When you start the Xulane patch varies based on if you are currently using a form of hormonal birth control, if you’ve recently had a baby or other circumstances. Choose the start time for the patch that best fits your situation. See the Xulane step-by-step "Instructions for Use" here or in the package insert that comes with your patches. In all cases, follow your doctor's instructions exactly for use of the Xulane patch.

To start the Xulane patch (ethinyl estradiol and norelgestromin transdermal) follow these instructions based on your circumstances:

Not currently using a hormonal birth control:

If you are not currently using a hormonal birth control, there are two ways you can start using the patch:

1. You can start the Xulane patch on the first day (within the first 24 hours) of your next menstrual period OR
2. You can start the Xulane patch on the first Sunday after your menstrual period begins. If you start the Xulane patch on the first Sunday after your period, use a non-hormonal contraceptive method of birth control (like a condom and spermicide, or a diaphragm and spermicide) for the first 7 days of your first cycle only. If your period starts on Sunday, apply your first Xulane patch that day, and no back-up birth control is needed.

Changing from oral hormone birth control pills, a vaginal contraceptive ring or another contraceptive skin patch to the Xulane skin patch:

1. Complete your current hormonal birth control cycle.
2. Apply your first Xulane patch on the day you would normally start your next oral birth control pill, patch or insert your next vaginal ring.
3. If you do not get your period within 1 week after taking your last active pill, removing your last vaginal ring or contraceptive patch, check with your doctor to make sure you are not pregnant. You may still go ahead and start Xulane for contraception.
4. If you apply your Xulane patch more than 1 week after taking your last active birth control pill, removing your last vaginal ring or contraceptive patch, use a non-hormonal contraceptive method (like a condom and spermicide, or a diaphragm and spermicide) with the Xulane patch for the first 7 days of patch use.

If you are starting Xulane after childbirth:

1. If you are not breastfeeding, wait 4 weeks before using Xulane and use a non-hormonal contraceptive method of birth control (like a condom and spermicide, or a diaphragm and spermicide), for the first 7 days of your first cycle only.
2. If you have had sex since your baby was born, wait for your first period, or see your doctor to make sure you are not pregnant before starting Xulane.

If you are starting Xulane after a miscarriage or abortion:

1. You may start Xulane immediately after a miscarriage or abortion that occurs in the first 12 weeks (first trimester) of pregnancy.
2. You do not need to use another method of birth control.

If you do not start Xulane within 5 days after a first trimester miscarriage or abortion, use a non-hormonal contraceptive method of birth control (like a condom and spermicide, or a diaphragm and spermicide), while you wait for your period to start. You have 2 ways to begin using your Xulane patch. Choose the way that is best for you:

• First day start: Apply your first Xulane patch during the first 24 hours of your menstrual period.
• Sunday start: Apply your first Xulane patch on the first Sunday after your menstrual period begins. Use a non-hormonal contraceptive method of birth control, such as a condom and spermicide or diaphragm and spermicide, for the first 7 days of your first cycle only. If your period starts on Sunday, apply your first Xulane patch that day, and no back-up birth control is needed.

If you are starting Xulane after a miscarriage or abortion that occurs after the first 12 weeks of pregnancy (second trimester), wait 4 weeks before using Xulane and use a non-hormonal contraceptive method of birth control, such as a condom and spermicide or diaphragm and spermicide, for the first 7 days of your first cycle only. If you have had sex since your miscarriage or abortion, wait for your first period, or see your healthcare provider to make sure you are not pregnant before starting Xulane.

How often do I change my Xulane patch?

A new Xulane patch is applied each week (wear one patch every 7 days) for 3 weeks (21 days) in a row, and then the fourth week is patch-free. Apply each new Xulane patch on the same day of the week. On Day 22, remove the patch and wait 7 days before applying a new patch.

Your menstrual period should start during your patch-free week. Your patch-free week should not be longer than 7 days. If the patch is off for more than 7 days in a row and you have sex during this time, you could become pregnant.

Wear only one Xulane patch at a time. Do not skip using any Xulane patches, even if you do not have sex often.

Learn More: Where do you place the Xulane patch?

What is in Xulane?

• Xulane patch contains two female hormones, an estrogen called ethinyl estradiol, and a progestin called norelgestromin to help protect against pregnancy when used correctly.
• In studies, 1 to 2 out of 100 women (1% to 2%) got pregnant during the first year that they used the Xulane patch.

DO NOT USE Xulane patch if your Body Mass Index (BMI) is 30 kg/m2 or more. Xulane is a birth control patch for women with a BMI less than 30 kg/m². Ask your doctor if you are not sure how to calculate your BMI. Women with a BMI of 30 kg/m² or more who use Xulane may be at a higher risk for developing blood clots compared to women with a lower BMI.

Xulane MAY NOT BE as effective in women weighing more than 198 lbs. (90 kg). If you weigh more than 198 lbs. (90 kg), talk to your healthcare provider about which method of birth control is right for you.

DO NOT USE Xulane if you smoke cigarettes and are over 35 years old. Smoking increases your risk of serious heart and blood vessel side effects from hormonal birth control methods, including death from heart attack, blood clots or stroke. This risk increases with age and the number of cigarettes you smoke.

DO NOT USE Xulane if you have an increased risk for blood clots.

This is not all the information you need to know about Xulane (ethinyl estradiol and norelgestromin transdermal) for safe and effective use and does not take the place of talking to your doctor about your treatment. Review the full Xulane information here, and discuss this information and any questions you have with your doctor or other health care provider.