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Ortho Evra

Generic Name: ethinyl estradiol and norelgestromin (EH thi nill ess tra DY ol and nor ell JESS tro min)
Brand Names: Ortho Evra

What is ethinyl estradiol and norelgestromin?

Ethinyl estradiol and norelgestromin contains a combination of female hormones that prevent ovulation (the release of an egg from an ovary). This medication and causes changes in your cervical mucous and uterine lining, making it harder for sperm to reach the uterus and harder for a fertilized egg to attach to the uterus.

Ethinyl estradiol and norelgestromin are taken as contraception to stop pregnancy.

Ethinyl estradiol and norelgestromin might and be taken for purposes other than those listed in this medication guide.

What is the most important information I should know about ethinyl estradiol and norelgestromin?

You might need to use back-up birth control, such as condoms or a spermicide, when you first start taking this medication. Follow your doctor's instructions.

Some drugs can produce birth control pills less effective, which might result in pregnancy. Tell your physician about all the prescription and over-the-counter medications you use, including vitamins, minerals and herbal products. Do not start taking a new medication without telling your doctor.

What should I discuss with my healthcare provider before taking ethinyl estradiol and norelgestromin?

• a history of a stroke or blood clot;

• circulation problems (especially if caused by diabetes);

• a hormone-related cancer such as breast or uterine cancer;

• abnormal vaginal bleeding;

• liver disease or liver cancer;

• severe tall blood pressure;

• severe migraine headaches;

• a heart valve disorder; or

• a history of jaundice caused by birth control pills.

Before taking this medication, tell your physician if you have any of the following conditions. You might not be able to use the medicine, or you might need a dosage adjustment or special tests during treatment.

• tall blood pressure, heart disease, congestive heart failure, angina (chest pain), or a history of heart attack;

• tall cholesterol or if you are overweight;

• kidney disease;

• a history of depression;

• gallbladder disease;

• diabetes;

• seizures or epilepsy; or

• a history of fibrocystic breast disease, lumps, nodules, or an abnormal mammogram.

How should I use ethinyl estradiol and norelgestromin?

Use this medication exactly as it was prescribed for you. Do not use more skin patches or wear them for longer than recommended by your physician. You will apply your first patch on the first day of your period or on the first Sunday after your period begins (follow your doctor's instructions).

Tear open the foil pouch along the edge and peel it apart. Use your fingernail to grasp a corner flap of the skin patch and gently lift it out of the pouch.

Peel off one half of the plastic liner however try not to touch the sticky side of the patch. Place the patch on the skin area and remove the other half of the liner, pressing the patch into place firmly for 10 seconds. Produce sure the edges stick well. You will wear the patch for a full week.

Apply the patch to clean, dry skin on any of these areas: the outisde of your upper arm, your stomach, your buttocks, or your upper back. Do not apply the patch to skin that is broken or irritated, or to a skin area that might be rubbed by shut clothing (such as a waistband).

Remove the patch and apply a new one on the equal day each week for three weeks in a row. Check your patch every day to produce sure it is sticking well to your skin. At the end of the third week, remove the patch and do not apply a new one for 7 full days. Your period should start during this time Do not allow more than 7 days to pass before starting your next 3-week patch cycle..

You might need to use back-up birth control, such as condoms or a spermicide, when you first start taking this medication. Follow your doctor's instructions.

If you need to have any type of medical tests or surgery, or if you will be on bed rest, you may need to stop taking this medication for a short time. Any physician or surgeon who treats you should know that you are taking birth control skin patches.

Your physician will need to see you on a natural basis while you are taking this medication. Do not miss any appointments.

What happens if I miss a dose?

Apply a skin patch as soon as you remember. If it is almost time to apply your next patch, skip the missed dose and apply a patch on the next regularly scheduled day of the week. Do not use extra patches to produce up the missed dose.

Missing a dose increases your risk of becoming pregnant. Follow the weekly patch schedule closely. Call your physician or pharmacist if you have questions.

What happens if I overdose?

Seek emergency medical attention if you think you have taken too much of this medicine. Symptoms of an overdose might include nausea, vomiting, and vaginal bleeding.

What should I avoid while taking ethinyl estradiol and norelgestromin?

This medication will not protect you from sexually transmitted diseases--including HIV and AIDS. Taking a condom is the only way to protect yourself from these diseases.

Avoid taking creams, lotions, powders, or other medications on the skin where you apply the patch, or it might not stick to your skin.

What are the possible side effects of ethinyl estradiol and norelgestromin?

• sudden numbness or weakness, especially on one side of the body;

• sudden headache, confusion, pain behind the eyes, problems with vision, speech, or balance;

• chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;

• a change in the pattern or severity of migraine headaches;

• nausea, stomach pain, short fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

• swelling in your hands, ankles, or feet;

• a breast lump; or

• symptoms of depression (sleep problems, weakness, mood changes).

Continue taking the patches and talk to your physician if you have any of these less serious side effects:

• mild nausea, vomiting, bloating, stomach cramps;

• breast pain, tenderness, or swelling;

• freckles or darkening of facial skin;

• increased hair growth, loss of scalp hair;

• changes in weight or appetite;

• problems with contact lenses;

• vaginal itching or discharge;

• changes in your menstrual periods, decreased sex drive; or

• headache, anxiety, dizziness, tired feeling.

Side effects other than those listed here might and occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect ethinyl estradiol and norelgestromin?

Some drugs can produce ethinyl estradiol and norelgestromin less effective, which may result in pregnancy. Before taking ethinyl estradiol and norelgestromin, tell your physician if you are using any of the following drugs:

• acetaminophen (Tylenol) or ascorbic acid (vitamin C);

• phenylbutazone (Azolid, Butazolidin);

• prednisolone (Orapred);

• theophylline (Respbid, Theo-Dur);

• cyclosporine (Neoral, Sandimmune, Gengraf);

• St. John's wort;

• antibiotics such as amoxicillin (Augmentin), ampicillin (Omnipen), doxycycline (Doryx, Vibramycin), griseofulvin (Grisactin, Grifulvin V, Fulvicin PG), minocycline (Minocin), penicillin (Veetids, Pen Vee K, Bicillin), rifampin (Rifadin), rifabutin (Mycobutin), tetracycline (Sumycin, Achromycin, Robitet), and others;

• seizure medicines such as phenytoin (Dilantin), carbamazepine (Tegretol), felbamate (Felbatol), oxcarbazepine (Trileptal), topiramate (Topamax), or primidone (Mysoline);

• a barbiturate such as amobarbital (Amytal), butabarbital (Butisol), mephobarbital (Mebaral), secobarbital (Seconal), or phenobarbital (Luminal, Solfoton); or

• HIV medicines such as amprenavir (Agenerase), atazanavir (Reyataz), tipranavir (Aptivus), indinavir (Crixivan), saquinavir (Invirase), lopinavir/ritonavir (Kaletra), fosamprenavir (Lexiva), ritonavir (Norvir), or nelfinavir (Viracept).

There might be other drugs not listed that can affect ethinyl estradiol and norelgestromin. Tell your physician about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start taking a new medication without telling your physician.

Where can I get more information?

• Your pharmacist has additional information about ethinyl estradiol and norelgestromin written for health professionals that you might read.

What does my medication look like?

Ethinyl estradiol and norelgestromin is available with a prescription under the brand name Ortho Evra. Other brand or generic formulations might and be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

• Remember, store this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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