Xulane Patch (ETHINYL ESTRADIOL/NORELGESTROMIN)

Updated: Jun 20, 2021


Typically supplied as the following:



  • Transdermal Patch, Extended Release:35 MCG/24 HR-150 MCG/24 HR –(Ethinyl Estradiol - Norelgestromin)

Xulane belongs to a class of medicine generally referred to as hormonal contraceptives. It is a transdermal patch usually worn once a week for 3 weeks (4 weeks cycle) on the upper arm, upper torso or dry skin area of buttocks. The 4th week is usually the patch free week and break through bleeding may occur during this period. Xulane exerts its contraceptive effect by decreasing or suppressing the release of the sex hormones involved in ovulation (release of fertile eggs from the ovaries). In addition, it may also create a harsh environment for male sperm to survive within a female genital tract, further reducing the chances of getting pregnant. Thus, it is generally prescribed by physicians and some pharmacists for the prevention of pregnancy in women who elect to use a transdermal patch method as their choice of contraception.

I am having a major nausea with my oral birth control pills and I am considering switching to the patch. Would it be any better?

One of the common and less severe side effects from using an oral hormonal contraceptive “the pill” is nausea. Patients are always advised to take them at night and with food to reduce this risk. If you still get nauseated following this recommendation, then you may need to discuss a change in treatment with your doctor or pharmacist. Click lets chat to be connected with a pharmacist. Xulane patches generally have similar side effects and contraindications as the oral birth control pills. In actual fact, the prescribing information mentions how estrogen concentration in women on xulane patches is generally higher compared to those on the combined oral hormonal contraception. However, it is not known or proven whether or not this would translate to increased risk of side effects (nausea) or severe adverse effects such as blood clot disorders, or heart health disorders. Thus, discuss your consideration with your doctor and you can both go over the risks and possible benefits of switching your contraceptive method.



I drink grapefruit juice often, should I totally avoid it while on Xulane? I read on google that interacts with a lot of medications.

Quite often on google you will come across information that is either misleading or infected with inaccuracies. However, it is indeed accurate that grape fruit juice interacts with several medications and may potentially increase the risk of side effects from those drugs or render them less effective. Grape fruit juice is thought to contain one or more components that may affect the function of the 3A4 subgroup of the liver enzyme, which play a key role in the metabolism of many prescription drugs including the active ingredients in the Xulane patch. Of note, the pattern of metabolism of the Xulane patch system following a transdermal application is slightly different from orally ingested contraceptives; yet, the consumption of grape fruit juice, especially in large amounts, may still hinder how quickly the medication is removed from your body contributing to an increase risk of side-effects.

I have been prescribed diflucan for an infection. Would this make my patch less effective?

Diflucan (Fluconazole) may interact with some medications rendering them either less effective or increasing their toxicity. Fluconazole is a potent inhibitor of the liver enzyme subgroup that plays a key role in breaking down ingested medications into active and inactive components. This is particularly a concern with oral medications that are primarily metabolized or broken down in the liver. Xulane is delivered into the body via an intra-dermal patch system, thus bypassing the so-called first-pass metabolism in the liver. Though the effectiveness of your Xulane patch should not be affected during concurrent use, the prescribing information still inferred to exercise caution when on both medications. Click let’s chat to be connected to a pharmacist for more information.

I take supplements including occasional Ascorbic acid –vitamin C. Should I be worried or stop taking these supplements?



Supplements, including over- the-counter vitamins and herbal products, may interact with other prescribed medications. It is always a good practice to check with your doctor or pharmacist before starting any over the counter medication or herbal supplement. According to the prescribing information for Xulane, vitamin C (Ascorbic acid) may interact with the Ethinyl Estradiol (EE) component of the patch by slowing down the process of its removal from the body. Consequently, this may translate to increased risk of side effects from increased levels of EE in the body during the concurrent use. However, it is not clearly stated or known the correlation between the amount of vitamin C consumed and its effect on the clearance of EE from the body. Discuss with your physician for more guidance.

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C. 2019

References:

  • XULANE- norelgestromin and ethinyl estradiol patch [prescribing information]. Canonsburg, PA: Mylan Pharmaceuticals Inc.2019



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