The risk of significant side effects from the contraceptive patch, such as heart attacks, blood clots, and strokes, is increased by smoking. Women over 35 who smoke heavily (15 or more cigarettes per day) and who have a body mass index (BMI) of 30 kg/m2 or higher are at higher risk. You shouldn’t smoke if you take the contraceptive patch.

Transdermal (patch) contraceptives containing oestrogen and progestin are used to prevent pregnancy. Two female sex hormones are oestrogen (ethinyl estradiol) and progestin (levonorgestrel or norelgestromin). Combinations of oestrogen and progestin operate by altering the uterine lining and cervical mucus, which stop ovulation (the release of eggs from the ovaries). The contraceptive patch is a very successful birth control device, but it does not stop the spread of the HIV virus (which causes AIDS and other sexually transmitted diseases) or other sexually transmitted diseases.

Transdermal patches are used to deliver transdermal oestrogen and progestin contraceptives to the skin. Three weeks of one patch each week are followed by a week without patches. Ask your doctor or pharmacist to explain any instructions on your prescription label that you are unsure about following. Follow the contraceptive patch’s instructions exactly.

Apply your first patch on the first day of your menstrual cycle if you are just beginning to use the Twirla brand oestrogen and progestin contraceptive patch. Apply your first patch on the first day of your period or the first Sunday after the start of your cycle if you are just beginning to use the Xulane brand oestrogen and progestin contraceptive patch. You must use a backup form of birth control (such as a condom and/or a spermicide) for the first seven days of the first cycle if you apply your first patch after the first day of your menstrual period. Find out when in your cycle you should begin using your contraceptive by speaking with your doctor or pharmacist.

Always apply your new patch on the same day of the week when changing your patch (the Patch Change Day). For three weeks, apply a fresh patch every week. In Week 4, take off the old patch but don’t put on a new one, and anticipate the start of your menstrual cycle. Apply a fresh patch to begin a new 4-week cycle the day after Week 4 concludes, even if your menstrual period hasn’t yet begun or finished. No more than seven days should pass without applying a patch.

In a location where it won’t be rubbed by tight clothing, apply the contraceptive patch to a clean, dry, intact, healthy piece of skin on the buttock, belly, upper outer arm, or upper chest. Avoid applying the contraceptive patch to areas of skin that are red, irritated, or cut, as well as to the breasts. Avoid touching the skin where the contraceptive patch is worn with creams, lotions, powders, or other topical preparations. To assist prevent irritation, each fresh patch should be put to a different area of the skin.

The patch may not be cut, altered, or decorated in any way. Do not secure the patch in place with additional tape, glue, or wrapping.

The exact instructions provided in the manufacturer’s material for the patient should be followed while applying each type of oestrogen and progestin contraceptive patches. Before taking oestrogen and progestin contraceptive patches and before each prescription refill, carefully read this information. If you have any inquiries, speak with your physician or pharmacist. When using any kind of oestrogen and progestin contraceptive patch, it’s crucial to remember the following general instructions:

1. Pull the pouch apart with your fingertips. Wait until you are prepared to apply the patch before opening the pouch.
2. From the pouch, remove the patch. As you remove the patch, take care not to damage the clear plastic liner.
3. Peel off the smaller or middle portion of the plastic liner. Don’t touch the patch’s adhesive surface.
4. After removing the other portion of the plastic lining, apply the patch’s sticky side to the skin. For 10 seconds, firmly press down on the patch with the palm of your hand, making sure that the edges adhere well.
5. Put the patch back on your skin after a week. The spent patch should be disposed of safely, out from the reach of kids and animals. Fold it in half so that it sticks to itself. Put the used patch in the trash instead of the toilet.

Make sure your patch is adhering by checking it every day. Try to reapply the patch in the same location right away if it has been detached in any way for less than a day. Reapplying a patch that is no longer sticky, has clung to itself or another surface, has any substance stuck to it, or has come loose or fallen off in the past is not advised. Instead, apply a fresh patch. The day of your next patch change won’t change. You could not be protected from pregnancy if the patch has been partially or totally detached for longer than one day, or if you are unsure of how long it has been disconnected. The day you apply the new patch becomes your new Patch Change Day, and you must immediately begin a new cycle by applying a new patch. For the first week of the new cycle, use a backup method of birth control.

You can take off your patch and place a fresh one on a different area of your skin if the skin underneath it starts to itch. Till your scheduled Patch Change Day, keep the new patch in place. You should never wear more than one patch at a time, so make sure to take off the previous one.

For a copy of the manufacturer’s information for the patient, ask your pharmacist or doctor.

Ask your doctor or pharmacist for more details if you believe this drug should be used for something else.

