Contraceptive patch

levonorgestrel / ethinyl estradiol
Combination of
Levonorgestrel	Progestogen
Ethinylestradiol	Estrogen
Clinical data
Trade names	Twirla
License data	US DailyMed: Twirla;
Pregnancy; category	Contraindicated;
Routes of; administration	Transdermal (patch)
ATC code	G03AB03 (WHO) ;
Legal status
Legal status	US: ℞-only;
Identifiers
ChemSpider	None;

norelgestromin / ethinyl estradiol
Combination of
Norelgestromin	Progestogen
Ethinylestradiol	Estrogen
Clinical data
Trade names	Ortho Evra, Xulane, Evra
AHFS/Drugs.com	Professional Drug Facts
MedlinePlus	a602006
License data	EU EMA: by INN; US DailyMed: Norelgestromin_and_ethinyl_estradiol;
Pregnancy; category	Contraindicated;
Routes of; administration	Transdermal (patch)
ATC code	G03AA13 (WHO) ;
Legal status
Legal status	CA: ℞-only; UK: POM (Prescription only); US: ℞-only; In general: ℞ (Prescription only);
Identifiers
CAS Number	53016-31-2 ; 57-63-6 ;
PubChem CID	91758695;
DrugBank	DB06713; DB00977;
ChemSpider	None;
UNII	R0TAY3X631; 423D2T571U ;
KEGG	D10839 ;
Chemical and physical data
Formula	C41H53NO4
Molar mass	623.878 g·mol−1
3D model (JSmol)	Interactive image;
	SMILES CCC12CCC3C(C1CCC2(C#C)O)CCC4=CC(=NO)CCC34.CC12CCC3C(C1CCC2(C#C)O)CCC4=C3C=CC(=C4)O;
	InChI InChI=1S/C21H29NO2.C20H24O2/c1-3-20-11-9-17-16-8-6-15(22-24)13-14(16)5-7-18(17)19(20)10-12-21(20,23)4-2;1-3-20(22)11-9-18-17-6-4-13-12-14(21)5-7-15(13)16(17)8-10-19(18,20)2/h2,13,16-19,23-24H,3,5-12H2,1H3;1,5,7,12,16-18,21-22H,4,6,8-11H2,2H3/b22-15-;/t16-,17+,18+,19-,20-,21-;16-,17-,18+,19+,20+/m01/s1; Key:KBFRRZPPJPKFHQ-WKXKRCMPSA-N;

Contraceptive patch
Contraceptive patch
	Ortho Evra brand of contraceptive patch
Background
Type	Hormonal (combined estrogen + progestin)
First use	2002
Failure rates (first year)
Perfect use	0.3%
Typical use	9%
Usage
User reminders	Weekly application for 3 weeks
Clinic review	3-6 monthly
Advantages and disadvantages
STI protection	No
Weight	No proven effect
Period advantages	Regulated, may be lighter and less painful
Benefits	Compared to oral pills, may be less affected by antibiotics
Risks	DVTs rates similar to oral combined pills

A contraceptive patch, also known as "the patch", is a transdermal patch applied to the skin that releases synthetic oestrogen and progestogen hormones to prevent pregnancy. They have been shown to be as effective as the combined oral contraceptive pill with perfect use, and the patch may be more effective in typical use.^[3]^[4]

Xulane^[5] and Twirla^[6] are approved for use in the United States. Evra is approved for use in Canada and marketed by Janssen Inc.,^[7] and it is approved for use in the United Kingdom^[8] and in Europe^[9] and marketed by Janssen-Cilag.^[8]^[9] The patches are packaged in boxes of three and are only available by prescription.^[5]

