).

Ortho Evra Possible Side Effects:
Nausea, vomiting, headache, redness or itching at the patch application site, dizziness, breast tenderness, vaginal discomfort/irritation, or stomach cramping/bloating may occur. If any of these effects persist or worsen, notify your doctor. Tell your doctor immediately if any of these serious side effects occur: dizziness or fainting spells; chest pain; coughing up blood; leg, arm or groin pain; severe or sudden headaches; sudden shortness of breath; stomach pain (severe); sudden loss of coordination, especially on one side of the body; vision or speech problems; swelling of the hands, feet or ankles, or rapid weight gain; weakness or numbness in the arms or legs, especially on one side of the body. Tell your doctor immediately if any of these highly unlikely but very serious side effects occur: yellowing eyes or skin, dark urine, one-sided weakness, numbness in the arms/legs, lumps in the breast. If you notice other effects not listed above, contact your doctor or pharmacist. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

Ortho Evra Precautions:
This medication is not recommended for use if you have the following medical conditions: blood circulation problems (e.g., history of blood clots in the legs or groin), history of heart disease or stroke, severe high blood pressure, diabetes (especially affecting the circulation), severe headaches, recent major surgery, long periods of sitting or lying down (e.g., immobility such as being bedridden), liver problems, history of yellowing eyes and skin (jaundice) during pregnancy or while using birth control pills, cancer (especially endometrial or breast cancer), undiagnosed abnormal vaginal bleeding, currently pregnant, heavy tobacco use (if 35 years old or greater). Tell your doctor your medical history, especially of: high cholesterol or triglyceride (fat) levels, depression, high blood pressure, gallbladder problems, thyroid problems, any allergies. Do not smoke cigarettes. Hormonal birth control products combined with smoking cigarettes significantly increase your risk for strokes, blood clots, high blood pressure, and heart attacks; especially in women older than 35 years of age. Before having surgery, including dental surgery, tell the doctor(s) that you are using this product. The drugs in this patch may cause blotchy, dark areas on your skin (melasma) and sunlight may intensify this effect. If this occurs, avoid prolonged sun exposure, use a sunscreen, and wear protective clothing when outdoors. If you are near-sighted or wear contact lenses, you may develop vision problems or may have problems wearing your contact lenses. Contact your eye doctor if these problems occur. Orho Evra is in the FDA pregnancy category X. Orho Evra is known to cause birth defects in an unborn baby. Do not use Orho Evra if you are pregnant or if you are breast-feeding a baby. If you become pregnant or think you may be pregnant, inform your doctor immediately. Ask your doctor or pharmacist or consult the patient information leaflet that comes with this product for more details.

Drug Interactions:
Many drugs can interact with Ortho Evra, resulting in side effects or decreased effectiveness of the medicine. Tell your doctor of all prescription and nonprescription medication you may use. Drugs that may interact with Ortho Evra include: antibiotics or medicines for infections, especially rifampin, rifapentine or rifabutin; aprepitant; atorvastatin; barbiturate medicines for producing sleep or treating seizures (convulsions); bexarotene; bosentan; caffeine; carbamazepine; cimetidine; clofibrate; cyclosporine; dantrolene; exemestane; felbamatep; griseofulvin; growth hormone; hydrocortisone; medicines for anxiety or sleeping problems, such as diazepam or temazepam; medicines for diabetes, including troglitazone and pioglitazone; medicines for mental depression; medicines for migraines; methotrexate; modafinil; mycophenolate; nefazodone; prednisolone; selegiline; soy isoflavones supplements; St. John's wort; tamoxifen or raloxifene; theophylline; topiramate; warfarin.

Missed Dose:
Try not to miss your weekly patch change; your risk of pregnancy increases with each day in a row you have missed your patch. If you do miss a patch change, it may be necessary to consult your doctor for instructions. The instructions may vary depending on when you have missed the patch (weeks 1, 2 or 3) during your monthly cycle. In some cases, you will also need to use a back-up method of birth control. If you forget to remove the patch on week 4, take it off as soon as you remember. However, it is important to start the next month's patch cycle on the scheduled day; there should not be more than a 7-day patch-free interval. If there are more than 7 patch-free days, there is a risk you could become pregnant and you should use a back-up birth control method for 7 days. If a patch is lost or falls off, it may be necessary to consult your health care professional for instructions. A replacement patch for your prescription may be needed to complete your monthly cycle and can be purchased from your pharmacist. In some cases, you will also need to use a back-up method of birth control if the patch has been off for more than 1 day.

Overdose:
If more than one patch is worn at a time, or if the medication has been ingested, call an emergency room or poison control left for advice. Symptoms of an overdose of Ortho Evra may include nausea, vomiting, or vaginal bleeding.

Storage:
Keep out of the reach of children. Store unopened patches at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Throw away any unused medicine after the expiration date. Once removed, a used patch should be folded to stick to itself and discarded in a waste receptacle out of the reach of children and pets.

Related information:
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