What are the available brands of birth control patches, such as Ortho Evra (norelgestromin/ethinyl estradiol)?

Available Birth Control Patch Brands

The primary birth control patch brand available in the United States is Norelgestromin and Ethinyl Estradiol Transdermal System (previously marketed as Ortho Evra), which contains 150 mcg of norelgestromin and 35 mcg of ethinyl estradiol per day. 1

Details of Available Patch Brands

• The transdermal contraceptive patch contains norelgestromin (a progestin) and ethinyl estradiol (an estrogen), delivering approximately 150 mcg of norelgestromin and 35 mcg of ethinyl estradiol daily to the systemic circulation 2
• The patch was originally marketed under the brand name Ortho Evra by Ortho-McNeil Pharmaceutical, but is now available as a generic Norelgestromin and Ethinyl Estradiol Transdermal System 1, 2
• Each patch measures approximately 1.75 × 1.75 inches and is designed to be worn for 7 days 2

Administration and Usage

• The patch is applied to the abdomen, upper torso, upper outer arm, or buttocks, with the buttock being the most preferred application site among adolescents (40%) 2, 3
• Usage involves applying 1 patch for each of 3 weeks in a row, followed by 1 week without a patch, during which a withdrawal bleed usually occurs 2
• Each transdermal system contains 4.678 mg norelgestromin and 0.53 mg ethinyl estradiol, designed to release approximately 150/35 mcg per day 1

Efficacy and Considerations

• Typical use failure rates are similar to those of combined oral contraceptives at approximately 9% 2
• Perfect use failure rate is less than 1%, but is slightly higher for women who weigh more than 198 pounds (0.9%) compared to women who weigh less (0.3%) 2
• The FDA has identified increased estrogen exposure (1.6 times higher than with a low-dose combined oral contraceptive) and a potential increased risk of venous thromboembolism with the patch 2

Side Effects and Tolerability

• Most common side effects include:
  • Application site reactions (64% of users, though 92% of these are mild to moderate) 3, 4
  • Breast discomfort/tenderness (18% of adolescent users) 3, 4
  • Nausea (18% of adolescent users) 3
  • Headache 4
  • Dysmenorrhea 4
• Approximately 5% of users experience at least one patch that does not stay attached completely, and about 21% experience complete detachment at least once 5, 3

Advantages and Patient Satisfaction

• The patch provides a simpler regimen compared to daily oral contraceptives, which may improve compliance 2, 6
• Studies show that 68% of adolescent users were very satisfied and 29% were somewhat satisfied with the method 3
• The patch provides excellent cycle control in adolescents, with 100% of adolescent users in one study reporting regular menstrual periods 3
• Many users (40%) found the patch easier to use than previous contraceptive methods 3

Important Considerations for Healthcare Providers

• The patch may be less effective in women weighing more than 198 pounds 2
• The patch has undergone multiple label revisions due to concerns about increased estrogen exposure and VTE risk 2
• Other methods may be safer first-line choices for patients interested in extended cycling due to the increased estrogen exposure 2
• Despite potential risks, the patch remains an important contraceptive alternative that may be the best option for some patients, especially when considering the risks associated with unplanned pregnancy 2