ORTHO EVRA CONTRACEPTIVE PATCH
Student Information Sheet

 

What is the contraceptive patch?
The contraceptive patch is a weekly hormonal  birth control method that is worn on the skin to prevent pregnancy.  Like birth control pills, it contains a combination of estrogen and progestin which are released continuously through the skin into the bloodstream.  These hormones work to prevent ovulation.  They also thicken the cervical mucus (making it difficult for sperm to penetrate) and cause the uterine lining to be thinner (making implantation of a fertilized egg unlikely). 

How effective is the patch?
When used correctly, the contraceptive patch has a comparable rate of effectiveness as oral contraceptives, about 97-99%.  The patch is less effective for women who weigh more than 198 pounds.

What are the possible side effects? 
The most common side effects reported with the patch are breast tenderness, headache, nausea and reactions at the application site.  Other side effects may include irregular vaginal bleeding, mood changes and vaginal infections. 

Are there any serious risks associated with the patch? 
The serious risks associated with the contraceptive patch occur rarely.  Serious risks, which can be life threatening, include blood clots, stroke or heart attacks.  Cigarette smoking increases the risk of serious side effects, especially if you are more than 35 years old.  Women who use hormonal contraceptives are strongly advised not to smoke.

Women with the following medical conditions should not use the contraceptive patch: 

  • Blood clotting disorders or history of  blood clots such as deep vein thrombophlebitis
  • Current or past history of heart disease or blockage of blood vessels
  • Severe high blood pressure
  • Diabetes with blood vessel complications
  • Headaches with focal neurological symptoms
  • Recent surgery with prolonged bedrest
  • Known or suspected cancer of the breast or personal history of breast cancer
  • Undiagnosed abnormal uterine bleeding
  • History of jaundice (yellow pigment to the skin) during pregnancy or with prior hormonal contraceptive use
  • Acute or chronic liver disease with abnormal liver function
  • Liver tumors or cancer
  • Known or suspected pregnancy

How do I use the contraceptive patch? 
The contraceptive patch uses a 28-day, or four-week, cycle.  You should apply a new patch each week for three consecutive weeks, for a total of 21 days.  The fourth week you do not wear a patch.

Each new patch should be applied on the same day of each week.  For example, if you apply your first patch on a Monday, all of your patches should be applied on a Monday.   Apply a new patch for Week 2 and  Week 3 on a Monday.  Do not wear a patch during Week 4.  Your period should start during this week.  On the day after Week 4 ends, you should begin a new four-week cycle by applying a new patch.  Begin this new cycle on your “patch change day” no matter when your period begins or ends. 

You should wear only one patch at a time.  Wear the patch continuously for seven days.  On Day 8 and 15, remove the used patch, discard it, and apply a new one immediately.  Do not apply the new patch to the same place on your skin where the previous patch was placed.  If a ring of adhesive is left on your skin, remove it by rubbing a small amount of baby oil on the area.

How do I begin using the contraceptive patch? 
There are many ways to start using the patch.  If you start using the patch on the first day of your period, the patch will be effective immediately and you do not need to use back up birth control.  If you do not begin using the patch on the first day of your period, you will need to use a non-hormonal backup method for one full week.  Never begin using the patch if there is any chance of pregnancy.

Where can I wear the contraceptive patch? 
You can wear the contraceptive patch on one of four areas of the body: your buttocks, abdomen, upper torso (front or back, excluding the breasts), or upper outer arm.  Apply the patch by pressing down firmly on the patch with the palm of your hand for 10 seconds, making sure the edges stick well.  The patch remains attached and effective even when you bathe, swim, exercise, or wear it in humid conditions.  You should not place the patch on skin that is red, irritated or cut.  Do not apply makeup, lotion, cream, powder or other products at the patch site.  Do not write, decorate, cut or alter the patch in any way.  This may cause the patch to be less effective.

How do I change my “patch change day”? 
If you wish to move your “patch change day” to a different day of the week, finish your current cycle, removing your third consecutive patch on the correct day.  During week 4, choose a new patch change day by applying a new patch on the day you prefer.  You now have a new Day 1 and a new patch change day.  You should never have the patch off more than seven days in a row.

What if I forget to change the patch?
At the start of any patch cycle-Week 1 (Day 1):
If you forget to apply your patch, you must use backup birth control for one week to prevent pregnancy.  Apply the first patch of your new cycle as soon as you remember.  You now have a new patch change day and Day 1.

In the middle of your patch cycle-Week 2 or Week 3:
If you forget to change your patch for one day, remove the patch as soon as you remember and apply a new patch.  Apply your next patch on your normal patch change day.  No backup birth control is needed.  If you forget to change your patch for two days or more, you could become pregnant.  Start a new four-week cycle as soon as you remember by removing the old patch and applying a new patch.  You now have a different patch change day and a new Day 1.  You will need to use non-hormonal backup birth control for the first week of your new cycle. 

At the end of your patch cycle-Week 4:
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.  No backup birth control is needed. 

What should I do if a patch seems loose, starts to lift off my skin, or falls off?
For less than 24 hours:  You should try to reapply it or apply a new patch immediately. Do not use tapes or wraps to keep a patch in place.  No backup contraception is needed, and your patch change day will remain the same.
For more than 24 hours:  Start a new four-week cycle immediately by applying a new patch.  You now have a new Day 1 and a new patch change day.  You  must use backup birth control for the first week of your new cycle. 

Are there special intructions for storage? 
Patches should be stored in their protective pouches.  When you remove the patch from its pouch, apply it immediately to the place on your skin that you’ve cleaned and dried.  Store the pouches at room temperature.  Do not store pouches in the refrigerator or freezer.

Does it matter which patch I use from the box? 
No.  Each patch delivers the same amount of medication each week; therefore, the patches can be used in any order.

Can I take other medications while I’m using the contraceptive patch? 
Certain drugs may interact with hormonal contraceptives, including the patch, to make them less effective in preventing pregnancy or cause an increase in breakthrough bleeding.  Such drugs include rifampin, drugs for epilepsy such as barbiturates (for example, phenobarbital),  anticonvulsants such as topiramate (Topamax), carbamazepine (Tegretol), phenytoin (Dilantin), phenylbutazone (Butazolidin), certain drugs used in the treatment of HIV or AIDS and possibly some antibiotics.  The herb known as St. John’s Wort may also make the patch less effective. As with all prescription products, you should tell your health care provider about any other medications you are taking.  You may need to use non-hormonal backup birth control when taking certain other medications.

When should I contact Health Services? 
Call Health Services immediately if you have any of the following symptoms:

  • Unusual pain or swelling in the arms or legs
  • Sharp chest pain or shortness of breath
  • Severe abdominal pain
  • Severe headaches
  • Sudden change in vision
  • Fainting or dizziness
  • Heavy, prolonged vaginal bleeding

Does the patch protect me against sexually transmitted infections? 
The contraceptive patch does not protect you from sexually transmitted diseases including HIV.  Health Services recommends the use of latex condoms in combination with the patch to protect yourself from STDs. 

 

SCHS: CJA
10/02

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Smith College Health Services // Northampton, Massachusetts 01063 // (413) 585-2800