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Home / Contraception / Contraceptive Patch / Evra Patch

Evra Patch

  • Pack of 9 Evra transdermal patches
  • Front view of Evra transdermal patch sachet
  • Box and sachets of Evra contraceptive patch

COVID-19 update: Our services are running as normal.

Note: You must complete a short online consultation so that our doctor can ensure that the treatment is suitable for you. The above pricing should only be used as a reference. The final decision to issue this treatment lies with the prescribing doctor.

What is Evra?

Evra is primarily used to prevent pregnancy. It works in the same way as the combined pill by using synthetic female and male hormones, but some women prefer to use Evra so they don't need to remember a daily tablet. If you happen to be sensitive to digesting tablets, the patch is also a good option.

Evra can also reduce the symptoms of PMS like the combined pill, it can help improve acne and alleviate fertility related conditions such as endometriosis and polycystic ovary syndrome.

The Advantages of Evra

Evra is an increasingly popular method of birth control and can help women to relax and enjoy sex without the worry of pregnancy. As well as the over 99% effectiveness rate it also has other positive benefits.

  • Changing the Evra patch is a weekly task rather than a daily one, meaning you may be less likely to forget and run the risk of pregnancy.
  • Some women are concerned that the patch will fall off if it gets wet, but you are able to live a normal life including showering, swimming and using saunas whilst wearing the patch.
  • Unlike the pill, Evra still releases its hormones if you vomit or have severe diarrhoea. Pill users need to use extra barrier contraception if they are unwell.
  • Because Evra uses hormones to prevent pregnancy it can manage periods. Irregular women will fall into a cycle of three weeks followed by a withdrawal bleed. Evra also reduces period volume because it thins the womb lining so less blood is shed.
  • Evra may reduce the unwelcome symptoms of PMT such as bloating, mood swings, skin changes and pain. Women who experience difficult periods often use hormonal contraception for period benefits over its contraceptive value.
  • Evra can lessen the symptoms of fertility based conditions such as endometriosis, and like the combined pill, it may reduce the risk of ovarian and womb cancers, the risk of fibroids, ovarian cysts and breast diseases that are non-cancerous.
  • Evra is absorbed through the skin you may avoid stomach related side effects.

How does Evra work?

Evra is a beige sticky patch that measures 5cm x 5cms. It can be placed anywhere on the skin as long as the patch is flat and not rubbed by clothing or skin creases. For Evra to provide over 99% effectiveness, you need to use it correctly.

Evra prevents pregnancy by delivering two hormones called progesterone and oestrogen (ethinyl norelgestromin and estradiol respectively). These hormones stop egg ovulation, thicken cervical mucus so sperm cannot enter the womb and thins the womb lining so a fertilised egg can't implant and grow there.

How to use Evra

Starting Evra

To start Evra you need to wait until the first day of your period. If you attach Evra correctly on the first day of your bleed, you will be protected against pregnancy immediately. You can also attach Evra within five days of your period starting. If you are further than five days after your period began, you can attach Evra but you must use additional barrier contraception for seven days so that the hormones have a chance to absorb. Condoms, caps and diaphragms and abstinence are options.

If you are switching from an oral contraceptive you can start Evra on the first day of your withdrawal bleed. If you do not bleed, take a pregnancy test before using Evra. If you attach Evra later than seven days after you stop taking an oral contraceptive, you should use additional barrier contraception for seven days.

If you are transferring from the mini pill, you can start using Evra on the first day of your bleed. If you don't have a period on the mini pill you can attach Evra at any point but use additional barrier contraception for seven days.

Women who have had an abortion or miscarriage before 12 weeks gestation can use Evra immediately and are covered against pregnancy. If the abortion or miscarriage happened after 12 weeks of pregnancy, additional barrier contraception is needed for seven days.

Evra process

  • Choose a location on your skin that is dry, flat and not too hairy. The patch must lie flat so a crease such as the crook of an arm is not suitable. Some women attach Evra to their upper arm, lower back or buttocks. Avoid any areas that are sore, inflamed or likely to be rubbed by tight clothing such as your waist. Evra must not be placed on your breasts.
  • Women also tend to alternate the patch area week by week to avoid any soreness and developing a rash.
  • Don't apply any skin creams or lotions before attaching Evra as this may reduce its adhesiveness.
  • You need to apply a new Evra patch every seven days for three weeks and then take a seven-day break. You may or may not have a period during this time. This process is similar to the pill with 21 days on synthetic hormones followed by a seven-day break, however, you're only changing the patch three times instead of remembering a pill every day.
  • Once seven days have passed you should attach a new patch even if you are still bleeding. If you do this correctly you will start a new patch on the same day of every week.

Attaching the Evra patch

  • To attach Evra you should gently open the packet taking care not to rip the contents.
  • Peel the transparent plastic cover away from the patch without touching the sticky area.
  • Attach it to a clean, dry area of skin.
  • Press firmly for ten seconds to ensure it is fully attached.
  • Once it's in place you can peel back the outer film.

