Zafemy is a generic prescription medication that comes in the form of a birth control patch. Zafemy patches are FDA-approved to help prevent pregnancy in certain females* who can become pregnant. For this purpose, they must have a body mass index (BMI) lower than 30. They must also be able to use birth control that contains a combination of hormones.

Note: Zafemy patches have a limitation of use. For more information, see the “Zafemy patch uses” section below.

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

Drug details

Zafemy patches contain two active ingredients: ethinyl estradiol and norelgestromin.

Ethinyl estradiol is a synthetic type of estrogen. Norelgestromin is a type of progestin, which is a synthetic kind of progesterone. Estrogen and progesterone are types of hormones your body makes naturally. Zafemy patches are a kind of combination hormonal birth control.

You apply Zafemy patches to your skin. The patches come in one strength. Each patch releases 35 micrograms (mcg) of ethinyl estradiol and 150 mcg of norelgestromin per day.

Brand-name versions

Zafemy doesn’t come in a brand-name version. It used to be available as the brand name Ortho Evra. However, Ortho Evra isn’t made anymore.

Another generic form of Ortho Evra is available, and it’s called Xulane. Zafemy and Xulane have the same active ingredients.

Effectiveness

For information about the effectiveness of Zafemy patch, see the “Zafemy patch uses” section below.

Zafemy is a generic drug. A generic drug is an exact copy of the active drug in a brand-name medication. Ortho Evra was the brand-name birth control patch that Zafemy patches were based on. However, Ortho Evra isn’t made anymore. This means there isn’t a brand-name form of Zafemy isn’t available. However, another generic form of Ortho Evra is available, and it’s known as Xulane.

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.

Zafemy comes as patches that you apply to your skin to help prevent pregnancy. The following information describes dosages of Zafemy that are commonly used or recommended. However, be sure to use the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug strength

Zafemy patches come in one strength. Each patch releases 35 micrograms (mcg) of ethinyl estradiol and 150 mcg of norelgestromin per day.

Dosage for birth control

With Zafemy patches, you’ll likely follow this 4-week cycle:

  • Day 1: Apply a new patch.
  • Day 8: Remove your old patch and apply a new one.
  • Day 15: Remove your old patch and apply a new one.
  • Days 22 through 28: Remove your old patch but don’t apply a new one. This is known as being “patch free.” During this week, you’ll likely have your period. Keep in mind that you shouldn’t go longer than 7 days before applying a new patch to start your new cycle.

Keep in mind that you shouldn’t apply more than one patch at a time.

Also, be sure to start using a new patch on the same day each week. This is called your patch change day. For example, if you apply your first Zafemy patch on a Tuesday, you should apply all your patches on a Tuesday. In each cycle, your patch change days are days 1, 8, 15, and 22.

To learn more about when to apply and change Zafemy patches, talk with your doctor or pharmacist. For tips on how to apply Zafemy patches, see the “How to use Zafemy patches” section below.

Children’s dosage

The dosage of Zafemy for girls is the same as the dosage for adult females*. See “Dosage for birth control” above for more details.

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

What if I forget to apply a new Zafemy patch?

If you forget to apply or change your Zafemy patch, you’ll take different steps depending on where you are in your cycle.

Start of your cycle. If you forget to put on a new Zafemy patch on day 1 of your cycle, apply it as soon as you remember. This day becomes your new patch change day and the first day of your 4-week cycle. Be sure to use backup birth control for the first week of this cycle. This can include condoms with spermicide or a diaphragm with spermicide.

Middle of your cycle. If you forget to change your Zafemy patch on day 8 or day 15 of your cycle, follow the steps below:

  • If you’re 1 or 2 days late, apply a new patch right away. Keep your usual patch change day for the next week of that cycle. You don’t need back up birth control.
  • If you’re 3 or more days late, it’s possible that you could become pregnant. You should stop your current cycle. Then apply a new patch and start a new cycle. This day becomes your new patch change day and the first day of your 4-week cycle. Be sure to use backup birth control for the first week of this cycle. This can include condoms with spermicide or a diaphragm with spermicide.

