Xulane (norelgestromin / ethinyl estradiol) is a once-weekly, combination hormonal birth control patch that can help prevent pregnancy. The patch is small in size so it's easy to hide under your clothes, but there is a small chance that the patch can fall off. Xulane (norelgestromin / ethinyl estradiol) isn’t a good option for people who weigh 198 pounds or more, because it might not work as well. It also isn't a good option for people identified as obese (body mass index or BMI of 30 kg/m^2^ or more) because of a higher risk of blood clots.
Prevention of pregnancy
Xulane (norelgestromin / ethinyl estradiol) contains norelgestromin (a progestin) and ethinyl estradiol (an estrogen). These components work together to prevent pregnancy by acting like natural progesterone and estrogen hormones in your body. Xulane (norelgestromin / ethinyl estradiol) works by stopping your body from releasing eggs (also known as ovulation). It also creates an environment that makes it both harder for sperm to move through and for a fertilized egg to attach and grow.
Source: DailyMed
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Body aches or pain
chills
difficulty with breathing
ear congestion
headache
loss of voice
unusual tiredness or weakness
Incidence not known
changes in skin color
chest pain or discomfort
confusion
dark urine
dizziness
fainting
inability to speak
lack or loss of appetite
light-colored stools
lightheadedness
numbness in the hands
pain in the stomach
pain in the chest, groin, or legs, especially the calves
pain or discomfort in the arms, jaw, back, or neck
pain, tenderness, or swelling of the foot or leg
pounding in the ears
rash
seizures
slow or fast heartbeat
slurred speech
sudden headache
sudden loss of coordination
sudden, severe weakness or numbness in the arm or leg on one side of the body
sweating
swelling, pain, or tenderness in the upper abdominal or stomach area
temporary blindness
unpleasant breath odor
vision changes
vomiting of blood
yellow eyes or skin
Get emergency help immediately if any of the following symptoms of overdose occur:
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Burning, itching, or redness of the skin
pain, soreness, swelling, or discharge from the breast or breasts
swelling or soreness at the patch site
Incidence not known
Absent, missed, or irregular menstrual periods
bloody vaginal discharge
brown, blotchy spots on exposed skin
change in amount of vaginal discharge
change in menstrual flow
decreased amount of breast milk
discouragement
feeling sad or empty
increase or decrease in weight
increased hunger or thirst
increased urination
irritability
itching of the vagina or outside of the genitals
light vaginal bleeding between periods and after sexual intercourse
loss of interest or pleasure
pain during sexual intercourse
stomach cramps or bloating
stopping of menstrual bleeding
swelling
thick, white curd-like vaginal discharge without odor or with mild odor
trouble concentrating
trouble sleeping
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Works very well at preventing pregnancy
Applied once a week
Patch stayed on the skin well for most people during clinical studies
Not for use in people with a BMI of at least 30 kg/m^2^ or a weight of at least 198 pounds
More estrogen absorbed into the body compared to most combination hormonal birth control pills, which might mean a higher risk of side effects
Small risk of blood clots, heart attack, or stroke
Won't work as well if you cut or tear the patch
It's important to follow the directions to make sure you apply Xulane (norelgestromin / ethinyl estradiol) correctly. Ask your provider or pharmacist if you have any questions about how to use the patch.
Apply the patch to the upper outer arm, lower stomach, buttock, or back. Don't apply the patch to your breasts, on irritated skin or cuts, in places where tight clothing can rub against the patch, or in the same place as your last patch.
The patch must stick to your skin completely for the whole week. Replace it with a new patch each week for 3 weeks in a row. Both of these things make sure the medication works best at preventing pregnancy.
If you forget to apply or change your patch, or if your patch comes off your skin, talk to your provider. In these situations, you might need to use a back-up, non-hormonal birth control method (e.g., condom) in addition to using Xulane (norelgestromin / ethinyl estradiol). Your provider can let you know if you need a back-up method and for how long.
Don't smoke while using Xulane (norelgestromin / ethinyl estradiol), because smoking raises your risk of getting blood clots. If you smoke, talk to your provider about steps to quit smoking. If you’re not ready to quit, your provider can guide you to other birth control options that are safer for you.
Wear sunscreen and avoid tanning beds to protect your skin while using Xulane (norelgestromin / ethinyl estradiol). This medication can cause areas of your skin to darken on your forehead, nose, cheeks, and around your mouth (chloasma).
Xulane (norelgestromin / ethinyl estradiol) should not be used during pregnancy. If you become pregnant while using this medication, you should stop using the patches, since you won't need birth control at that point.
Xulane (norelgestromin / ethinyl estradiol) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: Personal or family history of blood clots | Smoking | Age 35 years or older | High blood pressure | High cholesterol | High blood sugar | BMI of 30 kg/m^2^ or more | Migraines with flashes of light or tingling in the hand or face | Not moving for a long period of time
Combination hormonal birth control like Xulane (norelgestromin / ethinyl estradiol) can cause your blood to clump together (form clots), and block blood from getting to other parts of your body. These clots can lead to heart attacks or strokes.
