Evra patches

Evra patches are a unique form of combined hormonal contraception that was approved in Europe for treatment in 2002 by the EMA.

It is a highly effective form of birth control that you apply directly to the skin once a week.

Evra contains synthetic hormones which work to prevent ovulation and other key processes in the reproductive system to prevent pregnancy.

Evra is a combined contraceptive patch, which means it contains synthetic forms of oestrogen (ethinylestradiol) and progesterone (norelgestromin).

Unlike other combined hormonal contraceptives, it delivers the hormones directly through the skin.

These synthetic hormones work in several ways to prevent pregnancy.

How Evra patches work

A simple explanation of how Evra patches prevent pregnancy

Stops ovulation

Ovulation is the process in which your ovaries release an egg each month. Evra prevents the production of key reproductive hormones, luteinising hormone (LH) and follicle-stimulating hormone (FSH), that trigger ovulation. If no egg is released, there is nothing to fertilise, so pregnancy is prevented.

Thickens the cervical mucus

Sperm needs to travel through the cervix to reach an egg. Evra helps to thicken cervical mucus, creating a barrier which makes it difficult for sperm to get through. This further decreases the chances of an egg being fertilised.

Thins the uterine lining

The lining of the womb (uterine lining) thickens during your menstrual cycle so a fertilised egg can more easily implant in the womb. The Evra patch helps to thin the womb lining, making it unlikely for an egg to attach.

Evra is an effective form of contraception that many experts argue is underused.

Benefits of Evra patches

Highly effective

Evra patches have a very low risk of causing pregnancy. They are over 97-99% effective when used correctly.

Convenient

You apply Evra patches once a week. This is unlike contraceptive pills where you have to take them every day. This means you’re less likely to forget to use it and your contraception won’t be affected.

Simple to use

Evra patches are easy to apply and stay on your skin for the entire 7 days. They are also waterproof, meaning you can shower and exercise without them falling off.

Improves menstrual symptoms

Like other combined contraceptives, Evra can improve menstrual symptoms. Research shows Evra can make bleeding lighter, and your periods shorter and more regular.

Not affected by illness

Unlike the pill, the effectiveness of Evra is not affected by vomiting or diarrhoea.

Studies also show that Evra patches have high satisfaction and compliance rates. One study found that 75% of women preferred Evra to their previous contraceptive methods due to its convenience.

While no contraception method is 100% effective, some contraceptive methods have higher effectiveness rates than others.

🗸 Evra patches are 97-99% effective with perfect use

Evra patches offer one of the highest efficacy rates among contraceptives.

This is based on the Pearl Index, which measures how many pregnancies would occur per 100 women using the contraceptive method over one year. The lower the number, the more effective it is.

• With perfect use (applying the patch correctly and on time), research shows that Evra patches have a Pearl Index between 0.73 and 0.9. This means that 7-9 in every 1000 women who use Evra for one year will get pregnant.
• With typical use (e.g. forgetting to apply a patch), effectiveness drops to 93%.

However, Evra is only so effective if you use it correctly. Improper use like forgetting to change the patch on time can reduce its effectiveness and increase the risk of pregnancy.

Evra Patches are suitable for most people. However, you should always ask your doctor if you have another medical condition or take any other medication.

Who can use it

Evra patches are suitable for:

• Women of childbearing potential who want safe and effective contraception.
• Women looking to prevent pregnancy and improve menstrual symptoms.

Your doctor will want to monitor your weight and blood pressure throughout treatment to make sure you are still safe to take the medicine - even if you are a healthy weight or have a healthy blood pressure.

Who cannot use it

You cannot use Evra patches if any of the following apply to you:

Pregnancy and postpartum

• are pregnant or think you may be pregnant
• are less than 3 weeks post-partum and are not breastfeeding with other risk factors for blood clots
• are less than 6 weeks post-partum and are breastfeeding

Heart problems or blood disorders

• have certain heart problems (e.g. cardiomyopathy and heart disease)
• have acute porphyrias (a rare group of genetic disorders that affect red blood cells)
• have atrial fibrillation (a common heart rhythm disorder)
• have high blood pressure
• have known genetic mutations that increase the risk of blood clots
• have previously had a blood clot
• have had a stroke or a mini-stroke (a transient ischaemic attack or TIA)
• have systemic lupus erythematosus (SLE) with antibodies that can increase the risk of blood clots

Other medical conditions

• have severe diabetes
• currently have breast cancer or liver cancer
• have had major surgery and will be immobile for a prolonged period
• have migraine with aura
• smoke more than 15 cigarettes a day and are 35 years or older

Cautions

You should also ask your doctor if you have any of the following conditions, as you may be at a greater risk of side effects:

Cancer risks

• carrier of breast cancer gene mutations (e.g. BRCA1 or BRCA2)
• abnormal precancerous cervical cells or cervical cancer
• history of breast cancer
• focal nodular hyperplasia (a benign tumour on the liver)

Heart and blood-related risks

• a personal or family history of high triglyceride levels in the blood
• being at risk of heart problems or blood clots
• sickle-cell disease

Liver, gallbladder, and digestive issues

• Cholestasis (problems with bile flow) during pregnancy or whilst taking a combined contraceptive
• gallbladder disease
• inflammatory bowel disease
• viral hepatitis whilst taking combined contraception
• bariatric surgery (weight loss surgery) with a BMI between 30 and 34

Other medical conditions

• history of mood side effects on combined contraception
• having an organ transplant
• undiagnosed breast mass or symptoms whilst taking combined contraception
• undiagnosed vaginal bleeding
• a BMI of 35 or above

If you’re not sure, ask your doctor for advice.

What dose do I use?

Each Evra patch contains 203 mcg of norelgestromin (progesterone) and 33.9 mcg of ethinylestradiol (33.9 mcg). You apply one patch once a week.

When do I start it?

You should apply your first patch on day 1 of your cycle (when your period starts) for immediate effectiveness. If you start on day 6 or later, it will not be effective for 7 days - use additional protection, such as condoms, during this time.

Your doctor’s advice will be different if starting Evra after childbirth, miscarriage, abortion or when switching between contraceptives.

When do I apply it?

Here’s how to apply Evra:

1. Apply a new patch weekly on the same day each week for 3 weeks.
2. In week 4, you will have a 7-day interval without using a patch. This allows for withdrawal bleeding.
3. Apply a new patch after the 7-day break

You must use Evra exactly as prescribed and avoid applying new patches late. This will ensure your contraception isn’t affected and you don’t have to worry about an unexpected pregnancy.

Dr. Caroline Fontana Lead Prescribing Doctor

You must use Evra exactly as instructed. If you do not use it properly, it may reduce the effectiveness of your contraception and increase the risk of pregnancy.

What should I do if I miss a dose?

If you forget to apply a new patch or a patch falls off, your advice will depend on how long it has been.

How do I apply Evra patches?

How to apply Evra patches

	Choose a place to apply the patch You can apply the patch to your buttock, abdomen, upper outer arm or upper back. Make sure the patch of skin is dry, clean and hairless. Never put the patch on your breasts.
	Open the foil sachet Open it by tearing along the edge - do not use scissors. Firmly grasp a corner of the patch and gently take it from the foil sachet. Sometimes patches can stick to the inside of the sachet - be careful not to remove the clear covering as you remove the patch. Then, peel away half of the clear protective covering. Try not to touch the sticky surface.
	Apply the patch to your skin Take off the other half of the covering. Press down firmly on the patch with the palm of your hand for 10 seconds. Make sure the edges stick well.

Your Evra patch should not be affected by daily activities. This includes showering, bathing, using a sauna or exercising. However, you should regularly check on your patch to make sure it is still attached.

You may change where your patch is if it is causing skin irritation. Remove the current patch and apply a new patch in a new location.

When taking combined hormonal contraception like Evra patches, it’s important you follow a healthy lifestyle to avoid developing a blood clot.

Blood clots are serious but rare side effects of Evra. However, you can reduce the risk by making certain lifestyle changes.

Minimising how many saturated fats you eat will help lower your cholesterol levels and reduce your risk of blood clots. Instead, prioritise healthy fats like avocadoes, nuts, seeds and oily fish.

Silvia Fonda Nutritionist

Lifestyle tips for Evra users

How to reduce the risk of blood clots

Maintain a healthy weight

• Clinical studies show that being overweight is a significant risk factor for blood clots.
• It’s important to maintain a healthy weight while using Evra.
• For example, eating a balanced diet, swapping sugary drinks for water, and practising portion control.

Avoid high-fat foods

• Limit or avoid foods that are high in unhealthy fats like cakes, biscuits and fast food.
• Foods high in saturated fat can cause plaque to build up in the arteries which may rupture and cause a blood clot.

Do plenty of exercise

• A major risk factor for blood clots is immobility.
• Try to do some physical activity while using Evra.
• This could be as simple as a short walk or doing household chores like vacuuming or gardening.

Common side effects

Uncommon side effects

Rare side effects

Evra patches rarely cause blood clots either in the leg (deep vein thrombosis or DVT) which can travel up to the lung (pulmonary embolism). If you experience any of the following symptoms, you should seek immediate medical attention:

• a new and unexplained pain in your leg
• new swelling in your leg
• warm or discoloured skin on your leg
• breathlessness
• pain in the chest, back or ribs that may be worse when you breathe in
• collapsing
• coughing up blood

Evra patches, like other forms of combined contraception, can slightly increase the risk of breast cancer. The risk is small and gradually decreases after you finish using it. However, you should still check your breasts for any abnormalities regularly.

