Transdermal Patch

Question 1

Efficacy?

Answer 1

93%

Question 2

Acne?
Weight Gain?
VTE risk?

Answer 2

Improves
Neutral
Increased ( maybe higher than COCs)

Question 3

Bleeding
Cycle Control?
Withdrawal Bleeding/Spotting

Answer 3

Yes
Higher the Estrogen the less the spotting, with continuous or extended use can get more spotting at first and then end up with very little or no bleeding at all

Question 4

AE

Answer 4

Breast Tenderness, Nausea, Bloating
Skin irritation
( decreased spotting but increased breast tenderness compared to pill)

Question 5

Drug Interactions

Answer 5

Decrease hormone levels with Cp34A4 Inducers, anticonvulsants, some antivirals

Question 6

Return to Fertility

Answer 6

most ovulate within a month of stopping, 99% within 3- 6 months

Question 7

Additional Considerations

Answer 7

option for continuous dosing
decrease ovarian, endometrial and colorectal cancer
May increase risk of breast CA ( goes away after 10 years of D/C and debate whether it has to do with later childbearing and nullparity)
May increase Cervical Ca

Less effective if > 90kg
decreased privacy
<2% will detach

Question 8

Continuous Dosing Advantages

Answer 8

Less PMS symtpoms
Less endometriosis
Less anemia
Less PCOS

Question 9

Continuous Dosing Disadvantages

Answer 9

No long-term safety data, initially increased breakthrough bleeding, Decrease over time and can lead to amenorrhea by 1 year
delay in pregnancy recognition

Question 10

Hormones in Patch

Answer 10

Estradiol and norelgestromin

Question 11

Initiation and DOsing

Answer 11

Start with 1 patch on that is changed every week for 3 weeks and then off for 1 week
Extended = 1 patch weekly with 1 HFI ( max 7 days) every 3-6-12 months
Continuous: 1 patch weekly

Question 12

Missed dose
Week 1

Answer 12

Apply New patch and start a new 3 week cycle ( essesntially start at the beginning)
EC if you have had sex in last 5 days
Use backup for 7 days

Question 13

Missed dose
Week 2

Answer 13

Apply NEW patch
Use EC if unprotected sex within 5 days and more than 3 days without patch
Backup for 7 days if been more than 3 days without patch

Question 14

Missed dose
Week 3

Answer 14

Apply NEW patch
Use EC if unprotected sex within 5 days and more than 3 days without patch
Backup for 7 days if been more than 3 days without patch

Question 15

What if my patch fell off for less than 24 hours?

Answer 15

You can reapply the same patch

Question 16

Im late changing my patch?

Answer 16

You can be up to 2 days late and still be covered

Question 17

Does diarrhea or vomiitng effect the patch?

Answer 17

No only oral contraceptives

Question 18

What is considered a missed dose?

Answer 18

Patch is off for more than 24 hours