Removing the Evra patch

  • To remove Evra you should gently unstick an edge and pull it slowly from your skin.
  • Fold the patch in half, wrap it securely and place it in the bin.
  • Do not flush Evra down the toilet as it still contains some hormones after use.

What If You Forget To Remove the Last Patch?

Forgotten patches are common, but you run the risk of pregnancy if you forget a patch. Some women find it easier to remember Evra because it's taken on the same day each week; however, if you forget you need to follow these instructions.

If your Evra patch has been on less than two days extra, making the total eight or nine days of use, remove it and put on a new patch. If the extra time is less than 48 hours you are still covered and don't need to take extra precautions.

If you've forgotten Evra and it's been longer than 48 hours you will need to start the process again. Put on a new patch and use extra barrier contraception such as condoms for seven days. Your changeover day will come seven days after you attach the new patch.

If you've had unprotected sex in the extra days (10 days of use plus) you may be pregnant and should consider emergency contraception.

EllaOne is an emergency contraceptive that works by delaying ovulation. You can use it up to five days after unprotected sex with an effectiveness rate of 98%.

If you have reached week three of your monthly cycle and forget to remove your patch for a withdrawal bleed, simply remove the patch when you remember. Start the next patch on your usual changeover day even if you are still bleeding. This will shorten your seven-day break. There is no need to take extra precautions.

What To Do If The Patch Falls Off

It's highly unlikely that your patch will fall off. It is tested and should stay on even if you exercise, swim, bathe, shower or use a sauna. However, if it was not correctly attached or was placed on damp, moisturised skin, there is a risk it will come loose. If this happens you will need to follow these instructions:

  • If it's less than 48 hours and you have the patch, you can reattach it to your skin. However, if the patch won't stick, do not use any adhesives such as sticking plasters to hold it in place. Replace the patch with a new one. This is because Evra needs to lie flat in order to transfer the correct amount of hormones.
  • Change this new patch on your original changeover day. You will be protected against pregnancy if the patch was in place for at least seven days previously. If it was on for less than six days you should use extra barrier contraception for seven days.

If the patch has been off for longer than 48 hours or you are not sure how long it's been unattached you should immediately apply a new patch and start a new cycle. This will mean your changeover day will be different. Use barrier contraception for seven days.

You should follow these steps if your patch lifts at the edges or partially comes away. This is because you will not receive a full dose of hormones. Without the full dose you may become pregnant.

What To Do If You Forget Your Patch

If you forget to apply a new patch on your changeover day, do so immediately. If it's less than 48 hours late (nine days) you are still covered against pregnancy. If it's more than 48 hours you need to begin a new cycle and use barrier contraception for seven days.

Evra Dosages

Evra is the only available patch in the UK and it's supplied in measured doses, there are no variations. You should always use a patch without cutting it in half or tampering with it. Doubling up on Evra patches does not make it more effective and puts you at risk of side effects.

If you are nervous about pregnancy, you can use barrier methods of contraception alongside Evra such as the cap, diaphragms and condoms. If you have used Evra correctly you have a less than 1% chance of falling pregnant.

Evra contains synthetic progesterone and oestrogen hormones, specifically 6 mg of norelgestromin and 600 micrograms of ethinyl estradiol. These are released over a seven-day period, which is why it's important to keep your patch on. If you take it off early you will not be covered against pregnancy.

Evra Side Effects

As with all prescription medicines, Evra can cause side effects in some women. Most women are able to use Evra without issues, but some may experience unwanted symptoms. The most serious side effects of hormonal birth control, including combined pills, are an allergic reaction to the ingredients and the risk of blood clots.

An allergic reaction is typified by difficulty breathing, a swollen mouth, hands or face and hives or a rash. If you experience these symptoms seek medical advice immediately. It is a rare occurrence, but a serious one.

The oestrogen hormone in Evra raises your risk of developing a blood clot, although this risk is small. Blood clots can form, break away and travel through the arteries. If they reach the heart they can cause heart attacks, if they reach the brain they can cause a stroke. Symptoms are difficulty breathing, pain, dizziness, confusion and loss of vision. A blood clot is a medical emergency and can be fatal.

Your risk is higher if you smoke, are obese, are immobile, are diabetic, have migraines with visual aura disturbances, travel by air over four hours, or have a close family member who had a heart attack or stroke before the age of 45.

The risk of breast cancer is slightly higher if you use hormonal contraception. There is also a possible increase in the risk of cervical cancer although this may be due to the effects of unprotected sex. All women should have regular smear test and examine their breasts whether they use Evra or not.

Very rarely, liver cancer and benign (non-cancerous) tumours can occur. The symptoms are severe stomach pain and vomiting caused by internal bleeding. If you experience this, you need immediate medical attention.

Other side effects are less serious and more common. One in ten women may experience headaches, nausea and breast tenderness.

