Evra Transdermal Patch

Prescription required

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What is this medication used for​​​?

EVRA® Transdermal Patch is a small sticky patch that contains two types of female hormones, a progestogen called Norelgestromin and an estrogen called Ethinylestradiol. The patch works by releasing hormones into your body through your skin to prevent pregnancy.

Dosage and How to Use​

  • Do not stop taking your medication without checking with your healthcare professional.
  • If you are switching from other forms of contraception, please seek advice from your healthcare professional.
  • Each pack contains 3 patches.
  • Each patch lasts for 1 week. Change the patch every week for 3 weeks, then have a week off without a patch.
  • The next pack is to be started after the 7-day patch free period has elapsed, even if your menses is still ongoing. Withdrawal bleeding (menses) should begin during the 7-day patch free period and may not have finished before the next pack is started.

Steps

Where to put the patch

  • ​Always put your patch on clean, dry and hairless skin.
  • Put it on the buttock, abdomen, upper outer arm or upper back.
  • Put it on places where it won’t be rubbed by tight clothing.
  • Do not put on the breast or waistline, and on any open wounds, cuts or irritated skin.
  • Do not use adhesive or wraps to hold the patch in place.
  • Do not use creams, oils, lotions, powder or other skin care products on the application site. The patch may not stick well.
  • To reduce skin irritation, change the site of application for each new patch.

How to open the patch

  • Do not use scissors. Use your fingers, open the foil sachet by tearing it along the edge.
  • There is a clear protective covering on the patch.
  • Peel away half of the clear protective covering (refer to picture). Try not to touch the sticky surface.
    (Some patches might stick to the inside of the sachet. Be careful not to remove the clear coverings as you remove the patch.)

How to put the patch

  • Then, put the patch on your skin.
  • Take off the other half of the covering.
  • Press down firmly on the patch with the palm of your hand for 10seconds.
  • Make sure the edges stick well.
How to use the EVRA® patch

When will the contraceptive effect kick in?

If you start using the patch on the first 1-5 days of your period, you'll be protected from pregnancy straight away.

If you start using it on any other day, you need to use an additional form of contraception, such as condoms, for the first 7 days.

What to do if I missed a dose?

If you forget to change your patch for 1-2 days (up to 48 hours)

  • Put on a new patch as soon as you remember.
  • Put on your next patch on your usual “Patch Change Day”.
  • A barrier method of contraception is not needed.

If you forget to change your patch for more than 2 days (48 hours or more)

  • Start a new four-week cycle as soon as possible.
  • You must use a barrier method for the first week of your new cycle.

If you forget to take off your patch (at Week 4)

  • Take it off as soon as you remember.
  • Start your next cycle on your normal “Patch Change Day”, the day after Day 28.
  • A barrier method of contraception is not needed.

If you forget to take off your patch (after Week 4):

  • Take it off as soon as you remember.
  • Put on the first patch of your new cycle as soon as you remember.
  • You must use a barrier method for the first week of your new cycle.
  • You now have a new “Patch Change Day” and new Day 1.
What to do if you forgot to change or put on my patch?

What to do if the patch becomes loose, lifts at the edges or falls off?

For less than one day (up to 24 hours)

  • Try to put it on again or put on a new patch immediately.
  • A barrier method of contraception is not needed.
  • Your “Patch Change Day” remains the same.
  • Do not use tapes or wrapping to keep the patch in place.

Put on a new patch immediately, if:

  • it is no longer sticky
  • it has become stuck to itself or another surface
  • it has other material stuck to it
  • it is the second time it has become looser or has fallen off

For more than one day (24 hours or more) or if you are unsure of the duration:

  • Start a new cycle immediately by putting on a new patch.
  • Use a barrier method for the first week of your new cycle.
What to do if the patch becomes loose, lifts at the edges or falls off?

What are the possible side effects of the medicines?​

  • Spotting or bleeding may occur between your periods during the first few months of taking oral contraceptives. However, if this continues after the third month, check with your doctor. 
  • Nausea, vomiting, bloating and stomach cramps
  • Breast tenderness
  • Headache or migraine - You may take painkillers such as Paracetamol to manage headaches 
  • Unable to tolerate contact lenses
  • Weight changes, mood swings
  • Skin itching and skin irritation

Inform your doctor if the side effects above become severe and bother you.

What are some rare but serious side-effects that I need to seek medical advice immediately?

The symptoms of a drug allergy include one or more of the following: 

  • Swollen face/eyes/lips/tongue
  • Difficulty in breathing
  • Itchy skin rashes over your whole body

Using a combined hormonal medication increases a woman’s risk of developing blood clots compared to a woman not taking any combined hormonal contraception. The risk of developing a blood clot in a vein is highest during the first year a woman uses the medication. Other risk factors for developing blood clots include smoking and obesity. However, the formation of a blood clot is rare and the doctor would have considered the risks against the benefits before making the recommendation. 

The symptoms of a blood clot include one or more of the following:

  • Any unusual sudden cough, breathlessness or difficulty in breathing 
  • Severe pain in the chest which may reach the left arm
  • Severe pain in legs or swelling in either of your legs
  • Weakness or numbness in any part of your body
  • Change in your speech, including slurring of words
  • Change in your senses of hearing, smell or taste
  • Vision changes such as loss of vision/blurred vision 

Other rare but serious effects that you may or may not experience: 

  • Unusual, severe or long-lasting headache or worsening of migraine 
  • Dizziness or fainting
  • Severe pain in your abdomen
  • Dark urine or light coloured stools
  • Nausea and vomiting
  • Loss of appetite
  • Yellowing of eyes or skin

If you experience any of these symptoms, you should stop your medication and see your healthcare professional immediately.

What precautions should I take?

Inform your healthcare professional if: 

  • You are allergic to this medication or any of the other ingredients of this medication
  • You are pregnant, planning to become pregnant, or breastfeeding 
  • You are taking any other medications, including supplements, traditional medications and herbal remedies
  • You have a history of or current medical conditions such as liver problems, stroke, clotting disorders, heart diseases, migraine headaches, epilepsy (fits), diabetes or cancer 
  • You are a smoker 

Handling and storage

  • ​Keep your medicines in the original container or packaging, tightly closed or sealed in a cool and dry place, away from direct sunlight.
  • Keep the medicine out of reach of children.
  • Throw away all expired medicines.

The above information answers some common questions about this medicine. It does not contain all the available information. It also does not take the place of talking to your doctor or pharmacist.

References

https://www.singhealth.com.sg/patient-care/medicine/evra-transdermal-patch