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Ethinyl Estradiol and Norelgestromin


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    Related terms
    • Brand Names: U.S.: Ortho Evra®
    • Brand Names: Canada: Evra®

    • It is used to stop pregnancy.
    • Ethinyl estradiol and norelgestromin stops pregnancy by stopping egg release (ovulation) from hormonal changes. Changes in the cervical mucus and endometrium make it hard for sperm to get into and form a fertilized egg that can attach to the uterine lining.


    How to take

    • Follow how to use as you have been told by your doctor or read the package insert.
    • Put patch on once a week for 3 weeks. Put it on the same day each week. Do not use patch on the 4th week.
    • Put patch on clean, dry, healthy skin on the buttock, belly, upper arm, chest, or back.
    • Do not put on the breast.
    • Do not use adhesives or wraps to hold the patch in place.
    • Do not put on more than 1 patch at a time.
    • If you miss 2 periods in a row, take a pregnancy test before starting a new dosing cycle.

    Missed Dose

    • Use a missed dose as soon as you think about it.
    • Missed dosing facts may be found in the package insert or call your doctor to find out what to do.
    • Put the same patch on the same place if it falls off and has been off for less than 24 hours.
    • Put on a new patch if the patch being used is no longer sticky or if it is sticking to itself or some other surface.


    • Store at room temperature.



    • If you are taking this drug for birth control, do not smoke. Cigarette smoking raises the chance of unsafe heart and blood-related side effects. This chance is higher with age (older than 35 years of age) and with heavy smoking (15 or more cigarettes per day). Birth control pills do not stop the spread of diseases caused by having sex.
    • You will get more estrogen if you use this drug than if you use a typical birth control pill. This may cause more side effects. Talk with your doctor.
    • Sometimes drugs are not safe when you take them with certain other drugs. Taking them together can cause bad side effects. This is one of those drugs. Be sure to talk to your doctor about all the drugs you take.


    • If you have an allergy to ethinyl estradiol, norelgestromin, or any other part of this drug.
    • Tell your doctor if you are allergic to any drugs. Make sure to tell about the allergy and what signs you had. This includes telling about rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.
    • If you have any of these health problems: Blood clots, breast cancer, diseased arteries in the brain, disease of a heart valve with problems, endometrial cancer, heart disease, high blood pressure, liver disease, liver tumor, very bad headache, tumor where estrogen makes it grow, or vaginal bleeding.
    • If you have surgery and need bed rest.
    • If you are a heavy smoker (more than 15 cigarettes per day) and older than 35 years of age.
    • If you have not started your period.
    • If you turned yellow during pregnancy or with estrogen-based or hormone contraceptive use.
    • If you are pregnant or may be pregnant.


    • Keep a list of all your drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your doctor.
    • If you weigh 198 pounds (90 kilograms) or more, this drug may not work as well to stop pregnancy. Talk with your doctor.
    • If you have any blood flow problems, talk with your doctor.
    • If you have gallbladder disease, talk with your doctor.
    • If you have heart disease, talk with your doctor.
    • If you have high blood sugar (diabetes), you will need to watch your blood sugar closely.
    • If you have kidney disease, talk with your doctor.
    • If you have liver disease, talk with your doctor.
    • If you have migraine headaches, talk with your doctor.
    • Have your blood pressure and heart rate checked often. Talk with your doctor.
    • Have your blood work checked. Talk with your doctor.
    • If you are taking a blood thinner, have your blood work checked. Talk with your doctor.
    • Have an eye exam every year.
    • Do monthly breast self-exams and have a gynecologic exam every year.
    • Check all drugs you are taking with your doctor. This drug may not mix well with some other drugs.
    • Avoid grapefruit and grapefruit juice.
    • Do not take St John's wort, dong quai, black cohosh, saw palmetto, red clover, or ginseng with this drug.
    • If you are taking this drug and have high blood pressure, talk with your doctor before using OTC products that may raise blood pressure. These include cough or cold drugs, diet pills, stimulants, ibuprofen or like products, and some natural products or aids.
    • Avoid cigarette smoking. People older than 35 years of age and/or smoking more than 15 cigarettes per day have more chance for heart disease.
    • Limit your drinking of wine, beer, or mixed drinks.
    • To protect from diseases caused by having sex, use a latex condom.
    • Tell your doctor if you are breast-feeding.
    • If patch has not been put on the right way, and 1 monthly period is missed, take a pregnancy test.

    Side Effects

    • Weight gain.
    • Headache.
    • Belly pain.
    • Upset stomach or throwing up. Many small meals, good mouth care, sucking hard, sugar-free candy, or chewing sugar-free gum may help.
    • Bad taste in your mouth. This most often goes back to normal.
    • Enlarged breasts.
    • For women, vaginal yeast infection. Report itching or discharge.
    • Period (menstrual) changes. These include lots of bleeding, spotting, or bleeding between cycles.
    • Gallbladder disease, blood clots, heart attacks, and other blood vessel problems may rarely happen.

    Contact a healthcare provider

    • If you think there was an overdose, call your local poison control center or ER right away.
    • Signs of a very bad reaction to the drug. These include wheezing; chest tightness; fever; itching; bad cough; blue or gray skin color; seizures; or swelling of face, lips, tongue, or throat.
    • Chest pain or pressure.
    • Trouble breathing.
    • Change in strength on 1 side is greater than the other, trouble speaking or thinking, change in balance, or blurred eyesight.
    • Swelling, warmth, or pain in the leg or arm.
    • Very bad headache.
    • Very upset stomach or throwing up.
    • Very bad skin irritation.
    • Not able to eat.
    • Dark urine or yellow skin or eyes.
    • Change in how contact lenses feel in the eyes.
    • A lump in the breast or breast soreness.
    • For women, if you get pregnant while taking this drug.
    • Any rash.
    • Side effect or health problem is not better or you are feeling worse.

    General Statements

    • If you have a very bad allergy, wear an allergy ID at all times.
    • Do not share your drugs with others and do not take anyone else's drugs.
    • Keep all drugs out of the reach of children and pets.
    • Most drugs may be thrown away in household trash after mixing with coffee grounds or kitty litter and sealing in a plastic bag.
    • In Canada, take any unused drugs to the pharmacy. Also, visit to learn about the right way to get rid of unused drugs.
    • Keep a list of all your drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your doctor.
    • Call your doctor for help with any side effects. If in the U.S., you may also call the FDA at 1-800-FDA-1088 or if in Canada, you may also call Health Canada's Vigilance Program at 1-866-234-2345.
    • Talk with the doctor before starting any new drug, including OTC, natural products, or vitamins.
    • Read the package insert for more details.

    Author information
    • Copyright © 1978-2013 Lexi-Comp Inc. All rights reserved.

    Copyright © 2011 Natural Standard (

    The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

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