Ethinylestradiol with norelgestromin

How it works

The patch delivers both hormones across the skin into the systemic circulation, suppressing ovulation while thickening cervical mucus and altering the endometrium; the transdermal route bypasses first-pass hepatic metabolism.

Prescribing in practice

• The patch carries the same systemic VTE and arterial risks as combined oral contraceptives, so apply the full UKMEC screen; absorption may be reduced and failure more likely at higher body weight.
• Counsel on what to do if a patch detaches or a change is delayed beyond the permitted window.
• Efficacy can still be reduced by enzyme-inducing drugs; rotate application sites to limit skin irritation.

Monitoring

Check blood pressure and reassess cardiovascular and VTE risk at initiation and periodic review.

Counselling the patient

• Apply to clean, dry, hairless skin and rotate sites; check daily that the patch is stuck down.
• Know how long a patch can be off or overdue before back-up contraception is needed.
• Seek urgent help for leg swelling, chest pain, breathlessness or sudden severe headache.

Evidence & guidelines

UKMEC applies the same combined-method eligibility criteria to the transdermal patch as to oral combined contraceptives.