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).
To prevent pregnancy
Xulane (norelgestromin / ethinyl estradiol) is a combination of two hormones: norelgestromin (a progestin) and ethinyl estradiol (an estrogen). These two hormones work together to help prevent pregnancy by:
Stopping ovulation (release of an egg from the ovary)
Changing cervical mucus to block sperm movement
Creating an unfriendly environment for the fertilized egg by changing the lining in the uterus (womb)
Source: DailyMed
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Body aches or pain
chills
difficulty with breathing
ear congestion
headache
loss of voice
unusual tiredness or weakness
Incidence not known
changes in skin color
chest pain or discomfort
confusion
dark urine
dizziness
fainting
inability to speak
lack or loss of appetite
light-colored stools
lightheadedness
numbness in the hands
pain in the stomach
pain in the chest, groin, or legs, especially the calves
pain or discomfort in the arms, jaw, back, or neck
pain, tenderness, or swelling of the foot or leg
pounding in the ears
rash
seizures
slow or fast heartbeat
slurred speech
sudden headache
sudden loss of coordination
sudden, severe weakness or numbness in the arm or leg on one side of the body
sweating
swelling, pain, or tenderness in the upper abdominal or stomach area
temporary blindness
unpleasant breath odor
vision changes
vomiting of blood
yellow eyes or skin
Get emergency help immediately if any of the following symptoms of overdose occur:
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Burning, itching, or redness of the skin
pain, soreness, swelling, or discharge from the breast or breasts
swelling or soreness at the patch site
Incidence not known
Absent, missed, or irregular menstrual periods
bloody vaginal discharge
brown, blotchy spots on exposed skin
change in amount of vaginal discharge
change in menstrual flow
decreased amount of breast milk
discouragement
feeling sad or empty
increase or decrease in weight
increased hunger or thirst
increased urination
irritability
itching of the vagina or outside of the genitals
light vaginal bleeding between periods and after sexual intercourse
loss of interest or pleasure
pain during sexual intercourse
stomach cramps or bloating
stopping of menstrual bleeding
swelling
thick, white curd-like vaginal discharge without odor or with mild odor
trouble concentrating
trouble sleeping
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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
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
Xulane (norelgestromin / ethinyl estradiol) helps prevent pregnancy, but it doesn't protect you against human immunodeficiency virus (HIV), hepatitis, or other sexually transmitted diseases (STIs). Using a condom along with Xulane (norelgestromin / ethinyl estradiol) can help lower your risk of an STI.
Apply Xulane (norelgestromin / ethinyl estradiol) around the same day each week. Setting a reminder or alarm can help you stay on schedule.
If you forget to change your Xulane (norelgestromin / ethinyl estradiol) patch, talk to your prescriber or pharmacist. What you need to do next depends on which week of the cycle you're in and how long the patch was forgotten. You might also need to use backup birth control for a certain period.
Don't try to reapply a Xulane (norelgestromin / ethinyl estradiol) patch if it's no longer sticky, has folded onto itself or another surface, has dirt or material stuck to it, or has come loose before. Never use tape, adhesives, or wraps to hold the patch in place. Instead, apply a new patch right away.
Irregular bleeding (light vaginal spotting) is common while using Xulane (norelgestromin / ethinyl estradiol) and doesn't mean the medication isn't working. Keep using it as directed. Talk to your gynecologist if your bleeding doesn’t stop or if you miss your period.
Let your gynecologist know if you feel depressed or notice a worsening mood while using Xulane (norelgestromin / ethinyl estradiol). If symptoms become severe, they might have you stop the medication.
Tell your gynecologist if you notice swelling or sudden weight gain while using Xulane (norelgestromin / ethinyl estradiol). Discuss your medical history before starting this medication.
Xulane (norelgestromin / ethinyl estradiol) can interact with many medications. Tell your healthcare team about all prescription, over the counter, and supplement products you take before starting this medication.
