What are the benefits of Xulane (ethinyl estradiol and norelgestromin) versus Twirla (ethinyl estradiol and levonorgestrel)?

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From the Guidelines

Xulane and Twirla are both effective transdermal contraceptive patches, but the choice between them should be based on individual factors, including weight and sensitivity to hormones, with Xulane being more suitable for women weighing less than 198 pounds and Twirla being FDA-approved for women with a BMI less than 30 1. When considering the benefits of Xulane vs Twirla, it's essential to examine their composition and usage. Xulane contains 150 mcg norelgestromin and 35 mcg ethinyl estradiol, whereas Twirla contains 120 mcg levonorgestrel and 30 mcg ethinyl estradiol, making Twirla slightly lower in hormones. Some key points to consider when choosing between Xulane and Twirla include:

  • Efficacy: Both patches are effective in preventing pregnancy, but Xulane may be more suitable for women weighing less than 198 pounds.
  • Hormone content: Twirla has a lower hormone content, which may result in fewer hormonal side effects.
  • Usage: Both patches are typically changed weekly for three weeks, followed by a patch-free week.
  • Side effects: Both patches carry similar side effect profiles, including potential headaches, nausea, and skin irritation.
  • Cardiovascular risks: Both patches carry similar cardiovascular risks, particularly for smokers over 35.
  • Cost: The cost of both patches may differ depending on insurance coverage. It's crucial to consult a healthcare provider to determine the best option based on individual factors, including weight, sensitivity to hormones, and insurance coverage, as stated in the U.S. selected practice recommendations for contraceptive use, 2013 1.

From the Research

Comparison of Xulane and Twirla

  • Xulane and Twirla are both transdermal contraceptive patches, but there are some differences in their composition and effects.
  • Xulane contains ethinyl estradiol and norelgestromin, similar to the patch described in 2 and 3.
  • Twirla is a newer patch with a lower estrogen dose, as mentioned in 4.
  • The efficacy of Xulane has been demonstrated in several studies, including 2 and 3, which show that it has comparable safety and efficacy to oral contraceptives.
  • The study in 5 found that the transdermal contraceptive patch (similar to Xulane) had a failure rate of 0.70 pregnancies per 100 woman-years with perfect use, and 0.88 pregnancies per 100 woman-years with typical use.
  • In terms of side effects, the study in 2 found that the patch had similar side effects to oral contraceptives, with the exception of application site reactions.
  • The pharmacokinetics of ethinylestradiol in different contraceptive formulations, including the transdermal patch, were compared in 6, which found that the vaginal ring had significantly lower exposure to ethinylestradiol than the patch.
  • The study in 4 discussed the development of new contraceptive patches with lower estrogen levels, including Twirla, which may provide an important option for women.
  • The price of these new patches may influence their popularity, as mentioned in 4.
  • Overall, both Xulane and Twirla are effective contraceptive options, but they may have different benefits and drawbacks depending on the individual user, as discussed in 2, 3, and 4.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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