Ortho Evra

  “The Patch” 

General Information

• Ortho Evra is a thin beige patch that measures about two square inches. It is a once-a-week birth control patch that is 99% effective if used correctly. The patch is worn on the skin for one week and replaced on the same day of the week for 3 consecutive weeks, with the fourth week "patch-free."  It prevents pregnancy by delivering continuous levels of synthetic progesterone and estrogen into the bloodstream. It helps prevent pregnancy by preventing the release of an egg and by thickening the cervical mucus, making it more difficult for sperm to enter the uterus and reducing the chance of implantation.  

• The patch does not protect you from HIV or other sexually transmitted infections.  Use a back-up method of birth control until you have finished the first month of patches.  Some antibiotics, anticonvulsants, and St. John's Wort may make the patch less effective.  When taking these medications, be sure to use a back-up method of birth control along with your patch until your next period. 
• View the company website for more information: http://www.orthoevra.com

Using the Patch

• Apply patch to your buttock, abdomen, upper torso (NOT breasts), or on outside of upper arm.
• Apply patch in the same location or select a different site each week.  Avoid placing it in the same exact spot. 
• Apply your patch to clean, dry skin and check it daily.  Avoid creams, lotions, oils, powder, or makeup near your patch to make sure it sticks properly.
• Do not apply your patch to skin that is red, irritated or cut.
• You should never have the patch off for more than 7 days

Starting the Patch

Sunday Start:

• Apply your patch the first Sunday after your period starts, even if your period starts on Sunday. 
• Apply 1 patch each Sunday for 3 weeks, removing the old patch at the end of each week. 
• The fourth week you will not apply a patch.  This is your period week.  You should bleed during this 4th week. 
• Following week 4, repeat the same application routine each month.
• Use a back-up birth control method for the first month of patch use.

First Day Start:

• Apply your first patch within the first 24 hours of your period.
• Your “Patch Change Day” is exactly 1 week later.
• Use a back-up birth control method for the first month of patch use.

Following a first trimester abortion or miscarriage:

• Apply the patch within 5 days following a complete miscarriage/abortion. 
• Use a back-up birth control method for the first month of patch use.

Following full-term pregnancy and delivery (use only if you are not breastfeeding):

• You may begin using the patch 6 weeks after delivery.
• Use a back-up birth control method for the first month of patch use.  

Forgetting to Change Patch

If you are more than 1 day late in putting on your week 1 patch:

• To avoid becoming pregnant, you must use back-up contraception for 1 week.
• Apply the first patch of your new cycle as soon as you remember.
• You will now have a new Patch Change Day. 

If you forget to change your patch during week 2 or 3:

• If you are only 1 or 2 days late:
• Remove the used patch and apply a new patch immediately.
• Apply the next patch on your normal Patch Change Day.
• No backup contraception is needed.
• If you are more than 2 days late:
• Remove the used patch and apply a new patch immediately
• Apply a new patch as soon as you remember to start a new  4-week cycle.
• You will now have a new Patch Change Day.
• Use a back-up method for 1 week.                 

If you forget to take your patch off during week 4:

• Take the patch off as soon as you remember.    
• Start your next cycle on your normal Patch Change Day.
• No backup contraception is needed.                                     

If Patch Falls Off

If your patch has been off or partially off for less than 24 hours:

• Try to reapply it or apply a new patch immediately. 
• No backup contraception is needed

If your patch has been off or partially off for more than 24 hours:

(or if you are unsure how long your patch has been loose or off)

• Apply a new patch immediately
• Start a new 4-week cycle.
• You will now have a new Patch Change Day
• Use backup contraception for 1 week.

Missing Periods

If you have used your contraceptive patches correctly and miss a period:

• We encourage you to do a pregnancy test before reapplying a new patch.
• Please call the office to inform us of the missed period. 

If you have NOT used your contraceptive patches as instructed and miss a period, or if you miss 2 consecutive periods:

• Please call the office before restarting your patch as you may be pregnant. 

• Use back-up birth control until you have seen your medical provider for an evaluation.

Discontinuing The Patch

When you are ready to discontinue contraceptive patches, we recommend that you finish the monthly cycle of patches and not restart a new application.

• If you do not want to be pregnant: please call us before discontinuing patch use so that we can discuss alternative birth control. 
• If you wish to get pregnant: Use a non-hormonal birth control such as condoms and spermicide, until you have had 3 normal periods.  Your periods could be irregular after discontinuing patch use because you are adjusting to not taking hormones.

Side Effects

Most side effects will taper off within the first 3 months of patch use. If not, contact your clinician. 

• Application site irritation
• Nausea & Headaches
• Spotting between periods or less menstrual bleeding
• High blood pressure
• Breast tenderness
• Weight changes
• Depression or moodiness

Danger Signs

Call Mabel Wadsworth Center if you experience any of the following ACHES:

• Abdominal pain (severe)
• Chest pain or shortness of breath
• Headaches (severe)
• Eye problems, such as blurred vision or loss of vision
• Severe pain, weakness, or numbness in arms, legs, or face

Smoking significantly increases the potential for serious risks linked to hormonal birth control including blood clots, stroke, heart attack, gallbladder disease, liver tumor, and death.  If you are over 35 and smoke, you will not be able to obtain hormonal birth control from most providers including Mabel Wadsworth Women's Health Center.

Always inform any medical provider that you are taking Ortho Evra.

Call Mabel Wadsworth Women's Health Center if you have questions about your patch.   

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