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ORTHO EVRA       

      Ortho Evra is a contraceptive (birth control) skin patch used to prevent pregnancy. It is a combination hormonal contraceptive because it contains two hormones, estrogen and progestin. It does not protect against HIV infection (AIDS) and other sexually transmitted diseases.

How Taken
This birth control method uses a 28-day (four-week) cycle. One topical patch is applied and kept in place for one week. A new topical patch is applied each week for three weeks in a row (21 total days). You should not apply a patch during the fourth week (a one-week break). During the one-week break, you should have your menstrual period. Every new patch should be applied on the same day of the week; this will be your 'Patch Change Day'. Follow your healthcare provider's instructions regarding when to start using Ortho Evra and whether back-up contraception is needed temporarily. Clean and dry the area of skin where the patch will be applied. The patch can be placed on the buttock, abdomen, upper outer arm, or upper torso in a place where it won't be rubbed by tight clothing. Never put the patch on the breasts. To avoid skin irritation, apply each new patch to a different place on the skin. Do not apply the patches to skin that are red, irritated or cut. Do not use creams, oils, powder, or makeup on the skin where you will put a patch or near a patch your are wearing. It may cause the patch to become loose. If a patch causes irritation, it can be removed and a new patch may be applied to a new location until the next 'Patch Change Day'. Only one patch should be worn at a time.

Warnings/Precautions
The risks associated with using Ortho Evra increase significantly if you: smoke, have high blood pressure, diabetes, or high cholesterol, have or have had clotting disorders, heart attack, stroke, chest pain (angina pectoris), and cancer of the breast or reproductive organs, jaundice, or malignant or benign liver tumors. Ortho Evra may be less effective in women weighing more than 198 lbs. (90 kg). Do not use Ortho Evra without first talking to your doctor if you weigh more than 198 lbs. (90 kg). Ortho Evra is in the FDA pregnancy category X. This means that Ortho Evra is known to cause birth defects in an unborn baby. Do not use Ortho Evra if you are pregnant. Ortho Evra may decrease milk flow and have other effects on milk composition. Do not use Ortho Evra without first talking to your doctor if you are breast-feeding a baby.

Missed Dose
If you forget to change your patch:
-at the start of any patch cycle,
Week one (Day 1): If you forget to apply your patch, YOU COULD BECOME PREGNANT – you must use back-up contraception for one week. Apply the first patch of your new cycle as soon as you remember. You now have a new Patch Change Day and new Day 1.
-in the middle of your patch cycle,
Week two or week three: If you forget to change your patch for one or two days, apply a new patch as soon as you remember. Apply your next patch on your normal Patch Change Day. No back-up contraception is needed.
Week two or week three: If you forget to change your patch for more than two days, YOU COULD BECOME PREGNANT start a new four week cycle as soon as you remember by putting on a new patch. You now have a different Patch Change Day and a new Day 1. You must use back-up contraception for the first week of your new cycle.
-at the end of your patch cycle,
Week four: If you forget to remove your patch, take it off as soon as you remember. Start your next cycle on your normal Patch Change Day the day after Day 28. No back-up contraception is needed.
-at the start of your next patch cycle,
Day 1 (week one): If you forget to apply your patch, YOU COULD BECOME PREGNANT. Apply the first patch of your new cycle as soon as you remember. You now have a new Patch Change Day and new Day. You must use back-up contraception for the first week of your new cycle.

Possible Side Effects
Some common side effects with combination hormonal contraceptives like Ortho Evra are:
-breast tenderness and enlargement
-headache
-nausea
-menstrual changes
-abdominal cramps and bloating
-vaginal discharge.

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