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Contraception - Management
Managing common problems when using using a combined hormonal contraceptive patch

Detached (partial or complete) combined contraceptive patch: what should be done?

  • A partially detached combined contraceptive patch is treated the same as one that has completely detached.
  • If the patch has been off for less than 48 hours:
    • Reapply it as quickly as possible, if it is still sticky.
    • If it is not sticky, it may not work, so apply a new patch. Do not use sticking plaster, tape or bandage to hold the old patch in place.
    • No additional contraception is required.
    • Continue to use the patch as normal and change it as usual.
  • If the patch has been off for 48 hours or longer, or if the time it detached is uncertain:
    • Start a whole new patch cycle by applying a new patch as soon as possible.
    • Additional contraception is advised for the next 7 days.
    • If unprotected sexual intercourse has taken place in the past 5 days, emergency contraception should be considered — see the CKS topic on Contraception - emergency.

In depth

Combined contraceptive patch not changed or new cycle started late: what should be done?

  • Replace the old combined contraceptive patch as soon as possible.
  • If there is > 48 hours' delay in starting a new patch:
    • Consider the new patch as the start of a new cycle.
    • Use additional contraception for 7 days.
    • Consider emergency contraception if unprotected sexual intercourse has taken place in the past 5 days — see the CKS topic on Contraception - emergency.
  • If the woman forgets to take the patch off at the end of week 3 she should remove the old patch and start the next patch cycle as normal.
  • No additional contraceptive cover is required provided that the delay in changing the patch (or starting a new cycle) is not more than 48 hours.

In depth

Drug interactions with the combined contraceptive patch: how should I manage?

  • The efficacy of the combined contraceptive patch can be reduced by liver enzyme–inducing drugs (which include the antibiotics rifampicin and rifamycin) and non-liver enzyme–inducing antibiotics.
  • Precautions to be taken are the same as for women taking a combined oral contraceptive (COC). For further information, see Drug interactions (for a COC).

In depth

Unscheduled bleeding, immobilization or surgery: what should be done?

The management of these problems is similar to that for women using a combined oral contraceptive (COC). For more information, see Diarrhoea or vomiting, unscheduled bleeding, surgery (on a COC). Note: diarrhoea and vomiting do not affect the bioavailability of the combined oral contraceptive patch.

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