Patch's estrogen dose called risky

The makers of a popular birth-control patch warned millions of women Thursday that the patch exposes them to significantly higher doses of hormones and may put them at greater risk for blood clots and other serious side effects than previously disclosed.

The warning from Johnson and Johnson subsidiary Ortho McNeil, makers of Ortho Evra, says women using the patch will be exposed to about 60 percent more estrogen than those using typical birth-control pills because hormones from patches get into the bloodstream and are removed from the body differently than those from pills.

Thursday's warning comes four months after The Associated Press reported that patch users die and suffer blood clots at a rate three times higher than women taking the pill.

Citing federal death and injury reports, the AP also found that about a dozen women, most in their late teens and early 20s, died in 2004 from blood clots believed to be related to the birth-control patch, and dozens more survived strokes and other clot-related problems.

Ortho McNeil spokeswoman Bonnie Jacobs said Thursday that the warning speaks for itself and that the company has been cooperating with the Food and Drug Administration, which distributed the new warning to health-care providers.

More than 4 million women have used the patch since it went on sale in 2002. Several lawsuits have been filed by families of women who died or suffered blood clots while using the patch, and lawyers said more are planned.

Documents released to attorneys as a result of that litigation show Ortho McNeil has been analyzing the FDA's death and injury reports, creating its own charts that document a higher rate of blood clots and deaths in association with the patch than with the pill. In addition, an internal Ortho McNeil memo shows that the company refused, in 2003, to fund a study comparing its Ortho Evra patch to its Ortho-Cyclen pill because of concerns there was "too high a chance that study may not produce a positive result for Evra" and there was a "risk that Ortho Evra may be the same or worse than Ortho-Cyclen."

Last week, in response to AP questions about the Ortho McNeil memo, company spokesman Michael Beckerich said in a written statement that "decisions to fund studies are based upon scientific merit."

Beckerich said Ortho McNeil is conducting its own epidemiological study "designed with input from the FDA and similar to those previously conducted with the Pill."