Evra Patches

Evra is a combined hormonal contraceptive delivered as a transdermal patch. Each patch continuously releases norelgestromin (the active metabolite of norgestimate) and ethinylestradiol through the skin for seven days. The patch provides reliable contraception with the convenience of once-weekly application, eliminating the need for daily pill-taking. Hormone levels remain steady, avoiding the peaks and troughs associated with oral administration.

How to Apply the Evra Patch

Apply one Evra patch to clean, dry, unbroken skin on the buttock, abdomen, upper outer arm, or upper torso. Do not apply to the breasts, to broken or irritated skin, or to an area where tight clothing will rub. Press firmly with your hand for 10 seconds to ensure good adhesion. Change the patch on the same day of the week for three consecutive weeks, then have a patch-free week. A withdrawal bleed usually occurs during the patch-free week.

Rotate application sites with each new patch to reduce skin irritation. If a patch falls off, try to reapply it or apply a new one and keep the same change day.

Starting the Evra Patch

Start on the first day of your period for immediate contraceptive protection. If starting on any other day, use condoms for the first seven days. Each patch delivers norelgestromin 150 mcg and ethinylestradiol 20 mcg per day continuously through the skin.

One patch weekly for 3 weeks, then 1 week patch-free. Each patch delivers approximately 203 mcg norelgestromin and 33.9 mcg ethinylestradiol per 24 hours.

Common Side Effects

• Application site reactions (redness, itching, irritation, or rash under the patch)
• Headache
• Nausea (often settles after the first few cycles)
• Breast tenderness
• Mood changes
• Breakthrough bleeding or spotting in the first months

Serious Risks

Evra delivers a higher total daily oestrogen exposure than standard combined pills, which is associated with a moderately higher risk of blood clots (venous thromboembolism) compared to standard-dose pills. Do not use Evra if you smoke and are over 35, or if you have a history of blood clots, migraine with aura, or uncontrolled high blood pressure. Seek urgent medical attention if you develop sudden leg pain, chest pain, difficulty breathing, or severe headache — these may be signs of a serious blood clot.

The patch delivers a higher total oestrogen exposure than most oral pills. It may be less effective in women weighing over 90 kg. Same VTE and cardiovascular precautions as combined oral contraceptives apply.

Contraindicated in current or past VTE, arterial thromboembolism, migraine with aura, severe hepatic disease, breast cancer, and smokers over 35.