Xulane (norelgestromin/ethinyl estradiol) is a brand-name drug that’s prescribed as a combination birth control option to help prevent pregnancy. Xulane comes as a patch you apply to your skin once a week for 3 weeks. On week 4, you do not apply a patch.

Xulane belongs to a drug class called estrogen/progestin combination hormonal contraceptives. Xulane is available in a generic version.

Keep reading for specific information about the dosage of Xulane, including its strength and how to apply the medication. For a comprehensive look at Xulane, see this article.

Note: This article describes the typical dosage for Xulane provided by the drug’s manufacturer. During treatment with Xulane, always follow the dosage prescribed by your doctor.

Below is information about Xulane’s form, strength, and dosage.

Xulane form

Xulane comes as a patch that you apply to your skin. You’ll apply one Xulane patch at a time to your upper outer arm, buttock, lower abdomen, or back.

Xulane strength

Xulane comes in one strength. Each patch releases 150 micrograms (mcg) of norelgestromin and 35 mcg of ethinyl estradiol daily.

Typical dosage

The following information describes the dosage that is commonly prescribed. However, be sure to follow the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Dosage for pregnancy prevention

Doctors may prescribe Xulane to help prevent pregnancy.

Xulane patches are applied in a 28-day cycle. If your doctor prescribes Xulane for you, you will apply one Xulane patch to your body each week for 3 weeks (21 days). Then, on week 4, you will not apply a patch, and the cycle will restart again with week 1.

When you first start Xulane, your doctor may recommend placing your patch on your skin during the first 24 hours after your period starts. In this case, you will not need to use backup contraception.

But if you apply your patch after the first 24 hours of your period, you will need to use backup contraception, such as condoms or spermicide. You’ll use this for 7 days after starting Xulane for the first time. Then, you will not need to use backup contraception again during your Xulane treatment as long as you’re applying it as directed.

Your doctor may also recommend starting Xulane on the first Sunday after you get your period. In this case, you will need to use backup contraception, such as condoms or spermicide. You’ll use these for 7 days after starting Xulane for the first time. However, if your period begins on a Sunday, you can apply your first patch on that Sunday, and you will not need to use backup contraception.

If you are switching from another form of contraception (such as the pill, vaginal ring, or another patch), talk with your doctor about when to start Xulane.

For information on how to apply Xulane, see the “How to apply Xulane” section below.

For more information about your specific dosage, talk with your doctor.

Children’s dosage

Xulane is prescribed to help prevent pregnancy from occurring. It can be prescribed to help prevent pregnancy in adolescents under the age of 18 years old. However, it should not be prescribed to adolescents before they reach puberty.

If your child’s doctor recommends Xulane, the dose would be the same as an adult dose. Your child would apply one patch to their skin once weekly for 3 weeks. Then, on week 4, they would not apply a patch. The cycle would restart again with week 1.

Talk with your child’s doctor if you have questions about their dosage.

Long-term treatment

Xulane is meant to be a long-term treatment that you continue for as long as you would like to help prevent pregnancy. If you and your doctor determine that Xulane is safe and effective for you, you’ll likely continue treatment with it long term.

If you would like to become pregnant and are using Xulane patches, talk with your doctor about stopping treatment.

Before you start Xulane, your doctor will discuss your treatment plan with you.

Xulane comes as a patch that you apply to your skin once weekly for 3 weeks. Then, on week 4, you will not apply Xulane. Week 4 is when your period should occur.

Xulane can be applied to your upper outer arm, buttock, lower abdomen, or back. You should not place the patch anywhere it can be rubbed by tight clothing, such as under your waistband. You should also avoid applying Xulane to your breasts. Be sure to rotate where you place the patch each week so that your skin doesn’t become irritated. And do not use lotion or makeup in the area you apply Xulane.

Be sure to apply the full patch. Do not cut or damage the patch in any way before applying it. This can affect how much birth control your body is getting, which can change how effective Xulane is.

You should apply Xulane on the same day each week. This helps maintain a steady level of the drug in your body so Xulane can work effectively. This is called your “patch change day.” If you apply your first Xulane patch on a Sunday, you will always change your patch each Sunday.

To apply your patch, remove it from the foil pouch and take off the clear plastic. Then, apply the sticky side of the patch to clean, dry skin. Press on the patch for 10 seconds to ensure it sticks to your skin.

If you have questions about how to apply Xulane, talk with your doctor or pharmacist. There are also step-by-step instructions on the manufacturer’s website.

ACCESSIBLE DRUG LABELS AND CONTAINERS

Some pharmacies offer labels with large print, braille, or a code you scan with a smartphone to convert text to speech. If your local pharmacy doesn’t have these options, your doctor or pharmacist might be able to recommend a pharmacy that does.

In week 1

If you forget to apply your patch and it’s week 1 of your cycle (the week after your period), apply the patch as soon as you remember. The day you apply your patch will become your new patch change day.

For example, if you remember on Monday that you forgot to apply Sunday’s patch, you will apply your patch on Monday. Then, the following week, you would change your patch on Monday and continue applying patches on this day going forward.

You should also use backup contraception, such as condoms or spermicide, for the first 7 days after placing your patch.

In weeks 2 or 3

On weeks 2 or 3 of your cycle, if you’re 1 or 2 days late with changing your patch, apply your new patch as soon as you remember. Then, apply your next patch on your regular patch change day. In this case, you do not need to use backup contraception.

However, on weeks 2 or 3 of your cycle, if it’s been more than 2 days since you missed your dose, you’ll need to stop your current cycle and restart your week-4 cycle. You should apply a new patch as soon as you remember. This will now become your patch change day.

For example, if your regular patch change day is on Sunday, but you forget to change the patch until Wednesday, apply it as soon as you remember on Wednesday. Going forward, you will change your patch on Wednesdays. Also, you’ll need to restart your cycle. This means applying patches each Wednesday for 3 weeks and then skipping 1 week. Then, you’ll restart your cycle the following Wednesday.

In this case, you should use backup contraception, such as condoms or spermicide, for 7 days after placing your patch.

In week 4

If you forget to remove your patch on week 4 (when you should not be wearing a patch), take it off as soon as you remember. Then, replace your patch the following week on your regular patch change day.

For example, if your patch change day is Tuesday, you should take your patch off on Tuesday of week 4 of your cycle. However, if you forget to take the patch off on Tuesday and remember it on Wednesday, you should remove the patch on Wednesday. Then, when your cycle restarts on week 1, replace your patch on Tuesday as you typically would.

Additional information

Never apply two patches to make up for a missed one. If you’re unsure whether you should apply a patch or skip it, talk with your doctor or pharmacist.

To help make sure that you do not forget to apply your patch, try using a medication reminder. This can include setting an alarm or putting a note where you’ll see it, such as on your bathroom mirror or bedside table. You could also download a reminder app on your phone.

It’s important that you do not apply more Xulane than your doctor prescribes. For some medications, applying more than the recommended amount may lead to harmful effects or overdose.

Symptoms of an overdose

Overdose symptoms of Xulane can include:

  • nausea or vomiting
  • menstrual bleeding

If you apply more than the recommended amount of Xulane

Call your doctor right away if you believe you’ve applied too much Xulane. Another option is to call America’s Poison Centers at 800-222-1222 or use its online tool. If you have severe symptoms, immediately call 911 or your local emergency number or go to the nearest emergency room.

Below are some frequently asked questions about Xulane.

Is the dosage of Xulane similar to the dosage of Zafemy or Twirla?

Yes, the forms and how often you apply each drug are similar. Xulane, Zafemy, and Twirla are all birth control patches that you apply once weekly for 3 weeks. Then, on week 4, you do not apply a patch.

Both Xulane and Zafemy have the same active ingredients: ethinyl estradiol and norelgestromin. But Twirla has different active ingredients: levonorgestrel and ethinyl estradiol.

The dose in milligrams (mg) for Xulane and Zafemy is the same because these drugs have the same active ingredients. However, the dosage in mg for Twirla differs because it has different active ingredients. Your doctor will prescribe the drug and the dosage that’s right for you.

It’s important to note that Zafemy is not available in a brand-name form. A generic drug with the same active ingredients as Zafemy is available.

To learn more about how these drugs compare, talk with your doctor.

How long does it take for Xulane to start working?

Xulane starts to work after you apply your first patch. You likely won’t feel the drug working in your body. In some cases, Xulane won’t be fully effective for the first week after starting the medication. In this case, your doctor will recommend using backup contraception, such as condoms or spermicide, for the first week of Xulane treatment.

Talk with your doctor if you have questions about what to expect with Xulane treatment.

The dosage described in this article is the typical dosage provided by the drug’s manufacturer. If your doctor recommends Xulane for you, they will prescribe the dosage that’s right for you. Always follow the dosage that your doctor prescribes.

As with any drug, never change your dosage of Xulane without your doctor’s recommendation. If you have questions about the dosage of Xulane that’s best for you, talk with your doctor.

Besides learning about dosage, you may want other information about Xulane. These articles might be helpful:

  • More about Xulane: For information about other aspects of Xulane, refer to this article.
  • Side effects: To learn about side effects of Xulane, see this article.
  • Details about pregnancy prevention: For details about pregnancy prevention, see our “Pregnancy and parenthood” hub.

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.