End of your cycle. If you forget to remove your Zafemy patch on day 22 of your cycle, take it off as soon as you remember. Start your next cycle on your usual patch change day. You don’t need to use back up birth control.

If you have other questions about when to apply Zafemy patches, talk with your doctor or pharmacist.

To help you remember to change your Zafemy patches, put a calendar where you’ll see it or set up a weekly task in your email. You can also use a medication reminder, such as an alarm or timer on your phone, or a reminder app.

Will I need to use this drug long term?

If you and your doctor determine that Zafemy patch is a safe and effective form of birth control for you, you can use it long term.

If you decide you’d like to become pregnant, you can stop using Zafemy patches at any time. But before you stop, visit your doctor for a prenatal health check.

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

For more information about the possible side effects of Zafemy patches, 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 Zafemy patch, you can do so through MedWatch.

Mild side effects

Mild side effects* of Zafemy patches can include:

Most of these side effects may go away within a couple of weeks or a few cycles. 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 Zafemy patches. To learn about other mild side effects, talk with your doctor or pharmacist, or view Zafemy patch’s package instructions.
† For more information about this side effect, see “Side effect details” below.
‡ To learn more about this side effect, see the “Zafemy patch precautions” section below.

Serious side effects

Serious side effects from Zafemy patches 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:

  • Severe headache. Symptoms can include:
    • dull, aching, or throbbing head pain that comes back repeatedly or doesn’t go away
  • Liver tumors. Symptoms can include:
    • jaundice (yellowed skin or whites of your eyes)
    • unexplained weight loss
    • swollen or painful belly
  • Gallbladder problems. Symptoms can include:
    • belly pain
    • discomfort after eating fatty meals
    • gas or burping
    • nausea or vomiting
  • Problems related to blood clots in certain females.*†‡
  • Allergic reaction.‡

* Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.
Zafemy patches have 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.
‡ For more information about this side effect, see “Side effect details” below.

Side effect details

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

Problems related to blood clots in certain females

The use of Zafemy patches in certain females may increase the risk of blood clots and health problems related to blood clots. These problems can include cardiovascular problems such as heart attack or stroke. (“Cardiovascular” means related to the heart and blood vessels.)

In fact, Zafemy patches have two boxed warnings regarding these problems. A boxed warning is the most serious warning from the FDA. It alerts doctors and patients about drug effects that may be dangerous.

Zafemy patches and smoking

You should not use Zafemy patches if you’re a female* older than age 35 years and smoke. If you smoke while using Zafemy, you may have an increased risk for serious cardiovascular problems. These problems can include heart attack, stroke, and in some cases, death. These side effects aren’t common.

The risk for serious cardiovascular problems rises as you age and the more you smoke.

Zafemy patches and BMI

You also should not use Zafemy patches if you’re a female and your body mass index (BMI) is higher than 30.† You may have a higher risk for a serious blood clot while using Zafemy patches. This is in comparison with females who have lower BMIs. The risk for a serious blood clot is rare.

* Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.
† A BMI higher than 30 in adults is referred to as obesity. To determine your BMI, see this article.

Symptoms of serious blood clots and cardiovascular problems

Serious blood clots and cardiovascular problems can cause certain symptoms. If you develop any of the following symptoms while using Zafemy patches, immediately talk with your doctor or get emergency medical care:

If you have a serious blood clot or a cardiovascular problem, your doctor will typically have you stop using Zafemy patches. They can determine the best treatment for you and suggest a different form of birth control.

Anxiety and mood changes

The use of Zafemy patches may cause anxiety, changes in your mood, or mood swings. These are common side effects of the medication.

You may also experience unstable emotions, which may include outbursts of crying. Or you may notice differences in your overall emotions.

Typically, these side effects ease over time. But if your mental health worsens, talk with your doctor right away.

Breakthrough bleeding and changes in periods

Breakthrough bleeding and changes in your period are common side effects of using Zafemy patches. They occur most often during the first few months of using Zafemy.

