Ortho Evra Warnings and Precautions

Specific Precautions and Warnings for Ortho Evra

Some of the warnings and precautions to be aware of prior to using Ortho Evra include the following:
  • Because Ortho Evra patches are worn 24 hours a day, it is possible that women may be exposed to more hormones, compared to other birth control pills. It is possible that this could increase the risk of certain side effects.
  • Smoking cigarettes greatly increases the risk of serious Ortho Evra side effects (such as heart attacks, strokes, and blood clots). This risk is particularly high for smokers over the age of 35. Combined oral contraceptives (which are very similar to Ortho Evra) increase the risk of blood clots, strokes, and heart attacks. It is assumed that Ortho Evra also has these risks. These risks are minimal for healthy, young nonsmokers. Make sure to tell your healthcare provider if you have ever had a blood clot, stroke, heart attack, or chest pain.
  • Some studies have suggested that women taking Ortho Evra may have a higher risk of blood clots, compared to women taking birth control pills.
  • Ortho Evra is less effective in women who weigh 198 pounds or more. If you weigh 198 pounds or more, you may want to consider a different form of birth control.
  • Combined oral contraceptives may also slightly increase the risk of breast cancer or cervical cancer. It is assumed that Ortho Evra also has these risks.
  • Oral contraceptives increase the risk of benign (non-cancerous) liver tumors. Very rarely, these tumors can rupture and cause serious problems. It is assumed that Ortho Evra also shares this risk. If you have liver disease, Ortho Evra may not be the best choice for you.
  • Let your healthcare provider know if you have any sudden vision changes, as this may be a sign of a blood clot in the eyes (a possible side effect of Ortho Evra and other hormonal contraceptives).
  • Hormonal contraceptives (such as Ortho Evra) can make gallbladder disease worse. If you have had a problem with your gallbladder, Ortho Evra may not be the best contraceptive for you.
  • Ortho Evra may increase blood sugar levels, particularly in women with diabetes. Your healthcare provider may need to monitor you more closely.
  • Hormonal contraceptives (including Ortho Evra) can increase your blood pressure. This can be a problem if you already have high blood pressure.
  • Ortho Evra can change your menstrual bleeding patterns. Some women have breakthrough bleeding (bleeding between periods), while others may not have a period at all. It is normal to have shorter and lighter periods while using Ortho Evra. If you notice any unusual changes in your bleeding patterns, let your healthcare provider know. If you miss a period, you should make sure you are not pregnant.
  • Ortho Evra can affect your cholesterol. Your healthcare provider may need to check your cholesterol levels after you start Ortho Evra, especially if you already have high cholesterol.
  • There have been a few, very rare cases of toxic shock syndrome in women who use Ortho Evra. It is not clear whether these cases were due to Ortho Evra, tampon usage, or other causes.
  • Sometimes, hormonal contraceptives can make depression worse. Let your healthcare provider know if you develop new or worsening depression symptoms.
  • Occasionally, Ortho Evra (as well as any other hormonal contraceptive) can cause eye changes that make it more difficult to wear contact lenses.
  • Ortho Evra can interact with a number of different medications (see Ortho Evra Drug Interactions for more information).
  • Ortho Evra is considered a pregnancy Category X medication. This means that you should not use Ortho Evra during pregnancy (see Ortho Evra and Pregnancy).
  • Contraceptive hormones (such as the ones in Ortho Evra) do pass through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, discuss this with your healthcare provider prior to taking the drug (see Ortho Evra and Breastfeeding). Combined hormonal contraceptives (such as Ortho Evra) are not usually recommended for breastfeeding women.
Last reviewed by: Kristi Monson, PharmD
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