Drug Uses

Ortho Evra is a contraceptive (birth control) skin patch used to prevent pregnancy. It is a combination hormonal contraceptive because it contains two hormones, estrogen and progestin. It does not protect against HIV infection (AIDS) and other sexually transmitted diseases.

How Taken

This birth control method uses a 28-day (four-week) cycle. One topical patch is applied and kept in place for one week. A new topical patch is applied each week for three weeks in a row (21 total days). You should not apply a patch during the fourth week (a one-week break). During the one-week break, you should have your menstrual period. Every new patch should be applied on the same day of the week; this will be your 'Patch Change Day'. Follow your healthcare provider's instructions regarding when to start using Ortho Evra and whether back-up contraception is needed temporarily. Clean and dry the area of skin where the patch will be applied. The patch can be placed on the buttock, abdomen, upper outer arm, or upper torso in a place where it won't be rubbed by tight clothing. Never put the patch on the breasts. To avoid skin irritation, apply each new patch to a different place on the skin. Do not apply the patches to skin that are red, irritated or cut. Do not use creams, oils, powder, or makeup on the skin where you will put a patch or near a patch your are wearing. It may cause the patch to become loose. If a patch causes irritation, it can be removed and a new patch may be applied to a new location until the next 'Patch Change Day'. Only one patch should be worn at a time.

Warnings/Precautions

The risks associated with using Ortho Evra increase significantly if you: smoke, have high blood pressure, diabetes, or high cholesterol, have or have had clotting disorders, heart attack, stroke, chest pain (angina pectoris), and cancer of the breast or reproductive organs, jaundice, or malignant or benign liver tumors. Ortho Evra may be less effective in women weighing more than 198 lbs. (90 kg). Do not use Ortho Evra without first talking to your doctor if you weigh more than 198 lbs. (90 kg). Ortho Evra is in the FDA pregnancy category X. This means that Ortho Evra is known to cause birth defects in an unborn baby. Do not use Ortho Evra if you are pregnant. Ortho Evra may decrease milk flow and have other effects on milk composition. Do not use Ortho Evra without first talking to your doctor if you are breast-feeding a baby.

Missed Dose

If you forget to change your patch:
-at the start of any patch cycle,
Week one (Day 1): If you forget to apply your patch, YOU COULD BECOME PREGNANT - you must use back-up contraception for one week. Apply the first patch of your new cycle as soon as you remember. You now have a new Patch Change Day and new Day 1.
-in the middle of your patch cycle,
Week two or week three: If you forget to change your patch for one or two days, apply a new patch as soon as you remember. Apply your next patch on your normal Patch Change Day. No back-up contraception is needed.
Week two or week three: If you forget to change your patch for more than two days, YOU COULD BECOME PREGNANT start a new four week cycle as soon as you remember by putting on a new patch. You now have a different Patch Change Day and a new Day 1. You must use back-up contraception for the first week of your new cycle.
-at the end of your patch cycle,
Week four: If you forget to remove your patch, take it off as soon as you remember. Start your next cycle on your normal Patch Change Day the day after Day 28. No back-up contraception is needed.
-at the start of your next patch cycle,
Day 1 (week one): If you forget to apply your patch, YOU COULD BECOME PREGNANT. Apply the first patch of your new cycle as soon as you remember. You now have a new Patch Change Day and new Day. You must use back-up contraception for the first week of your new cycle.

Possible Side Effects

Some common side effects with combination hormonal contraceptives like Ortho Evra are:
-breast tenderness and enlargement
-headache
-nausea
-menstrual changes
-abdominal cramps and bloating
-vaginal discharge.

Storage

Store at 25°C (77°F); excursions permitted to 15-30°C (59-86°F). Store patches in their protective pouches. Apply immediately upon removal from the protective pouch. Do not store in the refrigerator or freezer. Used patches still contain some active hormones. Each patch should be carefully folded in half so that it sticks to itself before safely disposing of it in the trash. Used patches should not be flushed down the toilet.

Overdose

Ortho Evra is unlikely to cause an overdose because the patch releases a steady amount of the hormones. Do not use more than one patch at a time. Serious ill effects have not been reported when young children accidentally took large doses of oral contraceptives. Over dosage may cause nausea and vomiting. Vaginal bleeding may occur in females. In case of over dosage, contact your health care professional or pharmacist.

More Information

Your health care professional will take a medical and family history before prescribing Ortho Evra and will examine you. You should be reexamined at least once a year. Be sure to inform your health care professional if there is a family history of any of the conditions listed previously in this leaflet. Be sure to keep all appointments with your health care professional, because this is a time to determine if there are early signs of side effects of hormonal contraceptive use. Do not use the drug for any condition other than the one for which it was prescribed. This drug has been prescribed specifically for you; do not give it to others who may want birth control. If you want more information about Ortho Evra, ask your health care professional or pharmacist.

Disclaimer

This drug information is for your information purposes only, it is not intended that this information covers all uses, directions, drug interactions, precautions, or adverse effects of your medication. This is only general information, and should not be relied on for any purpose. It should not be construed as containing specific instructions for any particular patient. We disclaim all responsibility for the accuracy and reliability of this information, and/or any consequences arising from the use of this information, including damage or adverse consequences to persons or property, however such damages or consequences arise. No warranty, either expressed or implied, is made in regards to this information.

