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Use Twirla®

Use Twirla®

Become a Patch Pro

Ready to apply Twirla? We’ve got you covered.

WE GET IT

It can take time to learn how to use a new birth control. Read on for helpful information about how to use Twirla.

For Twirla to be most effective, you must use Twirla exactly as your healthcare provider tells you to. Each patch must be fully attached to the skin during the 7 days of wear for it to work the best.

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
  • Nausea
  • Headache
  • 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.

Troubleshooting

What to do if the patch starts to lift or completely comes off your skin

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 to put it on again in the same place or replace it with a new patch immediately. See Patient Information.

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 1‑855‑389‑4752.

*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.

Is Twirla Right For you?

Making a decision about which birth control is right for you starts with a conversation with your healthcare professional.

Ask for Twirla

Important Safety Information about the TWIRLA® (levonorgestrel and ethinyl estradiol) transdermal system

  • 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.

Who should not use TWIRLA?

Do not use TWIRLA if you have or have had blood clots; history of heart attack or stroke, high blood pressure that medicine cannot control, any condition that makes your blood clot more than normal, certain heart valve problems; smoke and are over 35 years old; BMI ≥ 30 kg/m2.

TWIRLA is also not for women who have diabetes and are over 35 years old, diabetes with high blood pressure or kidney, eye, nerve, or blood vessel damage, diabetes for longer than 20 years; have had breast cancer or any cancer that is sensitive to female hormones; certain kinds of severe migraine headaches; have liver problems or liver tumors; unexplained bleeding from the vagina, who are or may be pregnant; or take hepatitis C drugs containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir, as this may increase levels of liver enzymes in the blood.

TWIRLA may not be a good choice for you if you have ever had depression; jaundice (yellowing of the skin or eyes) caused by pregnancy (also called cholestasis of pregnancy) or related to previous use of hormonal birth control.

What are the most serious side effects of TWIRLA?

TWIRLA increases the risks of serious side effects, including blood clots, stroke, or heart attack especially in women who have other risk factors. These can be life-threatening or lead to permanent disability. This increased risk is highest when you first start using hormonal birth control and when you restart the same or different hormonal birth control after not using it for a month or more. Treatment with TWIRLA should be stopped at least 4 weeks before and through 2 weeks after major surgery.

What are the most common side effects of TWIRLA?

The most common side effects reported by women using TWIRLA in a study were skin reactions at the patch site, nausea, headache, menstrual cramps, and weight gain.

These are not all the possible side effects of TWIRLA. Call your health care provider for medical advice about side effects.

You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

What else should I know about TWIRLA?

TWIRLA is a birth control patch for women with a BMI less than 30 kg/m2 who can become pregnant. It contains two female hormones, a progestin called levonorgestrel, and an estrogen called ethinyl estradiol. TWIRLA may not be as effective in women with a BMI of 25 kg/m2 or more. If you have a BMI of 30 kg/m2 or more, please talk with your health care provider about which method of birth control is right for you.

You should not use TWIRLA any earlier than 4 weeks after having a baby or if you are breastfeeding.

Hormonal birth control methods help to lower the chances of becoming pregnant when taken as directed. They do 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 health care provider or pharmacist.

IMPORTANT SAFETY INFORMATION, INCLUDING BOXED WARNING

  • 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.