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<title>Contraceptive patch</title>

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<span id="openzim-page-title" class="mw-page-title-main"><span class="mw-page-title-main">Contraceptive patch</span></span>

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</style><div role="note" class="hatnote navigation-not-searchable">"Evra patch" redirects here. For the brand of patch containing estradiol only, see <a href="Evorel_patch" class="mw-redirect" title="Evorel patch">Evorel patch</a>.</div>

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</style><table class="infobox"><tbody><tr><th colspan="2" class="infobox-above" style="background-color:lavender">Contraceptive patch</th></tr><tr><td colspan="2" class="infobox-image"><span typeof="mw:File"></span><div class="infobox-caption">Ortho Evra brand of contraceptive patch</div></td></tr><tr><th colspan="2" class="infobox-header" style="background-color:lavender">Background</th></tr><tr><th scope="row" class="infobox-label">Type</th><td class="infobox-data">Hormonal (combined estrogen + progestin)</td></tr><tr><th scope="row" class="infobox-label">First use</th><td class="infobox-data">2002</td></tr><tr><th colspan="2" class="infobox-header" style="background-color:lavender">Failure rates (first year)</th></tr><tr><th scope="row" class="infobox-label">Perfect use</th><td class="infobox-data">0.3%<sup id="cite_ref-Trussell_2011_1-0" class="reference"><a href="#cite_note-Trussell_2011-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Typical use</th><td class="infobox-data">9%<sup id="cite_ref-Trussell_2011_1-1" class="reference"><a href="#cite_note-Trussell_2011-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></td></tr><tr><th colspan="2" class="infobox-header" style="background-color:lavender">Usage</th></tr><tr><th scope="row" class="infobox-label">User reminders</th><td class="infobox-data">Weekly application for 3 weeks</td></tr><tr><th scope="row" class="infobox-label">Clinic review</th><td class="infobox-data">3-6 monthly</td></tr><tr><th colspan="2" class="infobox-header" style="background-color:lavender">Advantages and disadvantages</th></tr><tr><th scope="row" class="infobox-label"><a href="Sexually_transmitted_infection" title="Sexually transmitted infection">STI</a> protection</th><td class="infobox-data">No</td></tr><tr><th scope="row" class="infobox-label">Weight</th><td class="infobox-data">No proven effect</td></tr><tr><th scope="row" class="infobox-label">Period advantages</th><td class="infobox-data">Regulated, may be lighter and less painful</td></tr><tr><th scope="row" class="infobox-label">Benefits</th><td class="infobox-data">Compared to oral pills, may be less affected by antibiotics</td></tr><tr><th scope="row" class="infobox-label">Risks</th><td class="infobox-data"><a href="DVT" class="mw-redirect" title="DVT">DVTs</a> rates similar to oral combined pills</td></tr></tbody></table>

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<table class="infobox" style="border-spacing:2px;"><caption class="infobox-title"><span title="International nonproprietary name (INN): norelgestromin / ethinyl estradiol">norelgestromin / ethinyl estradiol</span></caption><tbody><tr><th colspan="2" class="infobox-header" style="background:#ddd;color:inherit;">Combination of</th></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="Norelgestromin" title="Norelgestromin">Norelgestromin</a></th><td class="infobox-data"><a href="Progestogen_(medication)" title="Progestogen (medication)">Progestogen</a></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="Ethinylestradiol" title="Ethinylestradiol">Ethinylestradiol</a></th><td class="infobox-data"><a href="Estrogen_(medication)" title="Estrogen (medication)">Estrogen</a></td></tr><tr><th colspan="2" class="infobox-header" style="background:#ddd;color:inherit;">Clinical data</th></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="Drug_nomenclature#Trade_names" title="Drug nomenclature">Trade names</a></th><td class="infobox-data">Ortho Evra, Xulane, Evra</td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="American_Society_of_Health-System_Pharmacists" title="American Society of Health-System Pharmacists">AHFS</a>/<a href="Drugs.com" title="Drugs.com">Drugs.com</a></th><td class="infobox-data"><span title="www.drugs.com"><a rel="nofollow" class="external text" href="https://www.drugs.com/ppa/ethinyl-estradiol-and-norelgestromin.html">Professional Drug Facts</a></span></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="MedlinePlus" title="MedlinePlus">MedlinePlus</a></th><td class="infobox-data"><span title="medlineplus.gov"><a rel="nofollow" class="external text" href="https://medlineplus.gov/druginfo/meds/a602006.html">a602006</a></span></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="Regulation_of_therapeutic_goods" title="Regulation of therapeutic goods">License data</a></th><td class="infobox-data"><style data-mw-deduplicate="TemplateStyles:r1126788409">

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<li><small><abbr class="country-name" title="United States">US</abbr></small> <a href="DailyMed" title="DailyMed">DailyMed</a>: <span title="dailymed.nlm.nih.gov"><a rel="nofollow" class="external text" href="https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=Norelgestromin_and_ethinyl_estradiol">Norelgestromin_and_ethinyl_estradiol</a></span></li></ul></div>

</td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="Pregnancy_category" title="Pregnancy category">Pregnancy<br>category</a></th><td class="infobox-data"><div class="plainlist">

<ul><li>Contraindicated</li></ul>

</div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="Route_of_administration" title="Route of administration">Routes of<br>administration</a></th><td class="infobox-data"><a href="Transdermal" title="Transdermal">Transdermal</a> (patch)</td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="Anatomical_Therapeutic_Chemical_Classification_System" title="Anatomical Therapeutic Chemical Classification System">ATC code</a></th><td class="infobox-data"><div class="plainlist"><ul><li><a href="ATC_code_G03" title="ATC code G03">G03AA13</a> (<span title="www.whocc.no"><a rel="nofollow" class="external text" href="https://www.whocc.no/atc_ddd_index/?code=G03AA13">WHO</a></span>) </li></ul></div></td></tr><tr><th colspan="2" class="infobox-header" style="background:#ddd;color:inherit;">Legal status</th></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="Regulation_of_therapeutic_goods" title="Regulation of therapeutic goods">Legal status</a></th><td class="infobox-data"><div class="plainlist">

<li><small><abbr class="country-name" title="United Kingdom">UK</abbr>:</small> <a href="Prescription_drug" title="Prescription drug">POM</a> (Prescription only)<sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></li>

