Chapter 6

Supporting New and Continuing Users

Instructions for Late Replacement or Removal, or if the Patch Comes Off

Forgot to apply a new patch after the 7-day patch-free interval?
  • Apply a new patch as soon as possible.
  • Keep the same patch-change day.
  • If late by only 1 or 2 days (48 hours or less), there is no need for a backup method.
  • If more than 2 days late (more than 48 hours) (that is, no patch was worn for 10 days or more in a row), use a backup method* for the first 7 days of patch use.
  • Also, if more than 2 days late and unprotected sex occurred in the past 5 days, consider taking emergency contraceptive pills (ECPs) (see Chapter 3 – Emergency Contraceptive Pills).
Late changing the patch at the end of week 1 or 2?
  • If late by only 1 or 2 days (48 hours or less), apply a new patch as soon as possible. Keep the same patch-change day. No need for a backup method. 
  • If more than 2 days late (more than 48 hours), apply a new patch as soon as possible. This patch will begin a new 4-week patch cycle, and this day of the week will become the new patch-change day. Also use a backup method* for the next 7 days. 
  • Also, if more than 2 days late and unprotected sex occurred in the past 5 days, consider taking emergency contraceptive pills (ECPs) (see Chapter 3 – Emergency Contraceptive Pills). 
Late taking off the patch at the end of week 3?
  • Remove the patch. 
  • Start the next cycle on the usual patch-change day.
  • No need for a backup method.
The patch came off and was off for less than 2 days  
(48 hours or less)?
  • Apply a new patch as soon as possible. (The same patch can be re-used if it was off less than 24 hours.) 
  • No need for a backup method.
  • Keep the same patch change day.
The patch came off and was off for more than 2 days (more than 48 hours)?
  • Apply a new patch as soon as possible. 
  • Use a backup method* for the next 7 days.
  • Keep the same patch-change day.
  • If during week 3, skip the patch-free week and start a new patch immediately after week 3. If a new patch cannot be started immediately, use a backup method* and keep using it through the first 7 days of patch use.
  • If during week one and unprotected sex occurred in the past 5 days, consider taking emergency contraceptive pills (ECPs) (see Chapter 3 – Emergency Contraceptive Pills).

* Backup methods include abstinence, male and female condoms, spermicides, and withdrawal. Tell her that spermicides and withdrawal are the least effective contraceptive methods. If possible, give her condoms.