Ortho-Evra-Patch

Item	Count		Retail	Price	Order
Ortho Evra 150 mcg	1	patches	$122.23	$101.86
Ortho Evra 150 mcg	3	patches	$262.27	$218.56
Ortho Evra 150 mcg	6	patches	$487.03	$405.86

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

Common uses
ortho evra patch 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 ortho evra patch increases your chance of having heart problems. Do not smoke while using ortho evra patch . 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 ortho evra patch . 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 ortho evra patch 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 ortho evra patch .

Directions
Follow the directions for using ortho evra patch provided by your doctor. ortho evra patch COMES with a patient information leaflet. Read it carefully. Ask your doctor, nurse, or pharmacist any questions that you may have about ortho evra patch . 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 ortho evra patch to skin that is irritated or broken or over other topical products such as make-up, creams, lotions, or powders. DO NOT APPLY ortho evra patch 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 ortho evra patch 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 ortho evra patch 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 ortho evra patch , 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 ortho evra patch . IF YOU HAVE DIFFICULTY wearing contact lenses after you begin using ortho evra patch , check with your doctor. BEFORE YOU BEGIN TAKING ANY NEW MEDICINE, either prescription or over-the-counter, check with your doctor or pharmacist. ortho evra patch 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 ortho evra patch . SMOKING WHILE USING ortho evra patch may increase your risk of stroke, heart attack, blood clots, high blood pressure, or other diseases of the heart and blood vessels. USE OF ortho evra patch WILL NOT PREVENT HIV or the spread of other sexually transmitted diseases (STDs). Do Not Use ortho evra patch if you are pregnant. IF YOU SUSPECT THAT YOU COULD BE PREGNANT, contact your doctor immediately.

ortho evra patch Possible side effects
SIDE EFFECTS that may occur while taking ortho evra patch 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. Check drug interactions

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 ortho evra patch with others for whom it was not prescribed. Do Not Use ortho evra patch for other health conditions. KEEP ortho evra patch out of the reach of children. If using ortho evra patch for an extended period of time, obtain refills before your supply runs out.

Ortho Evra

THINYL ESTRADIOL/NORELGESTROMIN PATCH  TOPICAL

Ortho Evra - Overview

The Patch - Ortho Evra - is a reversible prescription method of birth control. Ortho Evra is a thin, beige, plastic patch that sticks to the skin. A new Ortho Evra patch is placed on the skin of the buttocks, stomach, upper outer arm, or upper torso once a week for three out of four weeks. No patch is used in the fourth week. The Ortho Evra Patch releases synthetic estrogen and progestin to protect against pregnancy for one month.

The combination of hormones works in three ways. Usually, it keeps the ovaries from releasing an egg (ovulation). Less often The Ortho Evra Patch thickens the cervical mucus, which prevents sperm from joining with an egg. Rarely, Ortho Evra prevents a fertilized egg from implanting in the uterus.

The Ortho Evra Patch works best when it is changed on the same day of the week for three weeks in a row. Pregnancy can happen if an error is made in using the Ortho Evra Patch - especially if

•  it becomes loose or falls off for more than 24 hours

•  the same Ortho Evra patch is left on the skin for more than one week

E ffectiveness of Ortho Evra

The Ortho Evra Patch is a very effective reversible method of birth control. With typical use, although no studies have yet been published, it is assumed that the Ortho Evra Patch will be more effective than the Pill - eight out of every 100 pill users become pregnant with typical use. Fewer than one woman out of every 100 women who use the Ortho Evra Patch will become pregnant with perfect use.

Certain medicines, including the antibiotic rifampin and certain drugs used to control seizures, may make the Ortho Evra Patch less effective. Ask your clinician for advice. Until then, use an additional method of birth control.

It is very important to remember that the Ortho Evra Patch does not protect against sexually transmitted infections. Always use a latex or female condom with the Ortho Evra Patch to reduce the risk of infection.

