Ortho Evra

Nursing mothers should not use most hormonal contraceptives, since these drugs can appear in breast milk and may cause jaundice and enlarged breasts in nursing infants. In this situation, your doctor may advise you to use a different form of contraception while you are nursing your baby.

Recommended dosage for Ortho Evra

If you have any questions about how you should use Ortho Evra, consult your doctor or the patient instructions that come in the drug package. The following is a partial list of instructions for using Ortho Evra; it should not be used as a substitute for consultation with your doctor.

You should use three Ortho Evra patches during each 28-day cycle. You should apply a new patch each week for 3 weeks (21 total days). Do not apply a patch during the fourth week. Your menstrual period should start during this patch-free week.

Apply each new patch on the same day of the week. This will be your "patch change day." The patch can be applied on the first day of your menstrual cycle or on the first Sunday afterwards. The instructions below are for the first-Sunday schedule.

FOR A SUNDAY PATCH CHANGE SCHEDULE

1. Apply your first patch on the first Sunday after your menstrual period starts. You must use backup contraception for the first week of your cycle when starting Ortho Evra for the first time.
2. Choose a place on your body to put the patch where it won't be rubbed by tight clothing. You can apply the patch to your buttock, abdomen, upper outer arm, or upper back. Never put the patch on your breasts . To avoid irritation, apply each new patch to a different place on your skin.
3. Open the foil pouch that contains the patch by tearing along the top edge and one side edge. Peel the foil pouch apart and open it flat.
4. You will see that the patch is covered by a layer of clear plastic. It is important to remove the patch and the plastic together from the pouch. Using your fingernail, lift one corner of the patch and peel the patch and plastic off the foil liner. Sometimes patches can stick to the inside of the pouch; be careful not to accidentally remove the clear liner as you remove the patch.
5. Peel away half of the clear plastic liner. Be careful not to touch the exposed sticky surface of the patch with your fingers.
6. Apply the sticky side of the patch to clean, dry skin, then remove the other half of the clear plastic. Press firmly on the patch with the palm of your hand for 10 seconds, making sure the edges stick well. Run your finger around the edge of the patch to make sure it is sticking properly. Check your patch every day to make sure all the edges are sticking.
7. Wear the patch for 7 days. On the next Sunday (day 8), remove the used patch. Apply a new patch immediately. The used patch still contains some medicine; carefully fold it in half so that it sticks to itself before throwing it away. Do not flush the used patch down the toilet.
8. Apply a new patch on the following Sunday (day 15). After 7 days, throw away the patch.
9. Do not wear a patch during the fourth week (day 22 through day 28). Your period should start during this week.
10. Begin your next 4-week cycle by applying a new patch on the Sunday after day 28, even if your period hasn't ended yet.

Overdosage

While any medication taken in excess can cause unwanted effects, the risk associated with Ortho Evra is minimal because the patch is designed to release a small amount of hormones at a slow, steady rate. Furthermore, even when young children have swallowed large amounts of oral hormonal contraceptives, they've suffered no ill effects. Nevertheless, if you suspect an overdose, seek medical help immediately.

• Symptoms of Ortho Evra overdose may include:
  Nausea, vomiting, vaginal bleeding in females