Do not smoke while using Twirla patches, especially if you are older than 35 years of age.
Grapefruit may interact with ethinyl estradiol and levonorgestrel and lead to unwanted side effects. Avoid the use of grapefruit products.
This medicine may cause darkening of your facial skin (chloasma), especially if you've ever had chloasma during a pregnancy. Avoid sunlight or tanning beds. Use sunscreen (SPF 30 or higher) when you are outdoors.
Avoid applying makeup, lotions, powders, or oils to the skin where you apply a skin patch.
