... type of birth control for about two months ..then I applied the patch on a weds and had unprotected sex on Friday... could I be pregnant?
Your Dr told you to start when your cycle ended?? That is unusual. It is supposed to be started the day you start bleeding or the first Sunday after. You should have waited a week or used back up protection for the first week since you did not start Day 1. If you put your first patch on the day your period starts then you do not need back up. So, yes, there is a chance for pregnancy. Here are the instructions for future reference:
HOW TO START USING THE Ortho Evra® PATCH FOR THE FIRST TIME
The woman has two options for starting the patch and she should choose the option that is right for her:
First Day Start-The woman should apply her first patch during the first 24 hours of her menstrual period.
Sunday Start-The woman should apply her first patch on the first Sunday after her menstrual period begins. With this option, a non-hormonal backup method of birth control, such as a condom or diaphragm and spermicide, is needed for the first 7 days of the first cycle only. If her period starts on a Sunday, the first patch should be applied that day, and no backup contraception is needed.
CHOOSING A PLACE ON THE BODY TO PUT THE PATCH
The patch may be placed on the upper outer arm, abdomen, buttock or back in a place where it won't be rubbed by tight clothing. For example, it should not be placed under the waistband of clothing.
The patch should not be placed on the breasts, on cut or irritated skin, or on the same location as the previous patch.
Before applying the patch:
The woman should make sure the skin is clean and dry.
She should not use lotions, creams, oils, powders, or make-up at the patch site. It may cause the patch to fail to stick properly or to become loose.
HOW TO APPLY THE PATCH
The woman should tear open the pouch at the top edge. She should peel open the foil pouch that contains the patch and its clear plastic cover. She should gently remove the patch and its plastic cover together from the pouch, being careful not to separate the patch from the clear plastic cover. Using a fingernail, the woman should peel away half of the clear plastic. She should avoid touching the sticky surface with her fingers. The woman should apply the sticky side of the patch on the skin she has cleaned and dried. She should then remove the other half of the clear plastic and attach the entire patch to her skin. The woman should press firmly on the patch with the palm of her hand for 10 seconds, making sure that the whole patch adheres to her skin.
She should run her fingers over the entire surface area to smooth out any "wrinkles" around the outer edges of the patch.
The woman should check her patch every day to make sure all edges are sticking correctly.
WHEN TO CHANGE THE Ortho Evra® PATCH
The patch works for seven days (one week). The woman applies a new patch on the same day each week (her Patch Change Day) for 3 weeks in a row. She must make sure she has removed her old patch prior to applying the new patch.
During week 4, she DOES NOT wear a patch. She must make sure she removes her old patch. (Her period should begin during this week.)
Following week 4, she repeats the cycle of three weekly applications followed by a patch-free week.
WHAT IF THE PATCH BECOMES LOOSE OR FALLS OFF?
The patch must stick securely to the skin to work properly. If the Ortho Evra® patch becomes partially or completely detached and remains detached, insufficient drug delivery occurs. The woman should not try to reapply a patch if it is no longer sticky, if it has become stuck to itself or another surface, or if it has other material stuck to it.
If a patch edge lifts up:
The woman should press down firmly on the patch with the palm of her hand for 10 seconds, making sure that the whole patch adheres to her skin. She should run her fingers over the entire surface area to smooth out any "wrinkles" around the edges of the patch.
If her patch does not stick completely, she should remove it and apply a replacement patch.
She should not tape or wrap the patch to her skin or reapply a patch that is partially adhered to clothing.
If the patch has been off or partially off:
For less than 1 Day, she should try to reapply it. If the patch does not adhere completely, she should apply a new patch immediately. (No backup contraception is needed and her Patch Change Day will stay the same).
For more than 1 Day or if she is not sure for how long, she may not be protected from pregnancy. To reduce this risk, she should apply a new patch and start a new 4-week cycle. She will now have a new Patch Change Day and MUST USE NON-HORMONAL BACKUP CONTRACEPTION (such as a condom or diaphragm and spermicide) for the first week of her new cycle.