Before using an estrogen and progestin contraceptive patch,

• If you have any allergies, including to any of the substances in oestrogen and progestin contraceptive patches, tell your doctor and pharmacist right away. Request a list of the components from your pharmacist.
• If you use any other hormonal birth control method, such as pills, rings, injections, or implants, be sure to let your doctor know. Your physician will advise you on how and when to switch from the other form of birth control to the contraceptive patch. While wearing the birth control patch, avoid using any other hormonal birth control.
• Inform your physician whether you are taking dasabuvir with or without ombitasvir, paritaprevir, and ritonavir (Technivie) (in Viekira Pak). If you are taking these medications, your doctor will probably advise you not to use an oestrogen or progestin contraceptive patch.
• Inform your doctor and pharmacist about all prescription and non-prescription drugs, vitamins, and dietary supplements you are using. Make sure you bring up any of the following: acetaminophen (APAP, Tylenol); anticoagulants (‘blood thinners’) like warfarin (Coumadin); antifungals like fluconazole (Diflucan), itraconazole (Onmel, Sporanox, Tolsura), ketoconazole, and voriconazole (Vfend); aprepitant (Emend); ascorbic acid (vitamin C); atorvastatin (Lipitor, in Caduet); barbiturates like phenobarbital, boceprevir (no longer available in the US), bosentan (Tracleer), clofibrate (no longer available in the US), colesevelam (Welchol), cyclosporine (Gengraf, Neoral, Sandimmune), griseofulvin (Gris-PEG), and HIV drugs like atazanavir (Reyataz, in Evotaz), ritonavir (Norvir, in Kaletra, in Viekira Pak), fosamprenavir (Lexiva), indinavir (Crixivan), nelfinavir (Viracept), nevirapine (Viramune), darunavir (Prevista, in Symtuza, in Prezcobix), etravirine (Intelence), tipranavir (Aptivus), and lopinavir (in Kaletra); drugs for seizures such as rufinamide (Banzel), felbamate (Qudexy, Topamax, Trokendi, in Qysmia), lamotrigine (Lamictal), oxcarbazepine (Oxtellar XR, Trileptal), phenytoin (Dilantin, Phenytek), and carbamazepine (Carbatrol, Equetro, Tegretol, among others); oral steroid medications such dexamethasone (Hemady), methylprednisolone (Medrol), prednisone (Rayos), and prednisolone (Orapred ODT, Prelone); morphine (Kadian, MS Contin); rifampin (Rifadin, Rimactane, in Rifamate, in Rifater); rosuvastatin (Ezallor Sprinkle, Crestor); theophylline (Theo-24, Theochron), tizanidine (Zanaflex), telaprevir (no longer available in the United States), temazepam (Restoril), and thyroid drugs like levothyroxine (Levo-T, Levoxyl, Synthroid, Tirosint, others). Your doctor might need to adjust your medication doses or keep a close eye out for any negative side effects. Be important to let your doctor know about all of your current medications, even those not on this list, as many other drugs may also interact with oestrogen and progestin contraceptive patches.
• Inform your doctor about any herbal medications you are taking, particularly any that contain St. John’s wort.
• If you have just undergone surgery or are on bed rest, let your doctor know. Tell your doctor if you have or have ever had blood clots in your legs, lungs, or eyes, a heart attack, a stroke, or any combination of these. hepatitis (liver swelling), a liver tumour, thrombophilia (condition in which the blood clots easily), chest pain from heart disease, cancer of the breasts, uterine lining, cervix, or vagina, vaginal bleeding between menstrual periods, hepatitis (liver swelling), yellowing of the skin or eyes, especially while you were pregnant or using hormonal contraceptives, high blood pressure, diabetes that is uncontrolled, and headaches even a heart valve disease. Most likely, your doctor will advise against using the contraceptive patch.
• If you weigh 198 pounds or more, have recently given birth, had a miscarriage, or had an abortion, or swim frequently or for extended periods of time, let your doctor know (30 minutes or more). Additionally, let your doctor know if you have or have ever had breast lumps, fibrocystic disease of the breast (a condition in which breast lumps or masses that are not cancerous occur), an abnormal mammography, or if anybody in your family has ever had breast cancer (x-ray of the breasts). Inform your doctor if you or anyone in your family has ever experienced high blood cholesterol or fat levels, diabetes, asthma, migraines or other types of headaches, depression, seizures, scanty or irregular periods, angioedema (a condition that causes painful swelling of the hands, feet, ankles, or lower legs as well as difficulty breathing), liver, heart, gallbladder, or kidney disease.
• Inform your doctor if you are expecting, intend to get pregnant, or are nursing a baby. Call your doctor right away if you become pregnant while using oestrogen and progestin contraceptive patches. If you have used the contraceptive patch correctly and you have missed two periods in a row, or if you have not used the contraceptive patch correctly and you have missed one period, you should be suspicious that you are pregnant and contact your doctor.
• Inform the surgeon or dentist that you are wearing an oestrogen and progestin contraceptive patch if you are having surgery, including dental surgery. As soon as your surgery is set, discuss this with your doctor because they could advise you to cease wearing the contraceptive patch a few weeks prior to the procedure.
• If you wear contact lenses, let your doctor know. Consult an eye doctor if you have any changes in your eyesight or ability to wear contact lenses while using an oestrogen and progestin contraceptive patch.
• The average level of oestrogen in your blood will be higher while you use the contraceptive patch than it would be if you took an oral contraceptive (birth control pill), and this could increase the risk of significant side effects such blood clots in the legs or lungs. Discuss the dangers of using the contraceptive patch with your doctor.

