Norelgestromin and Ethinylestradiol are combined in this medicine.
Norelgestromin + Ethinylestradiol is a transdermal contraceptive (birth control) patch. This medicine is used to prevent pregnancy in women of reproductive age.
Apply Norelgestromin + Ethinylestradiol patch on your skin exactly as directed by your doctor or according to the instructions on the label. Do not apply more or less than instructed by your doctor.
Do not apply the patch on broken or irritated skin. Do not cut the patch. The release pattern of the medicine will be affected if you cut the patch. Do not use it for a longer period than instructed by your doctor.
Instructions for application:
- Remove the patch from the protective foil pouch and peel away half of the liner. Avoid touching the sticky side with your fingers.
- Apply the patch to a clean, dry, and hairless area on your upper outer arm, upper back, lower abdomen, or on your buttock. Make sure that the area of skin is not oily, cut, blistered or irritated. The skin should be free of any powder, creams or lotions. Do not apply the patch on the breasts, or near the waistline or where your belt or clothes may rub against it.
- Peel away the other half of the liner. Press firmly on the skin for 10 seconds to ensure that the patch stays on the skin. Check on your patch every day to make sure all edges are sticking well.
- Wear the patch for 7 days (week one). Replace it on Day 8 (week two) and again on Day 15 (week three) on your usual "Patch Change Day". Do not wear a patch during the patch-free week from Day 22 to Day 28 (week four). The next four-week cycle will begin by applying a new patch on the usual "Patch Change Day", the day after Day 28. Remove the old patch before applying a new one. Change the site of application every week to avoid skin irritation. Do not apply the patch to the same area of skin as the previous patch.
- If the patch starts to lift at the edges or falls off for less than one day, try to reapply it to the same place or replace it with a new patch immediately if the patch does not stick completely. Do not tape or wrap the patch on your skin to keep it in place. If a patch starts to lift at the edges or falls off for more than 1 day or if you are not sure for how long, stop your current cycle and start on a new cycle right away by putting on a new patch. The day you apply your new patch is now your new Day 1 and your new "Patch Change Day".
- Throw away the used patch by folding the sticky sides together, put it back in the empty pouch, and place it in a rubbish bin. Do not throw it into the toilet bowl. Wash your hands after throwing the used patch.
If you missed to change your patch at the start of any patch cycle (Day 1/week one), apply the first patch of your new cycle as soon as you remember. This is now your new "Patch Change Day" and your new Day 1.
If you forget to change your patch in the middle of the patch cycle (Day 8/week two or Day 15/week three) for 1 or 2 days, apply a new patch right away. The next patch should be applied on your usual "Patch Change Day". If you forget to change your patch for more than 2 days, stop your current cycle and start a new four-week cycle right away by putting on a new patch. This is now your new "Patch Change Day" and your new Day 1.
If you missed to remove your patch at the end of your patch cycle (Day 22/week four), take it off as soon as you remember. Start your next cycle on your normal "Patch Change Day", which is the day after Day 28.
If you often forget to apply your medicine, let your doctor and pharmacist know.
Alert your doctor if you have the following conditions:
- current or history of blood clots e.g. deep vein thrombosis (blood clots in your leg veins), pulmonary embolism (blood clots in lung arteries)
- risk factors of blood clot formation e.g. severe or uncontrolled high blood pressure, severely high cholesterol level, diabetes with blood vessel damage, smoking (especially if you are more than 35 years old)
- hereditary or acquired blood clotting disorders
- heart valve or heart rhythm problems that may be associated with the formation of blood clots
- history of heart attack or stroke
- unexplained vaginal bleeding
- current or history of cancer of the breast or genital organs
- a certain type of migraine with symptoms known as aura
- liver disease e.g. hepatitis, liver tumours
as Norelgestromin + Ethinylestradiol may not be suitable for you.
Do not use this medicine if you are pregnant or if you think that you are pregnant. If you become pregnant while using Norelgestromin + Ethinylestradiol, alert your doctor immediately. This medicine may cause harm to your unborn child.