To properly throw away a used Xulane (norelgestromin / ethinyl estradiol) patch, fold it in half so the sticky sides stick together. This prevents accidental exposure to leftover medication. Discarded patches can be dangerous if children or pets chew or swallow them, as they can still contain some medication.
Xulane (norelgestromin / ethinyl estradiol) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: Over 35 years old who smoke cigarettes
Smoking cigarettes while using Xulane (norelgestromin / ethinyl estradiol) can significantly raise your risk for blood clots. These blood clots can lead to more serious problems, such as heart attack and stroke. The risk is greater if you're over 35 years old and have a history of smoking cigarettes. If you smoke, talk with your gynecologist about safer birth control alternatives.
Risk factors: Age 35 or older and smoke | Recent surgery with a long period of bed rest | Starting Xulane (norelgestromin / ethinyl estradiol) less than a month after childbirth | High blood pressure | People with BMI at or greater than 30 kg/m² | High cholesterol | Diabetes | Higher dose of estrogen
Compared to other combined hormonal contraceptives, Xulane (norelgestromin / ethinyl estradiol) leads to higher estrogen absorption, which might raise the risk of side effects, including serious blood clots. These clots can occur anywhere in your body, including your lungs (pulmonary embolism or PE), legs (deep vein thrombosis or DVT), brain (stroke), and heart (heart attack). Get emergency help right away if you have any signs of a blood clot.
Brain: weakness or numbness in your arms, legs, or face on one side of the body, trouble speaking, blurred vision, dizziness, loss of balance, trouble walking, or confusion
Eyes: trouble seeing, bulging eye, double vision
Heart: chest pain, sweating, nausea, or dizziness
Lungs: trouble breathing, chest pain, or cough
Legs: cramps, swelling, pain, or muscle tightness
If you need to have surgery, tell your care team you're taking Xulane (norelgestromin / ethinyl estradiol). They might have you stop taking it 4 weeks before until 2 weeks after your surgery to lower your risk of blood clots. If you recently delivered a baby, you shouldn't start Xulane (norelgestromin / ethinyl estradiol) until 4 weeks after delivery if you're not breastfeeding your child.
Risk factors: Using hormonal contraceptives for more than 8 years
Don't use Xulane (norelgestromin / ethinyl estradiol) if you have liver problems, such as hepatitis, severe cirrhosis, or liver tumors. Although rare, this medication can raise your risk of benign liver tumors. If you notice signs of liver problems, stop using Xulane (norelgestromin / ethinyl estradiol) and talk to your gynecologist about other birth control options. Signs of liver problems include jaundice (yellowing of the skin or whites of the eyes), fever, tiredness, loss of appetite, or dark urine.
Risk factors: Older age | Using hormonal contraceptives for a long time | History of high blood pressure
Xulane (norelgestromin / ethinyl estradiol) can raise your blood pressure. The risk is higher if you're older and have been using birth control for a long time. If you have a history of high blood pressure that's well-controlled, your prescriber might monitor you while you use Xulane (norelgestromin / ethinyl estradiol). If you have concerns, talk with them about the risks and benefits of using this medication.
Risk factors: History of gallbladder problems
Some studies show that Xulane (norelgestromin / ethinyl estradiol) can slightly raise your risk of gallbladder problems. And if you already have gallbladder problems, this medication could make them worse. If you’ve had cholestasis (a liver condition that slows or stops bile flow) from birth control or pregnancy before, you might have a higher risk of getting it again with Xulane (norelgestromin / ethinyl estradiol). Talk to your prescriber if you have a history of gallbladder or liver problems before using this medication.
Risk factors: Prediabetes or diabetes | High triglycerides
Xulane (norelgestromin / ethinyl estradiol) can raise your blood sugar and triglycerides levels. If you have prediabetes or diabetes, your prescriber will likely monitor your blood sugar while you take this medication. High triglycerides can lead to a higher risk of pancreatitis (inflammation of the pancreas). Speak with your gynecologist before starting Xulane (norelgestromin / ethinyl estradiol) if you have a history of high blood sugar or triglycerides. They might suggest a different birth control option or monitor your lab work more closely while you're using this medication.
