I thought it was a patch, Gator, but it is not. It is a transdermal gel that you rub on her inner ear. At first I thought it was not so good, but she hasn't had the pill in the last few days and I have been using the gel, and I don't think her mouth symptoms are worse---altho with all the family around, I have not been watching as much. Keeping my fingers crossed it does work, however, because she seems to be totally not taking the pill. The bummer is that the gel costs $90 for a month's supply :sad: