Editing Contraceptive patch (section)

{{Short description|Transdermal patch applied to prevent pregnancy}}
{{redirect|Evra patch|the brand of patch containing estradiol only|Evorel patch}}
{{Infobox Birth control
|name                 = Contraceptive patch
|image                = Contraceptivepatch.jpg
|width                = 200
|caption              = Ortho Evra brand of contraceptive patch
|bc_type              = Hormonal (combined estrogen + progestin)
|date_first_use       = 2002
|rate_type            = Failure
|perfect_failure% = 0.3
|perfect_failure_ref =<ref name="Trussell 2011">{{cite book| vauthors = Trussell J |year=2011|chapter=Contraceptive efficacy| veditors = Hatcher RA, Trussell J, Nelson AL, Cates Jr W, Kowal D, Policar MS |title=Contraceptive technology|edition=20th revised|location=New York|publisher=Ardent Media|isbn=978-1-59708-004-0|issn = 0091-9721|oclc=781956734|pages=779–863}} Table 26–1 = <span class="plainlinks">[http://www.contraceptivetechnology.org/wp-content/uploads/2013/09/CTFailureTable.pdf Table 3–2 Percentage of women experiencing an unintended pregnancy during the first year of typical use and the first year of perfect use of contraception, and the percentage continuing use at the end of the first year. United States.] {{Webarchive|url=https://web.archive.org/web/20170215224018/http://www.contraceptivetechnology.org/wp-content/uploads/2013/09/CTFailureTable.pdf |date=2017-02-15 }}</span></ref>
|typical_failure% = 9
|typical_failure_ref  = <ref name="Trussell 2011"/>
|duration_effect      = 
|reversibility        = 
|user_reminders       = Weekly application for 3 weeks
|clinic_interval      = 3-6 monthly
|STD_protection_YesNo = No
|periods_advantage    = Regulated, may be lighter and less painful
|benefits             = Compared to oral pills, may be less affected by antibiotics
|periods_disadvantage = 
|weight_gain_loss     = No proven effect
|risks                = [[DVT]]s rates similar to oral combined pills
|medical_notes        = 
}}

{{Infobox drug
| drug_name         = norelgestromin / ethinyl estradiol
| type              = combo
| component1        = Norelgestromin
| class1            = [[Progestogen (medication)|Progestogen]]
| component2        = Ethinylestradiol
| class2            = [[Estrogen (medication)|Estrogen]]

<!-- Clinical data -->
| tradename         = Ortho Evra, Xulane, Evra
| Drugs.com         = {{drugs.com|ppa|ethinyl-estradiol-and-norelgestromin}}
| MedlinePlus       = a602006
| licence_EU        = yes
| DailyMedID        = Norelgestromin_and_ethinyl_estradiol
| licence_US        = 
| pregnancy_AU      = <!-- A / B1 / B2 / B3 / C / D / X -->
| pregnancy_US      = N
| pregnancy_category= Contraindicated
| legal_AU = <!-- S2, S3, S4, S5, S6, S7, S8, S9 or Unscheduled -->
| legal_CA = Rx-only
| legal_UK = POM
| legal_UK_comment = <ref>{{cite web | title=Evra transdermal patch - Summary of Product Characteristics (SmPC) | website=(emc) | date=26 June 2020 | url=https://www.medicines.org.uk/emc/product/6794/smpc | access-date=4 July 2020 | archive-date=24 October 2020 | archive-url=https://web.archive.org/web/20201024122318/https://www.medicines.org.uk/emc/product/6794/smpc | url-status=dead }}</ref>
| legal_US = Rx-only
| legal_status      = Rx-only
| routes_of_administration = [[Transdermal]] (patch)
| ATCvet            = 
| ATC_prefix        = G03
| ATC_suffix        = AA13
| ATC_supplemental  =

<!-- Identifiers -->
| CAS_number_Ref = {{cascite|correct|CAS}}
| CAS_number = 53016-31-2
| CAS_number2_Ref = {{cascite|correct|CAS}}
| CAS_number2 =	57-63-6
| UNII_Ref          = {{fdacite|correct|FDA}}
| UNII              = R0TAY3X631
| UNII2_Ref         = {{fdacite|correct|FDA}}
| UNII2             = 423D2T571U
| PubChem           = 91758695
| PubChemSubstance  = 
| IUPHAR_ligand     = 
| DrugBank          = DB06713
| DrugBank2         = DB00977
| ChemSpiderID      = None
| KEGG_Ref = {{keggcite|correct|kegg}}
| KEGG              = D10839
| ChEBI             = 
| ChEMBL            = 
| synonyms          =

<!-- Chemical and physical data -->
| IUPAC_name        = (3Z,8R,9S,10R,13S,14S,17R)-13-ethyl-17-ethynyl-3-hydroxyimino-1,2,6,7,8,9,10,11,12,14,15,16-dodecahydrocyclopenta[a]phenanthren-17-ol;(8R,9S,13S,14S,17R)-17-ethynyl-13-methyl-7,8,9,11,12,14,15,16-octahydro-6H-cyclopenta[a]phenanthrene-3,17-diol
| C = 41 | H = 53 | N = 1 | O = 4
| SMILES            = CCC12CCC3C(C1CCC2(C#C)O)CCC4=CC(=NO)CCC34.CC12CCC3C(C1CCC2(C#C)O)CCC4=C3C=CC(=C4)O
| StdInChI          = 1S/C21H29NO2.C20H24O2/c1-3-20-11-9-17-16-8-6-15(22-24)13-14(16)5-7-18(17)19(20)10-12-21(20,23)4-2;1-3-20(22)11-9-18-17-6-4-13-12-14(21)5-7-15(13)16(17)8-10-19(18,20)2/h2,13,16-19,23-24H,3,5-12H2,1H3;1,5,7,12,16-18,21-22H,4,6,8-11H2,2H3/b22-15-;/t16-,17+,18+,19-,20-,21-;16-,17-,18+,19+,20+/m01/s1
| StdInChI_comment  = 
| StdInChIKey       = KBFRRZPPJPKFHQ-WKXKRCMPSA-N
| density           = 
| density_notes     = 
| melting_point     = 
| melting_high      = 
| melting_notes     = 
| boiling_point     = 
| boiling_notes     = 
| solubility        = 
| sol_units         = 
| specific_rotation = 
}}

