How To Use Evra Patch

How to Take Evra: Step‑by‑Step Usage Guide

Follow these instructions exactly to ensure the patch sticks properly and delivers the right amount of hormones.

1. Choose your start day: If you are starting Evra for the first time, apply the first patch during the first 24 hours of your menstrual period. This gives immediate protection. If you start later, use non‑hormonal contraception (e.g., condoms) for the first 7 days.
2. Select a clean application site: Buttock, abdomen, upper outer arm, or upper back. The skin must be clean, dry, and hairless (do not shave – if needed, use a trimmer). Avoid areas that are red, irritated, or cut. Do not apply to the breasts.
3. Open the foil sachet: Tear along the edge – do not use scissors, as you might cut the patch. Remove the patch carefully; it may stick to the inside of the sachet.
4. Remove half the protective liner: Peel away one half of the clear plastic. Try not to touch the sticky adhesive.
5. Apply to skin and remove the other half: Press the sticky side onto the chosen spot, then peel off the second half. Press firmly with the palm of your hand for 10 seconds, ensuring the edges stick well.
6. Wear for exactly 7 days: Check daily that the patch remains attached. Normal activities (bathing, swimming, exercise) should not loosen it, but always check afterwards.
7. Change on Day 8: Remove the used patch and immediately apply a new one on a different area to avoid skin irritation. This is your “Patch Change Day”.
8. Repeat for Week 3: On Day 15, remove the second patch and apply a third.
9. Week 4 – patch‑free: Remove the third patch on Day 22 and wear nothing for 7 days. Withdrawal bleeding usually occurs during this week. Start your next cycle on Day 29 (same day of the week as your previous Patch Change Day).

Evra Dosage Schedule and Cycle Guide

Each patch releases 203 mcg norelgestromin and 33.9 mcg ethinyl estradiol per 24 hours. The dosage is consistent throughout the 7‑day wear period.

After the patch‑free week, start the next cycle on Day 29 (which is the same weekday as your previous Day 1). If you wish to change your Patch Change Day, you can do so during Week 4 by starting the next cycle earlier or later, but never exceed 7 patch‑free days.

Delaying your period

You can delay your period by skipping the patch‑free week. After removing the third patch, immediately apply a new one and wear it for 7 days. You may experience breakthrough bleeding. Do not wear patches for more than 6 consecutive weeks. After that, take a 7‑day break before restarting.

Who Should Use Evra (Candidates)

Evra is suitable for most women of reproductive age who want a reliable, reversible contraceptive and can remember to change a patch once weekly. It may be particularly convenient for women who have difficulty swallowing tablets or prefer not to think about daily contraception.

Before prescribing, a healthcare professional will assess your medical history and blood pressure. Evra may be appropriate if you:

• Are not pregnant and do not plan to become pregnant in the near future
• Do not have any of the contraindications listed below
• Are not breastfeeding (or are willing to use progestogen‑only methods if breastfeeding)
• Have a BMI below 30 kg/m² (efficacy may be reduced in women weighing ≥90 kg)
• Are a non‑smoker or willing to stop smoking (smoking increases cardiovascular risk, especially over age 35)

Who Should NOT Use Evra (Contraindications)

Based on the Patient Information Leaflet, do not use Evra if you have any of the following conditions. If any apply, discuss alternative contraception with your doctor.

• Blood clots: current or past deep vein thrombosis (DVT), pulmonary embolism (PE), or clotting disorders (e.g., protein C/S deficiency, Factor V Leiden).
• Heart or circulatory problems: history of heart attack, stroke, angina, transient ischaemic attack (TIA), or conditions that increase risk (severe diabetes with vascular changes, very high blood pressure, very high cholesterol).
• Migraine with aura.
• Liver disease: severe liver disease, liver tumours (benign or malignant), or impaired liver function.
• Cancer: known or suspected breast cancer, cancer of the womb, cervix, or vagina – or history of these.
• Unexplained vaginal bleeding.
• Allergy to norelgestromin, ethinyl estradiol, or any patch ingredient.
• Pregnancy or suspected pregnancy.
• Taking certain hepatitis C medicines (ombitasvir/paritaprevir/ritonavir, dasabuvir, glecaprevir/pibrentasvir, sofosbuvir/velpatasvir/voxilaprevir) – these may increase liver enzymes.

Special Conditions: Pregnancy, Breastfeeding and Other Considerations

Pregnancy

Do not use Evra if you are pregnant or think you might be. If you become pregnant while using Evra, stop immediately and consult your doctor. There is no evidence that accidental use in early pregnancy causes harm, but you should switch to non‑hormonal care.

Breastfeeding

Evra is not recommended during breastfeeding. Oestrogen can reduce milk production and pass into breast milk. If you wish to breastfeed, discuss progestogen‑only methods (mini‑pill, implant, injection) with your doctor.

After childbirth, miscarriage or abortion

If you have just given birth (and are not breastfeeding), wait at least 4 weeks before starting Evra, as the risk of blood clots is higher postpartum. After a first‑trimester miscarriage or abortion, you can start immediately; if more than 5 days have passed, use backup contraception for 7 days. After a second‑trimester loss, follow your doctor’s advice – usually starting on Day 21 or with your first period.

Older women and adolescents

Evra is not intended for use after menopause. In adolescents under 18, safety and efficacy have not been studied, but it may be used off‑label after menarche under medical supervision.

Application Tips: Skin Care, Bathing & Interactions

To keep your patch firmly attached and working properly, follow these guidelines:

• Avoid oils, creams, lotions, powders, or makeup on the skin where you apply the patch or near it. These can prevent adhesion.
• Bathing and swimming: The patch is designed to stay on during showering, bathing, or swimming. However, after these activities, check that the edges are still stuck. If a patch lifts, press it back down firmly.
• Exercise and sauna: Normal exercise and sauna use should not affect adhesion, but always check afterwards.
• If a patch becomes loose or falls off:
  • If off for less than 24 hours: reapply the same patch or use a new one immediately. No backup needed. Keep the same Patch Change Day.
  • If off for 24 hours or more, or you are unsure how long: start a new 4‑week cycle immediately by putting on a new patch. That day becomes your new Day 1. Use non‑hormonal contraception (condoms) for the first 7 days of the new cycle.
• Do not use tapes or bandages to hold a loose patch in place; if it won’t stick, replace it.
• Drug interactions: Certain medicines (rifampicin, some HIV drugs, anti‑seizure drugs, St John’s wort) can reduce Evra’s effectiveness. Always tell your doctor about all medicines and herbal products you take. If you take any of these, use extra barrier contraception during and for 28 days after stopping the interacting drug.
• Food and alcohol: Evra is a patch; food does not affect absorption. Alcohol in moderation is not known to reduce efficacy, but binge drinking may increase risk of forgetting to change patches or other risky behaviour.

Evra Usage FAQs

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