<li>In general: ℞ (Prescription only)</li></ul></div>

</td></tr><tr><th colspan="2" class="infobox-header" style="background:#ddd;color:inherit;">Identifiers</th></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="CAS_Registry_Number" title="CAS Registry Number">CAS Number</a></th><td class="infobox-data"><div class="plainlist"><ul><li><span title="commonchemistry.cas.org"><a rel="nofollow" class="external text" href="https://commonchemistry.cas.org/detail?cas_rn=53016-31-2">53016-31-2</a></span><sup> <span typeof="mw:File"><span></span></span><span style="display:none">Y</span></sup></li><li><span title="commonchemistry.cas.org"><a rel="nofollow" class="external text" href="https://commonchemistry.cas.org/detail?cas_rn=57-63-6">57-63-6</a></span><sup> <span typeof="mw:File"><span></span></span><span style="display:none">Y</span></sup></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="PubChem#CID" title="PubChem">PubChem</a> <span style="font-weight:normal"><abbr title="Compound ID">CID</abbr></span></th><td class="infobox-data"><div class="plainlist"><ul><li><span title="pubchem.ncbi.nlm.nih.gov"><a rel="nofollow" class="external text" href="https://pubchem.ncbi.nlm.nih.gov/compound/91758695">91758695</a></span></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="DrugBank" title="DrugBank">DrugBank</a></th><td class="infobox-data"><div class="plainlist"><ul><li><span title="www.drugbank.ca"><a rel="nofollow" class="external text" href="https://www.drugbank.ca/drugs/DB06713">DB06713</a></span></li><li><span title="www.drugbank.ca"><a rel="nofollow" class="external text" href="https://www.drugbank.ca/drugs/DB00977">DB00977</a></span></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="ChemSpider" title="ChemSpider">ChemSpider</a></th><td class="infobox-data"><div class="plainlist"><ul><li>None</li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="Unique_Ingredient_Identifier" title="Unique Ingredient Identifier">UNII</a></th><td class="infobox-data"><div class="plainlist"><ul><li><span title="precision.fda.gov"><a rel="nofollow" class="external text" href="https://precision.fda.gov/uniisearch/srs/unii/R0TAY3X631">R0TAY3X631</a></span></li><li><span title="precision.fda.gov"><a rel="nofollow" class="external text" href="https://precision.fda.gov/uniisearch/srs/unii/423D2T571U">423D2T571U</a></span><sup> <span typeof="mw:File"><span></span></span><span style="display:none">Y</span></sup></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="KEGG" title="KEGG">KEGG</a></th><td class="infobox-data"><div class="plainlist"><ul><li><span title="www.kegg.jp"><a rel="nofollow" class="external text" href="https://www.kegg.jp/entry/D10839">D10839</a></span><sup> <span typeof="mw:File"><span></span></span><span style="display:none">Y</span></sup></li></ul></div></td></tr><tr><th colspan="2" class="infobox-header" style="background:#ddd;color:inherit;">Chemical and physical data</th></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="Chemical_formula" title="Chemical formula">Formula</a></th><td class="infobox-data"><span title="Carbon">C</span><sub>41</sub><span title="Hydrogen">H</span><sub>53</sub><span title="Nitrogen">N</span><span title="Oxygen">O</span><sub>4</sub></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="Molar_mass" title="Molar mass">Molar mass</a></th><td class="infobox-data"><span class="nowrap">623.878</span> g·mol<sup>−1</sup></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;">3D model (<a href="JSmol" class="mw-redirect" title="JSmol">JSmol</a>)</th><td class="infobox-data"><div class="plainlist"><ul><li><span title="chemapps.stolaf.edu (3D interactive model)"><a rel="nofollow" class="external text" href="https://chemapps.stolaf.edu/jmol/jmol.php?model=CCC12CCC3C%28C1CCC2%28C%23C%29O%29CCC4%3DCC%28%3DNO%29CCC34.CC12CCC3C%28C1CCC2%28C%23C%29O%29CCC4%3DC3C%3DCC%28%3DC4%29O">Interactive image</a></span></li></ul></div></td></tr><tr><td colspan="2" class="infobox-full-data"><div class="collapsible-list mw-collapsible mw-collapsed" style="text-align: left;">

<div style="line-height: 1.6em; font-weight: bold;"><div><a href="Simplified_molecular-input_line-entry_system" class="mw-redirect" title="Simplified molecular-input line-entry system">SMILES</a></div></div>

</div></td></tr><tr><td colspan="2" class="infobox-full-data"><div class="collapsible-list mw-collapsible mw-collapsed" style="text-align: left;">

<div style="line-height: 1.6em; font-weight: bold;"><div><a href="International_Chemical_Identifier" title="International Chemical Identifier">InChI</a></div></div>

<ul class="mw-collapsible-content" style="margin-top: 0; margin-bottom: 0; line-height: inherit; list-style: none; margin-left: 0; word-break:break-all;"><li style="line-height: inherit; margin: 0"><div style="word-wrap:break-word; text-indent:-1.5em; text-align:left; padding-left:1.5em; font-size:97%; line-height:120%;">InChI=1S/C21H29NO2.C20H24O2/c1-3-20-11-9-17-16-8-6-15(22-24)13-14(16)5-7-18(17)19(20)10-12-21(20,23)4-2;1-3-20(22)11-9-18-17-6-4-13-12-14(21)5-7-15(13)16(17)8-10-19(18,20)2/h2,13,16-19,23-24H,3,5-12H2,1H3;1,5,7,12,16-18,21-22H,4,6,8-11H2,2H3/b22-15-;/t16-,17+,18+,19-,20-,21-;16-,17-,18+,19+,20+/m01/s1</div></li><li style="line-height: inherit; margin: 0"><div style="word-wrap:break-word; text-indent:-1.5em; text-align:left; padding-left:1.5em; font-size:97%; line-height:120%;">Key:KBFRRZPPJPKFHQ-WKXKRCMPSA-N</div></li></ul>

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<table class="infobox" style="border-spacing:2px;"><caption class="infobox-title"><span title="International nonproprietary name (INN): levonorgestrel / ethinyl estradiol">levonorgestrel / ethinyl estradiol</span></caption><tbody><tr><th colspan="2" class="infobox-header" style="background:#ddd;color:inherit;">Combination of</th></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="Levonorgestrel" title="Levonorgestrel">Levonorgestrel</a></th><td class="infobox-data"><a href="Progestogen_(medication)" title="Progestogen (medication)">Progestogen</a></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="Ethinylestradiol" title="Ethinylestradiol">Ethinylestradiol</a></th><td class="infobox-data"><a href="Estrogen_(medication)" title="Estrogen (medication)">Estrogen</a></td></tr><tr><th colspan="2" class="infobox-header" style="background:#ddd;color:inherit;">Clinical data</th></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="Drug_nomenclature#Trade_names" title="Drug nomenclature">Trade names</a></th><td class="infobox-data">Twirla</td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="Regulation_of_therapeutic_goods" title="Regulation of therapeutic goods">License data</a></th><td class="infobox-data"><div class="plainlist">

<ul><li><small><abbr class="country-name" title="United States">US</abbr></small> <a href="DailyMed" title="DailyMed">DailyMed</a>: <span title="dailymed.nlm.nih.gov"><a rel="nofollow" class="external text" href="https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=Twirla">Twirla</a></span></li></ul></div>

<ul><li>Contraindicated</li></ul>

</div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="Route_of_administration" title="Route of administration">Routes of<br>administration</a></th><td class="infobox-data"><a href="Transdermal" title="Transdermal">Transdermal</a> (patch)</td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="Anatomical_Therapeutic_Chemical_Classification_System" title="Anatomical Therapeutic Chemical Classification System">ATC code</a></th><td class="infobox-data"><div class="plainlist"><ul><li><a href="ATC_code_G03" title="ATC code G03">G03AB03</a> (<span title="www.whocc.no"><a rel="nofollow" class="external text" href="https://www.whocc.no/atc_ddd_index/?code=G03AB03">WHO</a></span>) </li></ul></div></td></tr><tr><th colspan="2" class="infobox-header" style="background:#ddd;color:inherit;">Legal status</th></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="Regulation_of_therapeutic_goods" title="Regulation of therapeutic goods">Legal status</a></th><td class="infobox-data"><div class="plainlist">

<p>A <b>contraceptive patch</b>, also known as "the patch", is a <a href="Transdermal_patch" title="Transdermal patch">transdermal patch</a> applied to the skin that releases synthetic <a href="Oestrogen" class="mw-redirect" title="Oestrogen">oestrogen</a> and <a href="Progestogen" title="Progestogen">progestogen</a> hormones to prevent <a href="Pregnancy" title="Pregnancy">pregnancy</a>. They have been shown to be as effective as the <a href="Combined_oral_contraceptive_pill" title="Combined oral contraceptive pill">combined oral contraceptive pill</a> with perfect use, and the patch may be more effective in typical use.<sup id="cite_ref-CT_3-0" class="reference"><a href="#cite_note-CT-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup>

</p><p><b>Xulane</b><sup id="cite_ref-Xulane_label_5-0" class="reference"><a href="#cite_note-Xulane_label-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> and <b>Twirla</b><sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> are approved for use in the United States. <b>Evra</b> is approved for use in Canada and marketed by Janssen Inc.,<sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> and it is approved for use in the United Kingdom<sup id="cite_ref-Evra_SmPC_8-0" class="reference"><a href="#cite_note-Evra_SmPC-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> and in Europe<sup id="cite_ref-Evra_EPAR_9-0" class="reference"><a href="#cite_note-Evra_EPAR-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> and marketed by <a href="Janssen-Cilag" class="mw-redirect" title="Janssen-Cilag">Janssen-Cilag</a>.<sup id="cite_ref-Evra_SmPC_8-1" class="reference"><a href="#cite_note-Evra_SmPC-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Evra_EPAR_9-1" class="reference"><a href="#cite_note-Evra_EPAR-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> The patches are packaged in boxes of three and are only available by prescription.<sup id="cite_ref-Xulane_label_5-1" class="reference"><a href="#cite_note-Xulane_label-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup>

</p>

<div class="mw-heading mw-heading2"><h2 id="Medical_uses">Medical uses</h2></div>

<p>Because the patch works similarly to that of birth control pills, many of the benefits are the same. For example, the patch may make a woman's period lighter and more regular. It may also help to clear acne, decrease cramps, and reduce PMS symptoms. Additionally, the patch is associated with increased protection against iron deficiency anemia, ovarian cysts, <a href="Pelvic_inflammatory_disease" title="Pelvic inflammatory disease">pelvic inflammatory disease</a>, and endometrial and ovarian cancer.

</p><p>The patch is a simple and convenient form of birth control that requires weekly attention. When a woman stops using the patch, her ability to become pregnant returns quickly.<sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup>

</p>

<div class="mw-heading mw-heading2"><h2 id="Side_effects">Side effects</h2></div>

<p>In three large clinical trials involving a total of 3,330 women using the Ortho Evra / Evra patch for up to one year, 12% of users discontinued the patch because of adverse events. The most frequent adverse events leading to patch discontinuation were: nausea and/or vomiting (2.4%), application site reaction (1.9%), breast discomfort, engorgement or pain (1.9%), headache (1.1%), and emotional lability (1.0%).<sup id="cite_ref-sibai_2002_11-0" class="reference"><a href="#cite_note-sibai_2002-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup>

</p><p>The most frequent adverse events reported while using the Ortho Evra / Evra patch were: breast discomfort, engorgement or pain (22%), headache (21%), application site reaction (17%), nausea (17%), upper respiratory tract infection (10%), menstrual cramps (10%), and abdominal pain (9%).<sup id="cite_ref-sibai_2002_11-1" class="reference"><a href="#cite_note-sibai_2002-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup>

</p><p><a href="Breakthrough_bleeding" class="mw-redirect" title="Breakthrough bleeding">Breakthrough bleeding</a> and/or spotting while using the Ortho Evra / Evra patch was reported by: 18% in cycle 1, 12% in cycle 3, 8% in cycle 6 and cycle 13. Breakthrough bleeding (requiring more than one pad or tampon per day) was reported by: 4% in cycle 1, 3% in cycle 3 and cycle 6, and 1% in cycle 13.<sup id="cite_ref-zieman_2002_12-0" class="reference"><a href="#cite_note-zieman_2002-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup>

</p><p>Overall, side effects that tend to go away after two or three months include bleeding between periods, breast tenderness, and nausea and vomiting. Symptoms that may last longer include skin irritation around the area where the patch is placed and a change in the woman's sexual desires.

</p><p>Additional side effect information is provided in the Ortho Evra label information and the Evra <a href="Summary_of_Product_Characteristics" class="mw-redirect" title="Summary of Product Characteristics">Summary of Product Characteristics</a> (SPC) and <a href="Patient_information_leaflet" class="mw-redirect" title="Patient information leaflet">PIL</a>.<sup id="cite_ref-Xulane_label_5-2" class="reference"><a href="#cite_note-Xulane_label-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Evra_SmPC_8-2" class="reference"><a href="#cite_note-Evra_SmPC-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Evra_PIL_13-0" class="reference"><a href="#cite_note-Evra_PIL-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup>

</p>

<div class="mw-heading mw-heading3"><h3 id="Interactions_and_contraindications">Interactions and contraindications</h3></div>

<p>Contraceptive effectiveness of the patch or any other hormonal contraceptive may be reduced significantly if administered alongside various <a href="Antibiotics" class="mw-redirect" title="Antibiotics">antibiotics</a>, <a href="Antifungals" class="mw-redirect" title="Antifungals">antifungals</a>, <a href="Anticonvulsants" class="mw-redirect" title="Anticonvulsants">anticonvulsants</a>, or other drugs that increase metabolism of contraceptive steroids.

</p><p>However, despite the interactions with many other antibiotics, a clinical pharmacokinetic drug interaction study showed that oral administration of <a href="Tetracycline" title="Tetracycline">tetracycline</a> HCl 500 mg for three days prior to and seven days during use of Ortho Evra "did not reduce effectiveness of Ortho Evra." This is a significant factor in the common decision to administer tetracycline-derived antibiotics following an <a href="Abortion" title="Abortion">abortion</a> (preventatively to fight potential infection) when synthetic hormone contraceptives are to be used afterwards.

</p><p>Drugs containing <a href="St._John's_Wort" class="mw-redirect" title="St. John's Wort">St. John's wort</a> are also known to affect the effectiveness of hormonal contraceptives.

</p><p>It has also been found that the patch is less effective in women who weigh more than 198 pounds (90 kg).

</p><p>The contraceptive patch and other combination hormonal contraceptives are contraindicated in women older than 35 years who smoke cigarettes.<sup id="cite_ref-Xulane_label_5-3" class="reference"><a href="#cite_note-Xulane_label-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup>

</p><p>The contraceptive patch is contraindicated for use in women with a BMI ≥ 30<span class="nowrap"> </span>kg/m<sup>2</sup>.<sup id="cite_ref-Xulane_label_5-4" class="reference"><a href="#cite_note-Xulane_label-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup>

</p>

<div class="mw-heading mw-heading3"><h3 id="Thromboembolism">Thromboembolism</h3></div>

<p>All combined <a href="Hormonal_birth_control" class="mw-redirect" title="Hormonal birth control">hormonal birth control</a> products have a very small increased risk of serious or fatal <a href="Thrombosis" title="Thrombosis">thromboembolic</a> events. There is ongoing research into the thromboembolic risks of Ortho Evra as compared to combined oral contraceptive pills. A recent study found that users of the contraceptive patch may have a twofold increased risk for non-fatal venous thromboembolic events compared with women who took a norgestimate-containing oral contraceptive with 35 μg of estrogen.<sup id="cite_ref-Alert_14-0" class="reference"><a href="#cite_note-Alert-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Cole2007_15-0" class="reference"><a href="#cite_note-Cole2007-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> However, a different study concluded that the risk of nonfatal venous thromboembolism for the contraceptive patch is similar to the risk for oral contraceptives containing 35 μg of ethinylestradiol and <a href="Norgestimate" title="Norgestimate">norgestimate</a>.<sup id="cite_ref-Contraception_16-0" class="reference"><a href="#cite_note-Contraception-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> The contradiction in findings between the two studies is not easily resolved, because the <a href="Confidence_interval" title="Confidence interval">confidence intervals</a> for the studies are overlapping.

</p><p>In studies with oral contraceptives, the risk for cardiovascular disease (such as thromboembolism) is significantly increased in women over the age of 35 years who also <a href="Tobacco_smoking" title="Tobacco smoking">smoke tobacco</a>.<sup id="cite_ref-smoking_17-0" class="reference"><a href="#cite_note-smoking-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> Hence, Ortho Evra's package insert states: "Women who use hormonal contraceptives, including Ortho Evra, should be strongly advised not to smoke."

</p><p>According to the manufacturer, the patches introduce a 60% higher level of estrogen into the bloodstream as compared to oral contraceptives; however, the clinical significance of this difference is unknown.

</p><p>On November 10, 2005, Ortho McNeil, in conjunction with the <a href="U.S._Food_and_Drug_Administration" class="mw-redirect" title="U.S. Food and Drug Administration">FDA</a>, revised the label for Ortho Evra, including a new bolded warning about higher exposure to estrogen for women using the weekly patch compared to taking a daily birth control pill containing 35 μg of estrogen, noting that higher levels of estrogen may put some women at increased risk for getting blood clots. The label was again revised in September 2006, and on January 18, 2008, the FDA again updated the label to reflect study results: "The FDA believes that Ortho Evra is a safe and effective method of contraception when used according to the labeling, which recommends that women with concerns or risk factors for serious blood clots talk with their health care provider about using Ortho Evra versus other contraceptive options."<sup id="cite_ref-FDA2008_18-0" class="reference"><a href="#cite_note-FDA2008-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup>

</p>

<div class="mw-heading mw-heading2"><h2 id="Method_of_use">Method of use</h2></div>

<p>The patch is first applied onto the upper outer arm, buttocks, abdomen or thigh on either the first day of the <a href="Menstrual_cycle" title="Menstrual cycle">menstrual cycle</a> (day 1) or on the first Sunday following that day, whichever is preferred. The day of application is known from that point as <i>patch change day</i>. Seven days later, when <i>patch change day</i> comes again, the user removes the patch and applies another to one of the approved locations on the body. This process is repeated again on the next <i>patch change day</i>. On the following <i>patch change day</i>, the patch is removed and not replaced. The user waits seven days without a patch in place, and on the next <i>patch change day</i> they apply a new patch. <a href="Extended_cycle_combined_hormonal_contraceptive" title="Extended cycle combined hormonal contraceptive">Extended use regimens</a>, where patches are used for several weeks before a patch-free week, have been studied.<sup id="cite_ref-19" class="reference"><a href="#cite_note-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup>

</p><p>The patch should be applied to skin that is clean, dry, and intact. This means if skin is red, irritated, or cut, the patch should not be placed in that area. Additionally, avoid using lotions, powder, or makeup around the area where the patch is or will be placed.<sup id="cite_ref-Mayo_Clinic_Evra_20-0" class="reference"><a href="#cite_note-Mayo_Clinic_Evra-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup>

</p>

<div class="mw-heading mw-heading3"><h3 id="Backup_contraception">Backup contraception</h3></div>

<dl><dd><ul><li>If someone chooses to begin with their <i>patch change day</i> as day one of their menstrual cycle, the patch is able to take effect in time to prevent ovulation (see Mechanism of Action below) and no form of backup contraception is needed at all.

<ul><li>In the case that one wishes to begin using the contraceptive patch following a first trimester abortion or miscarriage, patch application can be done immediately afterwards. This can be considered the same as a day one start above, and no backup contraception is required.</li></ul></li>

<li>If a user chooses to begin with their <i>patch change day</i> as the first Sunday following day 1, it is necessary to use a backup form of contraception such as spermicide<sup id="cite_ref-21" class="reference"><a href="#cite_note-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> or condoms for the first week of patch wear.</li>

<li>If the user is late placing her patch in the first week, or more than two days late placing the patch in the second and third weeks, they should apply the patch immediately, and then use a backup form of barrier protection for a week.<sup id="cite_ref-Mayo_Clinic_Evra_20-1" class="reference"><a href="#cite_note-Mayo_Clinic_Evra-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup></li></ul></dd></dl>

<div class="mw-heading mw-heading2"><h2 id="Mechanism_of_action">Mechanism of action</h2></div>

<p>Like all combined hormonal contraceptives, Ortho Evra / Evra works primarily by preventing ovulation. A secondary mechanism of action is inhibition of sperm penetration by changes in the cervical mucus. Hormonal contraceptives also have effects on the endometrium that theoretically could affect implantation; however, no scientific evidence indicates that prevention of implantation actually results from their use.<sup id="cite_ref-22" class="reference"><a href="#cite_note-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup>

</p><p>The 20 cm<sup>2</sup> Ortho Evra contraceptive patch contains 750 μg <a href="Ethinylestradiol" title="Ethinylestradiol">ethinylestradiol</a> (an estrogen) and 6000 μg <a href="Norelgestromin" title="Norelgestromin">norelgestromin</a> (a progestin).<sup id="cite_ref-Xulane_label_5-5" class="reference"><a href="#cite_note-Xulane_label-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> The 20 cm<sup>2</sup> Evra contraceptive patch contains 600 μg ethinylestradiol and 6000 μg norelgestromin.<sup id="cite_ref-Evra_SmPC_8-3" class="reference"><a href="#cite_note-Evra_SmPC-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> The Ortho Evra contraceptive patch and the Evra contraceptive patch are both intended to gradually release into the systemic circulation approximately 20 μg/day of ethinylestradiol and 150 μg/day of norelgestromin.<sup id="cite_ref-Xulane_label_5-6" class="reference"><a href="#cite_note-Xulane_label-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Evra_SmPC_8-4" class="reference"><a href="#cite_note-Evra_SmPC-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup>

</p>

<div class="mw-heading mw-heading2"><h2 id="Lawsuits">Lawsuits</h2></div>

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<p>The patch has been associated with strokes and thrombosis and the mechanism for hormone absorption and dissipation from the body's tissues is different from "the pill". Several lawsuits have been instigated over these issues.<sup id="cite_ref-:0_23-0" class="reference"><a href="#cite_note-:0-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup>

</p><p>A lawsuit filed in Federal Court in New Jersey on September 2, 2005, by a Georgia woman who had a pulmonary embolism alleges the company promoted the patch despite knowledge of its health risks, for financial gain, while failing to warn of the risks of blood clots and other injuries.<sup id="cite_ref-:0_23-1" class="reference"><a href="#cite_note-:0-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup>

</p><p>The parents of a 14-year-old girl from Wisconsin have filed a lawsuit against <a href="Johnson_%26_Johnson" title="Johnson & Johnson">Johnson & Johnson</a> because they claim that she died from a <a href="Thrombosis" title="Thrombosis">blood clot</a> that arose from her use of the patch.<sup id="cite_ref-24" class="reference"><a href="#cite_note-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup>

</p>

<div class="mw-heading mw-heading2"><h2 id="References">References</h2></div>

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</style><cite id="CITEREFTrussell2011" class="citation book cs1">Trussell J (2011). "Contraceptive efficacy". In Hatcher RA, Trussell J, Nelson AL, Cates Jr W, Kowal D, Policar MS (eds.). <i>Contraceptive technology</i> (20th revised ed.). New York: Ardent Media. pp. <span class="nowrap">779–</span>863. <a href="ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <bdi>978-1-59708-004-0</bdi>. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/0091-9721">0091-9721</a>. <a href="OCLC_(identifier)" class="mw-redirect" title="OCLC (identifier)">OCLC</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/oclc/781956734">781956734</a>.</cite> Table 26–1 = <span class=""><a rel="nofollow" class="external text" href="http://www.contraceptivetechnology.org/wp-content/uploads/2013/09/CTFailureTable.pdf">Table 3–2 Percentage of women experiencing an unintended pregnancy during the first year of typical use and the first year of perfect use of contraception, and the percentage continuing use at the end of the first year. United States.</a> <a rel="nofollow" class="external text" href="https://web.archive.org/web/20170215224018/http://www.contraceptivetechnology.org/wp-content/uploads/2013/09/CTFailureTable.pdf">Archived</a> 2017-02-15 at the <a href="Wayback_Machine" title="Wayback Machine">Wayback Machine</a></span></span>

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<li id="cite_note-4"><span class="mw-cite-backlink"><b><a href="#cite_ref-4">^</a></b></span> <span class="reference-text"><cite id="CITEREFNandaBurke2011" class="citation book cs1">Nanda K, Burke A (2011). "Contraceptive patch and vaginal contraceptive ring.". In Hatcher RA, Nelson AL, Trussell J, Cwiak C, Cason P, Policar MS, Edelman A, Aiken AR, Marrazzo J, Kowal D (eds.). <i>Contraceptive Technology</i> (twentieth ed.). Atlanta, Georgia: Ardent Media, Inc. p. 272. <a href="ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <bdi>978-1-59708-004-0</bdi>.</cite></span>

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<li id="cite_note-Mayo_Clinic_Evra-20"><span class="mw-cite-backlink">^ <a href="#cite_ref-Mayo_Clinic_Evra_20-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Mayo_Clinic_Evra_20-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20121015203449/http://www.mayoclinic.com/health/ortho-evra/MY01006/DSECTION=what-you-can-expect">"Ortho Evra (Contraceptive Patch)"</a>. Mayo Clinic. 2010. Archived from <a rel="nofollow" class="external text" href="http://www.mayoclinic.com/health/ortho-evra/MY01006/DSECTION=what-you-can-expect">the original</a> on 15 October 2012<span class="reference-accessdate">. Retrieved <span class="nowrap">3 February</span> 2011</span>.</cite></span>

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</ol></div></div>

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</style><div id="Birth_control_methods322" style="font-size:114%;margin:0 4em"><a href="Birth_control" title="Birth control">Birth control</a> methods</div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">Related topics</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Comparison_of_birth_control_methods" title="Comparison of birth control methods">Comparison of birth control methods</a></li>

<li><a href="Male_contraceptive" title="Male contraceptive">Male contraceptives</a></li>

<li><a href="Safe_sex" title="Safe sex">Preventing sexually-transmitted infections</a></li>

<li><a href="Birth_control#Approval" title="Birth control">Over-the-counter oral contraceptives</a></li>

<li><a href="Oral_contraceptive_formulations" class="mw-redirect" title="Oral contraceptive formulations">Oral contraceptive formulations</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Long-acting_reversible_contraception" class="mw-redirect" title="Long-acting reversible contraception">Long-acting reversible<br> contraception</a> (LARC)</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Intrauterine_device" title="Intrauterine device">Intrauterine device</a> (<a href="Hormonal_IUD" class="mw-redirect" title="Hormonal IUD">Hormonal IUD</a></li>

<li><a href="Copper_IUD" title="Copper IUD">Copper IUD</a>)</li>

<li><a href="Contraceptive_implant" title="Contraceptive implant">Contraceptive implant</a> (<a href="Etonogestrel_implant" title="Etonogestrel implant">Etonogestrel implant</a>, <a href="Levonorgestrel_implant" class="mw-redirect" title="Levonorgestrel implant">Levonorgestrel implant</a>)</li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Sterilization_(medicine)" title="Sterilization (medicine)">Sterilization</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Tubal_ligation" title="Tubal ligation">Tubal ligation</a> (female)</li>

<li><a href="Vasectomy" title="Vasectomy">Vasectomy</a> (male)</li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Hormonal_contraception" title="Hormonal contraception">Hormonal contraception</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Hormonal_contraception#Combined" title="Hormonal contraception">Combined<br> estrogen–progestogen</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<li><a href="Extended_cycle_combined_hormonal_contraceptive" title="Extended cycle combined hormonal contraceptive">Extended cycle Pill</a></li>

<li><a href="Combined_injectable_contraceptive" class="mw-redirect" title="Combined injectable contraceptive">Monthly injections</a></li>

<li><a href="Ethinylestradiol/etonogestrel" title="Ethinylestradiol/etonogestrel">Vaginal ring</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Progestogen-only_contraception" title="Progestogen-only contraception">Progestogen-only</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Progestogen-only_injectable_contraceptive" title="Progestogen-only injectable contraceptive">Multi-month injections</a></li>

<li><a href="Progestogen-only_pill" title="Progestogen-only pill">Progestogen-only pill</a></li>

<li><a href="Progesterone_vaginal_ring" title="Progesterone vaginal ring">Vaginal ring</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Selective_estrogen_receptor_modulator" title="Selective estrogen receptor modulator">SERMs</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Ormeloxifene" title="Ormeloxifene">Ormeloxifene</a></li></ul>

</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Barrier_contraception" class="mw-redirect" title="Barrier contraception">Barrier Methods</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Condom" title="Condom">External condom</a></li>

<li><a href="Female_condom" title="Female condom">Internal condom</a></li>

<li><a href="Cervical_cap" title="Cervical cap">Cervical cap</a></li>

<li><a href="Diaphragm_(birth_control)" title="Diaphragm (birth control)">Diaphragm</a></li>