How to Use Ortho Evra:

Open the patch container and apply one Ortho Evra patch to an area of clean, dry skin on the buttock, abdomen, upper outer arm, or upper body (torso) exactly as directed by your doctor. The Ortho Evra patch is worn for 7 days. Do not apply the patch to the breast(s), the area around the breast(s); to red, cut, or irritated skin; or over other topical products (e.g., make-up, creams, lotions, powders). After 7 days, remove the old patch and apply a new Ortho Evra patch. Repeat this weekly cycle for 3 weeks (3 patches equal 1 cycle). After your 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 Ortho Evra patch. If your menstrual cycle (period) does not begin during this week, consult your doctor. After your 4th 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 an Ortho Evra patch. Doing so may make Ortho Evra less effective. If the Ortho Evra patch accidentally comes off, is removed, or if it becomes detached, apply a new patch. If it is detached or comes off for longer than 24 hours, or if you are not sure how long the Ortho Evra patch has been detached or removed, use additional forms of birth control (e.g., condoms, spermicide) for at least 7 days and continue with the same cycle. After removing each patch, fold the patch in half so it sticks to itself and discard it in a trash container. Do not discard or flush the patches down a toilet. If you weigh more than 198 pounds (90 kg), Ortho Evra may not work as well for you. Make sure your doctor knows your current weight and ask about which form of birth control is best for you. If any of this information is unclear, consult the Patient Information Leaflet or your doctor or pharmacist.

A dvantages of Ortho Evra

The Ortho Evra Patch protects against pregnancy for one month. And it does not involve taking a daily pill. Using the Ortho Evra Patch is simple, safe, and convenient. Many women who use the Ortho Evra Patch have more regular, lighter, and shorter periods. And a woman's ability to become pregnant returns quickly when use of the Ortho Evra Patch is stopped. The Ortho Evra Patch does not interfere with having sex, and may improve a woman's sex life. Some women say they feel free to be more spontaneous because they do not have to worry about becoming pregnant. Results of long-term studies won't be available for some time, but researchers assume that the non-contraceptive advantages associated with the Ortho Evra Patch are similar to those known to be associated with the Pill.

These health benefits may include some protection against

•  irregular menstrual cycles

•  infection of the fallopian tubes (pelvic inflammatory disease), which often leads to infertility

•  ectopic pregnancy (in the fallopian tubes)

•  noncancerous breast growths

•  ovarian cysts

•  cancer of the ovaries

•  cancer of the lining of the uterus

•  troublesome menstrual cramps

•  iron deficiency anemia that results from heavy menses

•  acne

•  premenstrual symptoms, as well as related headaches and depression

•  excess body hair

•  osteoporosis - loss of bone mass

•  vaginal dryness and painful intercourse associated with menopause

Side Effects of Ortho Evra:

Nausea, vomiting, headache, redness or itching at the Ortho Evra patch application site, dizziness, breast tenderness, vaginal discomfort/irritation, or stomach cramping/bloating may occur. If any of these effects persist or worsen, notify your doctor. Promptly tell your doctor if any of these side effects occur: dark patches on the skin (melasma), change in appetite, weight changes (gain or loss), a problem wearing contact lenses. Tell your doctor immediately if any of these serious side effects occur while using Ortho Evra: unusual vaginal discharge, changes in vaginal bleeding (e.g., spotting, breakthrough bleeding, prolonged or complete stoppage of bleeding), swelling, severe headache, mental/mood changes. Tell your doctor immediately if any of these unlikely but serious side effects occur: pain in the groin or lower legs, trouble breathing, rash, chest pain, stomach pain, vision or eye problems. Tell your doctor immediately if any of these highly unlikely but very serious side effects occur: yellowing eyes or skin, dark urine, one-sided weakness, numbness in the arms/legs, lumps in the breast. If you notice other effects not listed above, contact your doctor or pharmacist.

