WARNING

Twirla is a contraceptive patch used to prevent pregnancy. Like all medications, it carries certain risks and side effects. Some of the risks associated with Twirla include:

• Blood Clots: Twirla increases the risk of blood clots, especially in women who smoke and are over the age of 35. Blood clots can lead to serious conditions such as deep vein thrombosis (DVT) or pulmonary embolism (PE).
• Cardiovascular Risks: Women with certain medical conditions such as hypertension, diabetes, or a history of cardiovascular problems may have an increased risk of heart attack or stroke while using Twirla.
• Liver Problems: Twirla can cause liver problems in some women, particularly those with a history of liver disease.
• Increased Risk of Cancer: Some studies suggest that the use of hormonal contraceptives like Twirla may slightly increase the risk of breast and cervical cancer, although the overall risk remains relatively low.
• Skin Irritation: The patch itself can cause skin irritation or allergic reactions in some users.
• Other Side Effects: Common side effects of Twirla may include headache, nausea, breast tenderness, and mood changes.

It’s essential for women considering the use of Twirla to discuss their medical history and any concerns with their healthcare provider to assess individual risks and benefits. Additionally, it’s crucial to follow the usage instructions carefully to minimize risks and ensure effectiveness.

Why is this medication prescribed?

Twirla is prescribed as a contraceptive method to prevent pregnancy. It is a combination hormonal patch containing two hormones: ethinyl estradiol (an estrogen) and levonorgestrel (a progestin). These hormones work together to prevent ovulation, thicken cervical mucus to make it difficult for sperm to reach an egg, and thin the uterine lining to prevent implantation of a fertilized egg.

How should this medicine be used?

Twirla should be used according to the instructions provided by a healthcare provider. Here’s a general guide on how to use Twirla:

• Placement: Apply the patch to clean, dry, healthy skin on the buttock, abdomen, upper outer arm, or upper torso (excluding the breasts). Avoid areas with cuts, irritation, or rashes. Do not apply the patch to areas where tight clothing may rub against it.
• Start Date: Start using Twirla on the first day of your menstrual cycle (day 1 of your period). If you start on any other day, use backup contraception (such as condoms) for the first week.
• Replacement: Change the patch once a week on the same day each week for three weeks. After wearing the patch for three weeks, have a patch-free week (week 4). During the patch-free week, you will likely experience withdrawal bleeding, similar to a menstrual period.
• Cycle Repeat: After the patch-free week, start a new three-week cycle by applying a new patch on the same day of the week you started previously, even if you are still bleeding.
• Continuous Use: Some healthcare providers may recommend continuous use of Twirla without a patch-free week to suppress menstruation. Follow your healthcare provider’s instructions if this is the case.
• Additional Instructions: Read the patient information leaflet provided with Twirla for detailed instructions on how to apply and remove the patch, what to do if the patch falls off, and what to do if you miss a dose.

It’s essential to use Twirla exactly as prescribed to maximize its effectiveness in preventing pregnancy. If you have any questions or concerns about using Twirla, consult your healthcare provider for guidance.

Other uses for this medicine

Some potential off-label uses for Twirla include:

• Regulation of Menstrual Cycles: Twirla may be used to regulate irregular menstrual cycles or to reduce menstrual cramps.
• Treatment of Acne: Twirla, like other hormonal contraceptives, may help improve acne in some individuals by regulating hormone levels.
• Management of Polycystic Ovary Syndrome (PCOS): Twirla may be used as part of the treatment plan for PCOS to regulate menstrual cycles and hormone levels.
• Hormone Replacement Therapy (HRT): In some cases, Twirla may be prescribed as part of hormone replacement therapy for women experiencing symptoms of menopause.

What special precautions should I follow?

Special precautions to follow when using Twirla include:

• Medical History: Inform your healthcare provider about your complete medical history, including any past or present medical conditions, allergies, surgeries, and medications you are taking.
• Smoking: Do not use Twirla if you are over the age of 35 and smoke. Smoking while using hormonal contraceptives increases the risk of serious cardiovascular side effects, such as blood clots, heart attack, and stroke.
• Blood Clot Risk: Twirla increases the risk of blood clots, particularly in women with other risk factors such as obesity, hypertension, or a history of blood clots. Discuss your individual risk factors with your healthcare provider.
• Monitoring: Your healthcare provider may recommend regular check-ups and monitoring while using Twirla to assess its effectiveness and monitor for any potential side effects or complications.
• Interactions: Inform your healthcare provider about all medications, supplements, and herbal products you are taking, as they may interact with Twirla and affect its effectiveness or increase the risk of side effects.
• Emergency Contraception: Twirla is not intended for use as emergency contraception. If you have unprotected sex or a contraceptive failure, talk to your healthcare provider about emergency contraception options.

