Evra Contraceptive Patches

EVRA Contraceptive Patches

What is the EVRA contraceptive patch used for?

EVRA is a combined hormonal contraceptive patch used to prevent pregnancy. It’s a sticky patch worn on the skin that contains an oestrogen and progestogen, norelgestromin and ethinyl estradiol. EVRA is a reliable contraceptive method for adult women who want an alternative to a daily oral contraceptive pill.

How does the EVRA contraceptive patch work?

EVRA is a hormone-releasing patch that delivers two hormones through the skin directly into the bloodstream.

The patch contains the same hormones as the combined pill, an oestrogen and a progestogen, and works in the same way, with the difference that the hormones are absorbed through the skin as a transdermal contraceptive rather than taken by mouth.

It delivers norelgestromin and ethinyl estradiol, releasing an average of 203 micrograms of norelgestromin and 33.9 micrograms of ethinyl estradiol every 24 hours.

Who can use the EVRA contraceptive patch?

EVRA is suitable for adult women who want a weekly contraceptive option. It isn’t suitable for anyone under 18 and must not be used before the first menstrual period.

Don’t use EVRA if you:

• Have or have ever had a blood clot in a vein or artery, such as deep vein thrombosis (DVT), pulmonary embolism, heart attack or stroke
• Have a blood clotting disorder such as protein C deficiency, protein S deficiency or antithrombin-III deficiency
• Have or have ever had migraine with aura
• Have or have ever had breast cancer or cancer of the womb, cervix or vagina
• Have ever had liver tumours or liver disease that has affected liver function
• Have unexplained vaginal bleeding
• Are allergic to norelgestromin, ethinyl estradiol or any other ingredients
• Are pregnant or breastfeeding
• Are taking certain hepatitis C medicines (ombitasvir/paritaprevir/ritonavir, dasabuvir, glecaprevir/pibrentasvir or sofosbuvir/velpatasvir/voxilaprevir)

Speak to your doctor before using EVRA if you:

• Smoke and are over 35 years old
• Are very overweight (BMI over 30)
• Have high blood pressure, diabetes, migraines, gallbladder disease or depression
• Have Crohn’s disease or ulcerative colitis
• Have sickle cell anaemia or elevated levels of fat in the blood
• Have recently given birth or are planning surgery
• Weigh 90kg or more

How To Use the EVRA Contraceptive Patch

Apply the first patch during the first 24 hours of your period to be protected from pregnancy immediately. Apply the patch on the first day of your period if possible. If you start on any other day, use non-hormonal contraception as back-up for the first 7 days.

You wear each patch for 7 days before changing it, using one patch at a time for 3 consecutive weeks, then taking a 7-day patch-free break. During this week you’ll be without the patch and your period will usually occur. Women who use EVRA contraceptive patches should check that the patch is still in place each day and change the patch on the same day each week. Using the contraceptive patch on a consistent schedule is the best way to stay protected.

Put the patch on clean, dry, hairless skin on the buttock, abdomen, upper outer arm or upper back. Never put the patch on sore or irritated skin, or on or near your breasts. Don’t use creams, oils, lotions, powder or makeup on the area where the patch is applied, as this can cause it to come loose. Don’t put a new patch on exactly the same area of skin as the previous one, as this can cause irritation.

To apply the EVRA patch:

1. Open the foil sachet by tearing along the edge.
2. Peel away half of the clear protective covering, avoiding contact with the sticky surface.
3. Apply the exposed side to your skin, then remove the remaining covering.
4. Press down firmly with your palm for 10 seconds, making sure the edges stick well.

If your patch falls off for less than 24 hours, try to reapply it or put on a new one and continue to use the patch as normal. No back-up contraception is needed and your patch change day stays the same. If it’s been off for 24 hours or more, start a new four-week cycle immediately and use non-hormonal contraception as back-up for the first 7 days.

Side Effects of the EVRA Contraceptive Patch

Like all medicines, the patch may cause side effects, though not everyone gets them. The most common EVRA patch side effects are listed below.

Very Common Side Effects

These may affect more than 1 in 10 women:

• Headache
• Nausea
• Breast tenderness

Common Side Effects

These may affect up to 1 in 10 women:

• Vaginal yeast infection (thrush)
• Mood changes, depression or anxiety
• Dizziness or migraine
• Stomach pain or bloating
• Vomiting or diarrhoea
• Acne, skin rash or itching
• Muscle spasms
• Breast pain, enlargement or lumps
• Changes in menstrual bleeding, vaginal discharge or uterine cramps
• Skin reactions at the patch site such as redness, irritation or itching
• Tiredness or feeling generally unwell
• Weight gain

Uncommon Side Effects

These may affect up to 1 in 100 women:

• Allergic reaction or hives
• Fluid retention or swelling
• High levels of fats in the blood
• Difficulty sleeping
• Reduced interest in sex
• Eczema or skin redness
• Abnormal breast milk production
• Vaginal dryness
• High blood pressure
• Hair loss
• Sensitivity to sunlight

Serious Side Effects

Stop using EVRA and seek immediate medical help if you experience:

• Signs of a blood clot, such as painful swelling in the leg, sudden chest pain, difficulty breathing, or sudden weakness or numbness
• Signs of a stroke, such as sudden confusion, trouble speaking or severe headache
• Yellowing of the skin or eyes (jaundice)
• Severe allergic reaction causing swelling of the face, lips, mouth, tongue or throat

You can also report side effects via the MHRA Yellow Card scheme.

EVRA Contraceptive Patch Ingredients

Active ingredients: Norelgestromin 6mg and ethinyl estradiol 600 micrograms per patch (releasing an average of 203 micrograms norelgestromin and 33.9 micrograms ethinyl estradiol per 24 hours)

Other ingredients: Backing layer: low-density pigmented polyethylene outer layer, polyester inner layer. Middle layer: polyisobutylene/polybutene adhesive, crospovidone, non-woven polyester fabric, lauryl lactate. Third layer: polyethylene terephthalate (PET) film, polydimethylsiloxane coating.

Warnings and Precautions

• Using a combined hormonal contraceptive like EVRA increases your risk of developing a blood clot compared with not using one. The risk is highest in the first year of use or when restarting after a break of 4 weeks or more.
• Smoking increases the risk of serious cardiovascular side effects. If you’re over 35 and unable to stop smoking, your doctor may recommend a different contraceptive.
• If you need surgery or will be immobile for a long period, tell your doctor you’re using EVRA patches. You may need to stop using them several weeks before your operation.
• Some medicines can stop EVRA from working properly, including certain epilepsy medicines, HIV medicines, antibiotics such as rifampicin and the herbal remedy St John’s Wort. Tell your doctor or pharmacist about all medicines you’re taking.
• EVRA may make some medicines less effective, including ciclosporin and lamotrigine. Your doctor may need to adjust your dose.
• If you have brown patches on your face (chloasma) or have had them before, avoid excessive sun exposure or sunbed use while on EVRA.
• If you experience mood changes or depressive symptoms, contact your doctor as soon as possible.
• Tell your doctor or the laboratory that you’re using EVRA before any blood or urine test, as it can affect some results.
• You’re advised to put the patch on a different area of skin each time to avoid irritation. Never apply to broken, red or irritated skin.
• EVRA doesn’t protect against HIV or any other sexually transmitted infection. Always use condoms to protect yourself from these.
• Store in the original packaging away from light and moisture. Don’t refrigerate or freeze.
• Used patches still contain active hormones. Fold the used patch within the disposal label provided and discard safely. Don’t flush patches down the toilet.