You should not use this medicine if you have: uncontrolled high blood pressure, heart disease, coronary artery disease, health problems caused by diabetes (such as damage to your kidneys, eyes, nerves, or blood vessels), undiagnosed vaginal bleeding, liver disease or liver cancer, severe migraine headaches, if you also take certain hepatitis C medication, if you will have major surgery, if you smoke and are over 35, or if you have ever had a heart attack, a stroke, a blood clot, jaundice caused by pregnancy or this medicine, or cancer of the breast, uterus/cervix, or vagina.
Using this medicine can increase your risk of blood clots, stroke, or heart attack (especially if you smoke). You should not use this medicine if you smoke and are over 35 years old.
Using this medicine can increase your risk of blood clots, stroke, or heart attack. You are even more at risk if you have high blood pressure, diabetes, high cholesterol, or if you are overweight
Smoking can greatly increase your risk of blood clots, stroke, or heart attack. Your risk increases the older you are and the more you smoke. You should not use ethinyl estradiol and levonorgestrel if you smoke and are over 35 years old.
Your risk of serious blood clot may be higher with the use of birth control skin patches than with the use of birth control pills.
You should not use ethinyl estradiol and levonorgestrel if you have:
Tell your doctor if you have ever had:
Do not use this medicine if you are pregnant. You may need to have a negative pregnancy test before using ethinyl estradiol and levonorgestrel. Tell your doctor if you think you may be pregnant.
Ethinyl estradiol and levonorgestrel can slow breast milk production. You should not breastfeed while using this medicine.
Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed. Do not wear more than one skin patch at a time. Never cut a skin patch.
Apply a new skin patch every 7 days for 3 weeks in a row (21 days). Change your patch on the same day of the week, and wear each patch for 7 full days. On Day 22, remove the patch and wait 7 days before applying a new patch. Your patch-free week should not be longer than 7 days.
Apply the patch to clean, dry skin that is not broken or irritated and won't be rubbed by tight clothing (such as a waistband).
You may need to use back-up birth control (such as a condom/diaphragm with spermicide) when you first start using this medicine, or if a patch has become loose or has been off for longer than 1 day. Read and carefully follow all instructions about what to do if a patch gets loose or falls off, or if you forget to change your patch on time.
If you need major surgery or will be on long-term bed rest, do not use wear a skin patch for at least 4 weeks ahead of time and 2 weeks afterward.
You may have breakthrough bleeding, especially during the first 3 months. Tell your doctor if this bleeding is very heavy, or if you miss 2 or more regular periods.
Store patches at room temperature away from moisture and heat. Do not freeze or refrigerate. Keep each patch in its foil pouch until you are ready to apply it.
After removing a skin patch fold it in half, sticky side in, and throw it away in a place where children and pets cannot get to it. Do not flush a used patch down the toilet.
During your patch-free week, do not go without wearing a patch for longer than 7 days. Missing a dose increases your risk of becoming pregnant and you may need to use back-up birth control. Call your doctor if you miss a period for 2 months in a row.
If you forget to apply a patch at the start of a new cycle:
If you forget to change your patch during the 3-week wearing time:
Do not smoke while using this medicine, especially if you are older than 35 years of age.
Grapefruit may interact with ethinyl estradiol and levonorgestrel and lead to unwanted side effects. Avoid the use of grapefruit products.
This medicine may cause darkening of your facial skin (chloasma), especially if you've ever had chloasma during a pregnancy. Avoid sunlight or tanning beds. Use sunscreen (SPF 30 or higher) when you are outdoors.
Avoid applying makeup, lotions, powders, or oils to the skin where you apply a skin patch.
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Stop using this medicine and call your doctor at once if you have:
Common side effects may include:
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Many drugs can affect ethinyl estradiol and levonorgestrel, and some drugs can make hormonal birth control less effective, which may result in pregnancy. Tell your doctor about all your other medicines, especially:
This list is not complete and many other drugs may affect ethinyl estradiol and levonorgestrel. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
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