EVRA Patches

EVRA patches are a prescription-only contraceptive patch used to prevent pregnancy. They are an alternative to the commonly used contraceptive pill that contains a combination of the synthetic sex hormones progesterone (norelgestromin) and oestrogen (ethinyl estradiol).

If you apply EVRA patches as advised by your doctor or pharmacist, they are 99% effective.

EVRA patches offer more than just effective pregnancy prevention. Clinical studies have found that combined hormonal patches can also:

• regulate the menstrual cycle in pre-menopausal women
• reduce heavy menstrual bleeding

EVRA patches work to prevent pregnancy by:

• stopping the ovaries from releasing an egg (ovulation)
• thickening the mucus around the cervix (making it harder for sperm to reach an egg)
• thinning the lining of your womb (making it difficult for a fertilised egg to attach to)

How long does an EVRA patch last?

Each EVRA patch lasts for 1 week (7 days). You apply a new patch every week for the first 3 weeks of using them, followed by a patch-free week.

How long do EVRA patches take to start working?

If you start using EVRA patches between the first and fifth day of your period, they will start working immediately.

If you start the patch at any other time during your cycle, it will take 7 days to start working. To prevent pregnancy you’ll need to use other types of contraception, such as condoms, if you have sex during this time.

How effective are EVRA patches?

EVRA patches are over 99% effective at preventing pregnancy when used correctly. In reality the effectiveness of the patch is slightly lower, when accounting for mistakes such as forgetting to change your patch.

EVRA patches are traditionally used once per week with a week's break on week 4:

1. For weeks 1, 2, and 3 wear a new patch for exactly 7 days.
2. Replace the patch with a new one and leave it on for exactly 7 days.
3. On week 4, remove your patch and do not replace it. You might have a breakthrough bleed.
4. Repeat this method again for as long as you want to use EVRA patches unless you want to try a different method of taking it.

You will still be protected from pregnancy, even during your break, as long as you follow these instructions and your patch does not fall off or become detached.

You should check every day that your patch is still attached properly. If your patch falls off or partly detaches and it has been:

Less than one day (up to 24 hours):

• put it on again or replace it with a new one
• no back-up contraception is needed
• your patch change day can remain the same

Do not try to put the patch back on if it's no longer sticky, has other material stuck to it, or it's not the first time it has fallen off. You mustn't use tape to keep it in place. If you cannot get a patch back on, put a new one on.

More than one day (24 hours or more):

• start a new 4-week cycle immediately by putting on a new patch
• your change day will now be changed to the new day you have applied your patch
• use non-hormonal contraception during the first week of this new cycle

If you need further advice, speak with your nurse, GP, or pharmacist.

Can you use EVRA patches continuously?

Yes, you can use EVRA patches continuously. There are a few ways you can use EVRA patches, which are:

1. A shortened hormone-free interval: This involves using the patches for 21 days before having a shortened 4-day, (instead of 7-day) break. After the break, repeat this process.
2. Tricycling: This involves using your EVRA patches for 9 weeks (9 patches in a row) before taking a 4 or 7-day break. You can then continue taking your patches this way if it works for you.
3. Flexible extended use: This involves using your EVRA patches continuously until you get some breakthrough bleeding for 3 or 4 days. When this happens, you’ll take a 4-day break before repeating this process.
4. Continuous use: This involves taking your EVRA patches continuously, with no breaks. If you get breakthrough bleeding when using your patches this way, speak with your doctor or pharmacist. They might recommend taking a short break to see if this helps.

These different methods are just as safe and effective as taking EVRA patches with a 7-day break but are usually more convenient as you’ll have fewer bleeds. They can also reduce symptoms that happen during the hormone-free break between patches.

Before taking your patch in these ways, it’s best to speak with your doctor or pharmacist.

