Xulane (norelgestromin/ethinyl estradiol) is a branded-generic patch prescribed to help prevent pregnancy in adults. As with other drugs, Xulane can cause side effects, such as abdominal pain, nausea, and headache.

Xulane can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

These are just a few of the more common side effects reported by people who used Xulane in clinical trials:

  • nausea
  • headache
  • abdominal pain
  • breast pain, tenderness, or swelling
  • skin irritation, itchiness, or discoloration at the application site

Mild side effects can occur with Xulane use. This list doesn’t include all possible mild side effects of the drug. For more information, you can refer to Xulane’s prescribing information.

Mild side effects that have been reported with Xulane include:

These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

Note: After the FDA approves a drug, it tracks side effects of the medication. If you develop a side effect while using Xulane and want to tell the FDA about it, visit MedWatch.

* An allergic reaction is possible after using Xulane. However, this side effect wasn’t reported in clinical trials. To learn more, see the “Side effect specifics” section below.

Xulane may cause serious side effects. The list below may not include all possible serious side effects of the drug. For more information, you can refer to Xulane’s prescribing information.

If you develop serious side effects while using Xulane, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Serious side effects that have been reported and their symptoms include:

  • Anxiety. Symptoms can include:
  • Depression. Symptoms can include:
    • persistent low mood
    • feelings of hopelessness
    • loss of interest in activities you typically enjoy
  • High blood pressure. This condition doesn’t typically cause symptoms, but it may increase the risk of heart attack or stroke.
  • High cholesterol or triglyceride levels. These conditions also do not typically cause symptoms. However, they may increase the risk of serious heart problems, such as heart attack or stroke.
  • Risk of serious heart problems in females* who smoke.†
  • Risk of serious blood clots in females* with a BMI of 30 or more.†
  • Severe allergic reaction.‡

* Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.
† Xulane has a boxed warning for this side effect. A boxed warning is the most serious warning from the FDA. To learn more, see the “Side effect specifics” section below.
‡ An allergic reaction is possible after using Xulane. However, this side effect wasn’t reported in clinical trials. To learn more, see the “Side effect specifics” section below.

Xulane may cause several side effects. Here are some frequently asked questions about the drug’s side effects and their answers.

Will I experience more side effects during the first week of using Xulane?

It’s possible. There is no specific information from clinical trials regarding side effects that were more common in the first week. However, most side effects from this patch are expected to ease or go away after a few days.

If you experience side effects with Xulane that are persistent or bothersome, talk with your doctor.

How long do side effects of Xulane typically last?

It depends. Most side effects of Xulane are temporary and should ease within days to weeks as your body adjusts to the drug. This includes side effects such as nausea, vomiting, and abdominal pain.

However, other side effects may persist for as long as you use Xulane. These include menstrual spotting, depression or anxiety, and cholesterol changes.

In addition, certain side effects of Xulane may cause long-term complications. For example, this drug may cause a serious heart problem, such as a heart attack or stroke, in certain people.* These conditions may have long-term health effects.

If you have questions about long-term side effects of Xulane, talk with your doctor or pharmacist.

* Xulane has a boxed warning for this side effect. A boxed warning is the most serious warning from the FDA. To learn more, see the “Side effect specifics” section below.

Learn more about some of the side effects that Xulane may cause, including its boxed warnings. To find out how often side effects occurred in clinical trials, see the prescribing information for Xulane.

Risk of serious heart problems in females who smoke

Xulane has a boxed warning about the risk of serious cardiovascular events in females who smoke cigarettes while using Xulane. A boxed warning is the most serious warning from the FDA. It alerts doctors and patients about the most serious side effects a drug may cause.

While rare, Xulane was shown to increase the risk of serious cardiovascular events in clinical trials. A cardiovascular event is a problem that occurs in the heart or blood vessels, such as a blood clot, heart attack, or stroke. Symptoms can include:

What you can do

Cigarette smoking increases the risk of a serious cardiovascular event with certain hormonal contraceptives. This risk increases with age, particularly after 35 years of age.

Before you start using Xulane, tell your doctor if you’ve ever smoked. If you’re age 35 years or older and currently smoke cigarettes, your doctor will likely not prescribe Xulane. However, they can recommend a safer birth control option for you.

Risk of serious side effects in females with a BMI of 30 or more

Xulane has a boxed warning about the increased risk of blood clots in females with a BMI of 30 or higher. Boxed warnings alert doctors and patients about the most serious side effects a drug may cause. In Xulane’s clinical trials, this side effect was rare.

If you have a BMI of 30 or higher, you may have a higher risk of developing certain blood clots, such as deep vein thrombosis (DVT) or pulmonary embolism.

Symptoms of DVT can include the following (typically in the leg or pelvis):

Symptoms of a pulmonary embolism can include:

  • dizziness
  • sharp chest pain that may worsen when inhaling
  • difficulty breathing
  • rapid breathing

What you can do

Before you start using Xulane, your doctor will explain certain risk factors for blood clots, including your BMI. If you have a BMI of 30 or higher, your doctor will likely not prescribe Xulane. However, they can recommend a safer birth control option for you.

Allergic reaction

As with most drugs, Xulane can cause an allergic reaction in some people. However, this side effect wasn’t reported in the drug’s clinical trials.

Symptoms can be mild or serious and can include:

  • skin rash
  • itching
  • flushing
  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What you can do

For mild symptoms of an allergic reaction, call your doctor right away. They may recommend ways to ease your symptoms and determine whether you should keep using Xulane. However, if your symptoms are serious and you think you’re having a medical emergency, immediately call 911 or your local emergency number.

