Zafemy and Xulane are generic skin patches. They both contain the active ingredients norelgestromin and ethinyl estradiol. Zafemy and Xulane are prescribed to help prevent pregnancy.
This article explains the main similarities and differences between Zafemy and Xulane. If you’re considering one of these drugs, discussing this information with your doctor can help you decide if one of these treatments may be right for you.
Note: For more comprehensive information about these two drugs, you can refer to our Zafemy and Xulane articles.
Key differences between Zafemy and Xulane
Zafemy and Xulane are generic versions of the same brand-name drug. They’re both hormonal birth control patches applied to the skin once per week. However, they may differ slightly in patch size or appearance.
If you have questions about the differences between Zafemy and Xulane, talk with your doctor or pharmacist.
In this article, we use the terms “females” and “males” to refer to someone’s sex assigned at birth. For information, see this article about the difference between sex and gender.
Here’s information about the generic status for Zafemy and Xulane, as well as details on their active ingredients.
| Zafemy | Xulane | |
| Generic available | see below | see below |
| Active ingredients | norelgestromin and ethinyl estradiol | norelgestromin and ethinyl estradiol |
| Drug class | hormonal birth control | hormonal birth control |
Zafemy and Xulane are generic versions of the brand-name drug Ortho Evra. However, Ortho Evra is no longer available.
Both Zafemy and Xulane are approved by the Food and Drug Administration (FDA) to help prevent pregnancy. They’re prescribed for females of any age who can become pregnant and who meet these conditions:
- have a body mass index (BMI) lower than 30
- are able to use hormonal birth control
Zafemy and Xulane may not work as well to prevent pregnancy in females who weigh 90 kilograms (about 198 pounds) or more.
Zafemy or Xulane and children
Both Zafemy and Xulane are approved to help prevent pregnancy in females of any age who can become pregnant. Females are typically able to become pregnant after their first period, which often happens around age 12 years. Doctors may prescribe Zafemy or Xulane to help prevent pregnancy in adolescents.
Here’s a quick look at the dosage and administration of Zafemy and Xulane for the uses of both drugs.
Dosage for preventing pregnancy
The following are the dosages of Zafemy and Xulane to help prevent pregnancy. Strengths are listed in micrograms (mcg).
| Zafemy for preventing pregnancy | Xulane for preventing pregnancy | |
| Form | birth control patch | birth control patch |
| Strength | each patch releases 150 mcg of norelgestromin and 35 mcg of ethinyl estradiol per day | each patch releases 150 mcg of norelgestromin and 35 mcg of ethinyl estradiol per day |
| Dose | one patch | one patch |
| Frequency | apply one new patch weekly for 3 weeks, then remove the patch for 1 week | apply one new patch weekly for 3 weeks, then remove the patch for 1 week |
| Given by | self (see below) | self (see below) |
You’ll apply one patch to your upper outer arm, abdomen, buttock, or back each week. Be sure to remove the old patch before applying the new one. Apply each new patch on the same day of the week.
If you have questions about using Zafemy or Xulane, talk with your doctor or pharmacist.
Zafemy and Xulane contain the same active ingredients and have very similar side effects. Some of the side effects reported in clinical trials of these drugs are mentioned below.
For more details about side effects of the two drugs, see our side effect articles about Zafemy and Xulane. You can also refer to the Zafemy prescribing information and Xulane prescribing information.
Mild side effects
The following table lists some of the more commonly reported mild side effects of Zafemy and Xulane. The table may also include mild side effects that are less common but that you might have concerns about in some cases.
| Mild side effects | Zafemy | Xulane |
| abdominal pain | ✓ | ✓ |
| breast pain, breast discomfort, or increased breast size | ✓ | ✓ |
| changes in emotions or mood, which may include anxiety | ✓ | ✓ |
| diarrhea | ✓ | ✓ |
| headache | ✓ | ✓ |
| nausea or vomiting | ✓ | ✓ |
| skin reactions (such as discoloration, itching, or pain) around the patch application site | ✓ | ✓ |
| period pain | ✓ | ✓ |
| breakthrough bleeding and irregular periods | ✓ | ✓ |
| yeast infection | ✓ | ✓ |
These side effects may be temporary, lasting a few days to weeks. If the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.
Serious side effects
The following table lists the reported serious side effects of Zafemy and Xulane.
| Serious side effects | Zafemy | Xulane |
| severe headache or migraine | ✓ | ✓ |
| gallbladder problems | ✓ | ✓ |
| depression | ✓ | ✓ |
| high blood pressure | ✓ | ✓ |
| melasma | ✓ | ✓ |
| high triglyceride or cholesterol levels | ✓ | ✓ |
| risk of serious cardiovascular problems with cigarette smoking* | ✓ | ✓ |
| risk of blood clots in certain people* | ✓ | ✓ |
* Zafemy and Xulane have a boxed warning for this side effect. A boxed warning is a serious warning from the Food and Drug Administration (FDA). To learn more, see the “Precautions for Zafemy and Xulane” section below.
If you have serious side effects while using Zafemy or Xulane, call your doctor immediately. If the side effects feel life threatening or you believe you’re having a medical emergency, call 911 or your local emergency number right away.
ALLERGIC REACTIONFor some people, Zafemy and Xulane can cause an allergic reaction. But this side effect wasn’t reported in clinical trials of Zafemy or Xulane.
