What you can expectBy Mayo Clinic staff
To use Ortho Evra:
- Consult your health care provider about a starting date. If you're using Ortho Evra for the first time, wait until the day your period starts. If you use the first-day start, you'll apply your first contraceptive patch on the first day of your next period. No backup method of contraception is needed. If you use the Sunday start, you'll apply your first patch on the first Sunday after your period starts. Use a backup method of contraception for the first week.
- Choose an area to apply the patch. You can place Ortho Evra on your buttocks, upper outer arm, lower abdomen or upper body. Don't put it on your breasts or in a place where it will be rubbed, such as under a bra strap. Apply to skin that's clean, dry and intact. Avoid areas of the skin that are red, irritated or cut. Don't apply lotions, creams, powders or make-up to the skin area where the patch is or will be placed. If skin irritation develops, remove the patch and apply a new patch to a different area until your next change day.
- Apply the patch. Carefully open the foil pouch. Use your fingernail to lift one corner of the contraceptive patch. Peel the patch and the plastic liner away from the pouch, then peel away half of the protective clear lining. Be careful not to cut, alter or damage the patch. Apply the sticky surface of the patch to your skin and remove the rest of the liner. Press down firmly on top of the skin patch with the palm of your hand for about 10 seconds, making sure that the edges stick well. Leave the patch on for seven days. There's no need to take it off to bathe, shower, swim or exercise.
- Use one patch a week for three weeks. Apply a new contraceptive patch to your body each week — on the same day of the week — for three consecutive weeks. Apply each new patch to a different area of skin to avoid causing irritation. After you remove a patch, fold it in half with the sticky sides together, place it in a sturdy container, and throw it in the trash. Don't flush it down the toilet. Remove any adhesive that remains on your skin with baby oil or lotion.
- Check the patch regularly to make sure it's still in place. If the patch becomes partially or completely detached and can't be reapplied, replace it with a new patch immediately. Don't reapply a patch if it's no longer sticky, it becomes stuck to itself or another surface, or it has other material stuck to it. Don't use other adhesives or wraps to hold the patch in place. If your patch becomes partially or completely detached for more than 24 hours, apply a new patch and use a backup method of contraception for one week.
- Skip the patch on the fourth week. Don't apply a new patch during the fourth week, when you'll have your period. After the fourth week ends, apply a new patch.
- If you're late applying a new patch, use backup contraception. If you're late applying Ortho Evra in your first week or more than two days late in your second or third week, apply a new patch immediately and use a backup method of contraception for one week.
Consult your health care provider as soon as possible if you have:
- Sharp chest pain, sudden shortness of breath or coughing up blood, which can be signs of a blood clot
- Persistent pain in your calf or other signs of a blood clot in your leg
- Sudden partial or complete blindness or other signs of a blood clot in your eye
- Crushing chest pain or other signs of a heart attack
- Sudden severe headache, problems with vision or speech, or numbness in an arm or leg, or other signs of stroke
- Yellowing of the skin or whites of the eyes, possibly accompanied by fever, fatigue, loss of appetite, dark urine or light-colored bowel movements
- Severe trouble sleeping, fatigue or feeling sad
- Severe abdominal pain or tenderness
- Breast lumps
- Two missed periods or other signs of pregnancy
- Birth control methods fact sheet. U.S. Department of Health and Human Services. http://www.womenshealth.gov/publications/our-publications/fact-sheet/birth-control-methods.cfm. Accessed Nov. 9, 2012.
- Ortho Evra (prescribing information). Raritan, N.J.: Ortho-McNeil-Janssen Pharmaceuticals Inc.; 2012. http://www.orthoevra.com/fullprescribeinfo.html. Accessed Nov. 14, 2012.
- Zieman M. Overview of contraception. http://www.uptodate.com/home/. Accessed Nov. 9, 2012.
- Hatcher RA, et al. Contraceptive Technology. 20th ed. New York, N.Y.: Ardent Media; 2011:343.
- Burkman RT. Transdermal contraceptive patch. http://www.uptodate.com/index. Accessed Nov. 14, 2012.
- Dore DD, et al. Extended case-control study results on thromboembolic outcomes among transdermal contraceptive users. Contraception. 2010;81:408.