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How does the Xulane patch work?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Jan 31, 2023.

Official answer


The Xulane (ethinyl estradiol and norelgestromin) birth control patch works by releasing hormones through your skin that prevent pregnancy. The hormones in the Xulane patch, ethinyl estradiol (an estrogen) and norelgestromin (a progestin) stop ovulation - the release of an egg from the ovary. If there is no ovulation, there is no egg for the sperm to fertilize which lowers the chances for pregnancy.

The hormones found in the Xulane patch (transdermal) form also cause changes in your cervical mucus and uterine lining. These changes make it harder for an egg to be fertilized or to successfully attach to the uterus. Xulane is 91% to 99% effective in preventing pregnancy depending upon if it is used correctly.

Where do I put the Xulane patch?

You can place the Xulane transdermal patch on your upper outer arm, abdomen (stomach) area, buttock or on your back. Only apply the Xulane patch to a clean, dry skin area. Do not apply the patch to your breasts or the same skin area as the previous patch.

One Xulane patch is worn for 3-weeks in a row, and then removed for one week. This is known as a 28-day (4-week) cycle. A new patch is applied at the beginning of the next 4-week cycle. There should never be more than a 7-day patch-free interval between dosing cycles.

Every new patch should be applied on the same day of the week. This day is known as the “patch change day.” For example, if the first patch is applied on a Monday, all subsequent patches should be applied on a Monday.

Check your patch each day to be sure the edges are sticking correctly to your skin. If your patch is loose or falls off, throw it away and apply a new one. This will start a new 4-week cycle with a new “patch change day”. If your patch has been off for more than 24 hours, you may need to use a back-up form of birth control, such as a condom with spermicide or a diaphragm with spermicide. Ask your doctor for instructions.

Place the patch in an area where it will not be rubbed off by tight clothing, such as a belt or elastic. Your patch must adhere to your skin securely to work. Do not cut the patch or wear more than one patch at a time.

Do not use creams, lotions, oils, ointments, powders or make-up on the skin area where you place the patch. Do not apply the Xulane patch to any area with cut or irritated skin.

Can I use Xulane if I am overweight?

Do not use Xulane if your BMI is 30 kg/m2 or more because of an increased risk of blood clots. Xulane may be less effective in preventing pregnancy if you weigh 198 lbs (90 kg) or more. Your doctor will determine your correct BMI and weight before prescribing Xulane.

Do not use Xulane if you smoke cigarettes and are over 35 years old. Smoking increases your risk of serious heart and vessel side effects from hormonal birth control methods, including death from a heart attack, stroke or blood clots. This risk increases with age and the number of cigarettes you smoke. Do not use Xulane if you have an increased risk for blood clots.

It is important you understand all of the warnings, dosage, side effects, risks and other medical information associated with the use of Xulane before you start this birth control. Read the full manufacturer's patient information found here. Discuss this information with your doctor.

How much does Xulane cost?

  • The cost for the Xulane patch using the discount coupon is around $87 for a supply of 3 patches, depending on where you live and which pharmacy you visit.
  • Prices with the coupon are valid if you are paying cash, but not with insurance plans.
  • Xulane was approved in 2014 and is a lower-cost option for the Ortho Evra patch, which is no longer on the U.S. market.

This is not all the information you need to know about Xulane (ethinyl estradiol and norelgestromin) for safe and effective use. Review the full Xulane information here, and discuss this information and any questions you have with your doctor or other health care provider.


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