Combined transdermal patch (EE / norelgestromin)

• Contraception when daily pill adherence unreliable

Ethinylestradiol + norelgestromin suppress FSH/LH → anovulation; also thickens cervical mucus.

• 3 patches × 1 week each
• 1 patch-free week for withdrawal bleed
• UKMEC identical to COC

Regimen

1 patch/week × 3 weeks, then 7-day patch-free interval

Site

Buttock, upper arm, abdomen (not breast); rotate sites

• AbsoluteMigraine with aura, VTE hx, BMI ≥ 35 with additional risk, <6/52 postpartum + breastfeeding
• CautionWeight ≥ 90 kg — reduced efficacy

• Skin reaction at site
• Breast tenderness
• Breakthrough bleeding
• Same VTE risk as COC

• • Not for use in pregnancy — remove immediately if pregnancy confirmed

• Enzyme inducers (rifampicin, some AEDs)

  Avoid

  ↓ efficacy — use alternative

• Lamotrigine

  Caution

  ↓ lamotrigine levels; seizure risk

• 💡 Delayed change ≤ 48 h: apply new patch, no extra cover
• 💡 Delayed > 48 h: apply, use condoms 7 days, consider EC