Starting Twirla for the first time
You should apply your first Twirla patch during the first 24 hours of starting your period. That will be your Patch Change Day. If you start after this time, you will need to use non-hormonal backup contraception (ie, condoms/spermicide) for the first 7 days you are using Twirla.
If you are switching from another form of hormonal birth control, see the Instructions for Use in the Patient Information and talk to your healthcare provider or pharmacist.
Speaking of periods...
No patch is worn during the 4th week, when withdrawal bleeding is expected. In the clinical trial, a typical period in Twirla users lasted approximately 2 to 3 days. Your period may be longer or shorter. When using Twirla, you may have bleeding and/or spotting between periods, and you also may have no bleeding at all. If you miss your period, you might be pregnant. Tell your doctor if you miss your period and have not used your Twirla patch every day or if you miss 2 periods in a row.
- DO'S AND DON'TS
Apply Twirla to the lower abdomen, buttock, or upper torso (excluding the breasts)
Apply Twirla to clean, dry skin, free from makeup, creams, lotions, oils, powders, and other products
Make sure the patch is lying flat and smooth with no wrinkles or folds
Check Twirla daily and after any water exposure to ensure it is in the right place
Do not put the patch on breasts, on cut or irritated skin, or where you had the previous patch
Do not place the patch on your waistline or near clothing or undergarment seams
Do not wear more than 1 patch at a time
Do not cut, damage, or change the Twirla patch in any way. If the patch is cut, damaged, or changed in any way, it may be less effective
Possible Side Effects
In the clinical trial, the most common side effects of Twirla were:
- Skin reactions at the patch site such as bumps, redness, or changes in color of your skin, bleeding, itching, rash, dryness, pain and swelling
- Menstrual cramps
- Weight gain
These are not all the possible side effects of Twirla. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Do not use Twirla if you smoke cigarettes and are over 35 years old. Smoking increases your risk of serious cardiovascular side effects from combination hormonal contraceptives (CHCs), including death from heart attack, blood clots or stroke. This risk increases with age and the number of cigarettes you smoke.
Do not use Twirla if your Body Mass Index (BMI) is 30 kg/m2 or more. If you do not know what your BMI is, please talk to your health care provider. Women with a BMI of 30 kg/m2 or more who use CHCs may have a higher risk for developing side effects like blood clots compared to women with a BMI lower than 30 kg/m2.
Hormonal birth control methods help to lower the chances of becoming pregnant when taken as directed. Twirla does not protect against HIV infection (AIDS) and other sexually transmitted infections (STIs).
The risk information provided here is not complete. To learn more, review the Twirla Patient Information and talk with your healthcare provider or pharmacist.
TroubleshootingWhat to do if the patch starts to lift or completely comes off your skin
If your patch starts to lift off your skin or completely comes off and you don’t replace it, you may not get enough hormones to keep you from getting pregnant.If the patch was not attached for less than a day (24 hours or less)
If a patch starts to lift off your skin or is completely off for less than 1 day (up to 24 hours), you should try and put it on again in the same place or replace it with a new patch immediately. If your patch cannot be put on again, a new patch should be put on right away. No backup birth control is needed, and your Patch Change Day remains the same. See Patient Information.If the patch was not attached for 24 hours or more, or you are unsure how long
If a patch starts to lift off your skin or is completely off for more than 1 day (24 hours or more) or if you are not sure how long the patch has been not attached to your skin, you may not be protected from pregnancy. You should stop your current patch cycle and start over on a new patch cycle right away by putting on a new patch. Non-hormonal backup birth control, such as condoms and spermicide, or diaphragm and spermicide, must be used for the first week of the new patch cycle.
These are not complete instructions for what to do if you experience an issue with your patch. For more information, please review the Patient Information or connect with your health professional.
If you still have questions about patch application or use, you can speak to one of our nurse educators* by calling
*Our nurse educators are not affiliated with your healthcare provider. They can provide Twirla support but cannot offer medical advice. Please contact your doctor or pharmacist with medical questions.