Combined hormonal contraceptive (transdermal patch)
Ethinylestradiol with norelgestromin
Brand names: Evra
Adult dose
Dose: 1 patch weekly for 3 weeks then 1 patch-free week
Route: Transdermal
Frequency: Weekly
Clinical pearls
- Useful for adherence; bypasses GI absorption
- FSRH: VTE risk similar to or slightly above 3rd-gen COCs
- Reduced efficacy in women ≥90kg — alternative method preferred
Contraindications
- Standard CHC contraindications
- BMI ≥90kg (reduced efficacy)
Side effects
- Application-site reactions
- Breakthrough bleeding
- VTE
- Headache
- Breast tenderness
Interactions
- Enzyme inducers
Monitoring
- BP
- Application-site condition
- BMI
- VTE risk factors
Reference: BNF; FSRH CHC guideline; UKMEC; https://bnf.nice.org.uk/drugs/ethinylestradiol-with-norelgestromin/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Pathways
- Spinal Anaesthesia Hypotension Management · AAGBI; ASA
- Pre-Eclampsia / Eclampsia in ED · NICE NG133; RCOG Green-top 10A
- Suspected Ectopic Pregnancy · NICE NG126; RCOG Green-top 21
- Polycystic Ovary Syndrome (PCOS) · International PCOS Guideline 2023; NICE CKS
- Pre-eclampsia Management · NICE NG133 2019
- Ectopic Pregnancy · NICE CG154 / RCOG GTG 21