<li><a href="Contraceptive_sponge" title="Contraceptive sponge">Contraceptive sponge</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Emergency_Contraception" class="mw-redirect" title="Emergency Contraception">Emergency Contraception</a><br>(Post-intercourse)</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Copper_IUD#Emergency_contraception" title="Copper IUD">Copper IUD</a></li>

<li><a href="Ulipristal_acetate" title="Ulipristal acetate">Ulipristal acetate</a></li>

<li><a href="Levonorgestrel#Emergency_birth_control" title="Levonorgestrel">Levonorgestrel</a></li>

<li><a href="Mifepristone#Other" title="Mifepristone">Low-dose mifepristone</a></li>

<li><a href="Yuzpe_regimen" title="Yuzpe regimen">Yuzpe regimen</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Spermicides" class="mw-redirect" title="Spermicides">Spermicides</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Lactic_acid/citric_acid/potassium_bitartrate" title="Lactic acid/citric acid/potassium bitartrate">Vaginal pH modulation</a></li>

<li><a href="Nonoxynol-9" title="Nonoxynol-9">Nonoxynol-9</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Behavioral</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Including<br> <a href="Penile-vaginal_intercourse" class="mw-redirect" title="Penile-vaginal intercourse">vaginal intercourse</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Lactational_amenorrhea#Use_as_birth_control" title="Lactational amenorrhea">Breastfeeding method</a></li>

<li><a href="Calendar-based_contraceptive_methods" title="Calendar-based contraceptive methods">Calendar (rhythm) methods</a></li>

<li><a href="Fertility_awareness" title="Fertility awareness">Fertility awareness methods</a></li>

<li><a href="Coitus_interruptus" title="Coitus interruptus">Withdrawal</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Avoiding<br> <a href="Penile-vaginal_intercourse" class="mw-redirect" title="Penile-vaginal intercourse">vaginal intercourse</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Non-penetrative_sex" title="Non-penetrative sex">Non-penetrative sex</a></li>

<li><a href="Sexual_abstinence" title="Sexual abstinence">Abstinence</a></li></ul>

</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Experimental</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Male_contraceptive#Research_into_new_methods" title="Male contraceptive">Male contraceptives in development</a></li></ul>

</div></td></tr></tbody></table></div>

<div class="navbox-styles"></div><div role="navigation" class="navbox" aria-labelledby="Active_molecules_in_hormonal_contraceptives112" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Active_molecules_in_hormonal_contraceptives112" style="font-size:114%;margin:0 4em"><a href="Hormonal_contraception" title="Hormonal contraception">Active molecules in hormonal contraceptives</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;"><a href="Androgen" title="Androgen">Androgens</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><i>Male-only:</i> <a href="Dimethandrolone" title="Dimethandrolone">Dimethandrolone</a></li>

<li><a href="Testosterone_buciclate" title="Testosterone buciclate">Testosterone buciclate</a></li>

<li><a href="Testosterone_undecanoate" title="Testosterone undecanoate">Testosterone undecanoate</a></li>

<li><a href="Trestolone" title="Trestolone">Trestolone</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;"><a href="Estrogen" title="Estrogen">Estrogens</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Diethylstilbestrol" title="Diethylstilbestrol">Diethylstilbestrol</a></li>

<li><a href="Estradiol" title="Estradiol">Estradiol</a></li>

<li><a href="Estradiol_benzoate" title="Estradiol benzoate">Estradiol benzoate</a></li>

<li><a href="Estradiol_cypionate" title="Estradiol cypionate">Estradiol cypionate</a></li>

<li><a href="Estradiol_enanthate" class="mw-redirect" title="Estradiol enanthate">Estradiol enanthate</a></li>

<li><a href="Estradiol_valerate" title="Estradiol valerate">Estradiol valerate</a></li>

<li><a href="Ethinylestradiol" title="Ethinylestradiol">Ethinylestradiol</a></li>

<li><a href="Mestranol" title="Mestranol">Mestranol</a></li>

<li><a href="Ormeloxifene" title="Ormeloxifene">Ormeloxifene</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;"><a href="Progestogen" title="Progestogen">Progestogens</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">First generation (<i>estranes</i>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Ethisterone" title="Ethisterone">Ethisterone</a></li>

<li><a href="Etynodiol_diacetate" title="Etynodiol diacetate">Etynodiol diacetate</a></li>

<li><a href="Lynestrenol" title="Lynestrenol">Lynestrenol</a></li>

<li><a href="Norethisterone" title="Norethisterone">Norethisterone (norethindrone)</a></li>

<li><a href="Norethisterone_acetate" title="Norethisterone acetate">Norethisterone acetate</a></li>

<li><a href="Norethisterone_enanthate" title="Norethisterone enanthate">Norethisterone enanthate</a></li>

<li><a href="Noretynodrel" title="Noretynodrel">Noretynodrel</a></li>

<li><a href="Quingestanol" title="Quingestanol">Quingestanol</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Second generation</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><i>Estranes:</i> <a href="Norethisterone_enanthate" title="Norethisterone enanthate">Norethisterone enanthate</a></li>

<li><a href="Norgestrienone" title="Norgestrienone">Norgestrienone</a></li>

<li><i>Gonanes:</i> <a href="Levonorgestrel" title="Levonorgestrel">Levonorgestrel</a></li>

<li><a href="Norelgestromin" title="Norelgestromin">Norelgestromin</a></li>

<li><a href="Norgestrel" title="Norgestrel">Norgestrel</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Third generation (<i>gonanes</i>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Desogestrel" title="Desogestrel">Desogestrel</a></li>

<li><a href="Etonogestrel" title="Etonogestrel">Etonogestrel</a></li>

<li><a href="Gestodene" title="Gestodene">Gestodene</a></li>

<li><a href="Norgestimate" title="Norgestimate">Norgestimate</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Fourth generation</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><i>Estranes:</i> <a href="Dienogest" title="Dienogest">Dienogest</a></li>

<li><i>Norpregnanes:</i> <a href="Segesterone_acetate" title="Segesterone acetate">Segesterone acetate</a></li>

<li><a href="Demegestone" title="Demegestone">Demegestone</a></li>

<li><a href="Nomegestrol_acetate" title="Nomegestrol acetate">Nomegestrol acetate</a></li>

<li><a href="Promegestone" title="Promegestone">Promegestone</a></li>

<li><a href="Trimegestone" title="Trimegestone">Trimegestone</a></li>

<li><i>Spironolactone derivatives:</i> <a href="Drospirenone" title="Drospirenone">Drospirenone</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Pregnanes</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Chlormadinone_acetate" title="Chlormadinone acetate">Chlormadinone acetate</a></li>

<li><a href="Medrogestone" title="Medrogestone">Medrogestone</a></li>

<li><a href="Medroxyprogesterone_acetate" title="Medroxyprogesterone acetate">Medroxyprogesterone acetate</a></li>

<li><a href="Megestrol_acetate" title="Megestrol acetate">Megestrol acetate</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Miscellaneous</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Mifepristone" title="Mifepristone">Mifepristone</a></li>

<li><a href="Ulipristal_acetate" title="Ulipristal acetate">Ulipristal acetate</a></li>

<li><a href="Algestone_acetophenide" title="Algestone acetophenide">Algestone acetophenide</a></li>

