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Ortho Evra

"Nov. 20, 2012 -- Oral contraceptives should be made available without a prescription to reduce unintended pregnancies, according to a newly published opinion by the American College of Obstetricians and Gynecologists (ACOG).

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Ortho Evra

Ortho Evra Side Effects Center

Medical Editor: John P. Cunha, DO, FACOEP

Ortho Evra (norelgestromin / ethinyl estradiol) used as contraception to prevent pregnancy. It contains a combination of female hormones. Common side effects include vaginal bleeding between periods (spotting) during the first few months of use. If this bleeding is persistent or unusually heavy, contact your doctor. Nausea, vomiting, headache, redness/irritation at the application site, dizziness, breast tenderness/enlargement, vaginal discomfort/irritation, increased vaginal discharge, missed/irregular periods, acne, or stomach cramping/bloating may occur.

The Ortho Evra system uses a 28-day (four-week) cycle. A new patch is applied the same day each week for three weeks (21 total days). Week Four is patch-free. Withdrawal bleeding is expected during this time. Ortho Evra may interact with acetaminophen, ascorbic acid (vitamin C), bosentan, griseofulvin, prednisolone, theophylline, cyclosporine, St. John's wort, antibiotics, seizure medicines, barbiturates, or medication to treat HIV or AIDS. Tell your doctor all medications and supplements you use. Ortho Evra must not be used during pregnancy. If you become pregnant or think you may be pregnant, tell your doctor. If you have just given birth or had a pregnancy loss/abortion after the first 3 months, consult your doctor about birth control, and find out when it is safe to use birth control containing estrogen, such as this medication. The medication from this patch passes into breast milk and may have undesirable effects on the nursing infant. Consult your doctor before breast-feeding.

Our Ortho Evra (norelgestromin / ethinyl estradiol) Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What is Patient Information in Detail?

Easy-to-read and understand detailed drug information and pill images for the patient or caregiver from Cerner Multum.

Ortho Evra in Detail - Patient Information: Side Effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using the patches and call your doctor at once if you have any of these serious side effects:

  • sudden numbness or weakness, especially on one side of the body;
  • sudden and severe headache, confusion, problems with vision, speech, or balance;
  • chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;
  • sudden cough, wheezing, rapid breathing, coughing up blood;
  • pain, swelling, warmth, or redness in one or both legs;
  • a change in the pattern or severity of migraine headaches;
  • nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
  • swelling in your hands, ankles, or feet;
  • a breast lump; or
  • symptoms of depression (sleep problems, weakness, tired feeling, mood changes).

Less serious side effects may include:

  • mild nausea (especially when you first start taking this medicine), vomiting, bloating, stomach cramps;
  • breast tenderness or swelling, nipple discharge;
  • freckles or darkening of facial skin, increased hair growth, loss of scalp hair;
  • changes in weight or appetite;
  • problems with contact lenses;
  • vaginal itching or discharge; or
  • changes in your menstrual periods, decreased sex drive.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Read the entire detailed patient monograph for Ortho Evra (Norelgestromin, Ethinyl Estradiol Transdermal) »

What is Patient Information Overview?

A concise overview of the drug for the patient or caregiver from First DataBank.

Ortho Evra Overview - Patient Information: Side Effects

SIDE EFFECTS: Skin irritation at the application site, nausea, vomiting, headache, bloating, breast tenderness, swelling of the ankles/feet (fluid retention), or weight change may occur. Vaginal bleeding between periods (spotting) may occur, especially during the first few months of use. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. If you miss 2 periods in a row (or 1 period if the patch has not been used properly), talk to your doctor about a pregnancy test.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: lumps in the breast, mental/mood changes (such as new/worsening depression), severe stomach/abdominal pain, unusual changes in vaginal bleeding (such as continuous spotting, sudden heavy bleeding, missed periods), dark urine, yellowing eyes/skin.

This medication may rarely cause serious (sometimes fatal) problems from blood clots (such as deep vein thrombosis, heart attack, pulmonary embolism, stroke). Get medical help right away if any of these side effects occur: chest/jaw/left arm pain, confusion, sudden dizziness/fainting, pain/swelling/warmth in the groin/calf, slurred speech, sudden shortness of breath/rapid breathing, unusual headaches (including headaches with vision changes/lack of coordination, worsening of migraines, sudden/very severe headaches), unusual sweating, weakness on one side of the body, vision problems/changes (such as double vision, partial/complete blindness).

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Read the entire patient information overview for Ortho Evra (Norelgestromin, Ethinyl Estradiol Transdermal)»

What is Prescribing information?

The FDA package insert formatted in easy-to-find categories for health professionals and clinicians.

Ortho Evra FDA Prescribing Information: Side Effects
(Adverse Reactions)

SIDE EFFECTS

The following serious adverse reactions with the use of combination hormonal contraceptives, including ORTHO EVRA, are discussed elsewhere in the labeling:

Adverse reactions commonly reported by users of combination hormonal contraceptives are:

Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice.