“Breakthrough bleeding” refers bleeding or spotting at times other than during your period. This can occur in the weeks you’re wearing Zafemy patches. Changes in your period may include having periods that are lighter than usual, absent, irregular, or painful.

To help reduce the risk of breakthrough bleeding, use Zafemy patches exactly as your doctor recommends. If you have breakthrough bleeding or periods that concern you while using Zafemy patches, talk with your doctor. They can help determine whether Zafemy is right for you.

You should also talk with your doctor if you miss your period and don’t change your patch as scheduled. Or if you’ve missed two periods in a row. It’s possible that you may be pregnant.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Zafemy patch.

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:

  • 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 Zafemy patch, 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.

The Food and Drug Administration (FDA) approves prescription drugs such as Zafemy patch to treat certain conditions. Zafemy patches 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.

Zafemy patch for birth control

Zafemy comes in the form of a birth control patch. Zafemy patches are FDA-approved to help prevent pregnancy in certain females* who can become pregnant. For this purpose, they must:

  • Have a body mass index (BMI) lower than 30. BMI is an estimate of body fat or whether you’re at a moderate weight. A BMI higher than 30 in adults is referred to as obesity. To determine your BMI, see this article.
  • Be able to use birth control that contains a combination of hormones. Zafemy patches are a type of combination hormonal birth control.

Zafemy patches have a limitation of use. If you weigh 198 pounds (90 kilograms) or more, the medication may be less effective than usual at preventing pregnancy. Talk with your doctor to see whether Zafemy or another birth control medication is right for you.

Note: Keep in mind that hormonal birth control methods don’t protect against sexually transmitted infections, which can include HIV. To find the right form to help prevent pregnancy and protect your health, talk with your doctor. And to learn more about birth control and other topics to help you live your healthiest life, visit our women’s health hub.

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

Effectiveness for birth control

In three, year-long clinical studies, Zafemy patches were effective at preventing pregnancy. Keep in mind that the patches may be less effective than usual if you weigh 198 pounds (90 kilograms) or more. Also, not using Zafemy patches consistently or correctly may also decrease their effectiveness.

To learn how Zafemy patches performed in clinical studies, see the medication’s prescribing information.

Zafemy patches and children

Zafemy patches are approved to help prevent pregnancy in females* who can become pregnant. This includes girls who have started having their period. For this purpose, they must have a BMI lower than 30. They must also be able to use birth control that contains a combination of hormones.

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

Typically, drinking alcohol doesn’t affect how Zafemy patches work in your body.

However, drinking too much alcohol can damage your liver. You shouldn’t use Zafemy patches if you have certain liver problems.

In addition, consuming alcohol may worsen other side effects of Zafemy patches. These can include headache, nausea, vomiting, and diarrhea. The side effects can also include anxiety and unstable emotions, which may include crying outbursts or changes in mood.

If you have questions about drinking alcohol while using Zafemy patches, talk with your doctor.

Zafemy patches can interact with several other medications. They can also interact with certain supplements and 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.

Before using Zafemy patches, talk with your doctor and pharmacist. Tell them about all prescription, 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.

Zafemy patch and other medications

Below are lists of medications that can interact with Zafemy patches. These lists don’t contain all drugs that may interact with Zafemy patches.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Increased risk of side effects from Zafemy. The use of Zafemy patches with certain drugs may increase the risks of side effects from Zafemy patches. Examples of these drugs include:

Decreased effectiveness of Zafemy. The use of Zafemy patches with certain drugs may make Zafemy patches less effective than usual at helping prevent pregnancy. It may also cause breakthrough bleeding or other period symptoms. Examples of these drugs include:

  • certain anticonvulsant drugs, such as carbamazepine (Tegretol), topiramate (Topamax), and phenytoin (Dilantin)
  • an antifungal drug called griseofulvin (Gris-Peg)
  • certain HIV antiretroviral drugs, such as ritonavir (Norvir) or nelfinavir (Viracept)
  • certain hepatitis C antiviral drugs, such as nevirapine (Viramune)
  • certain antibiotics, such as rifabutin (Mycobutin) or rifampicin (Rifadin)

Increased risks of side effects from certain drugs used with Zafemy. The use of Zafemy patches with certain drugs may increase the risks of side effects from the other drugs. Examples of these drugs include:

Decreased effectiveness of certain drugs used with Zafemy. The use of Zafemy patches with certain drugs may make the drugs less effective than usual. Examples of these drugs include:

  • an anxiety drug called temazepam (Restoril)
  • an opioid pain drug called morphine (Kadian, MS Contin)
  • an anticonvulsant called lamotrigine (Lamictal)
  • thyroid hormone replacement drugs, such as levothyroxine (Synthroid)
  • adrenal hormone replacement drugs, such as hydrocortisone (Cortef)

If you need to take a medication that can make Zafemy patches less effective than usual, be sure to use back up birth control. This can include condoms with spermicide or a diaphragm with spermicide. You should continue to use the backup birth control for 28 days after you stop taking the medication.

Liver problems. Also, you shouldn’t use Zafemy patches if you’re being treated for hepatitis C with the combination antiviral drug ombitasvir/paritaprevir/ritonavir (Technivie), with or without dasabuvir (Exviera). Using Zafemy with that drug or those drugs may lead to liver problems. If you need to take ombitasvir/paritaprevir/ritonavir, your doctor will have you pause your Zafemy use. They’ll restart it once you’ve completed your hepatitis C regimen.

Zafemy patch and supplements or herbs

Taking a supplement that contains vitamin C may increase your risk of side effects from Zafemy patches.

Taking a supplement that contains the herb St. John’s wort may make Zafemy patches less effective than usual at helping prevent pregnancy. It may also cause breakthrough bleeding, which is bleeding or spotting at times other than during your period. This can occur in the weeks you’re wearing Zafemy patches.

Be sure to use back up birth control while using St. John’s wort and Zafemy patches. This can include condoms with spermicide or a diaphragm with spermicide. You should keep using the backup birth control for 28 days after you stop taking St. John’s wort.

It’s important to check with doctor or pharmacist before taking any supplements or herbs while using Zafemy patches.

Zafemy patches and foods

Typically, you shouldn’t eat grapefruit or drink grapefruit juice while using Zafemy patches. Drinking or eating grapefruit products may increase the risk of side effects from Zafemy patches. (To learn more about side effects, see the “Zafemy patch side effects” section above.)

If you have questions about consuming grapefruit or grapefruit juice while using Zafemy patches, talk with your doctor or pharmacist.

Zafemy patch and lab tests

The use of Zafemy patches may affect the accuracy of certain lab tests. These tests include:

Before having any lab tests, ask your doctor if Zafemy patches could alter the results.

As with all medications, the cost of Zafemy patches can vary. To find current prices for Zafemy patches 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 Zafemy patches. 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, talk with your doctor or your insurance company.

Before approving coverage for Zafemy patches, 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 Zafemy patches, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Zafemy patches, or if you need help understanding your insurance coverage, reach out to your insurance company. They can aid you and tell you if there are any financial assistance options available.

Mail-order pharmacies

Zafemy patches 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 Zafemy patches, 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.

If you don’t have insurance, you can ask your doctor or pharmacist about online pharmacy options or other types of financial support, such as prescription discount cards.

Other forms of hormonal birth control are available that can help prevent pregnancy. Some may be a better fit for you than others. If you’re interested in finding an alternative to Zafemy patches, talk with your doctor. They can tell you about which forms may work well for you. You can also refer to this article on birth control.