{{Infobox drug
| drug_name         = levonorgestrel / ethinyl estradiol
| type              = combo
| component1        = Levonorgestrel
| class1            = [[Progestogen (medication)|Progestogen]]
| component2        = Ethinylestradiol
| class2            = [[Estrogen (medication)|Estrogen]]

<!-- Clinical data -->
| tradename         = Twirla
| Drugs.com         = 
| MedlinePlus       = 
| licence_EU        = 
| DailyMedID        = Twirla
| licence_US        = 
| pregnancy_AU      = <!-- A / B1 / B2 / B3 / C / D / X -->
| pregnancy_US      = N
| pregnancy_category= Contraindicated
| legal_AU = <!-- S2, S3, S4, S5, S6, S7, S8, S9 or Unscheduled -->
| legal_CA = 
| legal_UK = 
| legal_US = Rx-only
| legal_status      = <!-- For countries not listed above -->
| routes_of_administration = [[Transdermal]] (patch)
| ATCvet            = 
| ATC_prefix        = G03
| ATC_suffix        = AB03

<!-- Identifiers -->
| CAS_number_Ref    = 
| CAS_number        = 
| UNII_Ref          = 
| UNII              = 
| UNII2_Ref         = 
| UNII2             = 
| PubChem           = 
| PubChemSubstance  = 
| IUPHAR_ligand     = 
| DrugBank          = 
| DrugBank2         = 
| ChemSpiderID      = None
| KEGG_Ref          = 
| KEGG              = 
| ChEBI             = 
| ChEMBL            = 
| synonyms          = 
}}

A '''contraceptive patch''', also known as "the patch", is a [[transdermal patch]] applied to the skin that releases synthetic [[oestrogen]] and [[progestogen]] hormones to prevent [[pregnancy]]. They have been shown to be as effective as the [[combined oral contraceptive pill]] with perfect use, and the patch may be more effective in typical use.<ref name=CT>{{cite book | vauthors = Trussell J |year=2007 |chapter=Contraceptive Efficacy | veditors = Hatcher RA |title=Contraceptive Technology |edition=19th rev. |location=New York |publisher=Ardent Media |isbn=978-0-9664902-0-6 |chapter-url=http://www.contraceptivetechnology.com/table.html |display-editors=etal |url-access=registration |url=https://archive.org/details/contraceptivetec00hatc }}</ref><ref>{{cite book | vauthors = Nanda K, Burke A | chapter = Contraceptive patch and vaginal contraceptive ring. | veditors =  Hatcher RA, Nelson AL, Trussell J, Cwiak C, Cason P, Policar MS, Edelman A, Aiken AR, Marrazzo J, Kowal D | title = Contraceptive Technology | edition = twentieth | publisher = Ardent Media, Inc. | location = Atlanta, Georgia | date = 2011 | page = 272 | isbn = 978-1-59708-004-0 }}</ref>

'''Xulane'''<ref name="Xulane label">{{cite web | title=Xulane- norelgestromin and ethinyl estradiol patch | website=DailyMed | date=19 April 2017 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f7848550-086a-43d8-8ae5-047f4b9e4382 | access-date=17 February 2020}}</ref> and '''Twirla'''<ref>{{cite web | title=FDA Approves Agile Therapeutics, Inc.'s Twirla (levonorgestrel and ethinyl estradiol) Transdermal System – A New Weekly Contraceptive Patch Delivering a 30 mcg Daily Dose of Estrogen and 120 mcg Daily Dose of Progestin | website=Agile Therapeutics | date=14 February 2020 | url=https://ir.agiletherapeutics.com/news-releases/news-release-details/fda-approves-agile-therapeutics-incs-twirlar-levonorgestrel-and | access-date=17 February 2020}}</ref> are approved for use in the United States. '''Evra''' is approved for use in Canada and marketed by Janssen Inc.,<ref>{{cite web | title=Evra Product information | website=Health Canada | date=2018-06-21 | url=https://health-products.canada.ca/dpd-bdpp/info.do?lang=en&code=72637 | access-date=17 February 2020}}</ref> and it is approved for use in the United Kingdom<ref name="Evra SmPC">{{cite web | title=Evra transdermal patch - Summary of Product Characteristics (SmPC) | website=(emc) | date=29 November 2018 | url=https://www.medicines.org.uk/emc/medicine/12124 | access-date=17 February 2020 | archive-date=7 November 2017 | archive-url=https://web.archive.org/web/20171107020253/https://www.medicines.org.uk/emc/medicine/12124 | url-status=dead }}</ref> and in Europe<ref name="Evra EPAR">{{cite web | title=Evra EPAR | website=European Medicines Agency | date=17 September 2018 | url=https://www.ema.europa.eu/en/medicines/human/EPAR/evra | access-date=18 February 2020}}</ref> and marketed by [[Janssen-Cilag]].<ref name="Evra SmPC" /><ref name="Evra EPAR" /> The patches are packaged in boxes of three and are only available by prescription.<ref name="Xulane label" />