In general, symptoms of allergic reaction can be mild or serious.
Ways to manage
For mild allergic reaction symptoms, such as a mild rash, call your doctor right away. They may recommend treatments to help manage your symptoms. They’ll also let you know whether you should keep taking the medication.
For severe allergic reaction symptoms, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms require immediate medical care because they can become life threatening. If you’ve had a serious allergic reaction to Zafemy or Xulane, your doctor may recommend taking a different medication instead.
Keep reading for details about the effectiveness of Zafemy and Xulane.
Prescribing information: For information about how effective these drugs were in clinical trials, see the prescribing information for Zafemy and Xulane. Keep in mind that trial results may not apply to your individual health situation.
Treatment guidelines: Another way to see whether a drug is considered effective is to look at treatment guidelines. When an organization includes certain drugs in treatment guidelines, this means that research has shown the drug to be safe and effective.
Guidelines from the U.S. Department of Health and Human Services recommend birth control patches as an option for pregnancy prevention. Both Zafemy and Xulane are birth control patches.
How much Zafemy or Xulane costs depends on the treatment plan your doctor prescribes, your insurance plan, and your pharmacy.
Both Zafemy and Xulane are generic drugs. Brand-name medications are often more expensive than generics. Talk with your doctor or pharmacist to learn more.
Zafemy and Xulane may not be right for you if you have certain medical conditions or other factors that affect your health. The two drugs share some of the same precautions, but they also have different ones. Some of these precautions are mentioned below.
Boxed warnings
Zafemy and Xulane have boxed warnings. These are serious warnings from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.
Risk of serious cardiovascular problems with cigarette smoking: Smoking cigarettes while using Zafemy or Xulane may increase the risk of serious cardiovascular problems. Examples include blood clots, stroke, and heart attack. This risk increases with age and is particularly high for people over age 35 years.
Cardiovascular problems weren’t common in clinical trials of Zafemy or Xulane. To be safe, your doctor may still have you watch for certain symptoms during treatment. These include:
- blood clot symptoms, such as difficulty breathing, warm or discolored skin, and pain in the affected area
- stroke symptoms, such as confusion, slurred speech, and weakness or numbness on one side of your body
- heart attack symptoms, such as nausea, sweating, and pain in your neck, shoulder, chest, or arm
Before using Zafemy or Xulane, it’s important to tell your doctor if you’ve ever smoked cigarettes. If you smoke and are over age 35 years, your doctor is unlikely to prescribe Zafemy or Xulane. They may prescribe a different type of birth control instead.
If you have symptoms of a blood clot while using Zafemy or Xulane, contact your doctor immediately. If your symptoms are severe or related to a stroke or heart attack, call 911 or a local emergency number right away.
Risk of blood clots in certain people: The use of Zafemy or Xulane may increase the risk of blood clots in people with a BMI of at least 30. These clots may occur in the lungs or a deep vein, such as a vein in the leg.
Blood clots weren’t common in clinical trials of Zafemy or Xulane. However, your doctor may have you watch for certain symptoms while you’re using either drug.
Symptoms of a blood clot in the lungs may include chest pain and difficulty breathing. Symptoms of a blood clot in a deep vein may include warmth, discolored skin, and pain in the affected area.
Your doctor may calculate your BMI before they prescribe Zafemy or Xulane. If your BMI is 30 or greater, they’re unlikely to prescribe either drug. They may prescribe a different type of birth control instead.
If you have symptoms of a blood clot while using Zafemy or Xulane, contact your doctor right away. If your symptoms seem severe or life threatening, call 911 or a local emergency number immediately.
Precautions
In addition to boxed warnings, Zafemy and Xulane have other warnings.
If any of the following medical conditions or other health factors are relevant to you, talk with your doctor before using Zafemy or Xulane.
| Precaution | Zafemy | Xulane |
| if you’ve had an allergic reaction to either drug or any of its ingredients | ✓ | ✓ |
| if you’re pregnant or thinking about becoming pregnant | ✓ | ✓ |
| if you’re breastfeeding or thinking about breastfeeding | ✓ | ✓ |
| if you’ve had gallbladder problems during pregnancy | ✓ | ✓ |
| if you’ve had melasma during pregnancy | ✓ | ✓ |
| if you’ve had breast cancer | ✓ | ✓ |
| if you have factors that raise your risk of blood clots, such as migraine episodes, certain genetic (inherited) conditions, and others | ✓ | ✓ |
| if you have depression | ✓ | ✓ |
| if you have high blood pressure | ✓ | ✓ |
| if you have high triglyceride or cholesterol levels | ✓ | ✓ |
| if you have hereditary angioedema | ✓ | ✓ |
| if you have liver problems, including liver tumors | ✓ | ✓ |
| if you have dysfunctional uterine bleeding without a known cause | ✓ | ✓ |
| if you have prediabetes or diabetes | ✓ | ✓ |
| if you have a planned surgery or procedure | ✓ | ✓ |
Switching between Zafemy and Xulane might be possible. Both drugs are birth control patches that contain the same active ingredients. These products may be interchangeable.
If you’d like to know more about switching between Zafemy and Xulane, talk with your doctor. They can give you additional details and help determine the best course of action for your personal situation.
It’s important that you do not stop, start, or switch any of your drug treatments without your doctor’s recommendation.
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.