Hormonal birth control alternatives to Zafemy patches include:

  • combination pills, such as drospirenone/ethinyl estradiol (Yaz) or norethindrone acetate/ethinyl estradiol (Loestrin 21 Day)
  • combination patches, such as norelgestromin/ethinyl estradiol (Xulane) or levonorgestrel/ethinyl estradiol (Twirla)
  • progestin-only pills, such as norethindrone (Lyza)
  • a vaginal ring, such as etonogestrel/ethinyl estradiol (Nuvaring)
  • forms injected under the skin, such as medroxyprogesterone acetate (Depo-SubQ Provera 104)
  • forms implanted under the skin, such as etonogestrel (Nexplanon)
  • intrauterine devices, such as levonorgestrel (Mirena) or levonorgestrel (Kyleena)

To help determine which birth control medication is right for you, talk with your doctor.

To help prevent pregnancy, you should use Zafemy according to the instructions your doctor or other healthcare professional gives you.

Zafemy comes as a birth control patch. You apply it to the skin of your upper outer arm, lower belly, buttocks, or back. To avoid skin irritation, be sure to rotate the site so the new patch isn’t in the same spot as the previous one. Also, make sure the patch is in an area where clothing won’t rub it.

Your skin should be clean, dry, and unbroken. Make sure the patch sticks well to your skin. Run your finger over the entire patch to smooth out any wrinkles around its edges.

You shouldn’t apply more than one patch at a time. You also shouldn’t use a patch that’s cut, torn, or damaged.

When you get Zafemy patches from the pharmacy, the medication should come with instructions on how to use the patches. You can also ask your doctor or pharmacist if you have questions.

For tips on what to do if your Zafemy patch peels or falls off, see the “Common questions about Zafemy patches” section above.

When to use if you haven’t used hormonal birth control

Zafemy is a type of hormonal birth control. If you haven’t used hormonal birth control before, there are two times when you can begin using Zafemy patches. These are called the first-day start and the Sunday start. Talk with your doctor to see which time is best for you.

To help you remember to change your Zafemy patches, put a calendar where you’ll see it or set up a weekly task in your email. You can also use a medication reminder, such as an alarm or timer on your phone, or a reminder app.

First-day start

With the first-day start, you’ll apply your first Zafemy patch within 24 hours of getting your period. If you apply it during this time, you don’t need backup birth control. You’ll repeat the usual 4-week cycle.*

If you don’t apply your patch within 24 hours of getting your period, you should use backup birth control for the first week (7 days) of your cycle. This can include condoms with spermicide or a diaphragm with spermicide. You can continue the rest of your cycle without backup. You’ll repeat the usual 4-week cycle.*

* For details on the typical Zafemy patch 4-week cycle, see the “Zafemy patch dosage” section above.

Sunday start

With the Sunday start, you should apply your first patch on the first Sunday after getting your period. You must use back up birth control for the first week (7 days) of your cycle. This can include condoms with spermicide or a diaphragm with spermicide. You can continue the rest of your cycle without backup birth control. You’ll repeat the usual 4-week cycle.

If you’re period starts on Sunday, apply your first patch that day. You don’t need to use back up birth control. Follow and repeat the usual 4-week cycle.

* For details on the typical Zafemy patch 4-week cycle, see the “Zafemy patch dosage” section above.

When to use if switching birth control

If you’re currently using birth control, talk with your doctor about when and how to switch to Zafemy patches. They’ll work with you to help prevent you becoming pregnant while you change your birth control.

Other types of birth control may include:

Note: If you’ve given birth or had a loss of pregnancy, talk with your doctor about when you can start using Zafemy patches.

Zafemy birth control patches are used to prevent pregnancy.

Zafemy patches contain two active ingredients: ethinyl estradiol and norelgestromin. These two hormones mimic the effects of hormones females* make naturally. Ethinyl estradiol acts like estrogen in your body. And norelgestromin acts like progesterone in your body.

When ethinyl estradiol and norelgestromin are absorbed through your skin, they affect other female hormones that control your menstrual cycle. Overall, Zafemy patches help prevent pregnancy by:

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

How long does it take to work?

Zafemy patches may begin to help prevent pregnancy starting the day you apply the patch or day 8 to 15 of your Zafemy cycle.* The timing depends on when you begin your period.

If you’re switching to Zafemy patches from another form of hormonal birth control, talk with your doctor. They can tell you when Zafemy should start helping prevent pregnancy.

* For details on the typical Zafemy patch 4-week cycle, see the “Zafemy patch dosage” section above.

Zafemy patches are approved to help prevent pregnancy. But keep in mind that no form of birth control is 100% effective. This means that if you’re sexually active, there’s a chance you could become pregnant while using Zafemy patches. This risk increases if you don’t use Zafemy exactly as your doctor recommends.

Also, if you weigh 198 pounds (90 kilograms) or more, Zafemy patches may be less effective than usual at helping prevent pregnancy.

To learn more about the effectiveness of Zafemy patches, see the “Zafemy patch uses” section above.

Zafemy patch risks during pregnancy

You’re not meant to use Zafemy patches during pregnancy. However, studies haven’t shown any risk of harm to a fetus (birth defects) when hormonal birth control was used just before becoming pregnant or during early pregnancy. (Zafemy patches are a type of hormonal birth control.)

You should talk with your doctor right away if you’re using Zafemy patches and:

  • think you may be pregnant
  • miss your period during your patch-free week* and haven’t used your Zafemy patch exactly as your doctor recommends
  • miss your period during your patch-free week for two cycles* in a row

If you’ve used Zafemy patches beyond early pregnancy, talk with your doctor. They can order a test to confirm if you’re pregnant and discuss the next steps with you.

* For more information on patch-free weeks and Zafemy cycles, see the “Zafemy patch dosage” section above.

Zafemy patch and fertility

Zafemy patches shouldn’t have a lasting effect on female* fertility (the ability to become pregnant). This means if you stop using the medication, your fertility should return to its usual state.

If you have questions about fertility and using Zafemy patches, talk with your doctor.

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

Zafemy patches are a type of hormonal birth control. You use them to help prevent pregnancy.

But in some situations, you may need to also use nonhormonal forms of backup birth control, such as condoms with spermicide or a diaphragm with spermicide. You may need to use the backup birth control when you:

  • are starting to use Zafemy patches
  • are switching from a different type of birth control to Zafemy patches
  • have had a pregnancy loss
  • forget to change a Zafemy patch or it falls off
  • use certain medications with Zafemy patches

Keep in mind that Zafemy patches aren’t a form of emergency contraception and you shouldn’t use them for this purpose.

If you have questions about backup birth control and when to use it, talk with your doctor or pharmacist.

Zafemy patches and STI protection

It’s important to note that Zafemy patches don’t protect you from sexually transmitted infections (STIs). Examples of STIs can include chlamydia, gonorrhea, syphilis, and HIV. STIs can be transmitted between people during sex and sexual activity.

To help you avoid contracting an STI, use barrier forms of birth control, such as male or female condoms, with Zafemy patches.

Using birth control that contains a form of estrogen, such as Zafemy, may decrease your milk production. This is less likely to happen once you’re already successfully producing milk. But the decrease can occur at any time. Until you’re no longer breastfeeding, you should try to use birth control that doesn’t contain estrogen.

It’s not known if Zafemy patches are safe to use while breastfeeding. Studies of Zafemy patch safety while breastfeeding haven’t been done.

Zafemy can pass into breast milk. But the effects on a breastfed child aren’t known.

If you’re breastfeeding or plan to, talk with your doctor about what birth control is right for you.

Here are answers to some frequently asked questions about Zafemy patches.

What should I know about my period when using Zafemy?

With Zafemy patches, you’ll likely have your period during your patch-free week. This is the fourth week (days 22 through 28) of your 4-week cycle.* In clinical studies of Zafemy patches, periods started most often on day 4 of the patch-free weeks.

You may also experience changes in your period and breakthrough bleeding, which is bleeding or spotting at times other than during your period. This can occur in the weeks you’re wearing Zafemy patches. For more information, see “Side effect details” in the “Zafemy patch side effects” section above.

If you have any concerns about your period while using Zafemy patches, talk with your doctor.