Most other side effects usually go away within a few days to a few weeks. If they do not subside, talk to your doctor.

To view a full list of side effects, check out the patient information leaflet.

Most common side effects of Evra go away on their own after a few months of using it. This is because your body slowly gets used to the medication.

However, there are a few things you can do to reduce certain side effects:

How to manage side effects of Evra

	Stay hydrated by drinking plenty of fluids. This will help with nausea, diarrhoea and dizziness.
	Take over-the-counter painkillers if you are able to help with headaches or cramps.
	Eat smaller portions and eat more slowly to help with nausea.
	Eat soft and easily digestible foods to help with diarrhoea, like bananas and plain rice.
	Go outdoors and get some fresh air to help with nausea.

Evra may interact with other medicines you take. You should talk to your doctor if you take any other medications before using Evra patches.

Some medicines may alter or reduce the effectiveness of Evra, this includes:

• certain antinausea medicines (e.g. fosaprepitant)
• certain cancer treatments
• medicines used to treat seizures (e.g. carbamazepine, phenytoin & cenobamate)
• medicines used to treat narcolepsy (e.g. modanafil and pitolisant)
• certain antibiotics (rifabutin and rifampicin)
• bosentan (used to treat pulmonary arterial hypertension)
• medicines for HIV (e.g. cobicistat or efavirenz)
• St John’s Wort (a herbal medicine)
• cytisine (a stop-smoking treatment)
• mavacamten (used to treat symptomatic obstructive hypertrophic cardiomyopathy)
• metreleptin (used to treat dyslipidaemia)
• ulipristal (the morning-after pill)

Some medicines may affect your exposure to Evra, this includes:

• medicines for HIV (e.g. atazanavir)
• certain cancer treatments
• clozapine (used to treat schizophrenia)
• lumacaftor (used to treat cystic fibrosis)
• sugammadex (used to reverse the effects of muscle relaxants in anaesthesia)

Some medicines used to treat blood cancer and types of anaemia may increase the risk of blood clots when taken with Evra.

Evra may also reduce the effects of certain medicines, this includes:

• ospemifene (a treatment for vulvar and vaginal atrophy)
• raloxifene (a treatment for post-menopausal osteoporosis)

Evra may also increase the risk of increased concentration of certain liver enzymes when taken with treatments for hepatitis C.

You can find a full list of interactions here.

Storage

Evra patches have no specific storage instructions. However, you should keep it out of sight and reach of children and away from sunlight and moisture.

Do not freeze or refrigerate patches.

Disposal

When you dispose of Evra patches, you should be careful to not touch used patches. This is because they may still contain some active hormones.

To discard used patches, you should:

1. Peel back the disposal label on the outside of the sachet.
2. Place the used patch within the open disposal label so that the sticky surface covers the shaded area.
3. Close the label sealing the used patch within and discard.

Used patches should be taken to a pharmacy to be disposed of with their medical waste. Do not dispose of used patches in your household waste or down the toilet.

No, Evra is a prescription-only medication. You need a valid prescription from a healthcare professional to purchase it. This ensures the medication is safe and suitable for your needs.

You can receive an online prescription from euroClinix.

Ordering Evra Patches online from euroClinix is convenient.

Follow these simple steps:

1. Complete a quick online consultation to check your eligibility.
2. UK-registered doctors review your responses to ensure the medication is right for you.
3. Upon approval, an e-prescription will be issued.
4. Enjoy free delivery from our licensed pharmacy with tracking details.

Your privacy is our top priority. euroClinix uses secure, encrypted transactions and complies with UK’s medical standards to keep your information confidential.

Start your online consultation today to enjoy professional care from the comfort of your home.

euroClinix is trusted by thousands of UK users for its safe and convenient service. Here’s why:

• Experienced doctors manage your consultations and prescriptions.
• Online consultations, quick approvals, and discreet doorstep delivery add to the convenience.
• A supportive team is on hand to answer treatment-related questions or concerns.
• Patients can manage their prescriptions hassle-free through our secure platform.

Join thousands who trust euroClinix for their healthcare needs and take control of your health today.

The price of Evra patches at euroClinix includes everything you need:

• Free online consultation with our experienced doctors
• Free prescription, if approved
• Free delivery straight to your door

Our pricing is transparent, with no hidden fees. Order today and benefit from our complete, all-inclusive service.

There are many types of contraception available if Evra patches are not suitable for you.