Do not use Norelgestromin + Ethinylestradiol with medicines used to treat hepatitis C such as drug combinations containing ombitasvir, paritaprevir, ritonavir and dasabuvir.
Inform your doctor if you have the following conditions:
- history of chloasma gravidarum (discolouration of the skin especially on the face or neck during pregnancy)
- risk factors for heart disease e.g. high cholesterol or triglyceride levels
- diabetes
- depression
- history of cholestasis of pregnancy (decrease in bile flow in the gallbladder causing severe itching)
- hereditary angioedema (inherited disorder characterised by recurrent swelling of the limbs, face or airways)
- systemic lupus erythematosus (an autoimmune disease that causes inflammation)
- kidney disease
Let your doctor know if you are breastfeeding.
This medicine does not lower the risk of getting HIV infection or any other sexually transmitted diseases. Ensure that you use proper precautions to avoid getting these diseases.
If you are going to have an operation or certain laboratory tests (e.g. liver, kidney or thyroid function tests), inform your doctor that you are using Norelgestromin + Ethinylestradiol.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Pregnancy tests must be done before treatment to know if this medicine is suited for you to use.
- Routine tests (e.g. liver function, cholesterol/sugar levels) may be done while you are using Norelgestromin + Ethinylestradiol. Your doctor will advise you about how often you need to have these tests.
- Your blood pressure may rise to unsafe levels without you noticing it. Monitor your blood pressure regularly during treatment.
- Regular monitoring for signs and symptoms of depression, unusual bleeding and changes in vision may also be needed.
Norelgestromin + Ethinylestradiol may cause any of the following side effects: headache, dizziness, nausea, vomiting, diarrhoea, abdominal pain, tiredness, weakness, muscle spasm, weight gain, anxiety, mood changes, breast tenderness, menstrual cramps, pimple, and application site irritation, rash, itching, or redness.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- pain, swelling or tenderness in your leg accompanied by redness and warmth
- sudden breathlessness, chest pain, irregular heartbeat
- sudden partial or complete blurring or loss of vision
- recurrent, persistent, or severe migraine or headache
- sudden fainting, disturbances of speech, weakness or numbness in the face, arm or leg particularly on one side of the body
- yellowing of the skin or eyes, fever, loss of appetite, dark coloured urine
- changes in the nipple, lumps in the breast, dimpling of the skin
- golden brown pigment patches on the skin especially on the face and neck
- swelling of the face or limbs
- unusual vaginal bleeding or spotting
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Do not use Norelgestromin + Ethinylestradiol with medicines used to treat hepatitis C such as drug combinations containing ombitasvir, paritaprevir, ritonavir and dasabuvir.
Inform your doctor and pharmacist if you are taking or using any of these medicines:
- medicines for epilepsy (fits or seizures) e.g. primidone, phenytoin, phenobarbital, carbamazepine, lamotrigine
- medicines to treat TB (infection known as tuberculosis) e.g. rifampicin, rifabutin
- medicines for HIV infection e.g. ritonavir, nelfinavir, efavirenz, nevirapine
- medicines to treat fungal infection e.g. griseofulvin, voriconazole, ketoconazole
- modafinil (medicine used to treat excessive sleepiness due to narcolepsy)
- aprepitant (medicine for nausea and vomiting caused by chemotherapy)
- bosentan (medicine to treat high blood pressure in the blood vessels leading to the lungs)
- ciclosporin (medicine used in organ transplant or certain immune disorders)
- tizanidine (muscle relaxant)
- theophylline (asthma medicine)
- etoricoxib (NSAID [medicine for pain and inflammation])
- St. John's wort (herbal medicine)
This list does not include all medicines that may interact with Norelgestromin + Ethinylestradiol.
Always notify your doctor and pharmacist if you are taking or using any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
Avoid alcohol.
Avoid excessive consumption of grapefruit or grapefruit juice (more than 1 litre a day).
Store in a cool, dry place away from the reach of children.
Protect from light and moisture. Do not refrigerate or freeze.
Medicines must not be used past the expiry date.
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