MedlinePlus Drug Information: Estradiol Transdermal System

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Estradiol Transdermal System

(es tra dye' ole)

Brand name(s): Climara; Estraderm; Vivelle

Contents of this page:
Why is this medication prescribed? How should this medicine be used? What special precautions should I follow? What special dietary instructions should I follow? What should I do if I forget a dose?	What side effects can this medication cause? What storage conditions are needed for this medicine? In case of emergency/overdose What other information should I know?

IMPORTANT WARNING:

Estrogens have been reported to increase the risk of endometrial cancer in postmenopausal women. If you have abnormal vaginal bleeding, your doctor may do tests to check for endometrial cancer. Talk to your doctor about the possible risks of using this drug.Do not use estradiol transdermal system if you are pregnant, plan to become pregnant, or are breast-feeding. Treatment with estrogen during pregnancy can cause birth defects in the fetus. Estrogens do not prevent miscarriage and should not be used to prevent breast engorgement after giving birth. If you become pregnant while using estradiol transdermal system, call your doctor immediately.

Why is this medication prescribed?

Estradiol transdermal system is a type of estrogen used to treat symptoms associated with menopause: hot flashes (feelings of warmth in the face, neck, and chest), sweating, sleep disturbances, vaginal discomfort (dryness and itching), poor concentration, and irritability. It is also used in the treatment of female hypogonadism, female castration, primary ovarian failure, conditions caused by low amounts of estrogen such as atrophic vaginitis, and uterine bleeding caused by a hormonal imbalance.

Estradiol transdermal system is also used with diet, calcium supplements, and exercise to slow the progression of osteoporosis, a disease common in women after menopause resulting in bones that break easily.

Estradiol transdermal system may be used alone or together with a progestin taken 10 or more days each cycle.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

How should this medicine be used?

Estradiol transdermal system is applied once weekly (Climara) or twice weekly (Vivelle, Estraderm) for 3 weeks (on the same days each week), followed by 1 week without the transdermal system; then the cycle is repeated. In women who have had a hysterectomy, the transdermal system is applied once weekly (Climara) or twice weekly (Vivelle, Estraderm), continuously.

To apply the system, follow the directions that come with the package and these steps:

Remove the skin patch from its protective pouch and peel off the protective strip to expose the adhesive surface of the system. Throw out the protective strip. The system should be applied immediately after removal of the protective strip.
Place the adhesive side against a clean, dry, and not excessively hairy area of skin on the trunk of your body, preferably your abdomen (not your waistline or breasts, since tight clothing may cause the system to rub off). Do not apply the system to oily, broken, or irritated skin.
Press the system on the selected site firmly with the palm of your hand for about 10 seconds, making sure the edges stick to your skin. If the system accidentally comes off, you can either reapply it or apply a fresh system, but follow your regular dosing schedule.

Remove and discard the system and apply a fresh system according to the schedule prescribed by your doctor. To prevent skin irritation, use a different site for each application and wait at least 1 week before using a certain area again. Used systems should be cut up and disposed of, out of reach of children and pets.

Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use estradiol transdermal system exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor. Do not stop using estradiol transdermal system without talking to your doctor.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

What special precautions should I follow?

Before using estradiol transdermal system,

tell your doctor and pharmacist if you are allergic to estrogen or any other drugs.
tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially antibiotics or anti-infectives; anticoagulants ('blood thinners') such as warfarin (Coumadin); carbamazepine (Tegretol); phenobarbital; phenylbutazone; phenytoin (Dilantin); primidone (Mysoline); rifampin; steroids (Decadron, Medrol, Prednisone); and vitamins.
tell your doctor if you have or have ever had breast lumps or cancer; high blood pressure; high blood cholesterol and fats; diabetes; asthma; a history of stroke, blood clots, toxemia (high blood pressure during pregnancy), or heart attack; epilepsy (seizures); migraine headaches; a history of depression; bone, liver, heart, gallbladder, or kidney disease; jaundice (yellowing of the skin or eyes); abnormal genital bleeding; or excessive weight gain and fluid retention (bloating) during the menstrual cycle.
if you are having surgery, including dental surgery, tell the doctor or dentist that you are using estradiol transdermal system.
tell your doctor if you use tobacco products.
plan to avoid unnecessary or prolonged exposure to sunlight and to wear protective clothing, sunglasses, and sunscreen. Estradiol transdermal system may make your skin sensitive to sunlight.
tell your doctor and pharmacist if you wear contact lenses.

What special dietary instructions should I follow?

Follow all dietary and exercise recommendations, including those regarding calcium supplements, if you are taking estradiol transdermal system to treat osteoporosis.

What should I do if I forget a dose?

If you forget to apply a skin system, apply it as soon as you remember; note the date on the package, and adjust your schedule.

What side effects can this medication cause?

Although side effects from estradiol transdermal system are not common, they can occur. Tell your doctor if any of these symptoms are severe or do not go away:

rash
redness or irritation at the application site
upset stomach
stomach cramps
bloating
diarrhea
appetite and weight changes
glucose intolerance (increased blood sugar)
acne
swelling of hands, feet, or lower legs (fluid retention)
increased blood pressure
changes in menstrual flow
painful or missed periods
breast tenderness, enlargement, or secretion
intolerance to contact lenses
a spotty darkening of the skin, especially on the face

If you experience any of the following symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately:

sudden, severe headache
sudden, severe vomiting
sudden partial or complete loss of vision
speech problems
crushing chest pain or chest heaviness
coughing up blood
sudden shortness of breath
calf pain
severe stomach pain
yellowing of the skin or eyes
dizziness or faintness
weakness or numbness of an arm or leg
depression
unusual bleeding
loss of appetite

What storage conditions are needed for this medicine?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Do not remove skin systems from their protective pouches until just before applying them. Discard systems by cutting them into pieces and disposing of them, out of reach of children and pets. Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

What other information should I know?

Keep all appointments with your doctor and the laboratory. You should have a complete physical examination, including blood pressure measurements, breast and pelvic exams, and a Pap test at least yearly. Follow your doctor's directions for examining your breasts; report any lumps immediately.

Before you have any laboratory tests, tell the laboratory personnel that you are using estradiol transdermal system; this medication may interfere with some laboratory tests.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Last Revised - 01/01/2003

American Society of Health-System Pharmacists, Inc. Disclaimer