How does this medication work? What will it do for me?
This is a contraceptive (birth control) patch that is worn on the skin. The medication is continuously absorbed through the skin into the bloodstream. It is a combination contraceptive that contains 2 hormones (norelgestromin and ethinyl estradiol) to alter the female reproductive cycle. This medication prevents eggs from being released by the ovaries and changes the cervical mucus, making it harder for sperm to swim. This medication is used to prevent pregnancy.
This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.
Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are using this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.
What form(s) does this medication come in?
Each transdermal system sealed within a protective pouch and heat-stamped "EVRA™" contains norelgestromin 6 mg and ethinyl estradiol 0.60 mg in the middle layer, releasing approximately 200 µg norelgestromin and 35 µg ethinyl estradiol every 24 hours.
Nonmedicinal ingredients: backing layer: low-density pigmented polyethylene outer layer and a polyester inner layer; middle layer inactive components: polyisobutylene/polybutene adhesive, crospovidone, non-woven polyester fabric, lauryl lactate; release liner: polyethylene terephthalate film with polydimethylsiloxane coating on one side. The EVRA transdermal system does not contain any metal components.
How should I use this medication?
Follow the instructions in the package insert or those given to you by your doctor.
A patch is worn every day for 3 weeks. The patch is changed each week and is worn for 7 days. During the 4th week, no patch is worn and menstruation will occur. Always change the patch on the same day of the week. Never be without a patch for longer than 7 days at a time - you may not be protected against pregnancy.
Only one patch should be worn at a time. Apply the patch to clean, dry, healthy skin. It should be applied to the buttock, abdomen, upper outer arm, or upper torso in a spot that will not be rubbed by clothing. Do not apply it to the breast. Do not apply the patch on red, irritated, or cut skin. Do not use creams or other skin products on the area where the patch is currently applied or where you will be soon placing the patch.
Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones given here, do not change the way you are using the medication without consulting your doctor.
It is important to use this medication exactly as prescribed by your doctor. If you make a dosing error (e.g., forget to change your patch), check the instructions that came with the medication. If you are not sure what to do, contact your doctor and use a backup method of birth control.
Store this medication at room temperature. Each patch should be stored inside its protective pouch inside the original box. Keep this medication out of the reach of children.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Who should NOT take this medication?
Do not use norelgestromin - ethinyl estradiol if you:
- are allergic to norelgestromin or ethinyl estradiol or any other ingredients of the medication
- are immobilized for prolonged periods
- are known or suspected to be pregnant
- have or have had blood clots (in the legs, lungs, eyes, or anywhere else) or have severe or multiple risk factors for them
- have or have had a stroke or TIA ("mini-stroke")
- have or have had a heart attack or chest pain (angina)
- have or have had valvular heart disease with complications
- have severe high blood pressure (always >160/100 mmHg)
- have diabetes with blood vessel involvement
- have very high cholesterol
- have health conditions that increase the risk of blood clots (such as certain inherited blood clotting diseases; talk to your doctor for more information)
- smoke heavily (more than 15 cigarettes per day) and are over the age of 35
- have active liver disease
- have or have had liver tumours (benign or malignant)
- have or are suspected to have breast cancer
- have or are suspected to have cancer of the reproductive organs (e.g., endometrium)
- have undiagnosed abnormal vaginal bleeding
- have yellowing of the skin (jaundice) due to steroids or blocked bile ducts
- have yellowing of the eyes or skin during pregnancy
- have vision problems due to vascular eye disease
- have migraine with focal aura
- have had major surgery associated with an increased risk of blood clots
What side effects are possible with this medication?
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
The side effects listed below are not experienced by everyone who uses this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people using this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- breast discomfort
- headache (unless it is sudden, severe, or worsening)
- painful menstrual periods
- skin irritation, redness, or rash where the patch was applied
Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
- abnormal swelling of arms or legs
- breast lumps
- severe pain or a lump in the abdomen
- unexpected vaginal bleeding
- yellow skin (jaundice)
Stop using the medication and seek immediate medical attention if any of the following occur:
- crushing chest pain or heavy feeling
- pain in the calf
- sharp chest pain, coughing up of blood, sudden shortness of breath
- sudden loss of vision (partly or completely)
- sudden severe or worsening headache, vomiting, dizziness, fainting; vision or speech problems; weakness or numbness in an arm or leg
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Are there any other precautions or warnings for this medication?
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
The information provided here results from studies of combination oral contraceptives; the patch contraceptive is thought to have similar risks. Oral combination contraceptives increase the risk of the following serious conditions:
- blood clots
- gallbladder disease
- heart attack
- liver tumours
The risk of disease or death from these conditions greatly increases if a woman has other risk factors such as high blood pressure, high cholesterol, obesity, or diabetes.
Smoking while taking oral contraceptives increases the risk of side effects that affect the heart and blood vessels (e.g., blood clots). This risk is greatest for women 35 years and older. You should not take this medication if you smoke and are 35 years or older.
You should stop using the patch immediately if you develop any of the following:
- blood clot disorders and cardiovascular disorders (e.g., inflammation of a vein due to blood clot, blood clot in your lung)
- a condition that makes you immobile for a long period of time (e.g., recovering from major surgery, being bedridden due to a long-term illness)
- vision or eye problems (e.g., double vision, certain eye conditions) - check with your doctor
- severe headache without known cause, or worsening of preexisting migraine
Body weight: For women weighing 90 kg (198 lbs.) or more, the patch may be less effective. Check with your doctor for more information.
Breast self-exam and physical exams: Women taking this medication should do regular breast self-exams and have yearly physical exams done by their doctor.
Heat sources: Do not expose the patch area to heat sources such as heating pads, electric blankets, saunas, hot tubs, or heat lamps. This may increase the amount of medication that enters your body through the skin.
Pregnancy: This medication should not be taken during pregnancy. You should stop using this medication if you become pregnant and contact your doctor.
Breast-feeding: This medication passes into breast milk and may affect your baby. Adverse effects on the baby, such as jaundice and breast enlargement, have been reported. Talk to your doctor about whether you should continue breast-feeding.
Children: This medication is not recommended for use before the start of menstruation in puberty.
What other drugs could interact with this medication?
There may be an interaction between norelgestromin - ethinyl estradiol patch and any of the following:
- aminocaproic acid
- antacids (when taken within 2 hours)
- antibiotics (e.g., ampicillin, metronidazole, penicillin, rifampin, neomycin, tetracyclines)
- anticoagulants (e.g., warfarin)
- anticonvulsants (e.g., carbamazepine, ethosuximide, phenobarbital, phenytoin, primidone, topiramate, lamotrigine)
- antihypertensives (medications used to treat high blood pressure)
- beta-mimetic agents (e.g., isoproterenol)
- barbiturates (e.g., phenobarbital)
- benzodiazepines (e.g., lorazepam, clonazepam, diazepam)
- blood pressure medications (e.g., metoprolol, guanethidine, methyldopa
- folic acid
- grapefruit juice
- oral diabetes medications (e.g., glyburide, gliclazide)
- other sedatives and hypnotics (e.g., chloral hydrate, glutethimide, meprobamate)
- St. John's wort
- theophyllines (e.g., aminophylline, oxtriphylline, theophylline)
- tricyclic antidepressants (e.g., clomipramine)
- vitamin B12
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
All material copyright MediResource Inc. 1996 – 2018. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Evra