What to do if you forget to change your EVRA patch

At the start of any patch cycle (week 1, day 1)

If you forget to apply your patch on day 1, your risk of pregnancy could be higher. You should:

• use another form of contraception for 1 week if you have sex
• apply your first patch as soon as you remember

Your patch change day will now be the day you applied the patch, and your new day 1.

In the middle of your patch cycle (after week 1)

If you forget to change your patch:

• replace it as soon as possible and within 48 hours of when it was due
• apply your next patch on your normal day

As long as you change your patch within 48 hours, you’ll still be protected from pregnancy.

If it’s been longer than 48 hours, you’re at a higher risk of pregnancy. You must:

• start a new cycle as soon as you apply your new patch
• change your patch change day to the same day you applied the new patch, which is also your new day 1
• use another form of contraception if you have sex within the first 7 days

At the end of your patch cycle

If you forget to take your patch off:

• take it off as soon as you remember
• start your next cycle on your usual patch change day

You’ll still be protected from pregnancy.

How to safely dispose of your EVRA patches

Used EVRA patches need to be disposed of carefully, as they still contain some active hormones. To discard a used patch, you should:

• peel back the disposal label on the outside of the sachet
• place the used patch in the disposal label so that the sticky side covers the shaded area
• close the label to seal the used patch inside

Collect your used patches somewhere safe and away from children. Do not throw them away down the toilet or in your household waste. Your local pharmacy can usually dispose of them for you.

You can buy EVRA patches online. EVRA Patches are prescription-only contraceptives, so you will need a prescription from a licensed healthcare professional before you are able to buy them.

You should only request EVRA patches online from trusted online doctor services like ZAVA. We are monitored and regulated to ensure you receive safe and genuine medication.

Getting EVRA patches with a prescription from ZAVA is quick and convenient, with no need for a face-to-face consultation.

1. Complete a short online medical questionnaire – share details about your health so our doctors can ensure EVRA patches are right for you.
2. Order and pay online – sign in or create your ZAVA account, select EVRA patches, and securely make your payment.
3. Doctor review and approval – a UK-licensed doctor will check your health information and approve your prescription request if EVRA patches are safe and appropriate for you.
4. Fast and discreet delivery – if approved, EVRA patches will be delivered discreetly to your home or a local post office for collection.

Can I buy EVRA patches over the counter?

No, EVRA Patches are only available on prescription. Over-the-counter contraceptive alternatives to EVRA patches include Hana (a mini pill), available at ZAVA.

Can I get EVRA patches on the NHS?

Contraceptive patches like EVRA are available from some GP surgeries, sexual health clinics, and young people’s services. To get access to EVRA patches on the NHS you would need to make an appointment with a doctor or other prescribing healthcare professional.

Like all medications, EVRA patches can cause some side effects, but not everyone experiences them.

Common side effects include:

• headache
• nausea
• breast tenderness
• thrush (vaginal yeast infection)
• feeling lightheaded (dizziness)
• migraine
• stomach ache or bloating
• mood changes (depression, anxiety, crying more often)
• vomiting
• diarrhoea
• acne
• skin rash, itching, or irritation
• muscle spasms
• breast problems (pain, enlargement, lumps)
• menstrual bleeding changes
• painful periods, vaginal discharge
• redness on skin where the patch has been (or itching, irritation, rash)
• tiredness
• malaise (feeling generally unwell)
• weight gain

Uncommon side effects include:

• hives (allergic reaction)
• swelling due to water retention levels rising
• high levels of fat in the blood (cholesterol)
• insomnia (trouble sleeping)
• lower libido (less interest in sex)
• eczema, skin reddening
• abnormal production of breast milk
• PMS (premenstrual syndrome)
• vaginal dryness
• swelling
• high blood pressure
• Increased appetite
• other problems in the place you have had the patch on your skin
• hair loss
• light sensitivity

Rare side effects include:

• blisters or ulcers where the patch has been on the skin
• blood clot
• changes in your breast
• fibroids in the womb (uterus)
• mood changes like anger or frustration
• increased libido (interest in sex)
• abnormal taste
• problem wearing contact lenses
• sharp increase in blood pressure
• inflammation in gallbladder or colon
• abnormal cervical cells
• brown spots or patches on the face
• gallstones or bile duct blockage
• yellowing of skin and whites of the eyes
• abnormal blood sugar or insulin levels
• severe allergic reaction
• skin rash with tender nodules on the shins and legs
• itchy, flaky, or red skin
• suppressed lactation (of breast milk)
• swelling in arms, hands, legs or feet (fluid retention)

If you feel you are experiencing any of these rare side effects, you should contact your doctor.

Stop using EVRA patches immediately, contact your doctor, and dial 999 in an emergency if you get any of the following serious, rare side effects (affecting only 1 and 10 in every 10,000 users):

Blood clot:

• throbbing or cramping pain
• swelling
• redness
• warmth in the leg or arm
• breathlessness
• sharp chest pains
• coughing up blood

Severe allergic reaction (anaphylaxis):

• swelling of hands, face, lips, mouth, tongue or throat
• difficulty swallowing or breathing
• rash, itching, or hives

How long do EVRA patch side effects last?

Side effects with EVRA patches are most common in the first 3 months as your body adjusts to the patches. These side effects should be temporary and subside on their own, or at least become more manageable.

If you have side effects since taking the patches that become bothersome, or begin to affect your daily life, it is important that you speak with your doctor. They may recommend an alternative contraceptive.

What to do if you get EVRA patch side effects

If you think you are experiencing side effects while using EVRA patches as your body adjusts to them, most symptoms should be manageable at home.

We recommend resting, taking over-the-counter painkillers, and keeping hydrated to manage common symptoms. If you experience side effects that are bothering you, or do not go away after 3 months, you should speak with your doctor. They might suggest an alternative contraceptive solution for you.

If you are bothered by skin irritation such as itching, redness or soreness, you should speak to your doctor if this does not go away after a few days or after trying the patch on a different area of skin.

If you experience any of the following serious side effects, you should go to A&E or call 999:

• swollen face, tongue, throat, difficulty swallowing
• hives
• blood clot symptoms (swelling in one leg, breathlessness, vision loss, chest pain, severe stomach pain)
• difficulty breathing

EVRA patches are a great contraceptive solution to prevent pregnancy, but they may not be right for everyone. Certain conditions or medications can interact with EVRA patches, potentially making them unsafe or less effective.

Do not use EVRA patches if you are pregnant or think you might be. Do not use EVRA patches if you are breastfeeding or planning to breastfeed.

Your doctor should ask about your personal and family medical background to ensure EVRA patches are right for you. Be sure to inform your doctor if you have:

• or have ever had a blood clot in your leg, or have a blood clotting disorder
• Crohn’s disease
• unexplained vaginal bleeding
• ever been told you may have breast, womb, cervical, or vaginal cancer
• systemic lupus erythematosus
• haemolytic uraemic syndrome
• sickle cell anaemia
• elevated fat levels in the blood
• just given birth
• an inflammation in the veins under the skin
• varicose veins
• symptoms of angioedema
• depression

You should also inform your doctor if you need an operation, or will be off your feet for a long time.

Some medications may interfere with the EVRA patch, cause side effects, or stop them from working properly. You should inform your doctor if you are taking:

• some antiretroviral medications used to treat HIV, AIDS, and Hepatitis C virus infections (so-called protease inhibitors and non-nucleoside reverse transcriptase inhibitors such as ritonavir, nevirapine, efavirenz)
• some medications for infection (rifampicin and griseofulvin)
• anti-seizure medications (such as barbiturates, topiramate, phenytoin, carbamazepine, primidone, oxcarbazepine, lamotrigine, and felbamate)
• bosentan (for high blood pressure in the blood vessels and lungs)
• St John’s wort (herbal remedy for depression)
• medications containing ciclosporin

It’s important to be aware that using a combined hormonal contraceptive can increase your risk of developing a blood clot, however the overall risk of it is small. Out of 10,000 women using EVRA patches, between 6 and 12 women will develop a blood clot in a year, compared to 2 out of 10,000 not using EVRA. You can find more information on blood clots and the combined contraceptive pill in the patient information leaflet.

