Transdermal contraceptive patch

Creasy GW, Fisher AC, Hall N, Shangold GA. Transdermal contraceptive patch delivering norelgestromin and ethinyl estradiol effects on the lipid profile. J Reprod Med... 

Transdermal Contraceptives. In 2001. the FDrug Administration (FDA) approved the first transdermal contraceptive patch. Onho-Evra. The product contains norel-gestnrmin and ethinyl estradiol. A patch is applied once a week for. 1 weeks, followed by a week with no patch. The pregnancy rate for this product is I in 100. a rale similar to that often observed with oral eonlraceplives. 

EE and most progestogens undergo extensive first-pass metabolism in the liver and gut wall, reducing their oral bioavailability. To avoid first-pass metabolism progestogens and EE can be absorbed transdermally via the combined contraceptive patch. Some hormones are metabolised... 

Norelgestromin. USP. Norelgestromin, (17contraceptive patch (Ortho-Evra). First-pass metaboli.sm in the liver is avoided by the transdermal application. Hepatic metabolism does occur, however, and norgestrel. an active tnetabolite, and other hydroxylated and conjugated metabolites are formed. 

Non-oral forms of contraceptives, such as the transdermal patch and the transvaginal ring, avoid the need for daily administration and, as such, may enhance convenience of use for the patient. 

A combination contraceptive is available as a transdermal patch (Ortho Evra), which may have improved adherence compared to OCs. Efficacy seems to be compromised in women over 198 lb (90 kg). The patch should be applied to the abdomen, buttocks, upper torso, or upper arm at the beginning of the menstrual cycle and replaced every week for 3 weeks. 

Switching from an oral contraceptive - Treatment with the norelgestromin/ethinyl estradiol transdermal patch should begin on the first day... 

Use after childbirth - Women who elect not to breast-feed should start contraceptive therapy with the norelgestromin/ethinyl estradiol transdermal patch no sooner than 4 weeks after childbirth. If a woman begins using the patch postpartum and has not yet had a period, consider the possibility of ovulation and conception occurring prior to use of the patch, and instruct her to use an additional method of contraception (eg, condoms, spermicide, diaphragm) for the first 7 days. 

Pregnancy Category D (inhaler, spray, transdermal patch) Category C(gum). Nicotine is contraindicated in women who are or may become pregnant advise patients to use contraceptive measures. 

Nonoral contraceptives Ethinyl estradiol Norelgestromin Ortho Evra (transdermal patch)... 

A new combination contraceptive is available as a transdermal patch (Ortho Evra), which includes 0.75 mg EE and 6 mg norelgestromin, the active metabolite of norgestimate. In comparative trials, it has been shown to be as effective as combined OCs. Of the 15 pregnancies reported with the patch, 5 were among women with a baseline weight of greater than 90 kg, so efficacy may be compromised as weight increases. Some patients experience application-site reactions, but other side effects are similar to OCs (i.e., breast discomfort, headache, nausea, and menstrual cramps). 

No authors listed. Thrombotic risk of contraceptive transdermal patches and the contraceptive vaginal ring. Prescrire Int 2013 22(143) 266-9. PMID 24427838. 

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