^ ^a ^b Trussell J (2011). "Contraceptive efficacy". In Hatcher RA, Trussell J, Nelson AL, Cates Jr W, Kowal D, Policar MS (eds.). Contraceptive technology (20th revised ed.). New York: Ardent Media. pp. 779–863. ISBN 978-1-59708-004-0. ISSN 0091-9721. OCLC 781956734. Table 26–1 = Table 3–2 Percentage of women experiencing an unintended pregnancy during the first year of typical use and the first year of perfect use of contraception, and the percentage continuing use at the end of the first year. United States. Archived 2017-02-15 at the Wayback Machine
^ "Evra transdermal patch - Summary of Product Characteristics (SmPC)". (emc). 26 June 2020. Archived from the original on 24 October 2020. Retrieved 4 July 2020.
^ Trussell J (2007). "Contraceptive Efficacy". In Hatcher RA, et al. (eds.). Contraceptive Technology (19th rev. ed.). New York: Ardent Media. ISBN 978-0-9664902-0-6.
^ Nanda K, Burke A (2011). "Contraceptive patch and vaginal contraceptive ring.". In Hatcher RA, Nelson AL, Trussell J, Cwiak C, Cason P, Policar MS, Edelman A, Aiken AR, Marrazzo J, Kowal D (eds.). Contraceptive Technology (twentieth ed.). Atlanta, Georgia: Ardent Media, Inc. p. 272. ISBN 978-1-59708-004-0.
^ ^a ^b "Xulane- norelgestromin and ethinyl estradiol patch". DailyMed. 19 April 2017. Retrieved 17 February 2020.
^ "FDA Approves Agile Therapeutics, Inc.'s Twirla (levonorgestrel and ethinyl estradiol) Transdermal System – A New Weekly Contraceptive Patch Delivering a 30 mcg Daily Dose of Estrogen and 120 mcg Daily Dose of Progestin". Agile Therapeutics. 14 February 2020. Retrieved 17 February 2020.
^ "Evra Product information". Health Canada. 2018-06-21. Retrieved 17 February 2020.
^ ^a ^b "Evra transdermal patch - Summary of Product Characteristics (SmPC)". (emc). 29 November 2018. Archived from the original on 7 November 2017. Retrieved 17 February 2020.
^ ^a ^b "Evra EPAR". European Medicines Agency. 17 September 2018. Retrieved 18 February 2020.

[Trussell_2011-1] Trussell J (2011). "Contraceptive efficacy". In Hatcher RA, Trussell J, Nelson AL, Cates Jr W, Kowal D, Policar MS (eds.). Contraceptive technology (20th revised ed.). New York: Ardent Media. pp. 779–863. ISBN 978-1-59708-004-0. ISSN 0091-9721. OCLC 781956734. Table 26–1 = Table 3–2 Percentage of women experiencing an unintended pregnancy during the first year of typical use and the first year of perfect use of contraception, and the percentage continuing use at the end of the first year. United States. Archived 2017-02-15 at the Wayback Machine

[2] "Evra transdermal patch - Summary of Product Characteristics (SmPC)". (emc). 26 June 2020. Archived from the original on 24 October 2020. Retrieved 4 July 2020.

[CT-3] Trussell J (2007). "Contraceptive Efficacy". In Hatcher RA, et al. (eds.). Contraceptive Technology (19th rev. ed.). New York: Ardent Media. ISBN 978-0-9664902-0-6.

[4] Nanda K, Burke A (2011). "Contraceptive patch and vaginal contraceptive ring.". In Hatcher RA, Nelson AL, Trussell J, Cwiak C, Cason P, Policar MS, Edelman A, Aiken AR, Marrazzo J, Kowal D (eds.). Contraceptive Technology (twentieth ed.). Atlanta, Georgia: Ardent Media, Inc. p. 272. ISBN 978-1-59708-004-0.

[Xulane_label-5] "Xulane- norelgestromin and ethinyl estradiol patch". DailyMed. 19 April 2017. Retrieved 17 February 2020.

[6] "FDA Approves Agile Therapeutics, Inc.'s Twirla (levonorgestrel and ethinyl estradiol) Transdermal System – A New Weekly Contraceptive Patch Delivering a 30 mcg Daily Dose of Estrogen and 120 mcg Daily Dose of Progestin". Agile Therapeutics. 14 February 2020. Retrieved 17 February 2020.

[7] "Evra Product information". Health Canada. 2018-06-21. Retrieved 17 February 2020.

[Evra_SmPC-8] "Evra transdermal patch - Summary of Product Characteristics (SmPC)". (emc). 29 November 2018. Archived from the original on 7 November 2017. Retrieved 17 February 2020.

[Evra_EPAR-9] "Evra EPAR". European Medicines Agency. 17 September 2018. Retrieved 18 February 2020.

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