* For more information on patch-free weeks and Zafemy cycles, see the “Zafemy patch dosage” section above.

What if my Zafemy patch peels or lifts off?

If your Zafemy patch peels or lifts off yours skin, press down on the entire patch firmly for 10 seconds. Make sure it sticks well to your skin. Run your finger over the entire patch to smooth out any wrinkles around its edges.

If it won’t fully stick, remove it and apply a new Zafemy patch, following the below steps. You shouldn’t tape or wrap the patch to your skin. You also shouldn’t reapply a patch that’s been stuck to itself or has debris, such as fabric or thread, on it.

If your Zafemy patch peels or falls off for less than 1 day, reapply it. If it won’t stick, apply a new patch right way. You don’t need back up birth control. You can continue with your current cycle and usual patch change day.

If your Zafemy patch peels or falls off for more than 1 day, it’s possible that you could become pregnant. You should apply a new patch and start a new cycle. This day becomes your new patch change day and the first day of your 4-week cycle.* Be sure to use back up birth control for the first week (days 1 to 8) of your new cycle.* (You should also follow these steps if you’re not sure how long it’s been since a patch peeled or fell off.)

For more information about what to do if your Zafemy patch peels or falls off, talk with your doctor or pharmacist.

* For a fuller explanation of patch change days, Zafemy cycles, and backup birth control, see the “Zafemy patch dosage” section above.

Will I experience changes in weight with Zafemy?

You may experience weight gain while using Zafemy patches. Although uncommon, weight gain occurred in clinical studies of Zafemy patches when used for six 4-week cycles or 13 4-week cycles.

Keep in mind that you may retain fluid with Zafemy patches. This rare side effect may resemble weight gain.

Also, since Zafemy patches were released onto the market, there have been reports of increased appetite with them. Eating more can lead to weight gain. But it’s unclear how often increased appetite occurred and whether Zafemy patches were the cause.

If you’re concerned about gaining weight with Zafemy patches, talk with your doctor. They should be able to recommend ways to help you maintain a moderate weight.

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.

  • Serious cardiovascular problems in females older than age 35 years who smoke. You should not use Zafemy patches if you’re a female* older than age 35 years and smoke. This is because you may have an increased risk for serious cardiovascular problems. (“Cardiovascular” means related to the heart and blood vessels.) These problems can include heart attack and stroke.
  • Blood clots in females with a BMI higher than 30. You should not use Zafemy patches if you’re a female and your body mass index (BMI) is higher than 30. You may have a higher risk for a serious blood clot while using Zafemy patches. This is in comparison with females who have lower BMIs.

For more information on these warnings, see “Side effect details” in the “Zafemy patch 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 starting Zafemy patch, talk with your doctor about your health history. Zafemy patch may not be right for you if you have certain medical conditions or other factors affecting your health. These include the ones mentioned below.

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

Other risks for blood clots. You should not use Zafemy patches if you have other conditions or factors that may increase your risk for blood clots. These include having:

Ask your doctor what birth control other than Zafemy is right for you.

Major surgery. Before you use Zafemy, talk with your doctor if you’re going to have major surgery. They may have you stop using Zafemy patches before and after your procedure to help prevent blood clots. You should also tell your doctor if you’re on bed rest or you aren’t going to be moving around much for a period of time. These situations can increase your risk for forming clots. Your doctor can advise you on when to stop and restart your use of Zafemy.

Abnormal bleeding. Before using Zafemy patches, tell your doctor if you have abnormal periods or bleeding between periods. Also tell them if your period is irregular or if you don’t have your period at all. Your doctor will rule out possible causes, including pregnancy, before you start usingZafemy patches. See the “Zafemy patch side effects” section above for more information.

Liver problems or tumors. You should not use Zafemy patches if you have liver problems, including cirrhosis and hepatitis. You also should not use the drug if you have liver tumors, even if they aren’t cancerous. Zafemy may cause liver tumors, so talk with your doctor about your liver health before starting the patches. If you develop new liver problems while using Zafemy, your doctor will typically pause your use and treat the liver problems. Once your liver is healthy, you may be able to use Zafemy again.