Let your gynecologist know if you experience new or worsening migraines or headaches while using Xulane (norelgestromin / ethinyl estradiol). If you develop frequent, severe, or new headaches, you might need to stop the medication.
People who use Xulane (norelgestromin / ethinyl estradiol) can sometimes experience breakthrough bleeding or spotting. If this happens, talk to your gynecologist to rule out pregnancy, infections, or other medical conditions. If no serious cause is found, the bleeding might stop over time or after switching to a different birth control.
In clinical trials, most people started their withdrawal bleeding on the fourth day of the patch-free week, lasting about 5 to 6 days. If you have concerns about irregular bleeding, talk to your gynecologist.
Risk factors: History of depression
If you have a history of depression, your prescriber will monitor you while using Xulane (norelgestromin / ethinyl estradiol). If your depression gets worse or becomes serious, they might stop the medication. Let your prescriber know if you experience mood changes, sadness, or loss of interest in activities while taking this medication.
Risk factors: History of breast or cervical cancer | Taking COCs for a long time
Study results are mixed, but Xulane (norelgestromin / ethinyl estradiol) and other combined hormonal birth control pills might raise your risk for breast and cervical cancer.
Don't take Xulane (norelgestromin / ethinyl estradiol) if you currently have or have had breast cancer because some types of breast cancer grow faster in the presence of estrogen, which is in this medication. Perform breast self-checks regularly at home and get yearly breast exams with your gynecologist to help with early detection. Let them know if you notice any new or abnormal lumps, pain, or swelling in your breasts.
Make sure you follow up with your gynecologist to get proper screenings for cervical cancer. Report any signs of vaginal bleeding or discharge that's not normal.
Risk factors: History of hereditary angioedema | History of chloasma gravidarum
If you have certain conditions, such as hereditary angioedema or chloasma (a skin condition that causes dark patches on the face), talk to your prescriber before taking Xulane (norelgestromin / ethinyl estradiol) because it might worsen your symptoms. If you have a history of chloasma, limit exposure to the sun or UV light while taking Xulane (norelgestromin / ethinyl estradiol).
Dosage | Quantity | Price as low as | Price per unit |
---|---|---|---|
3 patches of 150mcg/35mcg | 1 package | $27.38 | $27.38 |
Xulane (norelgestromin / ethinyl estradiol) follows a 28-day (4-week) cycle. Each patch releases 150 mcg of norelgestromin and 35 mcg of ethinyl estradiol per day.
Weeks 1 to 3: The typical dose is to apply 1 new patch to your skin once a week on the same day each week. Be sure to take off the old patch before applying a new one.
Week 4: Don't apply a patch this week. This is your patch-free week (three weeks on, one week off).
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Over 35 years old who smoke
Currently have or have had a blood clot
Blood clotting condition
Certain heart rhythm problems, like atrial fibrillation (AFib)
High blood pressure that's not under control
Diabetes with high blood pressure or organ damage
Any migraine headaches for those over 35 years old
Have a body mass index (BMI) at or greater than 30 kg/m²
Liver problems or liver disease
Unexplained vaginal bleeding that hasn't been diagnosed
Currently have or have had breast cancer
Take hepatitis C combination medications containing ombitasvir/paritaprevir/ritonavir
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Latwal, B., et al. (2020). Authorized generics vs. branded generics: A perspective. Journal of Generic Medicines.
MedlinePlus. (2024). Cholestasis.
Mylan Pharmaceuticals Inc. (2022). Xulane- norelgestromin and ethinyl estradiol patch [package insert]. DailyMed.
Planned Parenthood. (n.d.). How effective is the birth control patch?
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