ORTHO EVRA

Patches
Chemical Name: NORELGESTROMIN (nor-el-JES-troe-min) and ETHINYL ESTRADIOL (ETH-in-il es-tra-DYE-ol)

Common uses
This medicine is an estrogen and progestin combination used to prevent pregnancy. It may also be used to treat other conditions as determined by your doctor.

Before Using
WARNING: Smoking cigarettes while using this medicine increases your chance of having heart problems. Do not smoke while using this medicine. The risk of heart problems increases with age (women greater than 35 years of age) and with frequent smoking (15 cigarettes per day or greater). Some medicines or medical conditions may interact with this medicine. INFORM YOUR DOCTOR OR PHARMACIST of all prescription and over-the-counter medicine that you are taking. ADDITIONAL MONITORING OF YOUR DOSE OR CONDITION may be needed if you are also taking anti-seizure medicine (e.g., carbamazepine, felbamate, phenobarbital, phenytoin, topiramate), certain antibiotics (e.g., ampicillin, erythromycin), HIV protease inhibitors (e.g., indinavir, ritonavir), phenylbutazone, griseofulvin, atorvastatin, azole antifungals (e.g., itraconazole, ketoconazole), rifampin, St. John's wort, cyclosporine, temazepam, prednisolone, morphine, theophylline, ascorbic acid (vitamin C), acetaminophen, aspirin, clofibric acid, modafinil, troglitazone. Inform your doctor of any other medical conditions including high blood lipid levels (hypercholesterolemia, hypertriglyceridemia), depression, high blood pressure, gallbladder problems, thyroid problems, allergies, or breast-feeding. DO NOT USE THIS MEDICINE if you have any of the following conditions: pregnancy, blood circulation problems (e.g., history of blood clots in the legs or groin), history of heart disease or stroke, severe high blood pressure, diabetes, severe headaches, recent major surgery, long periods of sitting or lying down (e.g., immobility such as being bedridden), liver problems, history of yellowing eyes and skin (jaundice) during pregnancy or while using birth control pills, cancer (especially endometrial or breast), undiagnosed abnormal vaginal bleeding, heavy tobacco use (if 35 years old or greater). Contact your doctor or pharmacist if you have any questions or concerns about taking this medicine.

Directions
Follow the directions for using this medicine provided by your doctor. THIS MEDICINE COMES with a patient information leaflet. Read it carefully. Ask your doctor, nurse, or pharmacist any questions that you may have about this medicine. Remove patch from foil and peel off liner. Apply to area of clean, dry skin on the abdomen, buttocks, upper outer arm, or upper torso. Do not apply at the waistline, breast, or other place where it would be rubbed by tight clothing. Press firmly in place for 10 seconds. The patch is worn for 7 days. DO NOT APPLY THIS MEDICINE to skin that is irritated or broken or over other topical products such as make-up, creams, lotions, or powders. DO NOT APPLY THIS MEDICINE TO THE SAME SKIN SITE. Use a different site each week. After 7 days, remove the old patch and apply a new patch. Repeat this weekly cycle for 3 weeks (3 patches over 3 weeks equal 1 cycle). After the third patch is removed, you will have one week without using the patch. Your menstrual cycle (period) usually should start during the week when you do not use the patch. If your period does not begin during this week, consult your doctor. After your fourth week, begin a new patch cycle, even if you still are experiencing some bleeding (still having your period). Do not go longer than 7 days without a patch. Doing so may make this medicine less effective. IF YOUR PATCH ACCIDENTALLY FALLS OFF, dry your skin and reapply it. If you weigh more than 198 pounds (90 kg), this patch may not work as well for you. Be sure your doctor knows your current weight and ask your doctor about which form of birth control may be best for you. STORE THIS MEDICINE at room temperature between 59 and 86 degrees F (15 and 30 degrees C), away from heat and light. DO NOT REFRIGERATE or freeze. AFTER YOU REMOVE THE USED PATCH, fold the sticky side together. Discard out of the reach of children and pets. IF YOU FORGET TO CHANGE THE PATCH AS SCHEDULED follow the directions in the patient information leaflet or consult your doctor or pharmacist for a new schedule.

Cautions
WHILE USING THIS MEDICINE, YOU MAY EXPERIENCE absence of menstrual periods. If you experience irregular menstrual periods, contact your doctor. YOU SHOULD perform regular self-examinations of your breasts. If you have questions about how to do this, ask your doctor, nurse, or pharmacist. KEEP ALL DOCTOR AND LABORATORY APPOINTMENTS while you are using this medicine. IF YOU HAVE DIFFICULTY wearing contact lenses after you begin using this medicine, check with your doctor. BEFORE YOU BEGIN TAKING ANY NEW MEDICINE, either prescription or over-the-counter, check with your doctor or pharmacist. THIS MEDICINE MAY CAUSE dark skin patches on your face. Exposure to the sun may make these patches darker. If patches develop, use a sunscreen or protective clothing when exposed to the sun, sunlamps, or tanning booths. Some Laboratory test results (e.g., thyroid function, liver function) may be affected by this medicine. SMOKING WHILE USING THIS MEDICINE may increase your risk of stroke, heart attack, blood clots, high blood pressure, or other diseases of the heart and blood vessels. USE OF THIS MEDICINE WILL NOT PREVENT HIV or the spread of other sexually transmitted diseases (STDs). DO NOT USE THIS MEDICINE if you are pregnant. IF YOU SUSPECT THAT YOU COULD BE PREGNANT, contact your doctor immediately.

Possible side effects
SIDE EFFECTS that may occur while taking this medicine include nausea, vomiting, headache, redness or itching at the patch application site, dizziness, breast tenderness, vaginal discomfort or irritation, stomach cramping, or bloating. If they continue or are bothersome, check with your doctor. CHECK WITH YOUR DOCTOR AS SOON AS POSSIBLE if you experience dark patches on the skin (melasma), change in appetite, weight changes (gain or loss), problems wearing contact lenses, unusual vaginal discharge, changes in vaginal bleeding (e.g., spotting, breakthrough bleeding, prolonged or complete stoppage of bleeding), swelling, trouble sleeping, or mental or mood changes. CONTACT YOUR DOCTOR IMMEDIATELY if you experience pain in the groin or lower legs, trouble breathing, rash, chest pain, severe headache, stomach pain, vision or eye problems, yellowing eyes or skin, dark urine, one-sided weakness, numbness in the arms or legs, lumps in the breast. If you notice other effects not listed above, contact your doctor, nurse, or pharmacist.

Drug interactions
Drug interactions can result in unwanted side effects or prevent a medicine from doing its job. Use our drug interaction checker to find out if your medicines interact with each other.

If you take too much
If overdose is suspected, remove the patch. Contact your local poison control center or emergency room immediately. Symptoms of overdose may include severe nausea, vomiting, unusual vaginal bleeding, or irregular menstrual periods

Additional information
DO NOT SHARE THIS MEDICINE with others for whom it was not prescribed. DO NOT USE THIS MEDICINE for other health conditions. KEEP THIS MEDICINE out of the reach of children. IF USING THIS MEDICINE FOR AN EXTENDED PERIOD OF TIME, obtain refills before your supply runs out.