Less than ten women may experience common side effects, which include thrush (a vaginal and oral fungal infection), depression, mood swings, migraines, stomach ache, vomiting, diarrhoea, acne or skin irritation, muscle spasms, vaginal discharge, weight gain, irritation where the patch is located and tiredness.

Uncommon side effects may include water retention, high levels of fat in the blood (e.g. cholesterol), insomnia, decreased libido, eczema, premenstrual syndrome, breast milk production, vaginal dryness, high blood pressure, hair loss, sunlight sensitivity, swelling and increased appetite

Evra Precautions

Before Evra can be prescribed you should speak to your doctor about precautions. If you develop symptoms whilst taking Evra, stop using your patches and speak to your doctor:

  • If you have Crohn's disease or ulcerative colitis
  • If you have SLE (lupus)
  • If you have blood clotting disorders
  • If you have sickle cell anaemia
  • If you have high levels of fat in your blood or close family members have high levels of fat in their blood
  • If you have high levels of fat in your blood or close family members have high levels of fat in their blood
  • If you need an operation
  • If you have inflamed veins or varicose veins

Although Evra is suitable for many women, not everyone can use it. There are some conditions and medicines that prevent it working properly or raise the risk of side effects. If you have any of the following, do not use Evra and speak to your doctor about an alternative contraception.

  • You are pregnant or think you might be pregnant
  • You are breastfeeding
  • You have or have had blood clots
  • You have migraines with visual disturbances
  • You have migraines with visual disturbances
  • You have cardiovascular problems such as high blood pressure
  • You have or have had breast cancer
  • You smoke and you're over 35
  • You are over 35 and stopped smoking less than a year ago
  • You are obese
  • You have gallbladder or liver disease
  • You have diabetes with complications

There are many contraception options available if Evra is not right for you. The mini pill, for example, does not contain oestrogen and is, therefore, suitable for most women with migraines. Talk to your doctor about the options open to you.

Evra can cause irritation and itching in the local area. To avoid this, move the patch to a different site each time you start a new one.

There may be some side effects associated with Evra such as headaches and breast tenderness. You may also experience breakthrough bleeding and spotting in the first few months of use. This should settle down after a while, but if it doesn't speak to your doctor about an alternative contraceptive.

Evra does not protect against sexually transmitted infections. Only condoms can do this. If you have had unprotected sex and you're not certain about your partner's sexual history then it's worth a screening at your local STI clinic. Some STIs have no symptoms but can damage your fertility.

  • Chlamydia may have no symptoms in women, and the first stage of syphilis can be missed. Often STIs are easily treated with antibiotics.

    Pregnancy and Breastfeeding

    Evra shouldn't be used in pregnancy. If you think you're pregnant stop using Evra immediately.

    If you've had a baby you can use Evra no sooner than four weeks after delivery. You will need to be moving freely to reduce the risk of blood clots. If you use Evra more than four weeks after delivery you'll need extra barrier contraception for seven days. It's best to discuss the options with your doctor after giving birth.

    Breastfeeding mothers should not use Evra because its hormones stop the milk supply and traces of hormones may transfer to your infant. It's not known what effects these have. This applies to any combined hormonal contraception.

    Other Medication Interactions

    Some medicines can interfere with how your body absorbs hormones. If you are required to take high blood pressure medicines, antibiotics, antifungals, some HIV medicines, St John's Wort, or some epilepsy medicines in the short or long term speak to your doctor about their interaction with Evra. You may need to use extra barrier contraception.

    Evra can affect adversely medicines containing ciclosporin or make the epilepsy drug lamotrigine less effective.

  • Can you buy without a prescription?

    Evra is a prescription only medicine. Your doctor needs to examine you and investigate your family and medical history before it can be safely prescribed. This is to rule out the likelihood of serious side effects such as blood clots.

    How to buy Evra

    Evra is not available over the counter as it is clinically proven medication that requires a prescription. Certain doctors surgeries can prescribe the patch, or you can go to your local GUM clinic for advice. Once your doctor has safely prescribed Evra for you the first time, you are able to order it online after a quick consultation. It's important to report any changes to your health or new medicines you are taking (including herbal remedies) during your online consultation.

    Is it safe to order online?

    When ordering from a certified online pharmacy, you can be ensured that your medication is safe. If the pharmacy doesn't ask you to complete essential health and medical question, however, this is a telltale sign that the website isn't certified. The website should also display clear signs that it is registered and approved by the relevant authorities. In the UK, this includes being registered by the MHRA and GMC.

    All medication will be delivered in tamper proof packaging complete with the full patient leaflet, which confirms that the medication is clinically proven and highly effective.

    What is included in the price?

    Ordering Evra online here at Medilico comes with many advantages. For one, you don't need to book a face-to-face consultation for a repeat order of a contraceptive you know is working for you, saving you time and effort. But what do you pay for? The cost of the medication is an all-inclusive price including the prescription, consultation, medication and delivery. There are no hidden costs. The price adjusts depending on the dosage and quantity you have ordered.

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