Xulane

• Xulane
• Zafemy

• Norelgestromin-Eth Estradiol
• Ortho Evra
• Twirla
• Xulane
• Zafemy

• Patch

• Absorbed through the skin

Store the patches at room temperature in their original protective pouches.

Transdermal routePut on a new patch if the old one has fallen off and cannot be reapplied.

Transdermal routeDo not put the patch over burns, cuts, or irritated skin.

Transdermal routeThe patient instructions will show the body areas where you can wear the patch. When putting on each new patch, choose a different place within these areas. Do not put the new patch on the same place you wore the last one. Be sure to remove the old patch before applying a new one.

Transdermal routeLeave the patch in its sealed wrapper until you are ready to put it on. Tear the wrapper open carefully. NEVER CUT the wrapper or the patch with scissors. Do not use any patch that has been cut by accident.

Transdermal routeWash your hands with soap and water before and after applying a patch.

Apply your patch on the same day of every week ("Patch Change Day") for 3 weeks in a row.

You should also use a second form of birth control (including condoms, diaphragms, or contraceptive foams and jellies) when you first start using this medicine.

Carefully follow your doctor's instructions about when to start using your medicine. You may begin using the patch on the first day of your menstrual period, or on the first Sunday after your period begins.

Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.

Transdermal routeYour doctor will tell you how many patches to use, where to apply them, and how often to apply them. Do not use more patches or apply them more often than your doctor tells you to.

If you forget to wear or change your patch: Carefully follow the patient instructions that come with this medicine if you forget to use or change a patch. If your patch falls off and is not worn for more than 24 hours, you may need to start a new patch cycle and use a second form of birth control for at least 1 week.

This medicine is not right for everyone. Do not use it if you had an allergic reaction to norelgestromin or ethinyl estradiol, or if you are pregnant, or if you have breast cancer, heart disease, liver disease or liver cancer, or a history of blood clots, heart attacks, or strokes. Do not use this medicine if you have unusual vaginal bleeding, or certain types of headaches.

This medicine will not protect you from getting HIV/AIDS or other sexually transmitted diseases.

This medicine may not work as well in women who weigh 198 pounds (90 kilograms) or more.

If you think you have become pregnant while using this medicine, tell your doctor right away.

Tell your doctor if you are breastfeeding or if you recently had a baby. Tell your doctor if you have kidney disease, epilepsy, diabetes, high cholesterol levels, high blood pressure, gallbladder disease, migraine headaches, irregular monthly periods, or a history of depression, or chloasma gravidarum (skin discoloration during pregnancy). Tell your doctor if you are having a surgery that requires inactivity for a long time or if you smoke.

This medicine may cause the following problems:Increased risk of heart attack, stroke, or blood clotsLiver problems (including liver cancers or tumors)High blood pressureGallbladder diseaseHigh cholesterol in the bloodPossible risk of breast or cervical cancer

Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments.

Tell any doctor or dentist who treats you that you are using this medicine. This medicine may affect certain medical test results. You may need to stop using this medicine for a few weeks before and after surgery because of the risk of blood clots.

Unusual or unexpected vaginal bleeding

Keep all medicine out of the reach of children. Never share your medicine with anyone.

Your doctor will check the effects of this medicine at regular visits. Keep all appointments.

Keep all medicine out of the reach of children. Never share your medicine with anyone.

Do not eat grapefruit or drink grapefruit juice while you are using this medicine.

You may need to stop using this medicine for a few weeks before and after surgery because of the risk of blood clots.

Tell any doctor or dentist who treats you that you are using this medicine. This medicine may affect certain medical test results.

This medicine may not work as well in women who weigh 198 pounds (90 kilograms) or more.

Some foods and medicines can affect how ethinyl estradiol/norelgestromin combination works. Tell your doctor if you are using any of the following:Acetaminophen, aprepitant, ascorbic acid, bosentan, clofibric acid, cyclosporine, morphine, prednisolone, salicylic acid, St John€™s wort, temazepam, theophylline, tizanidineMedicine to treat an infection (including fluconazole, griseofulvin, itraconazole, ketoconazole, rifabutin, rifampicin, voriconazole)Medicine to treat HIV/AIDS (including amprenavir/ritonavir, atazanavir/ritonavir, darunavir/ritonavir, etravirine, fosamprenavir/ritonavir, indinavir, lopinavir/ritonavir, nelfinavir, nevirapine, ritonavir, tipranavir/ritonavir)Medicine to treat seizures (including carbamazepine, felbamate, lamotrigine, oxcarbazepine, phenytoin, rufinamide, topiramate)Medicine to treat thyroid problems

Do not use this medicine together with medicine to treat hepatitis C virus infection, including ombitasvir/paritaprevir/ritonavir, with or without dasabuvir.

• Sudden or severe headache, or problems with vision, speech, or walking
• Sudden and severe stomach pain, nausea, vomiting, lightheadedness
• Unusual or unexpected vaginal bleeding
• Numbness or weakness in your arm or leg, or on one side of your body
• Irregular, late, or missed menstrual period
• Dark urine or pale stools, loss of appetite, yellow skin or eyes
• Chest pain or tightness, trouble breathing, coughing up blood
• Breast lumps, tenderness, pain, swelling, or discharge
• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Pain in your lower leg (calf)
• Rapid weight gain, swelling in your hands, ankles, or feet
• Darkened skin on your face
• Vision changes or trouble wearing contact lenses
• Vision changes or trouble wearing contact lenses
• Mood changes, depression, nervousness
• Skin discomfort where the patch is worn