Evra Side Effects: Complete Safety Guide
When Do Side Effects Start? How Long Do They Last? Timeline, Contraindications & Food Interactions
Key Takeaways: Evra Side Effects
- Most common: headache, nausea, breast tenderness (very common); mood changes, application site reactions, weight gain (common).
- Onset: usually within first 1‑3 cycles; some (like headache) may start within days.
- Duration: most side effects resolve within 2‑3 months as your body adjusts.
- Serious risks: blood clots (rare), breast/cervical/liver cancer (rare), severe allergic reactions.
- Contraindications: history of clots, certain cancers, liver disease, migraine with aura, pregnancy.
Evra is a highly effective contraceptive patch, but like all hormonal contraceptives, it can cause side effects. Understanding what to expect, when, and for how long helps you manage them and know when to seek medical advice.
Important Medical Advice
Seek urgent medical attention if you experience: sudden leg swelling/pain, chest pain, breathlessness, severe headache, visual disturbances, or weakness on one side – these could be signs of a blood clot or stroke.
Common Evra Side Effects
Based on the Patient Information Leaflet, side effects are grouped by frequency. The most frequently reported are:
Very common (affect more than 1 in 10 women)
- Headache
- Nausea
- Breast tenderness
Common (affect up to 1 in 10 women)
- Vaginal yeast infection (thrush)
- Mood problems – depression, mood swings, anxiety, crying
- Dizziness
- Migraine
- Stomach ache or bloating
- Vomiting or diarrhoea
- Acne, skin rash, itching, or irritation
- Muscle spasms
- Breast pain, enlargement, or lumps
- Changes in menstrual bleeding (irregular bleeding, spotting, painful periods, vaginal discharge)
- Application site reactions – redness, irritation, itching, rash
- Feeling tired or generally unwell
- Weight gain
Uncommon and rare side effects include allergic reactions, high blood pressure, gallstones, blood clots, and certain cancers – see full list in the PIL.
When Do Evra Side Effects Start?
Most side effects appear during the first few cycles of use as your body adjusts to the hormones. Headache, nausea, and breast tenderness can begin within the first week of patch application. Mood changes and breakthrough bleeding often emerge in the first 1‑3 months. Application site reactions typically occur within the first few days of wearing a patch and may improve with site rotation.
If you experience side effects immediately after applying a new patch, they may be related to the adhesive or a mild local reaction. These usually subside within 24‑48 hours.
How Long Do Evra Side Effects Last?
Most common side effects are transient and resolve within 2‑3 months of continued use. For example:
- Nausea and headache: often improve after the first few weeks.
- Breakthrough bleeding/spotting: typically decreases after the third cycle.
- Breast tenderness: may persist but often lessens over time.
- Application site reactions: resolve within a few days of patch removal; rotating sites helps prevent recurrence.
If side effects persist beyond three months or become intolerable, consult your doctor – a different contraceptive method may be better suited.
Evra Side Effects Timeline
| Timeframe | Common Experiences |
|---|---|
| Days 1‑7 (first patch) | Headache, nausea, breast tenderness, mild skin irritation at application site. |
| Cycles 1‑3 | Irregular bleeding/spotting, mood swings, fatigue, dizziness, acne. Body adjusting to hormones. |
| After 3 cycles | Most side effects diminish. Cycle usually becomes regular. Persistent symptoms warrant review. |
| Long‑term use | Small increased risk of blood clots, breast cancer, cervical cancer (rare). Regular check‑ups advised. |
Contraindications: Who Should Not Use Evra
Do not use Evra if any of the following apply. Your doctor will assess these before prescribing.
- History of blood clots in leg (DVT), lung (PE), or other organs.
- Inherited clotting disorders (e.g., Factor V Leiden, protein C/S deficiency).
- Heart attack, stroke, angina, or transient ischaemic attack (TIA).
- Diseases that increase arterial clot risk: severe diabetes with vascular damage, very high blood pressure, very high cholesterol.
- Migraine with aura.
- Severe liver disease or liver tumours.
- Known or suspected breast cancer, cervical cancer, or other hormone‑dependent cancers.
- Unexplained vaginal bleeding.
- Pregnancy or suspected pregnancy.
- Allergy to norelgestromin, ethinyl estradiol, or any patch ingredient.
- Taking certain hepatitis C medicines (ombitasvir/paritaprevir/ritonavir, dasabuvir, glecaprevir/pibrentasvir, sofosbuvir/velpatasvir/voxilaprevir).
Food and Drug Interactions with Evra
Drug interactions
Some medicines can reduce Evra’s effectiveness or increase side effects. Always tell your doctor about any medications or herbal products you take. Key interactions include:
- Liver enzyme inducers: rifampicin, griseofulvin, some HIV drugs (ritonavir, nevirapine, efavirenz), anti‑seizure medicines (barbiturates, topiramate, phenytoin, carbamazepine, primidone, oxcarbazepine, felbamate), bosentan, St John’s wort. These may decrease contraceptive efficacy – use additional barrier methods during and for 28 days after stopping.
- Certain hepatitis C drugs: contraindicated (see above).
- Cyclosporin: Evra may increase cyclosporin levels.
- Lamotrigine: Evra may reduce lamotrigine levels, increasing seizure risk.
Food interactions
No specific food interactions are known. Grapefruit juice may slightly increase ethinyl estradiol levels by inhibiting CYP3A4, but the effect is not clinically significant with transdermal delivery. Alcohol in moderation does not affect efficacy, but binge drinking can impair judgement and increase risk of forgetting patch changes.
Serious Side Effects: When to Seek Help
Although rare, the following require immediate medical attention:
- Blood clots: symptoms as listed in emergency note.
- Allergic reaction (angioedema): swelling of face, lips, mouth, tongue, throat with difficulty swallowing/breathing.
- Severe hypertension: very high blood pressure, severe headache.
- Liver problems: yellowing skin/eyes, severe upper abdominal pain.
- Breast lumps or changes.
- Sudden vision loss or double vision.
If you experience any of these, stop using Evra and see a doctor immediately.
Evra Side Effects FAQs
Do Evra side effects go away after a few months?
Yes, most side effects like nausea, headache, and irregular bleeding improve within 2‑3 months as your body adjusts.
Can Evra cause weight gain?
Weight gain is reported as a common side effect, but studies show average changes are modest. Fluid retention may contribute.
What should I do if I get a rash under the patch?
Remove the patch and apply a new one on a different site. The rash usually resolves within a few days. If severe or persistent, consult your doctor.
Is it safe to use Evra with antibiotics?
Most antibiotics (except rifampicin/griseofulvin) do not affect Evra. However, if you have vomiting or diarrhoea from antibiotics, absorption is not affected, but additional contraception is not needed.
Can Evra cause depression?
Mood changes, including depression, are common side effects. If you experience low mood that interferes with daily life, speak to your doctor.
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Medical Content Manager
Nabeel is a co-founder, and medical content manager of Chemist Doctor. He works closely with our medical team to ensure the information is accurate and up-to-date.
Medical Doctor
Dr. Feroz is a GMC-registered doctor and a medical reviewer at Chemist Doctor. He oversees acute condition and urgent care guidance.
Medical Director
Usman is a co-founder, and medical director of Chemist Doctor. He leads the organisation's strategic vision, bridging clinical and operational priorities.
Review Date: 15 March 2026
Next Review: 15 September 2026
Published on: 15 March 2026
Last Updated: 15 March 2026