Ethinyl Estradiol and Norelgestromin



Ortho Evra™







Ethinyl Estradiol and Norelgestromin

(ETH in il es tra DYE ole & nor el JES troe min)

U.S. Brand Names
Ortho Evra™
Canadian Brand Names
Evra™
Pharmacologic Category
Contraceptive; Estrogen and Progestin Combination
What key warnings should I know about before taking this medicine?
  • If you are taking this medicine for birth control, do not smoke. Cigarette smoking increases the risk of serious heart and blood-related side effects. This risk increases with age (older than 35 years of age) and with heavy smoking (15 or more cigarettes per day). This medicine does not prevent the spread of sexually-transmitted diseases.
Reasons not to take this medicine
  • If you have an allergy to ethinyl estradiol, norelgestromin, or any other part of this medicine.
  • Tell healthcare provider if you are allergic to any medicine. Make sure to tell about the allergy and how it affected you. This includes telling about rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other symptoms involved.
  • If you have any of the following conditions: Blood clots, breast cancer, diseased arteries in the brain, disease of a heart valve with complications, endometrial cancer, heart disease, high blood pressure, liver disease, liver tumor, severe headache, tumor where estrogen makes it grow, or unexplained vaginal bleeding.
  • If you have major surgery and need bedrest.
  • If you are a heavy smoker (more than 15 cigarettes per day) and older than 35 years of age.
  • If you have not started menstruating.
  • If you turned yellow during pregnancy or with estrogen-based or hormone contraceptive use.
  • If you are pregnant or may be pregnant.
What is this medicine used for?
  • This medicine is used to prevent pregnancy.
How does it work?
  • The ethinyl estradiol and norelgestromin combination prevents pregnancy by preventing ovulation (egg release) through a variety of hormonal changes. Changes in cervical mucus and endometrium making it difficult for sperm to penetrate and form a fertilized egg that can attach to the uterine lining.
How is it best taken?
  • Follow directions given by healthcare provider or read the package insert.
  • Apply patch once a week for 3 weeks. Apply on the same day each week. Do not apply patch on fourth week.
  • Apply patch to clean, dry, healthy skin on the buttock, belly, upper arm, chest, or back.
  • Do not apply to breast.
  • Do not use adhesives or wraps to hold the patch in place.
  • Do not apply more than one patch at a time.
What do I do if I miss a dose? (does not apply to patients in the hospital)
  • Use a missed dose as soon as possible.
  • Missed dosing information can be found in the package insert or call healthcare provider for instructions.
  • Reapply the patch in the same place if it falls off and has been off for less than 24 hours.
  • Apply a new patch if patch being used is no longer sticky or if it is sticking to itself or another surface.
What are the precautions when taking this medicine?
  • If you weigh 198 pounds or more, this medicine may not work as well to prevent pregnancy. Talk with healthcare provider.
  • May contain conducting metal. Remove patch before MRI.
  • You will get more estrogen if you use this medicine than if you use a typical birth control pill. It is not known if this will cause more side effects. Talk with healthcare provider.
  • If you are taking a blood thinner, you will require more frequent monitoring.
  • If you have any circulation problems, talk with healthcare provider.
  • If you have gallbladder disease, talk with healthcare provider.
  • If you have heart disease, talk with healthcare provider.
  • If you have kidney disease, talk with healthcare provider.
  • If you have liver disease, talk with healthcare provider.
  • If you have migraines, talk with healthcare provider.
  • Check medicines with healthcare provider. This medicine may not mix well with other medicines.
  • Avoid grapefruit and grapefruit juice.
  • Do not take St John's wort, dong quai, black cohosh, saw palmetto, red clover, or ginseng with this medicine.
  • If you are taking this medicine and have high blood pressure, talk with healthcare provider before using over-the-counter products that may increase blood pressure. These include cough or cold remedies, diet pills, stimulants, ibuprofen or like products, and certain natural products or supplements.
  • Avoid cigarette smoking. Persons older than 35 years of age and/or smoking more than 15 cigarettes per day are at an increased risk for heart disease.
  • Limit alcohol intake (includes wine, beer, and liquor).
  • To protect against sexually-transmitted diseases, use a latex condom.
  • Tell healthcare provider if you are breast-feeding.
What are some possible side effects of this medicine?
  • Weight gain.
  • Headache.
  • Belly pain.
  • Nausea or vomiting. Small frequent meals, frequent mouth care, sucking hard, sugar-free candy, or chewing sugar-free gum may help.
  • Breast enlargement.
  • For females, vaginal yeast infection. Report itching or discharge.
  • For females, menstrual changes. These include lots of bleeding, spotting, or bleeding between cycles.
  • Gallbladder disease, blood clots, heart attacks, and other vascular problems can rarely occur.
What should I monitor?
  • Change in condition being treated. Is it better, worse, or about the same?
  • Check blood pressure and heart rate regularly.
  • If you are diabetic, you will need to monitor blood sugars closely.
  • Check blood work (cholesterol panel). Talk with healthcare provider.
  • Have a yearly eye exam.
  • Periodic breast (monthly self-exam) and yearly gynecologic exams are important.
  • If you miss two menstrual periods in a row, take a pregnancy test before starting a new dosing cycle.
  • If patch has not been applied correctly, and one menstrual period is missed, take a pregnancy test.
  • Take good care of your teeth. See a dentist regularly.
  • Follow up with healthcare provider yearly.
Reasons to call healthcare provider immediately
  • If you suspect an overdose, call your local poison control center immediately or dial 911.
  • Signs of a life-threatening reaction. These include wheezing; chest tightness; fever; itching; bad cough; blue skin color; fits; or swelling of face, lips, tongue, or throat.
  • Chest pain or pressure.
  • Difficulty breathing.
  • Change in strength on one side greater than the other, difficulty speaking or thinking, change in balance, or blurred vision.
  • Swelling or pain of leg or arm.
  • Severe headache.
  • Severe nausea or vomiting.
  • Severe skin irritation.
  • Not hungry.
  • Dark urine or yellow skin or eyes.
  • Change in contact lens tolerance.
  • A lump in the breast or breast tenderness.
  • For females, if you become pregnant while taking this medicine.
  • Any rash.
  • No improvement in condition or feeling worse.
How should I store this medicine?
  • Store at room temperature.
General statements
  • If you have a life-threatening allergy, wear allergy identification at all times.
  • Do not share your medicine with others and do not take anyone else's medicine.
  • Keep all medicine out of the reach of children and pets.
  • Keep a list of all your medicines (prescription, natural products, supplements, vitamins, over-the-counter) with you. Give this list to healthcare provider (doctor, nurse, nurse practitioner, pharmacist, physician assistant).
  • Talk with healthcare provider before starting any new medicine, including over-the-counter, natural products, or vitamins.
  • Read the package insert for more details.
Brand Names: