What is Xulane Uses, warnings & interactions
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Xulane (norelgestromin/ethinyl estradiol) is a once-weekly hormonal birth control patch manufactured by Mylan Pharmaceuticals Inc. It is the generic version of a now discontinued patch called Ortho Evra and was approved in 2014 by the U.S. Food and Drug Administration (FDA). Xulane is a contraceptive patch used to prevent pregnancy in women. It is not indicated for women who have a BMI of greater than 30kg/m^2, which is considered obese.
If your doctor has prescribed Xulane to you, you may want to know more about what it is and how it works. Here we’ll explain what Xulane is used for, how it works, its side effects, and more.
What is Xulane used for?
Xulane is an estrogen/progestin combination method of birth control that is used to prevent pregnancy in women with a BMI that is less than 30kg/m^2. Xulane may not work as well in women at or above 90kg (198lbs).
How does Xulane work?
Xulane contains a progestin (norelgestromin) and an estrogen (ethinyl estradiol). It works by preventing your ovaries from releasing eggs (ovulation) and increasing the thickness of mucus in the cervix to make it difficult for sperm to enter the uterus. Xulane also alters endometrial tissues, which makes it harder for an egg to attach to the uterus.
What are the most commonly prescribed doses of Xulane?
- 150 mcg/day of norelgestromin and 35 mcg/day of ethinyl estradiol transdermal system
Before taking Xulane
Before beginning Xulane, tell your doctor about your medical conditions, including:
- History of heart disease, heart attack, stroke, or blood clots
- Gallbladder disease
- Liver disease
- History of breast cancer
- If you have surgery scheduled, as Xulane can increase the risk of blood clots following surgery
- Are pregnant, plan on becoming pregnant, or are breastfeeding
How to take Xulane
- Read the Full Prescribing Information, Patient Information, and Medication Guide that comes with Xulane.
- You should wear 1 Xulane patch at a time. Always remove your old patch prior to applying a new patch. The Xulane patch may be placed on your upper outer arm, stomach, buttock or back where it won’t be rubbed by tight clothing.
- Xulane is used in a 4-week cycle. You apply a patch once a week for 3 weeks, then you will have a patch-free week. You should apply a new patch on the same day of the week each week. You will call this your “Patch Change Day”. Menstruation should occur during your patch-free week and you should begin a new cycle on the day after Week 4 ends.
- You should never be off of Xulane for more than 7 straight days. If your Xulane patch is off for more than 7 straight days, you could become pregnant if you have sex. You should use another effective form of birth control to minimize the risk.
- Call your doctor if you miss 1 period and have not used Xulane every day for a full menstrual cycle or if you miss 2 periods in a row.
- Store your Xulane patches at room temperature between 68°F to 77°F (20°C to 25°C) inside their pouches. To discard the Xulane patch, fold the sticky side of the patch together, put it in a child-proof container, and put it in the trash. You should not flush used patches down the toilet.
You should not use Xulane if you:
- Have a known allergy to norelgestromin/ethinyl estradiol or any inactive ingredients in this product.
- Are a smoker over the age of 35.
- Have a history of heart attack, stroke, or blood clots.
- Have uncontrolled hypertension (high blood pressure).
- Have diabetes.
- Have certain types of severe migraines.
- Have a BMI of 30 or higher.
- Have liver disease, tumors, or are taking Hepatitis C treatment containing ombitasvir, paritaprevir, and ritonavir.
- Have unexplained vaginal bleeding.
- Are pregnant or think you are pregnant.
- Have a history of breast cancer or cancer sensitive to female hormones.
- Stop this medication if you suffer a blood clot. Xulane should also be discontinued at least 1 month before major surgery and for 2 weeks after.
- Xulane can increase the risk of liver disease. Stop this medication if jaundice (yellowing of your skin and eyes) occurs.
- Your cholesterol should be monitored when taking Xulane if you are prediabetic or diabetic. You should use an an alternative birth control method if you have uncontrolled high cholesterol.
- Notify your doctor if you notice a significant change in headaches.
- While Xulane will help prevent pregnancy, it will not protect you against sexually transmitted infections such as HIV. You should use a condom to minimize your risk.
Xulane drug interactions
When Xulane is taken with other medications, it may change the way they work or increase the frequency and severity of side effects. You should discuss with your doctor whether any of the prescription drugs, over-the-counter medications, vitamins, and herbal supplements you take may interact with this medication, including:
- St. John’s Wort
- Grapefruit or grapefruit juice
- Thyroid medications
Xulane side effects
Some common side effects of Xulane include:
- Application site reactions such as skin irritation
- Breast tenderness
- Stomach pain
- Breakthrough bleeding
- Mood changes
- Painful periods
- Weight gain
Xulane can sometimes cause more serious side effects, including:
- Allergic reactions (hives, swelling of the face or throat, and shortness of breath)
- Increased risk of heart attacks, blood clots, and stroke
- Sudden, severe headache
- Depression and other mood disorders
- Increased risk of liver disease and tumors
Contact your healthcare professional for medical advice about any possible adverse events you experience while taking Xulane. You can report your adverse reactions to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
Your healthcare professional can prescribe other medications if Xulane is not right for you. There are many types of birth control pills and other forms of birth control available (IUDs, vaginal rings). They will vary by factors such as side effects and costs. Some FDA-approved alternatives to Xulane include:
- NuvaRing vaginal ring (etonogestrel/ethinyl estradiol)
- Safyral (drospirenone/ethinyl estradiol/levomefolate)
- Ortho Tri-Cyclen (norgestimate/ethinyl estradiol)
- Lo Loestrin Fe (norethindrone acetate/ethinyl estradiol/ferrous fumarate)
- Annovera (segesterone/ethinyl estradiol)
- Twirla (levonorgestrel/ethinyl estradiol)
Can you take Xulane while you are pregnant or breastfeeding?
While there is little or no increased risk of harm to the fetus if you accidentally use hormonal contraceptives during early pregnancy, there is no need to continue Xulane while pregnant. Small amounts of estrogen and progestin hormones are found in breast milk. Estrogen may also decrease the amount of breast milk you produce.
You should always discuss the risks and benefits of any medication with your healthcare provider if you are pregnant, plan on becoming pregnant, or are breastfeeding.
How well do Xulane patches stay on?
According to the manufacturer, 2% of Xulane patches became completely detached and around 3% became partially detached during clinical studies. You should apply the patch to clean, dry skin that doesn’t have any powder, cream, oil, makeup, or lotion on it.
How effective is Xulane at preventing pregnancy?
When used as directed, the manufacturer of Xulane reports it is 99% effective at keeping you from getting pregnant. They also state that it may be less effective in women that weigh 90kg (198lbs) or more.
What is the cost of Xulane?
The average cost for #3 Xulane 150mcg/35mcg patches is around $175.
Is there a generic for Xulane?
Currently, there is no generic Xulane available on the market. However, you can still save on brand-name drugs like Xulane through NiceRx if eligible for assistance.