Contraception - Contraceptive patch

The combination contraceptive patch (OrthoEvra®)
was introduced in 2002 and offers ease of use with
weekly replacement. It combines continuous systemic
doses of norelgestromin and ethinyl estradiol. The
patch is applied weekly three of four weeks; the fourth
week no patch needs to be applied. Risks, benefits and
potential drug interactions in general are similar to
those for oral contraceptives. The patch is associated
with 60% higher total exposure to ethinyl estradiol
than with the 35 mg pill, but peak estrogen levels are
lower. The significance of these data is currently
unknown. With typical use, its efficacy is reported to
be greater than that of an oral contraceptive and it
is easily reversible.38 In November 2005 the FDA
added information to the OrthoEvra label about the
increased exposure to estrogen in women who use
the patch compared with oral contraceptives containing
norgestimate and 35 mg ethinyl estradiol. In
September 2006 the FDA announced an update to
the OrthoEvra product label stating that users may
be at increased risk of thromboembolism (VTE)
when compared with OCP users and advising that
women with concerns or risk factors to talk with their
health care provider about using OrthoEvra versus
other contraceptive options. The FDA warning was
based on analysis of two studies. One study found the
risk of VTE doubled, another found no increased
risk in users of the patch. Women immobilized due
to surgery or injury should discontinue the patch
because of the associated risks for venous thromboembolic
events.39,40
The patch may be less effective in women
weighing more than 198 pounds. One study reported
less bleeding in women who applied the patch for
more weeks before the patch-free week.41

Posted in: Contraception,Health