Always follow your healthcare provider’s instructions and recommendations for using Twirla to ensure safe and effective use. If you have any questions or concerns, consult your healthcare provider for guidance.

What special dietary instructions should I follow?

Special dietary instructions for Twirla typically involve taking it with or without food, depending on individual preferences and tolerances. There are no specific dietary restrictions associated with Twirla. However, maintaining a healthy and balanced diet is important for overall health and well-being.

What should I do if I forget a dose?

If you forget to apply a patch of Twirla:

• Within 48 Hours: If you realize you missed a dose within 48 hours of the scheduled time, apply the patch as soon as you remember. Continue with your regular schedule, even if it means applying two patches at the same time. Use backup contraception (such as condoms) for the next week to ensure protection against pregnancy.
• More than 48 Hours: If you realize you missed a dose more than 48 hours after the scheduled time, remove the old patch and apply a new one immediately. This counts as the new start of your cycle. Use backup contraception for the next week and consult your healthcare provider for further guidance.

What side effects can this medication cause?

Twirla, like any medication, can cause side effects in some individuals. Common side effects associated with Twirla may include:

• Headache: Mild to moderate headaches are a common side effect of hormonal contraceptives like Twirla.
• Nausea: Some users may experience nausea or vomiting, especially during the first few months of using Twirla.
• Breast Tenderness: Hormonal changes from Twirla may cause breast tenderness or discomfort.
• Irregular Bleeding: Some individuals may experience breakthrough bleeding or spotting between periods, especially during the first few months of use.
• Skin Irritation: The adhesive on the patch may cause skin irritation or redness at the application site in some users.
• Mood Changes: Hormonal contraceptives can affect mood in some individuals, leading to mood swings, irritability, or changes in libido.
• Weight Changes: Some users may experience slight weight gain or loss while using Twirla.
• Changes in Menstrual Patterns: Twirla may cause changes in menstrual patterns, including lighter or heavier periods, or the absence of menstruation altogether.
• Vaginal Discharge: Some individuals may experience changes in vaginal discharge while using Twirla.
• Other Possible Side Effects: Less common side effects of Twirla may include dizziness, abdominal pain, bloating, fatigue, and changes in appetite.

It’s important to note that not all users will experience side effects, and some individuals may experience different side effects than those listed above. Additionally, serious side effects such as blood clots, stroke, heart attack, or liver problems are rare but possible with hormonal contraceptives like Twirla. If you experience any severe or concerning side effects while using Twirla, contact your healthcare provider for further evaluation and guidance.

What should I know about storage and disposal of this medication?

Storage and disposal of Twirla:

Storage:

• Store Twirla patches at room temperature, away from moisture and heat.
• Keep the patches in their original packaging until ready to use.
• Do not store Twirla patches in the bathroom or kitchen, where humidity and temperature fluctuations can affect their effectiveness.
• Keep Twirla patches out of reach of children and pets.

Disposal:

• Dispose of used or expired Twirla patches properly by folding them in half with the sticky sides together.
• Place the folded patch in a sturdy container, such as the original pouch or a sealable plastic bag.
• Dispose of the container in the trash, out of reach of children and pets.
• Do not flush Twirla patches down the toilet or throw them in the household trash without proper containment.

In case of emergency/overdose

In case of emergency or overdose of Twirla:

• If you suspect an overdose or experience severe symptoms such as chest pain, sudden shortness of breath, severe headache, blurred vision, weakness or numbness in an arm or leg, or difficulty speaking, seek immediate medical attention.
• If possible, provide the healthcare provider with information about the amount of Twirla used and when it was last applied.

What other information should I know?

• Follow the prescribed dosing schedule for Twirla carefully to maximize its effectiveness in preventing pregnancy.
• Attend regular check-ups with your healthcare provider while using Twirla to monitor for any potential side effects or complications.
• Inform your healthcare provider about all medications, supplements, and herbal products you are taking, as they may interact with Twirla.
• Do not use Twirla if you are pregnant or breastfeeding, as it is intended for use in non-pregnant women of reproductive age.
• Contact your healthcare provider if you have any questions or concerns about using Twirla or if you experience any side effects or adverse reactions.
• Read the patient information leaflet provided with Twirla for detailed instructions on proper use, storage, disposal, and what to do in case of missed doses or other emergencies.