<li><a href="Dydrogesterone" title="Dydrogesterone">Dydrogesterone</a></li>

<li><a href="Gestrinone" title="Gestrinone">Gestrinone</a></li>

<li><a href="Progesterone" title="Progesterone">Progesterone</a></li>

<li><a href="Proligestone" title="Proligestone">Proligestone</a></li></ul>

</div></td></tr></tbody></table><div></div></td></tr></tbody></table></div>

<div class="navbox-styles"></div><div role="navigation" class="navbox" aria-labelledby="Routes_of_administration,_dosage_forms650" style="padding:3px"><table class="nowraplinks hlist mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Routes_of_administration,_dosage_forms650" style="font-size:114%;margin:0 4em"><a href="Route_of_administration" title="Route of administration">Routes of administration</a>, <a href="Dosage_form" title="Dosage form">dosage forms</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Oral_administration" title="Oral administration">Oral</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:10em;white-space:normal;"><a href="Human_gastrointestinal_tract" class="mw-redirect" title="Human gastrointestinal tract">Digestive tract</a> (<a href="Enteral_administration" title="Enteral administration">enteral</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:5em;white-space:normal;"><a href="Solid" title="Solid">Solids</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Tablet_(pharmacy)" title="Tablet (pharmacy)">Tablet</a></li>

<li><a href="Capsule_(pharmacy)" title="Capsule (pharmacy)">Capsule</a></li>

<li><a href="Pastille" title="Pastille">Pastille</a></li>

<li><a href="Time_release_technology" class="mw-redirect" title="Time release technology">Time release technology</a></li>

<li><a href="Osmotic-controlled_release_oral_delivery_system" title="Osmotic-controlled release oral delivery system">Osmotic delivery system</a></li></ul>

</div></td><td class="noviewer navbox-image" rowspan="2" style="width:1px;padding:0 0 0 2px"><div><span typeof="mw:File"></span><br><span typeof="mw:File"></span></div></td></tr><tr><th scope="row" class="navbox-group" style="width:5em;white-space:normal;"><a href="Liquid" title="Liquid">Liquids</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Decoction" title="Decoction">Decoction</a></li>

<li><a href="Elixir" title="Elixir">Elixir</a></li>

<li><a href="Electuary" title="Electuary">Electuary</a></li>

<li><a href="Emulsion" title="Emulsion">Emulsion</a></li>

<li><a href="Effervescent_tablet" title="Effervescent tablet">Effervescent powder or tablet</a></li>

<li><a href="Herbal_tea" title="Herbal tea">Herbal tea</a></li>

<li><a href="Hydrogel" title="Hydrogel">Hydrogel</a></li>

<li><a href="Molecular_encapsulation" class="mw-redirect" title="Molecular encapsulation">Molecular encapsulation</a></li>

<li><a href="Powder" title="Powder">Powder</a></li>

<li><a href="Softgel" title="Softgel">Softgel</a></li>

<li><a href="Solution_(chemistry)" title="Solution (chemistry)">Solution</a></li>

<li><a href="Suspension_(chemistry)" title="Suspension (chemistry)">Suspension</a></li>

<li><a href="Syrup" title="Syrup">Syrup</a></li>

<li><a href="Tincture" title="Tincture">Tincture</a></li></ul>

</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:10em;white-space:normal;"><a href="Oral_mucosa" title="Oral mucosa">Oral mucosa</a> (<a href="Buccal_administration" title="Buccal administration">buccal</a>, <a href="Sublabial_administration" title="Sublabial administration">sublabial</a>, <a href="Sublingual_administration" title="Sublingual administration">sublingual</a>, <a href="Supralingual_administration" title="Supralingual administration">supralingual</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:5em;white-space:normal;"><a href="Solid" title="Solid">Solids</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Orally_disintegrating_tablet" title="Orally disintegrating tablet">Orally disintegrating tablet</a></li>

<li><a href="Lollipop#Medicinal_use" title="Lollipop">Lollipop</a></li>

<li><a href="Drop_(liquid)" title="Drop (liquid)">Sublingual drops</a></li>

<li><a href="Throat_lozenge" title="Throat lozenge">Lozenges</a></li>

<li><a href="Effervescent" class="mw-redirect" title="Effervescent">Effervescent</a> tablet</li>

<li><a href="Chewing_gum" title="Chewing gum">Chewing gum</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:5em;white-space:normal;"><a href="Liquid" title="Liquid">Liquids</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Mouthwash" title="Mouthwash">Mouthwash</a></li>

<li><a href="Toothpaste" title="Toothpaste">Toothpaste</a></li>

<li><a href="Topical" class="mw-redirect" title="Topical">Ointment</a></li>

<li>Spray</li></ul>

</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:10em;white-space:normal;"><a href="Respiratory_tract" title="Respiratory tract">Respiratory tract</a> (<a href="Inhalation" title="Inhalation">inhalation</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:5em;white-space:normal;"><a href="Solid" title="Solid">Solids</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Dry-powder_inhaler" title="Dry-powder inhaler">Dry-powder inhaler</a></li>

<li><a href="Smoking" title="Smoking">Smoking</a></li></ul>

</div></td><td class="noviewer navbox-image" rowspan="3" style="width:1px;padding:0 0 0 2px"><div><span typeof="mw:File"></span><br><span aria-hidden="true" style="visibility:hidden;color:transparent;">0</span><br><span aria-hidden="true" style="visibility:hidden;color:transparent;">0</span></div></td></tr><tr><th scope="row" class="navbox-group" style="width:5em;white-space:normal;"><a href="Liquid" title="Liquid">Liquids</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Anesthetic_vaporizer" class="mw-redirect" title="Anesthetic vaporizer">Anesthetic vaporizer</a></li>

<li><a href="Heated_humidified_high-flow_therapy" title="Heated humidified high-flow therapy">Heated humidified high-flow therapy</a></li>

<li><a href="List_of_medical_inhalants" title="List of medical inhalants">Medical inhalants</a></li>

<li><a href="Metered-dose_inhaler" title="Metered-dose inhaler">Metered-dose inhaler</a> (MDI)</li>

<li><a href="Nebulizer" title="Nebulizer">Nebulizer</a></li>

<li><a href="Vaporizer_(inhalation_device)" title="Vaporizer (inhalation device)">Vaporizer</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:5em;white-space:normal;"><a href="Gas" title="Gas">Gas</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Oxygen_mask" title="Oxygen mask">Oxygen mask</a> and <a href="Nasal_cannula" title="Nasal cannula">Nasal cannula</a></li>

<li><a href="Oxygen_concentrator" title="Oxygen concentrator">Oxygen concentrator</a></li>

<li><a href="Anaesthetic_machine" title="Anaesthetic machine">Anaesthetic machine</a></li>

<li><a href="List_of_medical_inhalants" title="List of medical inhalants">Medical inhalants</a></li>

<li><a href="Relative_analgesia_machine" title="Relative analgesia machine">Relative analgesia machine</a></li></ul>

</div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Ophthalmic_drug_administration" title="Ophthalmic drug administration">Ophthalmic</a>,<br><a href="Ear" title="Ear">otic</a>, <a href="Nasal_administration" title="Nasal administration">nasal</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Nasal_spray" title="Nasal spray">Nasal spray</a></li>

