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revised Friday October 12 2007

Transdermal Patch

What is it?

Evra is a beige, polyester patch, about 4 cm square which contains the hormones estrogen and progesterone. The hormones are slowly absorbed through the skin, into the bloodstream. The patch is latex free and is worn on the skin of the buttock, abdomen, upper body (not on the breasts) or the outside of the upper arm.

The patch is only available by a prescription from a doctor.

How does the patch work?

The patch works the same as birth control pills. It stops an egg from being released each month (ovulation) and changes the cervical mucous making it harder for sperm to enter the uterus.

The patch is 99% effective in preventing pregnancy when used correctly. This is the same as the pill. The patch may be less effective for women who weigh over 90kg (198 lbs).

How do you use the patch?

To start the patch for the first time, apply it on the first day of your period. One patch is put on the skin for one week and then replaced with a new patch on the same day of the week for 3 weeks in a row. For example, if you started your first patch on Monday, then you will change your patch every Monday for 3 weeks. On week 4 no patch is used and your period should start during this "patch-free" week.

Remember then to apply the first patch from a new package at the beginning of your next 4 week cycle on your normal patch change day, no matter when your period begins or ends.

If you want to start your patch on a Sunday, but this was not the first day of your period, you must use a back up method such as condoms for the next 7 days.

  • Put the patch on a different place (buttock, abdomen, upper body, upper arm) each week.
  • You can wear it on the same location but not in the exact same spot.
  • Do not put it on a cut, red or irritated skin.
  • Do not put it on areas of skin where oil, creams, lotions or powders are or will be applied.
  • Press the patch firmly with the palm of the hand to be sure edges are sticking well.
  • The patch will stay attached and be effective while bathing, swimming, and exercising or when it is very humid.

Read and follow the instructions that come with the patch package.

If you have made any mistakes using the patch, you may be able to take the emergency contraceptive pill (morning after pill) to help prevent pregnancy.

Are there side effects?

Some women may experience:

  • nausea
  • headache
  • breast tenderness
  • break-through bleeding
  • skin irritation.

If you use the patch, it is advised that you do not smoke. Women who use the patch and smoke have a slightly higher chance of developing a blood clot; however, it is extremely rare.

Signs of a blood clot include:

  • severe leg pain in calf or thigh
  • severe chest pain, cough, shortness of breath
  • severe headache, dizziness, weakness and numbness
  • eye problems such as vision loss or blurring
  • speech changes such as slurring
  • severe abdominal pain

If you have any of these signs, go to a hospital right away.

Things to remember:

  • Keep a supply of extra patches in case you need to replace one if it falls off or becomes loose. (remember to take extra ones on your vacation)
  • Store patches at room temperature.
  • Do not write on the patch or change it in any way.
  • Do not move the patch once it is applied.
  • It may be easier to remove the patch while bathing.
  • If switching from Depo to Evra, start the patch on the day the next injection is due.
  • If changing from birth control pills to Evra, start the patch the first day of your bleeding, not on pill start day.

Forgot to apply or change your patch?

During Week 1

  • Apply patch as soon as you remember.
  • This is now your new patch change day.
  • Use back-up method for 7 days.

During Week 2 or 3

If less than 2 days (48 hours) from usual change day:

  • remove your "old" patch
  • apply a new patch immediately
  • apply your next patch on your usual day
  • no back-up needed.

If more than 2 days (48 hours) from usual change day:

  • remove your "old" patch
  • apply a new patch immediately
  • this is now your new patch change day and you now start a new 4 week cycle
  • you may or may not have a period this cycle.
  • use back-up for 7 days
  • apply next patch in 7 days

During Week 4 (patch-free week)

  • Remove patch when you remember
  • Your period may start late
  • Apply new patch on usual patch change day
  • No back-up method needed
  • You should never have patch off for more than 7 days.

When else should I use back up?

You should also use a back up method such as condoms for 7 days if:

  1. you start the patch on a Sunday and this is not the first day of your period.
  2. you start the patch more than 24 hours after your period starts.
  3. you are changing from the pill to the patch and it is not the first day of your period.
  4. switching from Depo injection to the patch and you are more than the 13th week from your last injection.
  5. you are taking certain other drugs as they can make the patch not work as well. Check with your health care provider.

What if the patch becomes loose, partially lifts off or falls off?

If it is loose or off for less than 1 day (24 hours):

  • try to restick the patch or put new patch on immediately
  • no back-up needed
  • your patch change day stays the same.

If it is loose or off for more than 1 day (24 hours):

  • put a new patch on immediately - this starts a new 4 week cycle
  • you now have a new "patch change day"
  • use back-up method for next 7 days.

Remember: Use condoms every time to help prevent the spread of sexually transmitted infections (STI), HIV and Hepatitis B.

For more information, call 905-799-7700 and ask for Sexual Health Information.

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Revised: Friday October 12 2007

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