Make sure you discuss using combination hormonal birth control with your provider before starting, since there are many factors that raise your risk of blood clots. In general, your risk is highest during your first year of using Xulane (norelgestromin / ethinyl estradiol) and when you restart any hormonal birth control after a break of 4 weeks or longer. It's especially high if you're at least 35 years old and you smoke, or if you have a BMI of 30 kg/m^2^ or more. Other risk factors include having migraines with aura or during a short period of time after surgery. Let your provider know if you have a surgery coming up, so they can discuss when to stop and restart your birth control.
Symptoms of a stroke include sudden weakness on one side of your body, drooping face, bad headaches, trouble breathing, or changes in your speech or vision. Symptoms of a heart attack include arm pain, chest pain, or a cold sweat. If you experience any of these symptoms or swelling or pain in your arms or legs, go to the emergency room immediately.
Risk factors: History of liver damage | Liver tumors | Taking certain hepatitis C treatments
Xulane (norelgestromin / ethinyl estradiol) can cause damage to your liver or, rarely, raise your risk of liver tumors. You shouldn't take Xulane (norelgestromin / ethinyl estradiol) if you're taking hepatitis C combination medications containing ombitasvir, paritaprevir, and ritonavir. This is because there is an even higher risk of liver damage when Xulane (norelgestromin / ethinyl estradiol) is used together with these combination medications. Let your healthcare provider know as soon as possible if you notice symptoms of liver problems, like yellowing of your skin or eyes, upper right stomach pain, or dark urine, while using Xulane (norelgestromin / ethinyl estradiol).
Risk factors: High blood pressure | Older age | Long-term use
Xulane (norelgestromin / ethinyl estradiol) can raise your blood pressure. People who can’t keep a consistently healthy blood pressure shouldn't use Xulane (norelgestromin / ethinyl estradiol), since it can make it harder for you to reach your blood pressure goals. Your provider might monitor your blood pressure while you use Xulane (norelgestromin / ethinyl estradiol) to make sure it doesn't get too high. If you notice changes in your vision, headaches, or flushing, let your provider know immediately. These can be signs of very high blood pressure.
Risk factors: History of gallbladder condition
Xulane (norelgestromin / ethinyl estradiol) can cause new or worsening gallbladder problems. Tell your provider if you've had gallbladder problems in the past. Your provider will decide if you should stop taking Xulane (norelgestromin / ethinyl estradiol) and switch to a different birth control method.
Risk factors: Personal or family history of high triglyceride levels
Using Xulane (norelgestromin / ethinyl estradiol) can raise your triglyceride (fat) levels in your body. Higher levels of these fats can raise your risk of problems with your pancreas, including swelling (pancreatitis). If you have a history of high triglyceride levels, your provider might monitor them more closely through blood work while you're using Xulane (norelgestromin / ethinyl estradiol). If you notice sudden pain around your upper stomach to your back, stomach tenderness or bloating, nausea, or vomiting, let your provider know as soon as possible. These can be signs of pancreatic problems.
Risk factors: History of diabetes (high blood sugar)
Using Xulane (norelgestromin / ethinyl estradiol) can raise your blood sugar levels, since the medication can affect how well your body processes sugar. If you have a history of having high blood sugar levels, your provider might need to check these levels more often to make sure they don't get too high. If you experience extreme thirst, hunger, or urinate more often while taking the medication, let your healthcare provider know since this might mean your blood sugar levels are too high.
You might notice changes to your menstrual bleeding after starting Xulane (norelgestromin / ethinyl estradiol). It's normal to see some breakthrough bleeding and spotting when using Xulane (norelgestromin / ethinyl estradiol). If this irregular bleeding doesn't go away over time, let your healthcare provider know, because they might need to make changes to your birth control medication.
In addition, if your period doesn't come at all during the week you aren't wearing a patch (the last week in the 4-week cycle), let your provider know as well. This can be a sign that you might be pregnant, and your provider might recommend a pregnancy test to check. This is especially important if you might not have followed the exact instructions on when to apply the patch.
Risk factors: History of hormone receptor-positive cancer
According to some studies, there might be a higher risk of certain types of cancer (e.g., breast or cervical cancer) if you take combination hormonal birth control. Breast and cervical cancers are a type of hormone receptor-positive cancer, which means it can grow when there are more hormones (estrogen or progestin) in the body. Because Xulane (norelgestromin / ethinyl estradiol) is a medication that contains these hormones, it might cause breast or cervical cancer to grow. Research also suggests that the risk of these cancers might be higher with longer medication use. Xulane (norelgestromin / ethinyl estradiol) shouldn't be used if you currently have or have had breast cancer. If you want to start combination hormonal birth control but have questions about your cancer risk, talk to your healthcare provider.
Dosage | As low as |
---|---|
3 patches of 150mcg/35mcg | $34.24 for 1 package |
Each cycle lasts 4 weeks. Continue to repeat the cycle to prevent pregnancy.
Weeks 1 to 3: Apply 1 patch to your body once a week on the same day of the week. Be sure to take off the old patch before you apply a new one.
Week 4: Don't apply any patches this week.
Each day, the patch releases 150 mcg of norelgestromin and 35 mcg of ethinyl estradiol.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
BMI of 30 kg/m^2^ or more
Over the age of 35 who smoke or have migraine headaches
Liver problems
Current use of certain hepatitis C medications
History of breast cancer
Changes in menstrual bleeding (period) patterns that your provider hasn't checked out yet
Pregnancy
Prevention of pregnancy
Prevention of pregnancy
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