What to Know About Xulane: The Generic Ortho Evra Patch

Finding the right form of birth control can feel a bit overwhelming. Especially if remembering to take a pill every day doesn’t fit with your lifestyle. The good news is there are plenty of alternative options.

Here’s everything you need to know about one popular alternative — Xulane, the generic Ortho Evra birth control patch.

What is Xulane (Ortho Evra)?

Xulane (norelgestromin/ethinyl estradiol)is a branded generic of Ortho Evra. It’s a once-weekly patch that’s used to prevent pregnancy. It contains a combination of two hormones: ethinyl estradiol (an estrogen) and norelgestromin (a progestin).

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These hormones work together to prevent your ovaries from releasing eggs (ovulation). They also change the cervical mucus and lining of your uterus making it harder for an egg to be fertilized and implanted.

How do you use Xulane patches?

Xulane comes as a pack of 3 patches that offers pregnancy prevention for a 28-day (4-week) cycle. A patch is applied once a week for 3 weeks. Change your patch on the same day each week and only wear one at a time. You won’t wear a patch during the fourth week of the cycle — expect your period that week. You’ll restart the cycle with a new patch at the end of the fourth week.

Where can the Xulane patch be applied?

You can apply your Xulane patch to these areas:

• Outside of the upper arm

• Stomach

• Buttock

• Back

Avoid areas where the patch might be rubbed by tight clothing, like under a bra strap or waistband. You also shouldn’t put it on your breasts or on skin that is cut or irritated.

To avoid skin irritation, rotate where you apply the patch each time you change it.

Some important reminders for applying the patch correctly:

• Apply to clean, dry skin.

• Don’t apply makeup or lotion to the skin where the patch is placed.

• Don’t cut or alter the patch.

• Check the patch daily to make sure it’s sticking properly.

How effective is the Xulane patch?

If you use Xulane perfectly, it’s about 99% effective at preventing pregnancy. But, it’s closer to 93% effective with normal use since mistakes can happen.

Be aware Xulane might not work as well if you weigh 198 lbs or more. Talk to your healthcare provider about more effective options if this applies to you.

Does the Xulane patch work immediately?

You may need to use a backup birth control method (like condoms or spermicide) for the first 7 days of Xulane depending on when you start it. Here are the options for starting Xulane.

Sunday start

Although it’s called a “Sunday” start, any day of the week will do. Choose the day of the week that you want to change your patch. Once your menstrual period begins, apply Xulane on your chosen day.

For example, if you choose Sunday as your patch change day, you would apply Xulane on the first Sunday after your period starts. You’ll need to use a backup birth control method for 7 days after applying your first Xulane patch with this method.

First-day start

Apply your first Xulane patch during the first 24 hours of your menstrual period. With this method, you’re good to go — no backup birth control is needed. Make note of the day of the week, as this will be your patch change day. Not sure when your period started or it started longer than 24 hours ago? You’ll need to use the “Sunday start” method.

Restarting Xulane

Forget your patch change day? It happens. But instructions for restarting will be different depending on the week of your cycle and how long your patch has been forgotten. It’s best to give your pharmacist or healthcare provider a call. They can advise how to restart Xulane and if backup birth control is needed.

Side effects of the Xulane birth control patch

Because the Xulane patch contains hormones, it has similar side effects to other types of hormonal birth control. Common side effects can include:

• Skin irritation from the patch adhesive

• Breast tenderness

• Headache

• Nausea

• Irregular bleeding between periods

These side effects usually improve with time. But contact your health provider if they’re severe or don’t go away after a few months of using Xulane.

Xulane and other hormonal birth controls can also raise your risk for rare but serious side effects like blood clots, heart attack, or stroke. Certain risk factors may make these side effects more likely to happen, such as obesity, high blood pressure, or smoking.

In fact, if your BMI is 30 mg/k² or higher, you shouldn’t use Xulane because the risk of blood clots is too high. If you have any of these risk factors, talk to your healthcare provider about safer birth control options.

Get medical help if you have any of the following symptoms:

• Chest pain

• Weakness or numbness of an arm or leg

• Pain or swelling in the lower leg

• Sudden, severe headache

• Vision changes

What to do if your birth control patch comes off

Xulane needs to be fully attached to work properly. If the patch edge lifts up, press down firmly on it for 10 seconds. Run your fingers over the surface and smooth out any wrinkles.

If the patch comes partially or completely off, and it’s been less than 24 hours, try re-applying it. If it still doesn’t completely stick to your skin, remove it and apply a new patch.

You shouldn’t use tape or other methods to hold the patch in place. It won’t work properly if it doesn’t stick on its own. If you can replace the patch within 24 hours, you won’t need a backup birth control method and your patch change day will stay the same.

If the patch has been partially or fully off for more than 24 hours, or if you’re not sure how long it has been, you might not be protected from pregnancy. You’ll need to put on a new patch and restart a new 28-day cycle. You’ll also need to use a backup birth control method for 7 days.

How do you get a Xulane replacement patch?

Replacement patches need a separate prescription from your healthcare provider.

Once you notice your current patch is off or not sticking, let your healthcare provider know. They can send a prescription for a single replacement patch to your pharmacy.

Ask your provider to send a replacement patch prescription along with your first Xulane prescription. The pharmacy can then keep it on file for you in case you need it.

Will my insurance cover replacement patches?

Maybe. Depending on how your individual insurance plan is set up, a replacement patch may or may not be covered.

Keep in mind that if you don’t get a replacement patch and instead use another patch from your box, you’ll run out of your weekly patches sooner than you should. This may cause your insurance to reject your next refill, as it will appear that it’s happening too soon.

You can always call the member service number on your prescription insurance card before going into the pharmacy to find out about your coverage. Your pharmacist can also help you figure out your best option if you need a replacement patch and aren’t sure if it’s covered.

How to save on Xulane patches

There are ways to save on Xulane, which is available as a lower-cost generic. GoodRx can help you save over 70% off the average retail price. Xulane’s price at certain pharmacies is as low as $46.97 with a free GoodRx discount.

How do I dispose of a used birth control patch?

Once you remove the patch, simply fold the sticky sides together. Then, place it into a child-resistant container (if possible), and toss it in the trash. Don’t flush the patch down the toilet.

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Written by:

Tegan Smedley, PharmD, APh

Tegan Smedley, PharmD, APh, has 10 years of experience as a pharmacist. She has worked in a variety of settings, including retail, hospital, and ambulatory care.

Edited by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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