Xulane (norelgestromin/ethinyl estradiol) is a generic prescription birth control patch. It’s approved by the Food and Drug Administration (FDA) to prevent pregnancy in females* who can become pregnant. It’s used in females with a body mass index (BMI) of under 30.

Note: Xulane has a limitation of use. To learn more, see the “Xulane for birth control” section below.

* Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.

Drug details

Xulane comes as a transdermal patch that you apply to your skin like a bandage. (With a transdermal patch, the medication is absorbed through your skin.) Each patch provides 150 micrograms (mcg) of norelgestromin and 35 mcg of ethinyl estradiol per day.

Xulane is a form of hormonal birth control. It contains two active ingredients: norelgestromin and ethinyl estradiol. These ingredients act as hormones in your body (progesterone and estrogen). They are similar to the ingredients found in other forms of hormonal birth control.

Brand-name versions

Xulane is a generic version of the brand-name drug Ortho Evra. But Ortho Evra is no longer available.

Zafemy is another generic version of Ortho Evra. It contains the same active ingredients as Xulane.

Effectiveness

For more information about the effectiveness of Xulane, see the “Xulane for birth control” section below.

Xulane is a generic drug. A generic drug is an exact copy of the active drug in a brand-name medication. Ortho Evra is the brand-name medication that Xulane is based on. (But Ortho Evra is no longer available.)

A generic is considered to be as safe and effective as the original drug. Generics tend to cost less than brand-name drugs.

To learn more about how generics compare with brand-name drugs, see this article.

Xulane can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Xulane. These lists do not include all possible side effects.

For more information about the possible side effects of Xulane, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be concerning or bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Xulane, you can do so through MedWatch.

Mild side effects

Mild side effects* of Xulane can include:

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Xulane. To learn about other mild side effects, talk with your doctor or pharmacist, or view Xulane’s patient information.
† For more information about this side effect, see “Side effect details” below.

Serious side effects

Serious side effects from Xulane aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

* For more information about this side effect, see “Side effect details” below.
Xulane has boxed warnings for this side effect. A boxed warning is the most serious warning from the FDA. It alerts doctors and patients about drug effects that may be dangerous.

Side effect details

Here’s some detail on certain side effects this drug may cause.

Cardiovascular problems in certain people

Some females* using Xulane may have an increased risk for serious cardiovascular problems, including heart attack, blood clots, and stroke. (Cardiovascular problems affect your heart and blood vessels.)

In fact, Xulane has boxed warnings related to the risk of cardiovascular problems. A boxed warning is the most serious warning from the FDA. It alerts doctors and patients about drug effects that may be dangerous. Details for these boxed warnings are below.

Xulane should not be used in females older than age 35 years who smoke cigarettes. Smoking during Xulane treatment raises the risk of cardiovascular problems. Because the risk of heart problems also increases with age, females older than age 35 years have a higher risk. You’re also at higher risk the more you smoke. In addition, Xulane itself may raise your risk for heart attack or stroke.

Xulane should also not be used in females who have a body mass index (BMI) of 30 or greater (which is called obesity). This is because if you have a higher BMI, you may also have a higher risk for cardiovascular problems. In addition, Xulane isn’t as effective if your BMI is 30 or higher. Females with a BMI of 30 or greater also have an increased risk for a blood clot. Because Xulane itself may also cause blood clots, this risk is even higher.

To learn more about these boxed warnings and whether or not Xulane is right for you, talk with your doctor.

* Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.

Symptoms of cardiovascular problems

With some types of cardiovascular problems, you may not have symptoms. But if any of the following symptoms suddenly occur, call your doctor or get emergency medical care right away:

  • leg pain that doesn’t go away
  • trouble breathing
  • vision problems, such as vision loss
  • severe headache
  • weakness in an arm or leg
  • trouble speaking

If you have questions about your risk for cardiovascular problems with Xulane, talk with your doctor.

Changes in your periods or breast tissue

Some of the most common side effects with Xulane include changes in your periods or breast tissue. These may include:

You may only have light periods with Xulane. Or, you may have no period during your patch-free week. But if you think you could be pregnant, take a pregnancy test or call your doctor.

When you first start using Xulane, the hormones in Xulane could cause your breasts to grow slightly. But this effect is usually temporary.

Xulane can sometimes cause weight gain. You may notice breast growth as part of this gained weight. Xulane can also cause your body to retain more fluid, which may make your breast tissue more swollen.