IF THE WOMAN FORGETS TO CHANGE HER PATCH
at the start of any patch cycle (Week One/Day 1): SHE MAY NOT BE PROTECTED FROM PREGNANCY. She should apply the first patch of her new cycle as soon as she remembers. There is now a new "Patch Change Day" and a new "Day 1." The woman must use back-up contraception, such as a condom or diaphragm and spermicide, for the first week of the new cycle.
in the middle of the patch cycle (Week Two/Day 8 or Week Three/Day 15),
for one or two days (up to 48 hours), she should apply a new patch immediately. The next patch should be applied on the usual "Patch Change Day." No back-up contraception is needed.
for more than two days (48 hours or more), SHE MAY NOT BE PROTECTED FROM PREGNANCY. She should stop the current contraceptive cycle and start a new four-week cycle immediately by putting on a new patch. There is now a new "Patch Change Day" and a new "Day 1." The woman must use back-up contraception for one week.
at the end of the patch cycle (Week Four/Day 22),
Week Four (Day 22): If the woman forgets to remove her patch, she should take it off as soon as she remembers. The next cycle should be started on the usual "Patch Change Day," which is the day after Day 28. No back-up contraception is needed.
Under no circumstances should there be more than a seven-day patch-free interval between cycles. If there are more than seven patch-free days, THE WOMAN MAY NOT BE PROTECTED FROM PREGNANCY and back-up contraception, such as a condom or diaphragm and spermicide, must be used for seven days. As with combined oral contraceptives, the risk of ovulation increases with each day beyond the recommended drug-free period. If coital exposure has occurred during such an extended patch-free interval, the possibility of pregnancy should be considered.
Change Day Adjustment
If the woman wishes to change her Patch Change Day she should complete her current cycle, removing the third Ortho Evra® patch on the correct day. During the patch-free week, she may select an earlier Patch Day Change by applying a new Ortho Evra® patch on the desired day. In no case should there be more than 7 consecutive patch-free days.
Breakthrough Bleeding or Spotting
In the event of breakthrough bleeding or spotting (bleeding that occurs on the days that Ortho Evra® is worn), treatment should be continued. If breakthrough bleeding persists longer than a few cycles, a cause other than Ortho Evra® should be considered.
In the event of no withdrawal bleeding (bleeding that should occur during the patch-free week), treatment should be resumed on the next scheduled Change Day. If Ortho Evra® has been used correctly, the absence of withdrawal bleeding is not necessarily an indication of pregnancy. Nevertheless, the possibility of pregnancy should be considered, especially if absence of withdrawal bleeding occurs in 2 consecutive cycles. Ortho Evra® should be discontinued if pregnancy is confirmed.
In Case of Vomiting or Diarrhea
Given the nature of transdermal application, dose delivery should be unaffected by vomiting.
In Case of Skin Irritation
If patch use results in uncomfortable irritation, the patch may be removed and a new patch may be applied to a different location until the next Change Day. Only one patch should be worn at a time.
ADDITIONAL INSTRUCTIONS FOR DOSING
Breakthrough bleeding, spotting, and amenorrhea are frequent reasons for patients discontinuing hormonal contraceptives. In case of breakthrough bleeding, as in all cases of irregular bleeding from the vagina, nonfunctional causes should considered. In case of undiagnosed persistent or recurrent abnormal bleeding from the vagina, adequate diagnostic measures are indicated to rule out pregnancy or malignancy. If pathology has been excluded, time or a change to another method of contraception may solve the problem.
Use of Hormonal Contraceptives in the Event of a Missed Menstrual Period
If the woman has not adhered to the prescribed schedule, the possibility of pregnancy should be considered at the time of the first missed period. Hormonal contraceptive use should be discontinued if pregnancy is confirmed.
If the woman has adhered to the prescribed regimen and misses one period, she should continue using her contraceptive patches.
If the woman has adhered to the prescribed regimen and misses two consecutive periods, pregnancy should be ruled out. Ortho Evra® use should be discontinued if pregnancy is confirmed.
- Ortho Evra Information for Consumers
- Ortho Evra Information for Healthcare Professionals (includes dosage details)
- Side Effects of Ortho Evra (detailed)
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