Description
Evra is a contraceptive patch that is applied to the skin to prevent pregnancy. It is square, thin, and beige in colour. It is as effective as the pill, i.e., approximately 99% when taken as directed.
How it works
Each Evra patch may be worn (left in place) for one week. It works like the pill.
Cost
One box of 3 patches costs approximately $24. It is covered by both private insurance plans and the Régime d’assurance médicaments du Québec.
Before starting Evra
A consultation with a health professional is necessary before you start using the Evra patch. This visit makes it possible to determine whether you have medical conditions that could prevent you from using it. If you cannot use the pill, you may not be able to use the Evra patch either because the contraindications are the same.
When should I start on Evra ?
Starting Evra on the first day of your period is recommended. Protection against pregnancy is immediate in this case. If you start Evra on another day, using another method of birth control (e.g. condom) is recommended for the first 7 days (first patch). Usually, starting Evra on a Saturday makes it possible to avoid getting your period on weekends.
How do I use Evra ?
You wear the patch for one week then replace it on the same day of the week for three consecutive weeks. You do not wear a patch during the fourth week. The week when you stop wearing the patch is the week when you get your period. The patch is thus always reapplied on the same day of the week.
Changing from the pill to the patch
The patch should be applied on the first day of bleeding once the pill has been stopped. There is no decrease in contraceptive effectiveness. If the patch is applied more than 5 days after taking the last pill, another method of birth control (e.g. condom) is recommended for 7 days.
Applying the Evra Patch
- Remove one half of the protective transparent backing. Avoid touching the adhesive (sticky) surface of the patch.
- Place the patch on the skin and remove the other half of the backing. Press firmly on the patch with the palm of your hand for 10
- seconds, ensuring that the edges stick firmly to your skin. Check daily to make sure that the patch is holding well.
Where should I apply the Evra patch ?
The patch must be applied to dry, clean, healthy, unbroken skin. To ensure that the patch is holding well, make sure that theapplication site is clean and dry. Do not apply cream, lotion, powder or makeup to the patch or in the immediate area of the patch. The parts of the body where you may applythe Evra patch are the buttocks, the abdomen, the outside of the arms, and the upper back. Avoid places where it will be rubbed by tight clothing or where your skin is red, irritated or broken. Do not apply the Evra patch to your breasts.
Side effects
Side effects are more common during the first 3 months of use and usually disappear after this time. The main side effects are:
- Irregular periods (bleeding at any time of the month) occur mainly during the firstfew months, like with the pill. If the patch does not come off and if you remember to apply it on time, the patch remains just as effective. If the breakthrough bleeding persists, contact your doctor.
- Nausea may occur during the first few months of Evra use.
- Breast tenderness and swelling is a temporary side effect that often occurs during the first 3 months. Wear a bra with good support and cut back on cigarettes, salt, chocolate, coffee, tea, and alcohol. If the problem persists, talk to your doctor.
Advantages of the contraceptive patch
- Like the pill, this is a very effective, reversible method of contraception.
- It regulates your menstrual cycle.
- It reduces the frequency of:
- menstrual cramps
- anemia (due to a decrease in menstrual bleeding)
- the symptoms that precede
- menstruation (premenstrual syndrome)
- ovarian cancer
- cancer of the endometrium (inner lining of the uterus)
- colorectal cancer
- benign breast tumours
- ovarian cysts
- salpingitis (infection of the Fallopian tubes)
- ectopic pregnancies (pregnancy in the Fallopian tubes)
- symptoms related to endometriosis
Forgetting to apply or change the patch :
If the patch comes off (either partially or fully) within the past 24 hours: Try to re-apply the patch by pressing on it with the palm of your hand for 10 seconds.
Do not attempt to reapply a patch that no longer sticks, that has become stuck to itself, or that has become stuck to another surface. Do not use another adhesive or
tape to keep the patch in place. If the patch does not stick properly, remove it and apply a new patch. The patch change day stays the same.
During the first week: If you are more than one day late in applying the first patch of a cycle, or if your patch came off more than 24 hours ago, or if you are uncertain
when it came off, apply a new patch as soon as possible. Keep the same patch change day. Complete a 3 week cycle of patch use. Additional contraception (e.g.
a condom) is required for one week. Emergency oral contraception (the morning-after pill) is recommended if you had sexual relations in the preceding 5 days.
During the second or third week: If the patch comes off for less than 72 hours (3 days) or is applied less than 72 hours late, apply a new patch as soon as possible.
Complete the cycle of patches and begin a new cycle of three patches without taking a break (patch-free week). The patch change
day remains the same. You do not require additional contraception. You will not have a period that month.
If the patch comes off for more than 72 hours (3 days) or is applied more than 72 hours late, remove the patch (if still in place) and apply a new patch as soon as possible. Complete the cycle of patches and begin a new cycle of three patches without taking a break (patch-free week). The patch change day remains the same.
Additional contraception (e.g. a condom) is required for one week. Emergency oral contraception (the morning-after pill) is recommended if you had sexual relations
in the preceding 5 days. You will not have a period that month.
Special situations
Evra and antibiotics: The effectiveness of the Evra patch should not be affected by taking antibiotics.
Evra and pregnancy: Pregnancy is possible as soon as you stop using Evra. Youre future fertility remains the same, regardless of the number of years you used the Evra patch.
Evra and perimenopause: Healthy, nonsmoking women can use the Evra patch until menopause.
Evra and surgery: If you need surgery that requires immobilization (bedrest), tell your surgeon that you are using the Evra patch.
Evra and smoking: Smoking increases the risk of heart disease in women who use the Evra patch or who are on the pill. This risk increases with age and women over 35 years who smoke more than 15 cigarettes a day cannot receive a prescription for Evra. Why not use this opportunity to stop smoking now?
Evra, STIs (STDs) and HIV (AIDS): The patch does not offer protection against sexually transmitted diseases (STIs) or HIV. Your sexual health is important and you must use a condom if you are at risk for STIs.
Complications
They are very rare but require prompt medical attention. They occur mainly in women with health problems and women who smoke. These complications are the same as those for the pill:
- severe chest pain with difficulty breathing
- severe headaches
- serious vision problems (decrease or sudden loss of vision)
- severe pain in the thighs or calves and/or swelling in the legs
- persistent numbness and/or weakness on one side of the body
Seek medical attention promptly.
Some parts of the text and graphics have been taken from documents provided by Janssen-Ortho Inc.
Last update : July 2014