Estradiol skin patches

What are estradiol skin patches?
ESTRADIOL skin patches (Alora®, Climara®, Esclim®, Estraderm®, FemPatch®, Menostar™, Vivelle® and others) contain a natural estrogen female hormone. Estradiol is essential for maintaining normal female functions and is normally produced by the ovaries. After menopause, the ovaries decrease their production of this hormone. Estradiol can help relieve symptoms of the menopause (hot flashes, night sweats, mood changes, and vaginal dryness and irritation), and may also help to prevent the onset of osteoporosis (a loss of bone mass, so that bones become brittle and easily broken). Estrogens can also help improve female functions in women with hormonal imbalance or problems with their ovaries. Generic estradiol skin patches are available for some products. To determine if an appropriate generic product is available for your particular estradiol patch brand, discuss options with your pharmacist.

What should my health care professional know before I use estradiol skin patches?
They need to know if you have any of these conditions:

asthma
blood vessel disease, blood clotting disorder, or suffered a stroke
breast, cervical, endometrial or uterine cancer
diabetes
fibroids in the womb, or endometriosis
heart, kidney or liver disease
high blood lipids or cholesterol
high blood pressure
high level of calcium in the blood
hysterectomy
mental depression
migraine
porphyria
systemic lupus erythematosus (SLE)
tobacco smoker
vaginal bleeding
an unusual or allergic reaction to estrogens, other hormones, medicines, foods, dyes, or preservatives
pregnant or trying to get pregnant
breast-feeding

How should I use this medicine?
Estradiol skin patches are for external use only. Follow the directions on the prescription label. Use exactly as directed. Some women will only be prescribed the estradiol skin patches. Other women may be prescribed to wear a patch with estrogen only on certain days of the month, and will wear a patch containing estradiol and a progestin on on the rest of the days.

One estradiol patch contains enough medication for several days. It is worn continuously until it is time to replace with a new patch. Depending on the brand of skin patch you are prescribed, the patch is replaced once or twice weekly, or as directed by your prescriber or health care professional. Make a schedule and keep to it, so that you always change your patch on the days you have marked.

Tear open the pouch, do not use scissors. Remove the stiff protective liner covering the adhesive. Try not to touch the adhesive. Your patches will have instructions that will tell you which areas of the body you can apply your patch to. Apply the patch, sticky side to the skin, to an area that is clean, dry and hairless; avoid injured, irritated, calloused, or scarred areas. Do not apply the skin patches to your breasts or around the waistline. Use a different site each time to prevent skin irritation. Do not cut or trim the patch. Do not stop using except on your prescriber’s advice. Do not wear more than one patch at a time unless you are told to do so by your prescriber.

You may bathe or participate in other activities while wearing your patch. If the patch pulls loose or falls off, you may reapply it if the patch is sticky enough to stay on the skin. You should reapply the patch in a different area. Otherwise use a fresh patch. You should change your patch on the same day(s) each week.

After removal of a patch, fold the used patch in half (sticky side in) and throw it away in an area where children or pets cannot reach it.

For all uses of this medicine:

Before starting these patches, read the paper on your prescription provided by your pharmacist or health care professional. This paper will tell you about the product you are using. Make certain you understand the instructions.

Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed.

What if I miss a dose?
If you forget to change your patch as scheduled, apply it as soon as possible. Remember to remove the old patch. If it is almost time to apply the next patch, skip the missed patch and get back on your normal schedule. Remember to remove the old patch. Do not wear more than one patch at a time unless you are told to do so by your prescriber.

What drug(s) may interact with estradiol skin patches?

some antibiotics used to treat infections
some medications used to treat HIV (human immunodeficiency virus) infection or AIDS
ascorbic acid/vitamin C supplements
barbiturates or benzodiazepines used for inducing sleep or treating seizures (convulsions)
bromocriptine
carbamazepine
cimetidine
clofibrate
cyclosporine
dantrolene
medications for diabetes
griseofulvin
hormones
hydrocortisone, cortisone, or prednisolone
imipramine or some other antidepressants
isoniazid (INH)
methotrexate
mineral oil
phenytoin
raloxifene or tamoxifen
rifabutin, rifampin, or rifapentine
some medications for treating migraines
theophylline
thyroid hormones
topiramate
tricyclic antidepressants
warfarin

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What side effects may I notice from using estradiol skin patches?
Side effects that you should report to your prescriber or health care professional as soon as possible:

breakthrough bleeding and spotting
breast enlargement, tenderness, unusual discharge or milk production
chest pain
leg, arm or groin pain
nausea, vomiting
severe headaches
stomach or abdominal pain (severe)
sudden shortness of breath
swelling of the hands, feet or ankles, or rapid weight gain
vision or speech problems
yellowing of the eyes or skin

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):
More Common:

irritation or mild redness at patch application site

Less Common:

change in sexual desire
mild stomach upset
mood changes, anxiety, depression, frustration, anger, or emotional outbursts
increased or decreased appetite
skin rash, acne, or brown spots on the face
tiredness
vaginal yeast infection (irritation and white discharge)
weight gain

What should I watch for while taking estradiol skin patches?
Visit your prescriber or health care professional for regular checks on your progress. You should have a complete check-up every 6 months. You will need a regular breast and pelvic exam and ‘Pap’ smear while on estradiol skin patches. You should also discuss the need for regular mammograms with your health care professional, and follow his or her guidelines for these tests. If you have any unusual bleeding contact your prescriber or health care professional for advice.

Estradiol skin patches can make your body retain fluid, making your fingers, hands, or ankles swell. Your blood pressure can go up. Contact your prescriber or health care professional if you feel you are retaining fluid.

If you have any reason to think you are pregnant; stop wearing the skin patches at once and contact your prescriber or health care professional.

Tobacco smoking increases the risk of getting a blood clot or having a stroke while you are wearing estradiol skin patches, especially if you are more than 35 years old. You are strongly advised not to smoke.

If you wear contact lenses and notice visual changes, or if the lenses begin to feel uncomfortable, consult your eye care specialist.

In women who still have their uterus, estrogens increase the risk of developing a condition (endometrial hyperplasia) that may lead to cancer of the lining of the uterus. Taking progestins, another hormone drug, with estrogens lowers the risk of developing this condition. Therefore, if your uterus has not been removed (by a hysterectomy), your doctor may prescribe a progestin for you to take together with your estrogen. You should know, however, that taking estrogens with progestins may have additional health risks. You should discuss the use of estrogens and progestins with your health care professional to determine the benefits and risks for you.

If you are going to have elective surgery, you may need to stop taking your estrogens one month beforehand. Consult your health care professional for advice prior to scheduling the surgery.

If you are going to have a MRI procedure, let your MRI technician know about the use of these patches. Some drug patches contain an aluminized backing that can become heated when exposed to MRI and may cause burns. You may need to temporarily remove the patch during the MRI procedure.

Where can I keep my medicine?
Keep out of the reach of children in a container that small children cannot open.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Do not store any patches that have been removed from their protective pouch. Throw away any unused medicine after the expiration date.

Dispose of used patches properly. Since used patches may still contain active hormones, fold the patch in half so that it sticks to itself prior to disposal.

Estradiol skin patches

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