Proper Use

Drug information provided by: Merative, Micromedex®

It is very important that you use this medicine exactly as directed by your doctor. Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered.

This medicine comes with patient instructions. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.

To use the patch:

  • Wash your hands with soap and water before and after you use this medicine.
  • Carefully tear open the pouch when you are ready to put the patch on your skin. Do not cut it.
  • The patient instructions will show the body areas where you can wear the patch. When you put on a new patch, choose a different place within these areas. Do not put the new patch on the same place you wore the last one. Be sure to remove the old patch before you apply a new one.
  • You may apply the patch on the lower stomach area, buttocks, or upper part of the body. Make sure the application site is clean and dry before you use the patch. Do not put the patch on the waistline, near clothing, or undergarment seams, on the breasts, or cut or irritated skin.
  • Avoid using make up, creams, lotions, oils, powders, or any other products on the skin where you plan to apply the patch.
  • The patch should be flat and smooth without wrinkles or folds when you apply it on the skin.
  • Check the path everyday and after any water exposure, including bathing. showering, or swimming, to make sure it is in the right place.

Put on a new patch if the old one has fallen off and cannot be reapplied.

  • If the patch starts to lift or completely falls off for less than 24 hours, try to put it on again or replace with a new patch right away. An additional form of birth control is not needed.
  • If the patch starts to lift or completely falls off for more than 24 hours , you may not be protected from pregnancy. Start over on a new patch cycle right away. The day you apply a new patch is now your new Day 1 and new Patch Change Day. You must use another form of birth control (including condoms, spermicide, diaphragm) during the first week of the new patch cycle.

If you are switching from another birth control method to using Twirla®:

  • Birth control pill, transdermal system, or vaginal ring—Complete the current pill, transdermal, or vaginal ring cycle and apply Twirla® on the day that the next pill, transdermal, or vaginal ring cycle would normally start. Check with your doctor if your menses do not occur within a week after using the last active pill, transdermal, or vaginal ring. If you applied the patch more than a week after using the last active pill, transdermal, or vaginal ring, use another form of birth control (eg, condoms, spermicide, diaphragm) during the first week of using Twirla®.
  • Injection or progestin-only pill—Apply Twirla® on the day the next injection or progestin-only pill would normally start.
  • Intrauterine system or implant—Apply Twirla® on the day of intrauterine system or implant removal.

If you are using colesevelam, take it 4 or more hours before using levonorgestrel and ethinyl estradiol combination.

Do not eat grapefruit or drink grapefruit juice while you are using this medicine.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

You may begin using the patch during the first 24 hours of your menstrual period. This will be your Patch Change Day every week. If you start after Day 1 of your menstrual period, use another form of birth control (including condoms, spermicide, diaphragm) during the first week of the new patch cycle.

If you want to change your Patch Change Day, complete your current patch cycle first, removing the third patch on the correct day. Apply a new patch on your chosen day during the patch free week.

  • For transdermal dosage form (patch):
    • For contraception (to prevent pregnancy):
      • Adults—Apply 1 patch to the lower stomach area, buttocks, or upper part of the body once a week for 3 weeks (Weeks 1, 2, and 3) in a row. Do not apply a patch during Week 4. After Week 4 ends, apply a new patch to start a new 28-day cycle. The patch should never be off more than 7 days in a row.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

Call your doctor or pharmacist for instructions.

This medicine has specific patient instructions on what to do if you miss a dose. Read and follow these instructions carefully and call your doctor if you have any questions.

  • If you forget to change your patch at the start of any cycle (Day 1), apply a new patch as soon as you remember. This is now your new Day 1 and new Patch Change Day. You must use another form of birth control (eg, condoms, spermicide, diaphragm) during the first week of the new patch cycle.
  • If you forget to change your patch in the middle of the cycle (Day 8 or 15), apply a new patch during the first 48 hours. The next patch should be applied on your usual Patch Change Day. An additional form of birth control is not needed.
  • If you forget to change your patch for more than 48 hours, start over a new 4-week patch cycle right away. The day you apply a new patch is now your new Day 1 and new Patch Change Day. You must use another form of birth control during the first week of the new patch cycle.
  • If you forget to remove your patch for the patch free week:
    • Past Day 22: Take the patch off as soon as you remember. Start your next patch cycle on the usual Patch Change Day.
    • If you go more than 7 days without a patch, use another form of birth control to keep from getting pregnant. The patch should never be off more than 7 days in a row.

Storage

Store the patches at room temperature in a closed container, away from heat, moisture, and direct light.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Fold the used patch in half with the sticky sides together. Throw any used patch away so that children or pets cannot get to it.

Portions of this document last updated: May 01, 2024

Copyright: © Merative US L.P. 1973, 2024. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.