Generic Equivalent of Ortho Evra Patch
The generic equivalent of the Ortho Evra patch is a transdermal contraceptive patch containing 0.6 mg norelgestromin and 0.75 mg ethinyl estradiol, commonly referred to as the norelgestromin/ethinyl estradiol transdermal system. 1
Composition and Characteristics
The Ortho Evra patch (brand name) contains:
- 0.6 mg norelgestromin (progestin component)
- 0.75 mg ethinyl estradiol (estrogen component)
- Measures approximately 1.75 × 1.75 inches 1
The generic version contains identical active ingredients in the same dosages, delivering:
- 150 micrograms/day of norelgestromin
- 20 micrograms/day of ethinyl estradiol 2
Administration and Usage
The transdermal contraceptive patch is applied:
- Once weekly for three consecutive weeks
- Followed by one patch-free week during which withdrawal bleeding typically occurs
- Can be placed on the abdomen, upper torso, upper outer arm, or buttocks 1
Pharmacokinetic Properties
The generic patch offers several pharmacokinetic advantages:
- Maintains consistent hormone levels without the peaks and troughs characteristic of oral dosing
- Avoids hepatic first-pass metabolism
- Maintains effective serum concentrations under varying conditions (heat, humidity, exercise) 3
- Absorption is equivalent when applied to the buttock, arm, or torso
- Absorption is approximately 20% less when applied to the abdomen, though still within therapeutic range 4
Efficacy and Considerations
- Typical use failure rate is similar to combined oral contraceptives at approximately 9% 1
- Perfect use failure rate is 0.7% pregnancies per 100 woman-years 5
- Efficacy may be reduced in women weighing more than 198 pounds (90 kg) 1, 5
- The FDA has identified increased estrogen exposure (1.6 times higher than with low-dose combined oral contraceptives) 1
- There is a potential increased risk of venous thromboembolism compared to 20-35 μg ethinyl estradiol oral contraceptives 1
Practical Considerations
- Adhesion reliability is very high (detachment rate of only 3.8%), even with exposure to water, saunas, or during exercise 5
- Compliance is typically better with the patch compared to daily oral contraceptives due to the weekly application schedule 3, 6
- Side effects are similar to those of combined oral contraceptives, with the addition of application site reactions and potential skin effects (hyperpigmentation, contact dermatitis) 1
Important Cautions
- The patch carries a black box warning regarding increased risk of venous thromboembolism compared to some oral contraceptives 1
- Women with contraindications to estrogen should consider progestin-only alternatives 7
- Combined hormonal contraceptives, including patches, may increase attack frequency and severity in women with hereditary angioedema 1
When considering contraceptive options, healthcare providers should evaluate the patient's cardiovascular risk factors, weight, and preference for administration method to determine if the norelgestromin/ethinyl estradiol transdermal system is appropriate.