For more details, read about how often these side effects occurred in clinical studies. If you’re concerned about changes in your periods or breasts with Xulane, talk with your doctor.

Reactions at the patch application site

The Xulane patch sticks to your skin like an adhesive bandage. It’s a square patch that’s a little bigger than a quarter.

Skin-related side effects at the patch site were common in clinical studies of Xulane.

The Xulane patch can cause side effects at and around the skin area where you apply it. Some examples of these side effects may include:

  • skin irritation
  • changes or reddening of skin color
  • pain
  • swelling
  • itching
  • rash

To decrease the chance of skin-related side effects from Xulane, be sure to use a different application site with each patch change. Using the same site every time can increase your risk for these side effects.

If skin side effects become severe or don’t go away, call your doctor. They may suggest ways to relieve this side effect or suggest a different birth control option for you.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Xulane. It isn’t known how often allergic reactions occurred in clinical studies of the drug.

Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • hives (raised, itchy welts on your skin)
  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have an allergic reaction to Xulane, as the reaction could become severe. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

You should use Xulane according to the instructions your doctor or another healthcare professional gives you.

Instructions for applying and changing your Xulane patch are included in the product packaging. You can also see a step-by-step illustrated guide on the manufacturer’s website.

Xulane patch placement

Place a Xulane patch onto clean, dry skin in one of the following areas of your body:

  • upper outer arm
  • lower abdomen (belly)
  • buttock
  • back

It’s best to choose an area where the patch won’t be rubbed by tight clothing or bra straps. Don’t put the patch on your breasts. Avoid using lotion, makeup, or other skin products on the area where you’ve put the patch. This could make it more likely to fall off.

When you apply a Xulane patch, be sure to press down firmly on the patch for 10 seconds. Use your fingers to smooth out any wrinkles around the edges of the patch.

When it’s time to change your patch, choose a different area than where you placed your last patch. Repeatedly using the same site could irritate your skin.

When to use

You might be wondering if you can start using the Xulane patch anytime. It should be started at one of two specific times in your cycle. And, either way, you should use a backup birth control method (such as a condom) for your first week of Xulane treatment.

The two options for starting Xulane are:

  • You can put on your first Xulane patch during the first 24 hours after you get your period.
  • You can apply your first patch on the Sunday after your period begins. (See the example calendar schedule below.)

After applying a Xulane patch to your skin, you’ll leave it in place for 1 week. After 1 week, you’ll remove the old patch and apply a new one. You’ll do this for 3 weeks in a row. On the fourth week, you’ll remove the old patch, but you won’t apply a new one. Your period should start during your patch-free week.

Here’s an example schedule for using Xulane:

Week 1: Apply the patch on the Sunday after your period begins.

Weeks 2 and 3: Change the patch on Sunday.

Week 4: Remove the patch on Sunday. Don’t apply a new patch.

To help make sure that you don’t forget to change your patch, try using a medication reminder. This can include setting an alarm or timer on your phone or downloading a reminder app. A note on your calendar can work, too.

Here are answers to some frequently asked questions about Xulane.

Will I have side effects, such as no period, when stopping Xulane?

It’s possible that you may experience no period or irregular periods after you stop your Xulane treatment. This can happen after stopping any form of hormonal birth control. It may take up to 3 months for your regular menstrual cycle and periods to return.

If you missed periods before you started Xulane, you’re more likely to miss periods once you stop using it.

However, if you’ve stopped using Xulane, you could become pregnant if you’re sexually active and not using another form of birth control. If you haven’t had a period in the past month, or if you’ve only had light bleeding or spotting, consider taking a pregnancy test.

How long does it take for Xulane’s effect to wear off?

A single Xulane patch is designed to work for 7 days. If it’s worn longer than 7 days and you forget to apply a new patch, it won’t be as effective.

If the patch falls off for more than 2 days, its effects begin to wear off. If at any time you go longer than 7 days without applying a new patch, your chance of becoming pregnant increases.

If you and your doctor decide that you should stop using Xulane, it may take up to 3 months for your menstrual cycle to fully return. This includes the return of ovulation (the release of an egg from your ovary) and regular periods.

Can you get pregnant while using Xulane?

If you use Xulane exactly as prescribed, it’s 99% effective at preventing pregnancy. But certain factors can make it less effective, such as forgetting to change your patch on time.

So, with typical use, Xulane is about 91% effective. This means that for every 100 females* who use Xulane, nine will become pregnant each year.

It’s important to note that Xulane may be less effective in females who weigh 198 pounds (about 90 kilograms) or more.

If you haven’t had a period in the past month, or if you’ve only had light bleeding or spotting, consider taking a pregnancy test.

* Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.

Does Xulane cause weight loss?

It’s not likely. Weight loss wasn’t reported as a side effect of Xulane in clinical studies.

However, Xulane can cause mood changes in some people. Depression and anxiety disorders have been reported with Xulane use. Changes in your appetite, such as loss of appetite, can happen with mood changes. This could lead to unintentional weight loss.

If you’re concerned about weight loss or if you’ve had mood changes with Xulane, talk with your doctor. They may recommend changing to a different form of birth control.

What should you do if your Xulane patch falls off?

If your Xulane patch falls off, the instructions depend on how long the patch has been off. See below for details.

Less than 1 day:

If your Xulane patch falls off and it’s been less than 1 day, try to reapply it. Do this by pressing down firmly on the patch for 10 seconds. Be sure to run your fingers over the surface of the patch to smooth out any wrinkles in the patch.

If the reapplied patch doesn’t stick correctly, you should remove it and apply a new patch. You won’t need to use another birth control method. And you won’t need to change your patch schedule.

More than 1 day:

If your Xulane patch falls off and it’s been more than 1 day, apply a new patch. It’s important to use a backup birth control method (such as a condom) for the first week after applying the new patch. From here, you’ll change your patch 1 week later, establishing a new 4-week cycle.

If you realize that your patch isn’t on and you’re not sure when it fell off, follow the directions as if your patch fell off more than 1 day ago. If you’re still not sure what to do, talk with your doctor or pharmacist.

It’s a good idea to check your Xulane patch once each day to make sure it isn’t becoming loose.

How long does it take to get pregnant after stopping Xulane?

It’s possible to get pregnant at any time after stopping Xulane. A small percentage of females* even get pregnant while they’re using Xulane (or any form of hormonal birth control).

However, for most females, it may take up to 3 months for the menstrual cycle to return. This includes the return of ovulation (the release of an egg from your ovary) and regular periods. To get pregnant, ovulation is required for sperm to fertilize your egg.

If you’re trying to get pregnant and it’s been 3 or more months since you stopped using Xulane, you might wonder if you’re ovulating. Consider reading about how to detect if you’re ovulating, such as using an ovulation predictor kit. If you have questions about getting pregnant after stopping Xulane, talk with your doctor.

* Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.

The Food and Drug Administration (FDA) approves prescription drugs such as Xulane for certain uses. Xulane may also be used off-label for other conditions. Off-label drug use means using a drug for a purpose other than what it’s been approved for by the FDA.

Xulane (norelgestromin/ethinyl estradiol) is a prescription birth control patch. It’s approved by the FDA for females* of any age who can become pregnant. It’s used in females with a body mass index (BMI)† of under 30.

Xulane shouldn’t be used in females with obesity. This is because of an increased risk of blood clots. To learn more, see “Side effect details” under the “Xulane side effects” section above.

Xulane has a limitation of use. In clinical studies, Xulane was less effective in females who weighed 198 pounds (about 90 kilograms) or more. Talk with your doctor if you weigh 198 pounds or more. They can tell you about other birth control options that may be safer and more effective for you.

Learn more about birth control, nutrition, fitness, and more at the Medical News Today women’s health hub.

* Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.
† BMI is used to determine a target weight range that’s based on a person’s height. For adults, obesity is defined as a BMI of 30 or higher. Xulane shouldn’t be used in females with obesity. For more details, see the “Xulane for birth control” section below. You can calculate your BMI here.

Effectiveness for birth control

Xulane is 99% effective at preventing pregnancy if you use it perfectly. Xulane has been shown to be an effective method of birth control. But certain factors can make it less effective. Some examples include forgetting to change your patch on time or taking a medication that interacts with Xulane.

In clinical studies, Xulane was less effective in people who weighed 198 pounds (about 90 kilograms) or more. For information on how the drug performed in clinical studies, see Xulane’s prescribing information.

Xulane and children

Xulane can be used in girls* with a BMI of under 30 and who have had their period. (As long as their BMI is under 30, Xulane has been shown to be safe and effective in females* who menstruate.) Xulane should not be used in girls before their first menstruation.

* Sex and gender exist on spectrums. Use of the terms “girl” and “female” in this article refers to sex assigned at birth.

As with all medications, the cost of Xulane can vary. To find current prices for Xulane in your area, check out GoodRx.com.


The cost you find on GoodRx.com is what you may pay without insurance. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Keep in mind that you may be able to get a 90-day supply of Xulane. If approved by your insurance company, getting a 90-day supply of the drug could reduce your number of trips to the pharmacy and help lower the cost. If you’re interested in this option, check with your doctor or your insurance company.

Before approving coverage for Xulane, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure if you’ll need to get prior authorization for Xulane, contact your insurance company.

Financial and insurance assistance

Financial assistance to help you pay for Xulane may be available.

Xulane is a birth control drug, so its cost may be covered under the Affordable Care Act. For more information, talk with your insurance company to see if this drug is covered.

Also, Medicine Assistance Tool and NeedyMeds are two websites offering resources that may help lower your cost for Xulane. They also offer tools to help you find low cost healthcare, as well as educational resources. To learn more, visit their sites.

Mail-order pharmacies

Xulane may be available through a mail-order pharmacy. Using this service may help lower the drug’s cost and allow you to get your medication without leaving home.

If recommended by your doctor, you may be able to receive a 90-day supply of Xulane, so there’s less concern about running out of the medication. If you’re interested in this option, check with your doctor and your insurance company. Some Medicare plans may help cover the cost of mail-order medications.

If you don’t have insurance, you can ask your doctor or pharmacist about online pharmacy options.

Other birth control drugs are available. Some may be a better fit for you than others. If you’re interested in finding an alternative to Xulane, talk with your doctor. They can tell you about other medications that may work well for you.

Examples of other birth control drugs that may be used as alternatives to Xulane include:

  • norelgestromin/ethinyl estradiol transdermal patch (Zafemy), which is another generic version of Ortho Evra*
  • levonorgestrel/ethinyl estradiol transdermal patch (Twirla)
  • etonogestrel/ethinyl estradiol vaginal ring (NuvaRing)
  • etonogestrel/ethinyl estradiol vaginal ring (EluRyng), which is a generic version of NuvaRing

Many types of birth control pills and other forms of birth control are also available. To learn more about birth control options, see the Medical News Today women’s health hub.

* Ortho Evra patch was the original brand-name version of Xulane, but it’s no longer available.

Xulane comes as a transdermal patch that you apply to your skin like a bandage. (With a transdermal patch, the medication gets absorbed through your skin.) Each patch provides 150 micrograms (mcg) of norelgestromin (a form of progestin) and 35 mcg of ethinyl estradiol (a form of estrogen) per day.

Xulane is a form of hormonal birth control. Because it contains two types of hormones, it’s called a combination birth control.

To become pregnant, the female* body releases an egg from an ovary each month. This is called ovulation. If the egg comes into contact with sperm, it may become fertilized. In this case, the egg will then move through the fallopian tube and into the uterus, where it will implant. This is where the fetus will grow.

Hormonal birth control drugs, including Xulane, work to prevent pregnancy by preventing ovulation.

Note: Hormonal birth control also comes in other forms: pills, implants, vaginal rings, and intrauterine devices. This article addresses only the patch form. For information on other forms of hormonal birth control, talk with your doctor or pharmacist.

When does Xulane start working?

Xulane starts absorbing into your body shortly after the first patch is put on your skin. But it takes a few days for the hormone levels to build up in your system.

When you first start Xulane, you should use a backup birth control method (such as condoms and spermicide) for the first 7 days of your first cycle only.

Once you start your second cycle (and you continue to change your patch on time each week), Xulane will reach its full effectiveness. So, for the purpose of preventing pregnancy, you won’t need to keep using a backup birth control method.

However, Xulane doesn’t provide protection against sexually transmitted infections (STIs), such as HIV. So, you may need to use another form of birth control along with Xulane. Ask your doctor about the best way to protect yourself from STIs, including HIV.

How long does Xulane stay in your system?

It takes about 6 days for the active ingredients in Xulane to get out of your system.

If the Xulane patch is removed (or falls off) for more than 2 days, the drug’s level will become so low that it won’t be as effective. This means that the longer the patch is off, the more likely you are to ovulate (release an egg from your ovary). If you ovulate, you could become pregnant.

If you and your doctor decide that you should stop using Xulane, it may take up to 3 months for your menstrual cycle to fully return. This includes the return of ovulation and regular periods.

* Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Xulane strengths

Xulane is a birth control patch that comes in one strength. Each patch delivers 150 micrograms (mcg) of norelgestromin and 35 mcg of ethinyl estradiol per day.

Dosage for birth control

You’ll use Xulane in a 4-week cycle. You’ll apply one new patch once per week for 3 weeks. The fourth week is patch-free.

After the third week, remove the old patch, but don’t apply a new patch. Typically, your period begins during the fourth week. You’ll start the next 4-week cycle by applying a new Xulane patch after the patch-free week ends.

Once each day, you should check your Xulane patch to make sure it hasn’t loosened or fallen off.

Here’s an example schedule for using the Xulane patch:

Week 1: Apply the patch on the Sunday after your period begins.

Weeks 2 and 3: Change the patch on Sunday.

Week 4: Remove the patch on Sunday. Don’t apply a new patch.

If you have any questions about your dosage of Xulane, talk with your doctor or pharmacist.

Children’s dosage

The dosage for girls* under age 18 years is the same as it is for adult females,* which is described above.

* Sex and gender exist on spectrums. Use of the terms “girl” and “female” in this article refers to sex assigned at birth.

What if I miss a dose?

If you forget to change your Xulane patch, the instructions depend on the timing within your 4-week cycle.

Week 1:

If you forget to apply the Xulane patch during the first week, apply it as soon as possible. You’ll start a new 4-week cycle and change your patch 1 week later.

Keep in mind that you could get pregnant if you forget to apply your Xulane patch in the first week of your new cycle. A backup birth control method (such as a condom) is recommended for 7 days after you put on your patch.

Week 2 or 3:

If it’s the second or third week and you miss changing your patch by 1 or 2 days, change it as soon as possible. You should continue your usual patch changing schedule. You won’t need a backup birth control method to prevent pregnancy.

If it’s the second or third week and you miss changing your patch by more than 2 days, change it as soon as possible. From here, you’ll change your patch 1 week later, establishing a new 4-week cycle. You should use a backup birth control method (such as a condom) for the first week after applying the new patch.

Week 4:

If you forget to remove your patch during the last week of your cycle, take it off as soon as you remember. You should continue your usual patch changing schedule. You won’t need a backup birth control method to prevent pregnancy.

If you still have questions about what to do, talk with your doctor or pharmacist.

To help make sure that you don’t forget to change your patch, try using a medication reminder. This can include setting an alarm or timer on your phone or downloading a reminder app. A note on your calendar can work, too.

Will I need to use this drug long term?

Xulane can be used as a short-term or long-term treatment. It’s meant to be used for as long as you want to avoid getting pregnant. If you and your doctor determine that Xulane is safe and effective for you, you’ll likely use it for as long as it’s suitable for you.

Xulane isn’t known to interact with alcohol. If you drink alcohol, talk with your doctor about how much is safe for you to consume while you’re using Xulane.

Xulane can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Xulane and other medications

Below is a list of medications that can interact with Xulane. This list does not contain all drugs that may interact with Xulane.

Before taking Xulane, talk with your doctor or pharmacist. Tell them about all prescriptions, over-the-counter, and other drugs you take. Also, tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

Drugs you should not take with Xulane include:

  • Certain types of hepatitis C medications. With Xulane treatment, these drugs could increase certain liver enzymes, which can be a sign of liver damage. Examples include medications that contain:
    • ombitasvir
    • paritaprevir
    • ritonavir

Other drugs that can interact with Xulane include:

  • Drugs that could reduce Xulane’s effectiveness and cause breakthrough bleeding (bleeding between periods). If these medications are taken with Xulane, it’s recommended to use a backup birth control method, such as condoms. Examples of these drugs include:
    • certain seizure medications, such as phenytoin (Dilantin), carbamazepine (Tegretol), oxcarbazepine (Trileptal), and topiramate (Topamax)
    • certain antimicrobial drugs, such as griseofulvin (Grifulvin V) and rifabutin (Mycobutin)
    • combination HIV medications that contain nelfinavir, nevirapine, or ritonavir
    • drugs for nausea, such as aprepitant (Cinvanti, Emend)
  • Medications that could increase the levels of Xulane in your body. This could raise your risk for side effects from Xulane. Examples of these drugs include:
    • certain antifungal drugs, such as fluconazole (Diflucan) and ketoconazole
  • Other medications that could be less effective if they’re taken with Xulane. Examples of these drugs include:
    • certain seizure medications, such as lamotrigine (Lamictal)
    • thyroid hormone replacement therapy, such as levothyroxine (Synthroid)

These lists do not contain all drugs that may interact with Xulane. If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Xulane and herbs and supplements

Supplements that contain the herb St. John’s wort may make Xulane less effective. Your doctor may suggest that you stop taking St. John’s wort. Or, they may decide to prescribe a birth control option other than Xulane.

Taking Xulane with vitamins that contain ascorbic acid (vitamin C) could raise your risk for side effects from Xulane. So, your doctor may suggest that you stop using vitamins with ascorbic acid during your Xulane treatment.

Other herbs and supplements could also interact with Xulane. It’s important to talk with your doctor or pharmacist before using any herbs or supplements while taking Xulane.

Xulane and foods

It’s best to avoid grapefruit and grapefruit juice while using Xulane. Consuming grapefruit with Xulane could raise your risk for side effects from Xulane.

If you have questions, talk with your doctor.

Xulane is used to prevent pregnancy. But it isn’t 100% effective in preventing pregnancy. A small percentage of females* may become pregnant while using Xulane.

Also, some females may have a higher chance of becoming pregnant while using Xulane. In clinical studies, Xulane was less effective in females who weighed 198 pounds (about 90 kilograms) or more.

There’s no evidence of harmful effects on a fetus when Xulane is used during early pregnancy. Xulane also hasn’t been shown to raise the risk for miscarriage in females who were using the drug before becoming pregnant or during early pregnancy.

If you think you may be pregnant while using Xulane, call your doctor right away. They’ll likely have you take a pregnancy test, and, if you’re pregnant, you’ll stop using Xulane.

* Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.

Xulane and fertility

Xulane works to prevent pregnancy by stopping ovulation (the release of an egg from your ovary). After you’ve stopped using Xulane, it may take up to 3 months for your body to start ovulating again. Within a few months after stopping Xulane, your fertility (ability to become pregnant) should return to normal.

If you’re concerned about your fertility after stopping your Xulane treatment, talk with your doctor.

Xulane is approved to prevent pregnancy. Typically, you shouldn’t need to use other forms of birth control along with Xulane to avoid becoming pregnant.

However, in certain situations, a backup birth control method (such as condoms, spermicide, or a diaphragm) is recommended along with Xulane. Some examples include:

  • If you’re taking a medication that makes Xulane less effective. (For more details, see the “Xulane interactions” section above.)
  • The 7 days after applying your first patch when you start using Xulane. (For more details, see the “Xulane dosage” section above.)
  • Certain cases in which you forget to change your Xulane patch or if it falls off. (For more details, see the “Xulane dosage” and “Common questions about Xulane” sections above.)

If you have questions about when you should use other forms of birth control with Xulane, talk with your doctor or pharmacist.

Xulane isn’t recommended while breastfeeding. Xulane might reduce your body’s production of breast milk. Also, small amounts of the drug are present in breast milk, and its effects in a breastfed child are unknown.

If you have questions about using Xulane while breastfeeding, talk with your doctor. They can guide you on the risks and benefits of using this birth control method.

This drug comes with several precautions.

FDA warnings

This drug has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.

  • Females* older than age 35 years who smoke. Females ages 35 years and older who smoke cigarettes should not use Xulane. Smoking raises your risk for serious cardiovascular problems with this drug, such as heart attack and stroke. “Cardiovascular” means related to the heart and blood vessels.
  • Females with a body mass index (BMI) 30 or higher. Females who have a body mass index (BMI) of 30 or above should not use Xulane. BMI is used to determine a target weight range that’s based on a person’s height. For adults, obesity is defined as a BMI of 30 or higher. Obesity increases your risk for developing blood clots while using Xulane.

For more information on these warnings, see “Side effect details” in the “Xulane side effects” section above.

* Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.

Other precautions

Before taking Xulane, talk with your doctor about your health history. Xulane may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Blood clots. If you’ve had blood clots in the past or are at high risk for developing them, talk with your doctor before using Xulane. You may have a higher risk for blood clots during your Xulane treatment if you:
    • smoke and are age 35 years or older
    • have previously had a heart attack or stroke
    • have certain heart problems that can cause blood clots
    • have any condition that affects blood clotting
    • will be limited in your ability to move around for a while, such as after a surgery
    • gave birth in the past 4 weeks
  • Breast cancer or other cancers that are affected by hormones. If you’ve had breast cancer or another type of cancer that’s sensitive to hormones, you should not use Xulane. This is because some cancers are sensitive to certain hormones, which means that they become activated if these hormones bind (attach) to them. Breast cancer is an example of a cancer that can be activated by the hormones released by Xulane.
  • Liver disease. If you have liver disease, such as hepatitis or severe cirrhosis, you should not use Xulane. If you have liver problems or have had them in the past, talk with your doctor. They’ll likely suggest other birth control options that are safe for you.
  • Gallbladder disease. If you’ve had gallbladder problems, Xulane could worsen your condition. If you have gallbladder disease or have had it in the past, talk with your doctor. They’ll recommend the best birth control options for you and discuss the risks and benefits with your condition.
  • Hypertension. Having hypertension can increase your risk for serious cardiovascular side effects with Xulane. It’s also possible that Xulane could worsen your condition if you have hypertension. If you have hypertension, talk with your doctor. They may recommend a different birth control option for you, or they may monitor you more closely during your Xulane treatment.
  • Diabetes. Having diabetes can raise your risk for serious side effects with Xulane, including cardiovascular problems. If you have diabetes, Xulane could also worsen your condition, so talk with your doctor. They may recommend a different birth control option.
  • High cholesterol. High cholesterol levels can increase your risk for cardiovascular problems with Xulane. This is because Xulane might raise the levels of fats in your blood, including cholesterol and triglycerides. If you already have high cholesterol, Xulane could make your condition worse. Your doctor may recommend a different birth control option for you.
  • Migraine. You should not take Xulane if you get certain kinds of migraine headaches or if you’re age 35 or older and get any type of migraine. Xulane may worsen your condition. If you get migraine headaches, talk with your doctor. Depending on your migraine headaches, they may recommend a different birth control that’s a better option for you.
  • Depression. If you’ve received a diagnosis of depression or think you may be depressed, talk with your doctor before starting Xulane. This drug can sometimes cause mood changes that could worsen your condition. If you have depression, your doctor may suggest another birth control option.
  • Allergic reaction. If you’ve had an allergic reaction to Xulane or any of its ingredients, you shouldn’t take Xulane. Ask your doctor what other medications are better options for you.
  • Pregnancy. Xulane is used to prevent pregnancy. It’s not meant to be used during pregnancy. But it doesn’t cause harm if it’s used during early pregnancy (before you become aware that you’re pregnant). For more information, see the “Xulane and pregnancy” section above.
  • Breastfeeding. Xulane isn’t recommended for use while breastfeeding. For more information, see the “Xulane and breastfeeding” section above.

Note: For more information about the potential negative effects of Xulane, see the “Xulane side effects” section above.

* Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.

Using more than the recommended dosage of Xulane can lead to serious side effects. Do not use more Xulane than your doctor recommends.

Overdose symptoms

Symptoms of an overdose of Xulane can include:

What to do in case of overdose

If you think you’ve used too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use its online tool. But if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.

When you get Xulane from the pharmacy, the pharmacist will add an expiration date to the label on the packaging. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, ask your pharmacist if you can still use it.

Storage

How long a medication remains good to use can depend on many factors, including how and where you store the medication.

Xulane patches should be stored at room temperature, 68°F to 77°F (20°C to 25°C). Keep Xulane in its sealed, original packaging until the moment you’re ready to apply a patch. Avoid storing this medication in areas where it could get damp or wet, such as bathrooms.

Disposal

Used Xulane patches still contain some medication and should be disposed of carefully.

After you remove a Xulane patch, fold the sticky sides of the patch together. Then, place the folded patch in a container. Choose a container that children and pets can’t easily open or puncture. Finally, throw the container away in the trash, or check if your pharmacy offers a medicine disposal drop-box. Don’t flush used Xulane patches down the toilet.

If you no longer need to take Xulane and have leftover unused patches, it’s important to dispose of them safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information about how to dispose of your medication.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.