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Ethinyl Estradiol / Norelgestromin Dosage

Applies to the following strength(s): 20 mcg-150 mcg/24 hr ; 35 mcg-150 mcg/24 hr

The information at is not a substitute for medical advice. Always consult your doctor or pharmacist.

Usual Adult Dose for Contraception

The initial dosage of ethinyl estradiol-norelgestromin transdermal patch for contraception is the placement of one patch on the skin of the upper outer arm, or abdomen, or buttocks, weekly for 3 weeks (21 total days), which is to remain in place for 7 days, the fourth week is drug free.

A new transdermal patch is placed on the skin one-week after the last patch was removed. Regardless of withdrawal bleed presence, the new transdermal patch is placed on the skin the same day (at any time) as it was done in the previous cycle.

If a patch is partially or completed detached for less than 1 day (up to 24 hours), reapply it to the same place or replace it with a new patch immediately. No backup contraception is needed. If this event occurs for more than 1 day (24 hours or more), or if the woman is not sure how long the patch has been detached, she should stop the current contraceptive cycle and start a new cycle immediately by applying a new patch. Backup contraception, such as condoms, spermicide, or diaphragm, must be used for the first week of the new cycle.

In women switching from a combination oral contraceptive, begin use of the patch on the first day of withdrawal bleeding. If there is no withdrawal bleeding within 5 days of the last active (hormone-containing) tablet, pregnancy must be ruled out. If the patch is placed later than the first day of withdrawal bleeding, but within the 7 days from the last oral active tablet, a second method of contraception (non-hormonal) should be added for the first 7 days.

In women with a miscarriage or a complete first trimester abortion, begin use of the patch immediately. An additional method of contraception would not be needed if therapy is started immediately.

In women who choose not to breast-feed after childbirth, begin use of the patch no sooner than 4 weeks after childbirth. Postpartum women who have not had a period should add a second method of contraception (non-hormonal) for the first 7 days of patch use.

Renal Dose Adjustments

There are not data in the literature to recommend a safe dosage of ethinyl estradiol and norelgestromin transdermal patch for this patient.

Liver Dose Adjustments

There are no data in the literature to recommend a safe dosage of ethinyl estradiol and norelgestromin transdermal patch for this patient.

The combination contraceptive hormones may be poorly metabolized in women with impaired liver function.

Dose Adjustments

This product has not been studied in women over 65 years of age and is not indicated in this population.


Cigarette smoking increases the risk of serious cardiovascular side effects from combination hormonal contraceptive use. This risk increases with age and with heavy smoking (15 or more cigarettes per day) and is quite marked in women over 35 years of age. Women who use hormonal contraceptives, including the ethinyl estradiol-norelgestromin transdermal patch should be strongly advised not to smoke.

The use of combination hormonal contraceptives is associated with increased risks of several serious conditions including myocardial infarction, thromboembolism, stroke, hepatic neoplasia, and gallbladder disease, although the risk of serious morbidity or mortality is very small in healthy women without underlying risk factors. The risk of morbidity and mortality increases significantly in the presence of other underlying risk factors such as hypertension, hyperlipidemias, obesity and diabetes.

Ethinyl estradiol and norelgestromin transdermal patch should not be used if you are pregnant or suspect a pregnancy, if you have or had in the past blood clots in your legs (thrombosis), lungs (pulmonary embolism), or deep vein thrombophlebitis, cerebrovascular or coronary artery disease, valvular heart disease with complications, severe hypertension, diabetes with vascular involvement, headaches with focal neurologic symptoms, known or suspected breast cancer or cancer of the endometrium or other known or suspected estrogen-dependent neoplasia, undiagnosed abnormal genital bleeding, hepatic adenomas or carcinomas, acute or chronic hepatocellular disease with abnormal liver function, cholestatic jaundice of pregnancy or jaundice with prior hormonal contraceptive use (birth control pills), or hypersensitivity to any component of this product.

The manufacturer recommends that women be monitored closely if they are being treated or have a history of hyperlipidemias, diabetes (including prediabetes), gallbladder disease, fluid retention disorders, depression, breast cancer in family, or notice visual changes or decreased contact lens tolerance.

In women weighing greater than or equal to 90 Kg there are reports of statistically significant increases in the number of pregnancies, suggesting that the ethinyl estradiol and norelgestromin transdermal patch may be less effective in these women.


There are no data in the literature to recommend a safe dosage of ethinyl estradiol and norelgestromin transdermal patch for this patient.

Other Comments

-Must be used exactly as directed to achieve maximum contraceptive effectiveness.
-A new patch is applied each week for three weeks; week four is patch-free.
-The new patch should be applied on the same day of the week.
-Only one patch should be worn at a time.
-The patch should not be cut, damaged or altered in any way.
-The patch may be placed on the upper outer arm, abdomen, buttock or back. The patch should not be place on the breasts, on cut or irritated skin, or on the same location as the previous patch.
-Skin should be clean and dry and free from lotions, creams, oils, powders or makeup.
-See manufacturer product information for complete administration instructions.

The manufacturer suggests that patients discuss, with their doctors, their individual needs in choosing the most appropriate contraception option.