Ortho Evra

Generic Name: ethinyl estradiol and norelgestromin (EH thi nil ESS tra DYE ol and nor ell JESS tro min)
Brand Names: Ortho Evra

What is Ortho Evra?

Ortho Evra is a contraceptive skin patch containing a combination of female hormones (estrogen and progestin), that prevent ovulation (the release of an egg from an ovary). Fertility depends on regular fluctuations in the levels of these hormones. Ortho Evra also causes changes in your cervical mucus and uterine lining, making it harder for sperm to reach the uterus and harder for a fertilized egg to attach to the uterus.

Ortho Evra is used as contraception to prevent pregnancy.

Ortho Evra may also be used for other purposes not listed here.

Important information about Ortho Evra

Do not use Ortho Evra if you are pregnant or if you have recently had a baby. Do not use Ortho Evra if you have a history of stroke or blood clot, circulation problems (especially if caused by diabetes), a hormone-related cancer such as breast or uterine cancer, abnormal vaginal bleeding, liver disease or liver cancer, severe high blood pressure, migraine headaches, a heart valve disorder, or a history of jaundice caused by birth control pills. Using hormones can increase your risk of blood clots, stroke, or heart attack, especially if you smoke and are older than 35.

Many drugs can interact with birth control medication such as Ortho Evra, and some can make it less effective. Tell your doctor about all other medications you are using.

Before using Ortho Evra

Ortho Evra can cause birth defects. Do not use if you are pregnant. Tell your doctor right away if you become pregnant, or if you miss two menstrual periods in a row. If you have recently had a baby, wait at least 4 weeks before using this medication (6 weeks if you are breast-feeding). Do not use Ortho Evra if you have:

• a history of a stroke, blood clot, or coronary artery disease;

• circulation problems (especially if caused by diabetes);

• a hormone-related cancer such as breast or uterine cancer;

• abnormal vaginal bleeding;

• liver disease or liver cancer;

• severe high blood pressure;

• severe migraine headaches;

• a heart valve disorder; or

• a history of jaundice caused by birth control pills.

If you have any of these other conditions, you may need a dose adjustment or special tests to safely use Ortho Evra.

• high blood pressure, heart disease, congestive heart failure, angina (chest pain), or a history of heart attack;

• diabetes;

• high cholesterol or if you are overweight;

• kidney disease;

• a history of depression;

• gallbladder disease;

• seizures or epilepsy; or

• a history of fibrocystic breast disease, lumps, nodules, or an abnormal mammogram.

The hormones in Ortho Evra can pass into breast milk and may harm a nursing baby. Ortho Evra may also slow breast milk production. Do not use if you are breast-feeding a baby. Your risk of serious blood clot may be higher with the use of birth control skin patches than with the use of birth control pills.

How should I use Ortho Evra?

Use Ortho Evra exactly as it was prescribed for you. Do not use more skin patches or wear them for longer than recommended by your doctor. You will apply your first patch on the first day of your period or on the first Sunday after your period begins (follow your doctor's instructions).

Place the Ortho Evra patch on your skin and press it into place firmly for 10 seconds. Make sure the edges stick well. You will wear the patch for a full week.

Apply the Ortho Evra patch to clean, dry skin on any of these areas: the outside of your upper arm, your stomach, your buttocks, or your upper back. Do not apply the patch to skin that is broken or irritated, or to a skin area that may be rubbed by tight clothing (such as a waistband).

Remove the Ortho Evra patch and apply a new one on the same day each week for three weeks in a row. At the end of the third week, remove the patch and do not apply a new one for 7 full days. Your period should start during this time Do not allow more than 7 days to pass before starting your next 3-week patch cycle..

You may have breakthrough bleeding, especially during the first 3 months. Tell your doctor if this bleeding continues or is very heavy.

Check your Ortho Evra patch every day to make sure it is sticking well. If a patch comes loose or falls off, throw it away and apply a new one. You may need to use back-up birth control, such as condoms or a spermicide, if a patch has been off for more than 24 hours. Follow your doctor's instructions.