This drug comes with several precautions. Below is important information you should consider before using Xulane.

Boxed warnings

This drug has boxed warnings about the risk of serious cardiovascular events in females who smoke and the risk of serious side effects in females with a BMI of 30 or higher. A boxed warning is the most serious warning from the FDA. For details, see the “Side effect specifics” section above.

Other precautions

Be sure to talk with your doctor about your health history before using Xulane. This drug may not be the right treatment option for you if you have certain medical conditions or other factors that affect your health. These include:

Blood clot: Before you start using Xulane, your doctor will determine whether you have any risk factors for blood clots. This includes whether you’ve ever had a severe heart problem, such as heart attack, stroke, atrial fibrillation, or unmanaged hypertension. Tell your doctor if you’ve given birth in the past 4 weeks and aren’t breastfeeding.

These and other factors may increase your risk of developing a blood clot while using Xulane. Your doctor will determine the safest birth control option for you.

Liver problems: If you’ve ever had a severe liver problem, such as cirrhosis or hepatitis, talk with your doctor. Xulane may not be safe for you to use. This is because Xulane is processed by the liver. If you have a liver problem, your body may not process Xulane as well as it should. In turn, this could lead to a buildup of the drug in your system. Your doctor will determine whether Xulane is a safe birth control option for you.

Depression: Using Xulane can cause mood changes, such as depression. If you have depression, using this birth control may make your depression worse. Before your doctor prescribes Xulane, tell them about any conditions you may have that affect your mood. They can advise whether Xulane is a safe birth control option for you.

High blood pressure: If you have high blood pressure, talk with your doctor before you start using Xulane. This drug may cause high blood pressure. If you already have this condition, using Xulane may make it more severe. In addition, high blood pressure can increase your risk of a heart problem, such as a blood clot, heart attack, or stroke. Your doctor will determine whether Xulane is safe for you to use.

Lipid disorders: Xulane can increase the levels of fats in your blood. If you already have a lipid disorder, such as high cholesterol or high triglyceride levels, using Xulane can worsen your condition. In addition, lipid disorders may increase your risk of a heart problem, such as a blood clot, heart attack, or stroke. If you have one of these conditions, your doctor may monitor your symptoms more closely during treatment with Xulane. If necessary, they can recommend a different birth control option for you.

Breast cancer: If you currently have or have ever had breast cancer or another type of cancer that affects hormone levels, talk with your doctor. Certain cancers, such as breast cancer, rely on estrogen to develop. Because Xulane contains a form of estrogen, using it may increase your risk of breast cancer. If you already have breast cancer, Xulane may cause it to become more severe. Your doctor may instead recommend nonhormonal birth control options for you.

Hereditary angioedema: Hereditary angioedema is a genetic condition that causes episodes of fluid retention and swelling. If you have this condition, talk with your doctor before you start treatment with Xulane. This drug may cause fluid retention. Because of this, you may have a higher risk of developing this side effect from Xulane. Your doctor will determine the safest birth control option for you.

Migraine: Headache is a common side effect of Xulane. If you experience certain types of migraine headaches, talk with your doctor about your condition before you start using Xulane. Your doctor may recommend a different birth control option for you.

Unusual uterine bleeding: Xulane may cause spotting or breakthrough bleeding. Before you start using Xulane, tell your doctor if you’ve ever experienced this kind of bleeding before. Breakthrough bleeding without a known cause may be a sign of a serious condition, and using Xulane could make this condition worse. Your doctor will determine the cause of your spotting and decide whether Xulane is safe for you to use.

Gallbladder disease: Using certain types of birth control, such as Xulane, may increase your risk of developing gallbladder disease. If you’ve had gallbladder problems in the past, using this patch may worsen the condition. If you have a history of gallbladder or bile problems, talk with your doctor to determine whether Xulane is a safe option for you.

Chloasma: Chloasma is a condition that causes dark skin patches during pregnancy, especially on the face. If you’ve had chloasma in the past, your doctor may suggest using extra sun protection or avoiding excessive UV exposure. Talk with your doctor if you have additional questions or concerns about using Xulane if you’ve had chloasma.

Allergic reaction: If you’ve had an allergic reaction to Xulane or any of its ingredients, your doctor will likely not prescribe Xulane. Ask your doctor what other medications may be better options for you.

Pregnancy or breastfeeding: Xulane is a birth control patch prescribed to help prevent pregnancy. For this reason, it’s not meant to be used during pregnancy. If you become pregnant while using Xulane, tell your doctor as soon as possible. They will have you stop using Xulane.

If you’ve recently given birth and plan to breastfeed, talk with your doctor before they prescribe Xulane. This patch isn’t recommended for use within 4 weeks of giving birth, especially if you’re breastfeeding. This is because using Xulane soon after birth may increase your risk of a blood clot in your vein. Your doctor will recommend the safest birth control option for you, as well as the safest way to feed your child.

Alcohol consumption:There are no known interactions between alcohol and Xulane. Your doctor or pharmacist can tell you how much alcohol, if any, is safe to drink while using Xulane.

If you’d like to learn more about Xulane, talk with your doctor or pharmacist. They can help answer any questions you have about side effects from using the drug.

Besides talking with your doctor, you can do some research on your own. These articles might help:

  • More information about Xulane: For details about other aspects of Xulane, refer to this article.
  • Dosage: For information about the dosage of Xulane, view this article.
  • A look at sexual health: For details about birth control and other aspects of sexual health, see our sexual health 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.