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What kind of birth control is right for me?
The type of birth control you choose depends on your needs. Some people only need to prevent pregnancy. Other people may also want to protect themselves or their partners from diseases that can be passed by having sex. These diseases are called sexually transmitted diseases (STDs). Some STDs include acquired immunodeficiency syndrome (AIDS), chlamydia, herpes, genital warts, gonorrhea and syphilis.
Talk with your family doctor about the pros and cons of each birth control option.

Is saying "no" really an option?
Yes. The risk of getting pregnant or catching an STD may outweigh the pleasure you get from sex. The only way to make sure you don't get pregnant, get someone pregnant or get an STD is not to have sex at all.

What are barrier methods?
Barrier methods include the diaphragm, the cervical cap and condoms. These methods prevent pregnancy by blocking sperm from getting into the uterus. Barrier methods must be used every time you have sexdiaphragm - cervical cap.
A woman must visit her doctor to be fitted for a diaphragm or a cervical cap.
Using a diaphragm may increase the risk of urinary tract infections in some women.

Are condoms a good choice?
Yes. Condoms aren't expensive, and they are widely available. Condoms are an especially good choice if you or your partner are also having sex with other people or if either of you has had sex with other people in the past.
Condoms offer the most protection against STDs. Using a spermicide with condoms can offer better protection against pregnancy, but it does not increase your protection against STDs . Spermicides containing nonoxynol-9 can cause genital irritation and increase your risk of catching an STD.
Female condoms aren't as effective as male condoms, but they may be a good choice if a man won't use a male condom.

What about the pill?
Birth control pills work mostly by preventing ovulation (the release of an egg by the ovaries). Most pills are made of two hormones called estrogen and progestin. For the pill to work, you have to take it every day.
Some common side effects of birth control pills are nausea, headaches, breast swelling, water retention, weight gain and depression. The pill may reduce cramping and shorten the number of days of bleeding during the menstrual period. The pill may also help premenstrual syndrome (PMS). Women who take the pill should not smoke.

What about the patch?
The hormonal birth control patch (brand name: Ortho Evra) uses estrogen and progestin to prevent pregnancy. It is applied to 1 of 4 places -- the buttocks, abdomen, upper torso or outer arm. The patch is used on a 4-week cycle. You put on a new patch once a week for 3 weeks. During the 4th week, you don't use a patch, and your period will start.
The patch's side effects are similar to those of the pill. Women who use the patch should not smoke.

What is the vaginal contraceptive ring?
The vaginal contraceptive ring (brand name: NuvaRing) is a thin, flexible ring that is inserted into the vagina. It releases hormones that keep you from getting pregnant. These hormones are the same ones used in most birth control pills. The ring is left in the vagina for 3 weeks. It doesn't have to be in a specific position in the vagina. After 3 weeks, you remove the ring, and your period will start. After 7 days, you insert a new ring.
If the ring is out of your vagina for more than 3 hours, it may not work effectively when you put it back in. To protect against pregnancy, you will need to use another form of birth control until the ring has been in all the time for 7 days in a row.
Women who use the vaginal ring should not smoke.

What about hormone shots and implants?
Hormone shots (brand names: Depo-Provera, Lunelle) work much like the pill to prevent pregnancy. They may have some side effects, such as headaches and changes in your period, mood and weight. A Depo-Provera shot prevents pregnancy for 3 months. A Lunelle shot prevents pregnancy for 1 month.
Hormone implants (brand name: Norplant System) are no longer available. If you are currently using hormone implants, you should talk to your doctor to see what your birth control options will be when your hormone implants expire. The implants prevent pregnancy for 5 years, but you can have them removed at any time.

What about an IUD?
"IUD" stands for "intrauterine device." An IUD is put in a woman's uterus by her doctor. It's made of flexible plastic. It isn't known exactly how IUDs prevent pregnancy. They seem to stop sperm from reaching the egg or prevent the egg from attaching to the uterus.
Some IUDs used in the past were related to serious health problems. Today IUDs are safer, but they still have some risks. Most doctors prefer to use IUDs only in women who have already had a baby. Side effects of IUDs include heavier bleeding and stronger cramps during periods.

What about being sterilized?
Sterilization is when a man or woman has an operation to permanently prevent pregnancy. If you're sure that you don't want to have children or you don't want more children, sterilization may be the right choice for you.
Tubal ligation (also called "getting your tubes tied") involves closing off a woman's fallopian tubes so eggs can't travel through them to reach the uterus. A device called Essure can also be used to close off a woman's fallopian tubes. Essure is a metal coil that is inserted into your fallopian tubes by your doctor.
Men are sterilized with a vasectomy. The man's vas deferens (sperm ducts) are closed off so sperm can't get through.

What is natural family planning?
Natural family planning requires a couple to learn when in the woman's cycle she can get pregnant (usually 4 days before and 2 days after ovulation). They must use a barrier method of birth control or not have intercourse during those days. There are a number of ways to keep track of a woman's ovulation. All of them require a lot of planning and commitment.

Is withdrawal effective?
No. When a man tries to pull out before ejaculating ("coming"), he usually leaves behind a small amount of fluid that leaks from the penis during sex. This fluid has enough sperm in it to cause pregnancy.

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