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Xulane
Xulane is a transdermal contraceptive patch used to prevent pregnancy. It contains two hormones, ethinyl estradiol (an estrogen) and norelgestromin (a progestin), which work together to prevent ovulation (the release of an egg from the ovaries). In addition to preventing ovulation, Xulane also thickens the cervical mucus, making it harder for sperm to reach the egg, and alters the lining of the uterus to prevent implantation of a fertilized egg. Xulane is a convenient option for contraception because it only needs to be applied once a week.
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Frequently Asked Questions
How effective is Xulane at preventing pregnancy?
When used correctly and consistently, Xulane is about 99% effective at preventing pregnancy. However, its typical use effectiveness is slightly lower due to user error, making it 91% effective.
Can I swim or shower while wearing the Xulane patch?
Yes, Xulane is designed to remain effective even when exposed to water. You can swim, bathe, or shower while wearing the patch.
What should I do if the patch falls off?
If the patch becomes loose or falls off for less than 24 hours, you can reapply the same patch or apply a new one. If it’s been off for more than 24 hours, apply a new patch and use backup contraception (e.g., condoms) for 7 days.
Can I use Xulane if I have irregular periods?
Yes, Xulane can be used by women with irregular periods, and it may help regulate your menstrual cycle. However, consult your healthcare provider to determine if it is the right contraceptive method for you.
Is Xulane safe to use while breastfeeding?
Xulane is not recommended during breastfeeding, as the hormones in the patch may reduce breast milk production. A progestin-only contraceptive may be a better option for women who are breastfeeding.
Comprehensive Drug Guide
How Does Xulane Work?
- Inhibiting ovulation, which prevents the release of an egg from the ovaries.
- Thickening cervical mucus, which makes it harder for sperm to enter the uterus.
- Thinning the uterine lining, which makes it less likely for a fertilized egg to implant.
Common Dosages
- Apply one patch weekly for three consecutive weeks (21 days), followed by one patch-free week (7 days).
Typical Dosing
- Apply one Xulane patch to the skin on the same day each week for three weeks (patches are typically applied to the buttocks, abdomen, upper outer arm, or upper back). After the third week, remove the patch and go patch-free for one week (during which time you will have your period). Start a new patch cycle after the patch-free week.
Typical Dosing
FDA Approved Indications
- Xulane is FDA-approved for the prevention of pregnancy in women who choose to use hormonal contraceptives. It is a once-weekly patch that provides continuous pregnancy prevention when used correctly.
Who Shouldn't Take Xulane?
- History of blood clots, such as deep vein thrombosis (DVT) or pulmonary embolism.
- History of stroke or heart attack.
- Uncontrolled high blood pressure or severe cardiovascular conditions.
- Known or suspected breast cancer or other estrogen-dependent cancers.
- Liver disease or liver tumors.
- Smokers over the age of 35, as smoking increases the risk of serious cardiovascular side effects.
- Pregnancy or suspicion of pregnancy.
Advice From The Pharmacist
- Apply the patch to clean, dry, and intact skin. Avoid placing the patch on areas of skin that are oily, irritated, or exposed to excessive friction (such as near clothing waistbands).
- Rotate the patch application sites to avoid skin irritation.
- If the patch falls off or becomes loose, replace it immediately with a new patch. If it’s been off for more than 24 hours, use backup contraception (such as condoms) for 7 days.
- Avoid using lotions, oils, or powders on or near the patch, as these products can cause the patch to lose adhesion.
- If you miss a patch change, apply a new patch as soon as you remember and use backup contraception if necessary.
Side Effects of Xulane
Common Side Effects
- Skin irritation at the application site
- Breast tenderness
- Nausea
- Headache
- Menstrual changes (irregular bleeding or spotting)
- Weight gain
Uncommon/Severe Side Effects
- Blood clots, such as deep vein thrombosis (DVT) or pulmonary embolism
- Stroke or heart attack, particularly in women who smoke and are over 35
- Liver problems, including benign liver tumors
- Hypertension (high blood pressure)
- Gallbladder disease
Risks and Warnings of Xulane
- Cardiovascular Risk: Women who smoke and are over the age of 35 are at a significantly higher risk of cardiovascular events, including heart attack, stroke, and blood clots. It is recommended that women who fall into this category avoid using Xulane or any estrogen-containing contraceptive.
- Blood Clots: Xulane, like other hormonal contraceptives, increases the risk of developing blood clots. The risk is higher for women who have a personal or family history of blood clots, are overweight, or are immobile for extended periods.
- Liver Tumors: Rare but serious, benign liver tumors have been associated with hormonal contraceptive use. Any unusual abdominal pain or liver symptoms should be reported to your doctor.
- Breast and Cervical Cancer: Long-term use of hormonal contraceptives may slightly increase the risk of breast and cervical cancer.
Interactions with Xulane
Common Drug Interactions
- Antibiotics and anticonvulsants: Certain antibiotics (e.g., rifampin) and anticonvulsants (e.g., carbamazepine) can reduce the effectiveness of Xulane, potentially leading to contraceptive failure. Use backup contraception while on these medications.
- HIV medications: Some medications used to treat HIV, such as ritonavir, may interact with hormonal contraceptives and reduce their effectiveness.
- St. John’s wort: This herbal supplement may also reduce the effectiveness of hormonal contraceptives.
Alternatives to Xulane
- Oral contraceptive pills (combination or progestin-only): Taken daily to prevent pregnancy.
- NuvaRing: A vaginal ring that delivers a combination of estrogen and progestin, inserted once a month.
- Depo-Provera: A progestin-only injection given every 3 months to prevent pregnancy.
- Intrauterine devices (IUDs): Long-term, reversible contraceptives inserted into the uterus (hormonal and non-hormonal options available).