Depression. Using Zafemy patches may worsen depression symptoms. Tell your doctor if you’re currently being treated for depression or you have had it in the past. If you have a relapse in your depression while using the Zafemy, your doctor will typically have you switch to another form of birth control.

Hereditary angioedema. Before using Zafemy patches, tell your doctor if you have hereditary angioedema (HAE). The estrogen in the patches may trigger or worsen HAE symptoms. Ask your doctor if Zafemy is the right choice for you.

Melasma. If you’ve experienced melasma while pregnant, using Zafemy patches may cause new or worsening dark patches.Ask your doctor about possible treatment options.

Gallbladder problems. Talk with your doctor about your gallbladder health before you start using Zafemy patches. If you’ve had gallbladder disease while using combination hormonal birth control or during pregnancy, you may have a higher risk for it when using Zafemy patches.

Diabetes or prediabetes. If you have diabetes with cardiovascular disease, you should not use Zafemy patches. The use of the patches may affect your blood sugar. If you have diabetes or prediabetes, your doctor will monitor your blood sugar more closely than usual while you use Zafemy.

High triglycerides. If you have high triglycerides, you may be at an increased risk for pancreatitis while using Zafemy patches. Talk with your doctor to see if Zafemy is right for you.

Breast or cervical cancer. You should not use Zafemy patches if you have or had breast cancer. And if you’ve had cervical cancer or cervical dysplasia, tell your doctor before using Zafemy. Some evidence suggests that hormonal birth control can increase the risk of these conditions.(Zafemy is a form of hormonal birth control.)

High blood pressure. You should not use Zafemy patches if:

If your high blood pressure is being treated and you don’t have those conditions, your doctor will monitor you while you use Zafemy patches. They’ll likely have you stop using Zafemy if your readings become high.

Migraine. You should not use Zafemy patches if you have migraine with certain symptoms, such as vision loss. You also should not use the patches if you’re age 35 years or older and have migraine. The use of Zafemy in such situations may put you at risk for stroke and other serious blood vessel problems. Before using Zafemy patches, tell your doctor if you have or had migraine.

Allergic reaction. If you’ve had an allergic reaction to Zafemy patches or any of their ingredients, you should not use Zafemy patches. Ask your doctor about other types of birth control that might be better options for you.

Pregnancy. Zafemy patches are used to help prevent pregnancy. It’s not known if using them is harmful during pregnancy. However, you should stop using the patches if you become pregnant. For more information, see the “Zafemy patches and pregnancy” section above.

Breastfeeding. You should not breastfeed while using Zafemy patches. For more information, see the “Zafemy patches and breastfeeding” section above.

Using more than the recommended dosage of Zafemy patches can lead to serious side effects.

Don’t apply more than one Zafemy patch at a time.

Patches that you’ve used for a full 7 days may still contain hormones. To help prevent too much Zafemy from entering your body, remove your current patch before applying a new one.

Overdose symptoms

Symptoms of an overdose of Zafemy patches can include:

  • nausea or vomiting
  • period-like bleeding

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 Zafemy patches 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 dispense 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’s gone past the expiration date, talk with your pharmacist about whether you might still be able to use it.

Storage

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

You should store Zafemy patches at room temperature. Be sure to keep each patch in its original protective pouch and remove it only just before you apply it. You shouldn’t store Zafemy patches in the refrigerator or freezer. Also, don’t keep them damp or wet areas, such as bathrooms.

Disposal

Used Zafemy patches still have hormones that can be absorbed by your or others’ skin. After you remove a patch from your body, fold it together so the sticky sides touch. Then place it in a sturdy, child-resistant container. Be sure to dispose of the container in the trash. You shouldn’t flush used patches down the toilet.

If you no longer need to use Zafemy patches and have leftover medication, it’s important to dispose of them safely. This helps prevent others, including children and pets, from touching the patches 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 other 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.