Xulane (norelgestromin/ethinyl estradiol transdermal system)

Do’s

• Before starting to use Xulane, read the Patient Information Leaflet provided by your pharmacist. This leaflet contains crucial information on how to properly use and dispose of the patch. If you have any questions, consult with your healthcare provider.
• Xulane patches should be applied to clean, dry skin on the upper outer arm, abdomen, buttock, or upper body where it will not be rubbed by tight clothing. 
• If it's your first time using Xulane, apply the patch on the first Sunday following the beginning of your menstrual period or on the first day of your period. If your period begins on a Sunday, begin on that day. 
• For the first cycle of use only, use a backup form of non-hormonal birth control for the first 7 days to prevent pregnancy until the medication has enough time to work.
• Change the patch once a week on the same day. Remove the used patch before placing a new one, and apply the patch to a different area with each change to avoid skin irritation. 
• After wearing patches for 3 weeks in a row, do not wear a patch during week 4. You should have your period during this time. After not wearing a patch for a week, apply a new patch whether or not you have your period.
• If the patch falls off, re-apply it or apply a new patch within 24 hours. If the patch is not replaced within 24 hours, or if you are not sure how long it has been off, start a new cycle by applying a new patch and use a backup form of non-hormonal birth control for the next 7 days to prevent pregnancy.
• After removing each patch, fold it in half so it sticks to itself, and discard it in the trash away from children and pets. 
• Consult your healthcare provider about how to switch from other forms of hormonal birth control to Xulane. 

Don’t

• Do not apply the patch to your breasts or on red/cut/irritated skin.
• Avoid using lotions, creams, oils, powders, or make-up at the patch site, as they may affect the patch's adhesion
• Do not flush the patch down the toilet.

Common Side Effects: 

• Spotting or bleeding between periods
• Painful menstruation
• Skin irritation
• Abdominal pain
• Breast pain or swelling
• Changes in mood such as depression or anxiety

Most of these side effects are temporary and usually go away within 3 months after the body gets used to the hormones in Xulane. Consult a healthcare provider if the symptoms last longer than this or if they are severe.

Serious Side Effects:

• Blood clots, especially if there are other risk factors such as smoking, obesity, or age greater than 35. Examples of blood clots are deep vein thrombosis (legs), pulmonary embolus (lungs), loss of eyesight (eyes), heart attack (heart), and stroke (brain). These can cause death or lead to permanent disability.

Individual experiences with medication can vary. Consult a healthcare provider for personalized advice and guidance on the use of Xulane and its potential side effects.

If you have had or will be having surgery or if you will be confined to a bed or chair for a long time (such as a long plane flight), inform your healthcare provider. These conditions increase your risk of getting blood clots, especially if you are using hormonal birth control. You may need to stop this medication for a time or take special precautions.

Overdosage of Xulane may cause nausea and vomiting, and withdrawal bleeding may occur in women. In case of suspected overdose, all Xulane patches should be removed and symptomatic treatment given.

Xulane is contraindicated in women with certain conditions, including those at high risk of arterial or venous thromboembolic events, smokers over the age of 35, those with deep vein thrombosis or pulmonary embolism, inherited or acquired hypercoagulopathies, cerebrovascular disease, coronary artery disease, and thrombogenic valvular or rhythm diseases of the heart. Additionally, Xulane is contraindicated in women with a BMI greater than 30 kg/m2.

Xulane may not be as effective in women weighing more than 198 lbs. (90 kg), and it is not recommended for use while breastfeeding.

Smoking while using Xulane increases the risk of serious cardiovascular side effects from hormonal birth control methods, including death from heart attack, blood clots, or stroke.

Consult a healthcare provider before using Xulane or any drug, changing any diet, or commencing or discontinuing any course of treatment.