If you plan to consume grapefruits or grapefruit juice while taking this medication, consult your doctor.

You may not be protected against pregnancy if you don’t put your patch on on Week 1 of any patch cycle (Day 1). As soon as you recall, apply the first patch of the next cycle. New Patch Change Day and Day 1 have been added. For one week, use a backup form of birth control.

Apply a fresh patch right away, then put on the subsequent patch on your customary Patch Change Day if you neglect to change your patch for one or two days during Week 2 or Week 3 of the patch cycle. You might not be protected against pregnancy if you go more than two days without changing your patch in the midst of your cycle. Applying a fresh patch will immediately halt the current cycle and begin a new one. New Patch Change Day and Day 1 have been added. For a week, use a backup form of birth control.

At the conclusion of the patch cycle (Week 4), if you forget to remove your patch, do it right away. The day following Day 28, on the customary Patch Change Day, begin the subsequent cycle.

The contraceptive patch that contains oestrogen and progestin may have negative effects. If any of these symptoms are severe or do not go away, let your doctor know right once:

• Discomfort, redness, or rash where you applied the patch
• Breast sensitivity, swelling, or discharge
• Nausea
• Vomiting
• Abdominal pain or bloating
• Gaining weight
• Alteration in appetite
• Acne
• Hair fall
• Between menstrual cycles, there may be bleeding or spotting.
• Modifications to menstrual flow
• Unpleasant or skipped periods
• Itching or discomfort in the vagina
• White vaginal spotting

Some negative effects may be quite detrimental. Immediately contact your physician if you experience any of the following signs:

• Abrupt fainting, vomiting, nausea, or a strong headache
• Abrupt speech issues
• An arm or leg that is weak or numb
• Abrupt visual loss, either partial or whole
• Eyesight alterations or double vision
• Enlarged eyes
• Intense chest ache
• Chest discomfort
• Spitting blood
• Breathing difficulty
• Discomfort in the lower leg’s back
• Bad stomach ache
• Depression symptoms include sleep issues, mood swings, and other issues.
• Symptoms of yellowing include light-colored bowel motions, loss of appetite, dark urine, excessive fatigue, and yellowing of the skin or eyes.
• Dark skin patches on the chin, upper lip, cheeks, and/or forehead
• Edoema of the lower legs, hands, feet, ankles, tongue, or throat

The chance of developing endometrial and breast cancer, gallbladder disease, liver tumours, heart attack, stroke, and blood clots may all rise as a result of using an oestrogen and progestin contraceptive patch. Discuss the dangers of using this drug with your doctor.

Other adverse effects from the ethinyl estradiol and norelgestromin patch are possible. If you experience any strange issues while taking this drug, call your doctor right away.

You or your doctor can submit a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting programme online or by phone if you have a serious side event (1-800-332-1088).

Keep this medication tightly closed in the original container and out of the reach of children. Store it away from excessive heat and moisture at room temperature (not in the bathroom).

Unused prescriptions must be disposed of carefully to prevent pets, kids, and other people from ingesting them. You should not, however, dispose of this medication in the toilet. Instead, utilising a medicine take-back programme is the easiest approach to get rid of your medication. To find out about take-back programmes in your area, speak with your pharmacist or the garbage/recycling department in your city. If you do not have access to a take-back programme, see the FDA’s Safe Disposal of Medicines website at http://goo.gl/c4Rm4p for additional information.

All medications should be kept out of the sight and reach of children, as many containers (such as weekly pill containers and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for toddlers to open. Always lock safety caps and put the medication in a secure spot right away that is up and away from where young children can access it and cannot access it, in order to prevent poisoning in young children. http://www.upandaway.org

Remove all of the applied patches in the event of an overdose, then dial 1-800-222-1222 to reach your local poison control centre. Dial 911 to reach the nearest emergency services if the sufferer has collapsed or has stopped breathing.

Keep all of your appointments with your physician and the lab. Every year, you should undergo a thorough physical exam that includes taking your blood pressure and checking your breasts and pelvis. When checking your breasts, according to your doctor’s instructions and report any lumps right away.

Inform the lab staff that you use an oestrogen and progestin contraceptive patch prior to any laboratory tests since this medicine may affect the results of some tests.

Do not share your medication with anybody else. Any queries you may have regarding medication refills should be directed to your pharmacist.

You should keep a written record of every medication you take, including any over-the-counter (OTC) items, prescription drugs, and dietary supplements like vitamins and minerals. This list should be brought with you whenever you see a doctor or are admitted to the hospital. You should always have this information with you in case of emergencies.