After removing a Ortho Evra skin patch fold it in half, sticky side in, and throw it away in a place where children and pets cannot get to it. Do not flush a used patch down the toilet.

If you need to have any type of medical tests or surgery, or if you will be on bed rest, tell the doctor or surgeon ahead of time that you are using Ortho Evra. You may need to stop wearing the patches for a short time.

Your doctor will need to see you on a regular basis while you are using Ortho Evra. Do not miss any appointments.

Store the Ortho Evra skin patches at room temperature away from moisture and heat. Do not freeze or refrigerate. Keep each patch in its foil pouch until you are ready to apply it.

What happens if I miss a dose?

If you forget to change your patch at the end of the week, change it as soon as you remember. If it has been 24 hours or longer since your scheduled patch change, apply a new patch and start the cycle over (3 weeks wearing a weekly patch,1 week off). Do not use extra patches to make up the missed dose.

Missing a dose increases your risk of becoming pregnant and you may need to use back-up birth control. Follow the weekly patch schedule closely.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include nausea, vomiting, and vaginal bleeding.

What should I avoid while using Ortho Evra?

Do not smoke while using the birth control patch, especially if you are older than 35. Smoking can increase your risk of blood clots, stroke, or heart attack caused by using Ortho Evra.

This medication will not protect you from sexually transmitted diseases, including HIV and AIDS. Using a condom is the only way to protect yourself from these diseases.

Avoid using creams, lotions, powders, or other medications on the skin where you apply the Ortho Evra patch, or it may not stick to your skin.

Ortho Evra side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Ortho Evra: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using the patches and call your doctor at once if you have any of these serious side effects:

• sudden numbness or weakness, especially on one side of the body;

• sudden headache, confusion, pain behind the eyes, problems with vision, speech, or balance;

• chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;

• a change in the pattern or severity of migraine headaches;

• stomach pain, loss of appetite, dark urine, jaundice (yellowing of the skin or eyes);

• swelling in your hands, ankles, or feet;

• a breast lump; or

• symptoms of depression (sleep problems, weakness, mood changes).

Less serious Ortho Evra side effects:

• mild nausea, vomiting, bloating, stomach cramps;

• breast pain, tenderness, or swelling;

• freckles or darkening of facial skin;

• increased hair growth, loss of scalp hair;

• changes in weight or appetite;

• problems with contact lenses;

• vaginal itching or discharge;

• changes in your menstrual periods, decreased sex drive; or

• headache, nervousness, dizziness, tired feeling.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

See also: Ortho Evra side effects in more detail

What other drugs will affect Ortho Evra?

Many drugs can interact with birth control medication, and some can make it less effective. Below is just a partial list of these drugs. Tell your doctor if you are using:

• acetaminophen (Tylenol) or ascorbic acid (vitamin C);

• bosentan (Tracleer);

• griseofulvin (Fulvicin);

• prednisolone (Orapred);

• theophylline (Respbid, Theo-Dur);

• cyclosporine (Neoral, Sandimmune, Gengraf);

• St. John's wort;

• an antibiotic such as amoxicillin (Augmentin), ampicillin (Omnipen), doxycycline (Doryx, Vibramycin), tetracycline (Sumycin, Achromycin, Robitet), and others;

• seizure medicines such as carbamazepine (Carbatrol, Tegretol), felbamate (Felbatol), lamotrigine (Lamictal), oxcarbazepine (Trileptal), phenytoin (Dilantin), topiramate (Topamax), and others;

• a barbiturate such as phenobarbital (Solfoton), and others; or

• any medication to treat HIV or AIDS.

This list is not complete and there may be other drugs that can interact with Ortho Evra. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about Ortho Evra.

• Every effort has been made to ensure that the information provided is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects.

Copyright 1996-2009 Cerner Multum, Inc. Version: 5.01. Revision Date: 10/01/2009 9:02:51 AM.