The data described below reflect exposure to ORTHO EVRA in 3330 sexually active women (3322 of whom had safety data) who participated in three Phase 3 clinical trials designed to evaluate contraceptive efficacy and safety. These subjects received six or 13 cycles of contraception (ORTHO EVRA or an oral contraceptive comparator in 2 of the trials). The women ranged in age from 18 to 45 years and were predominantly white (91%).

The most common adverse reactions ( ≥ 5%) reported during clinical trials were breast symptoms, nausea/vomiting, headache, application site disorder, abdominal pain, dysmenorrhea, vaginal bleeding and menstrual disorders, and mood, affect and anxiety disorders. The most common events leading to discontinuation were application site reaction, breast symptoms (including breast discomfort, engorgement and pain), nausea and/or vomiting, headache and emotional lability.

Adverse drug reactions reported by ≥ 2.5% of ORTHO EVRA-treated subjects in these trials are shown in Table 3.

Table 3: Adverse Drug Reactions Reported by ≥ 2.5% of ORTHO EVRA-treated Subjects in Three Phase 3 Clinical Trials

System/Organ Class*
Adverse reaction
ORTHO EVRA (n=3322)
Reproductive system and breast disorders
Breast symptomsf 22.4%
Dysmenorrhea 7.8%
Vaginal bleeding and menstrual disordersf 6.4%
Gastrointestinal disorders
Nausea 16.6%
Abdominal painf 8.1%
Vomiting 5.1%
Diarrhea 4.2%
Nervous system disorders
Headache 21.0%
Dizziness 3.3%
Migraine 2.7%
General disorders and administration site conditions
Application site disorder† 17.1%
Fatigue 2.6%
Psychiatric disorders
Mood, affect and anxiety disorders† 6.3%
Skin and subcutaneous tissue disorders
Acne 2.9%
Pruritus 2.5%
Infections and infestations
Vaginal yeast infection† 3.9%
Investigations
Weight increased 2.7%
* MedDRA version 10.0
† Represents a bundle of similar terms

Additional adverse drug reactions that occurred in < 2.5% of ORTHO EVRA-treated subjects in the above clinical trials datasets are:

  • Gastrointestinal disorders: Abdominal distension
  • General disorders and administration site conditions: Fluid retention1, malaise
  • Hepatobiliary disorders: Cholecystitis
  • Investigations: Blood pressure increased, lipid disorders1
  • Musculoskeletal and connective tissue disorders: Muscle spasms
  • Psychiatric disorders: Insomnia, libido decreased, libido increased
  • Reproductive system and breast disorders: Galactorrhea, genital discharge, premenstrual syndrome, uterine spasm, vaginal discharge, vulvovaginal dryness
  • Respiratory, thoracic and mediastinal disorders: Pulmonary embolism
  • Skin and subcutaneous tissue disorders: Chloasma, dermatitis contact, erythema, skin irritation

Postmarketing Experience

The following adverse reactions (Table 4) have been identified during postapproval use of ORTHO EVRA. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Table 4: Alphabetical List of Adverse Drug Reactions Identified During Postmarketing Experience with ORTHO EVRA/EVRA by System Organ Class*

System Organ Class Adverse Drug Reactions
Cardiac disorders Myocardial infarctiont
Endocrine disorders Hyperglycemia, insulin resistance
Eye disorders Contact lens intolerance or complication
Gastrointestinal disorders Colitis
General disorders and administration site conditions Application site reaction†, edemat†
Hepatobiliary disorders Blood cholesterol abnormal, cholelithiasis, cholestasis, hepatic lesion, jaundice cholestatic, low density lipoprotein increased
Immune system disorders Allergic reaction†, urticaria
Investigations Blood glucose abnormal, blood glucose decreased
Metabolism and nutrition disorders Increased appetite
Neoplasms benign, malignant and unspecified (Incl. cysts and polyps) Breast cancer†, cervix carcinoma, hepatic adenoma, hepatic neoplasm
Nervous system disorders Dysgeusia, migraine with aura
Psychiatric disorders Anger, emotional disorder, frustration, irritability
Reproductive system and breast disorders Breast mass, cervical dysplasia, fibroadenoma of breast, menstrual disorder† suppressed lactation, uterine leiomyoma
Skin and subcutaneous tissues disorders Alopecia, eczema, erythema multiforme, erythema nodosum, photosensitivity reaction, pruritus generalized, rasht, seborrheic dermatitis, skin reaction
Vascular disorders Arterial thrombosis† cerebrovascular accident† deep vein thrombosis†, hemorrhage intracranial†, hypertension, hypertensive crisis, pulmonary embolism† thrombosist
* MedDRA version 10.0
† Represents a bundle of similar terms

REFERENCES

1Represents a bundle of similar terms

Read the entire FDA prescribing information for Ortho Evra (Norelgestromin, Ethinyl Estradiol Transdermal) »

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Ortho Evra - User Reviews

Ortho Evra User Reviews

Now you can gain knowledge and insight about a drug treatment with Patient Discussions.

Here is a collection of user reviews for the medication Ortho Evra sorted by most helpful. Patient Discussions FAQs

Report Problems to the Food and Drug Administration

 

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.


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