Precautions when taking Ortho Evra:

Ortho Evra is not recommended for use if you have the following medical conditions: 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 (especially affecting the circulation), 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 cancer), undiagnosed abnormal vaginal bleeding, currently pregnant, heavy tobacco use (if 35 years old or greater). Tell your doctor your medical history, especially of: high cholesterol or triglyceride (fat) levels, depression, high blood pressure, gallbladder problems, thyroid problems, any allergies. Do not smoke cigarettes. Hormonal birth control like Ortho Evra (e.g., pills, injections, devices) products combined with smoking cigarettes significantly increase your risk for strokes, blood clots, high blood pressure, and heart attacks; especially in women older than 35 years of age. Ask your doctor or pharmacist or consult the patient information leaflet that comes with Ortho Evra for more details. Before having surgery, including dental surgery, tell the doctor(s) that you are using Ortho Evra. The drugs in the Ortho Evra patch may cause blotchy, dark areas on your skin (melasma) and sunlight may intensify this effect. If this occurs, avoid prolonged sun exposure, use a sunscreen, and wear protective clothing when outdoors. If you are near-sighted or wear contact lenses, you may develop vision problems or may have problems wearing your contact lenses. Contact your eye doctor if these problems occur. Ortho Evra device must not be used in pregnancy. If you become pregnant or think you may be pregnant, inform your doctor immediately. The medication from the Ortho Evra patch passes into breast milk and may have undesirable effects on the nursing infant. Consult your doctor before breast-feeding.

Some women can use Ortho Evra under close medical supervision if they have

•  a high risk for heart disease

•  high cholesterol or slightly increased blood pressure

•  certain kinds of migraine headaches

•  a seizure disorder that requires taking anticonvulsant medication

•  had or have diabetes - not associated with vascular conditions

•  have gallbladder disease

•  a certain cancer of the nervous system called meningioma

•  have a parent or sibling who has had a heart attack or stroke before age 55

Combined Hormone Contraception and Breast Cancer

Most experts agree that using combined Ortho Evra hormone contraception will not increase the overall risk of developing breast cancer - no matter how long a woman uses a combined hormone contraceptive or even if she has a close relative with breast cancer.

Drug Interactions with Ortho Evra:

Tell your doctor of all prescription and nonprescription medication you may use, especially: 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. Ortho Evra can affect the results of certain lab tests (e.g., blood tests such as glucose, clotting factors, or thyroid). Make sure laboratory personnel and your doctors know you use Ortho Evra. Do not start or stop any medicine without doctor or pharmacist approval.

Pregnancy and Ortho Evra

There is a very slight chance that you will become pregnant even if you use Ortho Evra. However, a missed period does not always mean you are pregnant, especially if you have used the Patch correctly. But see your clinician if you miss a second period. It is unlikely that using Ortho Evra during early pregnancy will increase the risk of defects in the fetus. If you want to become pregnant, stop using Ortho Evra. If you want to plan the timing of your pregnancy, use another form of birth control until your period becomes regular. It usually takes about one to three months for your period to return to the cycle you had before using Ortho Evra. After childbirth, your clinician can help you decide when to use Ortho Evra again. Ortho Evra may reduce the amount and quality of milk in the first six weeks of breastfeeding. Also, the milk will contain traces of the Ortho Evra hormones. Although it is unlikely that these hormones will have any effect on your child, Ortho Evra is not recommended for use during breast-feeding.

Overdose of Ortho Evra:

Overdose with Ortho Evra is highly unlikely. If Ortho Evra overdose is suspected, remove the patch (or patches) and contact your local poison control center or emergency room immediately. The Ortho Evra device may be harmful if swallowed. Symptoms of overdose may include: severe nausea, vomiting, unusual vaginal bleeding or irregular menstrual periods.

Other Notes about Ortho Evra:

Do Not Share the Ortho Evra patch with others. Keep all appointments with your doctor and when having laboratory tests performed. You should have a complete physical exam including blood pressure, breast exams, pelvic exams, and PAP smears at least once a year.

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