<li><a href="Ear_drop" title="Ear drop">Ear drops</a></li>

<li><a href="Eye_drop" title="Eye drop">Eye drops</a></li>

<li><a href="Topical" class="mw-redirect" title="Topical">Ointment</a></li>

<li><a href="Hydrogel" title="Hydrogel">Hydrogel</a></li>

<li><a href="Insufflation_(medicine)" title="Insufflation (medicine)">Insufflation</a></li>

<li><a href="Bioadhesive" title="Bioadhesive">Mucoadhesive microdisc</a></li></ul></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Genitourinary_system" title="Genitourinary system">Urogenital</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<li><a href="Topical" class="mw-redirect" title="Topical">Ointment</a></li>

<li><a href="Pessary" title="Pessary">Pessary</a></li>

<li><a href="Vaginal_ring" title="Vaginal ring">Vaginal ring</a></li>

<li><a href="Douche" title="Douche">Douche</a></li>

<li><a href="Intrauterine_device" title="Intrauterine device">Intrauterine device</a> (IUD)</li>

<li><a href="Extra-amniotic_administration" title="Extra-amniotic administration">Extra-amniotic infusion</a></li>

<li><a href="Urinary_bladder" class="mw-redirect" title="Urinary bladder">Intravesical infusion</a></li>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Rectal_(medicine)" class="mw-redirect" title="Rectal (medicine)">Rectal</a> (<a href="Enteral_administration" title="Enteral administration">enteral</a>)</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Topical" class="mw-redirect" title="Topical">Ointment</a></li>

<li><a href="Suppository" title="Suppository">Suppository</a></li>

<li><a href="Enema" title="Enema">Enema</a>

<ul><li><a href="Solution_(chemistry)" title="Solution (chemistry)">Solution</a></li>

<li><a href="Hydrogel" title="Hydrogel">Hydrogel</a></li></ul></li>

<li><a href="Murphy_drip" title="Murphy drip">Murphy drip</a></li>

<li><a href="Nutrient_enema" title="Nutrient enema">Nutrient enema</a></li></ul></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Dermis" title="Dermis">Dermal</a> (<a href="Topical_medication" title="Topical medication">topical</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<li><a href="Topical" class="mw-redirect" title="Topical">Ointment</a></li>

<li><a href="Topical_cream" class="mw-redirect" title="Topical cream">Topical cream</a></li>

<li><a href="Topical_gel" class="mw-redirect" title="Topical gel">Topical gel</a></li>

<li><a href="Liniment" title="Liniment">Liniment</a></li>

<li><a href="Paste_(rheology)" title="Paste (rheology)">Paste</a></li>

<li><a href="Dimethyl_sulfoxide" title="Dimethyl sulfoxide">DMSO</a> solution</li>

<li><a href="Iontophoresis" title="Iontophoresis">Iontophoresis</a></li>

<li><a href="Hydrogel" title="Hydrogel">Hydrogel</a></li>

<li><a href="Liposome" title="Liposome">Liposomes</a></li>

<li><a href="Transfersome" title="Transfersome">Transfersome vesicles</a></li>

<li><a href="Cream_(pharmaceutical)" class="mw-redirect" title="Cream (pharmaceutical)">Cream</a></li>

<li><a href="Lotion" title="Lotion">Lotion</a></li>

<li><a href="Shampoo" title="Shampoo">Medicated shampoo</a></li>

<li><a href="Dermal_patch" title="Dermal patch">Dermal patch</a></li>

<li><a href="Transdermal_patch" title="Transdermal patch">Transdermal patch</a></li>

<li><a href="Transdermal_spray" title="Transdermal spray">Transdermal spray</a></li>

<li><a href="Jet_injector" title="Jet injector">Jet injector</a></li></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><div style="display: inline-block; line-height: 1.2em; padding: .1em 0;"><div class="plainlist"><ul><li><a href="Parenteral" class="mw-redirect" title="Parenteral">Parenterals</a></li><li><a href="Injection_(medicine)" title="Injection (medicine)">Injections</a></li><li><a href="Infusion_pump" title="Infusion pump">infusions</a></li></ul></div><br><small><i>(into tissue/blood)</i></small></div></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:10em;white-space:normal;"><a href="Human_skin" title="Human skin">Skin</a> (<a href="Transdermal" title="Transdermal">transdermal</a>)</th><td class="navbox-list-with-group navbox-list navbox-even" style="padding:0"><div style="padding:0 0.25em">

<li><a href="Intradermal_injection" title="Intradermal injection">Intradermal</a></li>

<li><a href="Subcutaneous_injection" class="mw-redirect" title="Subcutaneous injection">Subcutaneous</a>

<ul><li><a href="Injector_pen" title="Injector pen">Injector pen</a></li></ul></li>

<li><a href="Transdermal_implant" title="Transdermal implant">Transdermal implant</a></li>

</div></td><td class="noviewer navbox-image" rowspan="4" style="width:1px;padding:0 0 0 2px"><div><span typeof="mw:File"></span></div></td></tr><tr><th scope="row" class="navbox-group" style="width:10em;white-space:normal;"><a href="Human_anatomy#Major_organ_systems" title="Human anatomy">Organs</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Intracavernous_injection" title="Intracavernous injection">Intracavernous</a></li>

<li><a href="Intravitreal_administration" title="Intravitreal administration">Intravitreal</a></li>

<li><a href="Intra-articular_injection" class="mw-redirect" title="Intra-articular injection">Intra-articular</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:10em;white-space:normal;"><a href="Central_nervous_system" title="Central nervous system">Central nervous system</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="padding:0"><div style="padding:0 0.25em">

<ul><li>Intracerebral</li>

<li><a href="Intrathecal_administration" title="Intrathecal administration">Intrathecal</a></li>

<li><a href="Epidural_administration" title="Epidural administration">Epidural</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:10em;white-space:normal;"><a href="Circulatory_system" title="Circulatory system">Circulatory</a>,<br><a href="Human_musculoskeletal_system" title="Human musculoskeletal system">musculoskeletal</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Intravenous" class="mw-redirect" title="Intravenous">Intravenous</a></li>

<li><a href="Intracardiac_injection" title="Intracardiac injection">Intracardiac</a></li>

<li><a href="Intramuscular_injection" title="Intramuscular injection">Intramuscular</a></li>

<li><a href="Intraosseous_infusion" title="Intraosseous infusion">Intraosseous</a></li>

<li><a href="Intraperitoneal_injection" title="Intraperitoneal injection">Intraperitoneal</a></li>

<li><a href="Nanocell" title="Nanocell">Nanocell injection</a></li>

<li><a href="Patient-controlled_analgesia" title="Patient-controlled analgesia">Patient-controlled analgesia</a> pump</li>

</div></td></tr></tbody></table><div></div></td></tr></tbody></table></div>

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This article is issued from <a class="external text" title="Last edited on 2025-05-29" href="https://en.wikipedia.org/wiki/?title=Contraceptive_patch&oldid=1292955476">Wikipedia</a>. The text is available under <a class="external text" href="https://creativecommons.org/licenses/by-sa/4.0/deed.en">Creative Commons Attribution-Share Alike 4.0</a> unless otherwise noted. Additional terms may apply for the media files.

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