Xulane vs. Twirla for Birth Control: Important Differences and Potential Risks.

Xulane

(norelgestromin / ethinyl estradiol)

Twirla

(levonorgestrel / ethinyl estradiol)

Summary for Xulane

Prescription only

Xulane (norelgestromin / ethinyl estradiol) is a birth control patch that contains both estrogen and progesterone hormones. It works well to prevent pregnancy if you follow the instructions by applying a new patch once a week. Xulane (norelgestromin / ethinyl estradiol) is available for most people who can get pregnant, but it might not work as well for those who weigh more than 198 pounds or have a body mass index or BMI of 30 kg/m² or higher. The best places to apply the patch are the upper outer arm, stomach, buttock, or back. Common side effects include breast discomfort, headache, or application site reactions (such as rash or skin irritation).

Indications for Xulane

To prevent pregnancy

Pros and Cons for Xulane

Pros

Patch is applied once a week
99% effective at preventing pregnancy when used perfectly
Patch stayed on the skin for 95% of people in studies

Cons

Raises your risk for serious blood clots
More estrogen is absorbed compared to other combination birth control pills, which might cause more side effects
Might not work as well for people who weigh more than 198 pounds or have a BMI of 30 kg/m² or higher

Common Side Effects for Xulane

Breast symptoms (discomfort, swelling, or pain; 22%)
Headache (21%)
Skin irritation and redness (17%)
Nausea (17%)
Menstrual cramps (8%)
Stomach pain (8%)
Vaginal bleeding (6%)
Changes in mood (6%)
Vomiting (5%)

Warnings for Xulane

Cigarette smoking and risk for blood clots
Blood clots and strokes
Liver problems
High blood pressure
Gallbladder problems
High blood sugar and triglycerides
Headache
Irregular bleeding
Depression
Risk for breast and cervical cancer
Worsening of other health conditions

Summary for Twirla

Prescription only

Twirla (levonorgestrel / ethinyl estradiol) is a once-weekly birth control patch. It's a combination hormonal contraceptive that contains an estrogen and progestin. Twirla (levonorgestrel / ethinyl estradiol) is used to help prevent pregnancy in people with a body mass index (BMI) of less than 30 kg/m2. A new patch is placed on the skin every week for 3 weeks, followed by a patch-free week, and then the cycle is repeated. Side effects can include skin irritation where the patch is placed and nausea.

Indications for Twirla

Prevention of pregnancy

Pros and Cons for Twirla

Pros

When used correctly, 95% effective at preventing pregnancy
A patch that's placed on the skin; an alternative to the birth control pill
Applied once a week

Cons

Can't use if you have a BMI of 30 kg/m2 or more because of risk for blood clots
Might fall off if you get the patch wet for too long (more than 30 minutes) or if you use too much body lotion or oil
No lower-cost generic available; brand-name medication only

Common Side Effects for Twirla

Application site reactions (e.g., rash, skin color changes, irritation, itching; 6%)
Nausea (4%)
Headache (4%)
Pain with your menstrual period (2%)
Weight gain (2%)