Find more information on general warnings and specific guidance on medication interactions when using EVRA patches in the patient information leaflet.

It’s important that you choose the contraceptive that is most suited to you and your circumstances.

If you’re still unsure if EVRA patches are right for you, we provide a huge range of alternatives at ZAVA. We offer over 30 contraceptive pills with varying benefits, including but not limited to:

• Microgynon 30 – combined contraceptive pill that can also alleviate heavy menstrual bleeding and period pain
• Cerelle – progestogen-only pill, suitable if you cannot take oestrogen
• Cerazette – progestogen-only pill, suitable if you are over the age of 35, smoke, or have high blood pressure
• Yasmin – combined contraceptive, can alleviate acne
• Lucette – combined contraceptive, can help with PMS symptoms
• Femodene – combined contraceptive, can help with painful periods and acne
• Mercilon – low-dose combined contraceptive

If you’re still wondering if patches are right for you and feel that the contraceptive pill isn’t quite the right solution, there are other alternatives available, such as:

IUD

An IUD (intrauterine device, also called copper coil) is a small T-shaped plastic device that a doctor or nurse inserts into your uterus. It prevents pregnancy by releasing copper into the womb, it doesn’t use hormones. It is 99% effective and once inserted it works for 5 to 10 years.

The IUD isn’t for everyone, in some people it can cause a susceptibility to vaginal thrush, and in some cases prolonged period pain.

Contraceptive Injection

The contraceptive injection contains an artificial type of progestogen. It prevents pregnancy by stopping the release of the egg from the ovary (ovulation stage). It lasts for 8 to 13 weeks depending on which type of injection your doctor prescribes. It is 99% effective if taken as instructed by your doctor.

Some people experience weight gain with the contraceptive injection, in addition to changes to their periods. If you think the contraceptive injection is right for you and your circumstances you can discuss this with your doctor.

Contraceptive Implant

The contraceptive implant is a small plastic rod that a nurse or doctor puts under the skin of your arm. It contains an artificial type of progestogen and works to prevent pregnancy by stopping the ovulation phase (the release of an egg). It only needs to be replaced every 3 years and remains 99% effective if you replace it as and when instructed by your doctor.

There are side effects when using the contraceptive implant, such as increased risk of acne, weight gain, and thrush or bacterial vaginosis.

Vaginal Ring

A vaginal ring is a soft plastic ring that is only 5cm in diameter. It works to prevent pregnancy by releasing artificial types of progestogen and oestrogen into the blood, in turn stopping the ovaries from releasing an egg. It works for 3 weeks once inserted.

However, be aware that the vaginal ring can increase blood pressure in some women. While using the vaginal ring, you’ll require regular blood pressure checks.

➤ Find out more information on alternative contraceptive options in our contraceptive methods guide.

Is the EVRA patch better than ‘the pill’?

Both the EVRA patch and combined oral contraceptives are 99% effective if used correctly.

Clinical studies of patients using patches containing norelgestromin and ethinyl estradiol (the active ingredients in EVRA patches) found that contraceptive effectiveness was not significantly different between patches and combined oral contraceptives (‘the pill’). The study also found that women using the contraceptive patch had less breakthrough bleeding and spotting.

Since the EVRA patch is a combined contraceptive, like most combined contraceptive pills, clinical studies have shown that they can ease symptoms of:

• heavy menstrual bleeding
• period pain
• irregular periods
• endometriosis

The EVRA patch is a good option if you find it difficult to remember to take the daily pill, as long as you feel comfortable wearing a patch each week.

➤ Browse and discover our range of contraceptives here at ZAVA.