Indications 

Ortho Evra 21-Day is a contraceptive patch used for unexpected birth control. It is applied to the skin and releases hormones (ethinyl estradiol and norelgestromin) that prevent pregnancy. It should be applied to clean, dry skin and should be changed weekly on the same day of the week. 

Ortho Evra is a transdermal contraceptive patch that delivers a combination of hormones (norelgestromin and ethinyl estradiol) through the skin. It works by preventing the release of an egg from the ovary (ovulation) and by thickening the cervical mucus, making it difficult for sperm to reach the egg. 

Use and Dosage 

The Ortho Evra patch should be started on the first day of your menstrual period (Day 1 start) or on the first Sunday after your period starts (Sunday start). Your healthcare provider will help you determine which start method is appropriate for you.  

Apply the patch to clean, dry, healthy skin on your upper outer arm, abdomen, buttock, or back. Avoid areas where the patch may be rubbed off or irritated by tight clothing or excessive movement. Press the patch firmly onto your skin and hold it for about 10 seconds to ensure proper adhesion. The patch should stay in place during activities such as showering, bathing, swimming, and exercising.  

The patch is worn for 21 consecutive days, followed by a 7-day patch-free interval. During the 21 days that the patch is worn, it provides continuous contraception by releasing hormones into the bloodstream. After wearing three patches for 21 days, remove them and have a patch-free week. This is the fourth week of your cycle. During this week, you will likely experience withdrawal bleeding, similar to a period. After the patch-free week, apply a new patch to start the next cycle. Continue this pattern of wearing the patch for three weeks followed by a patch-free week. The patch is an effective method of birth control when used correctly. 

Side Effects 

Common Side Effects  

• Anxiety 
• Breast tenderness or swelling 
• Headache 
• Irregular vaginal bleeding or spotting 
• Itching 
• Menstrual cramps 
• Mood changes 
• Nausea 
• Redness 
• Skin irritation 
• Stomach pain 

• Swelling where the patch was worn 

Serious Side Effects 

• A breast lump 
• A change in the pattern or severity of migraine headaches 
• Chest pain or pressure 
• Clay-colored stools 
• Coughing up blood 
• Dark urine 
• Feeling, mood changes 
• Itching 
• Jaundice (yellowing of the skin or eyes) 
• Loss of appetite 
• Nausea 
• Pain spreading to your jaw or shoulder 
• Problems with balance 
• Rapid breathing 
• Redness in one or both legs 
• Sleep problems 
• Slurred speech 
• Sudden cough 
• Sudden numbness or weakness (especially on one side of the body) 
• Sudden severe headache 
• Sudden vision loss 
• Sweating 
• Swelling in your hands, ankles, or feet 
• Tired feeling 
• Upper stomach pain 
• Warmth 
• Weakness 
• Wheezing 

Cautions 

• Use with caution in certain medical conditions: Ortho Evra should be used with caution in women with certain medical conditions, such as a history of blood clots, heart problems, high blood pressure, liver disease, or certain types of cancer. 
• Increased risk of blood clots: Hormonal contraceptives, including Ortho Evra, have been associated with an increased risk of blood clots. Women with a history of blood clots or a family history of blood clotting disorders may have an increased risk. 
• Increased risk of serious cardiovascular events: Ortho Evra has been associated with an increased risk of serious cardiovascular events such as blood clots, heart attack, and stroke. Women who have a history of cardiovascular disease or risk factors for cardiovascular disease should use Ortho Evra with caution. 
• Increased risk of venous thromboembolism (VTE): Like other hormonal contraceptives, Ortho Evra may increase the risk of venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE). Women with a history of VTE or a family history of VTE should use Ortho Evra with caution. 
• Cigarette smoking: Smoking cigarettes while using Ortho Evra increases the risk of serious cardiovascular events. Women who smoke and are over 35 years old should be advised to use alternative non-hormonal methods of contraception. 
• Increased risk of liver disease: Ortho Evra may increase the risk of liver disease. Women with a history of liver disease or liver tumors should use Ortho Evra with caution and under close medical supervision. 
• Ectopic pregnancy: While rare, ectopic pregnancies can occur with contraceptive failure, including with Ortho Evra. Women who experience lower abdominal pain and suspect they may be pregnant while using Ortho Evra should seek medical evaluation for possible ectopic pregnancy. 
• Skin reactions: Some individuals may experience skin reactions, including irritation, rash, or redness, at the application site of the Ortho Evra patch. If a severe skin reaction occurs, the patch should be removed, and medical advice sought.