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Divigel
Divigel (generic name: estradiol) is a topical hormone replacement therapy (HRT) used to treat symptoms of menopause, such as hot flashes, night sweats, and vaginal dryness. It contains estradiol, a form of estrogen that helps restore hormonal balance in women who are experiencing a decline in natural estrogen production due to menopause. Divigel is applied to the skin, allowing for gradual absorption into the bloodstream.
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Frequently Asked Questions
How long does it take for Divigel to relieve menopausal symptoms?
Most women begin to experience relief from hot flashes and other symptoms within 1-2 weeks of starting Divigel.
Can I swim or bathe after applying Divigel?
It’s recommended to wait at least 1 hour after applying Divigel before swimming or bathing to ensure the gel is fully absorbed into the skin.
Can Divigel be applied anywhere on the body?
No, Divigel should only be applied to the upper thigh. Avoid applying it to the breasts, face, or vaginal area.
Does Divigel increase the risk of breast cancer?
Yes, long-term use of estrogen products like Divigel can increase the risk of breast cancer. Regular screenings are recommended while using hormone replacement therapy.
What should I do if I miss a dose of Divigel?
If you miss a dose, apply it as soon as you remember. If it’s close to the time of your next dose, skip the missed dose and apply the next one as scheduled. Do not double up doses.
Comprehensive Drug Guide
How Does Divigel Work?
Divigel works by providing estradiol, a form of estrogen, to replace the body’s declining levels during menopause. Estrogen helps regulate body temperature, mood, and maintains the health of tissues such as the vagina, uterus, and bones. By restoring estrogen levels, Divigel helps relieve menopausal symptoms and prevent long-term complications such as osteoporosis.
Common Dosages
- 0.25 mg estradiol
- 0.5 mg estradiol
- 1 mg estradiol
Typical Dosing
- The typical dosing for Divigel involves applying 1 unit of gel (usually containing 0.25 mg to 1 mg of estradiol) once daily to clean, dry skin on the upper thigh. The area should be allowed to dry completely before dressing.
Typical Dosing
FDA Approved Indications
- Moderate to severe hot flashes associated with menopause
- Vulvar and vaginal atrophy due to menopause
- Hypoestrogenism caused by hypogonadism, castration, or ovarian failure
Who Shouldn't Take Divigel?
- Known or suspected breast cancer or estrogen-dependent tumors
- History of deep vein thrombosis or pulmonary embolism
- Active or recent stroke or heart attack
- Known liver disease
- Known hypersensitivity to estradiol or any other ingredients in the formulation
Advice From The Pharmacist
- Apply Divigel to clean, dry skin on the upper thigh. Rotate application sites daily to prevent skin irritation.
- Avoid applying Divigel to the breasts or vaginal area.
- Allow the gel to dry completely before dressing to avoid transferring the medication to your clothes.
- Wash your hands thoroughly after applying Divigel to prevent accidental contact with other areas of the body.
- Do not apply Divigel right before swimming, bathing, or other activities that may wash off the gel.
Side Effects of Divigel
Common Side Effects
- Breast tenderness
- Headache
- Nausea
- Skin irritation at the application site
Uncommon/Severe Side Effects
- Increased risk of blood clots (deep vein thrombosis, pulmonary embolism)
- Increased risk of stroke or heart attack
- Increased risk of breast cancer
- Gallbladder disease
Risks and Warnings of Divigel
- Blood Clot Risk: Estrogen products like Divigel can increase the risk of developing blood clots. Patients with a history of blood clots or certain cardiovascular conditions should avoid this medication.
- Cancer Risk: Long-term use of estrogen therapy can increase the risk of breast cancer and endometrial cancer. Regular screenings and monitoring by a healthcare provider are recommended.
- Cardiovascular Events: Estrogen therapy may increase the risk of heart attack, stroke, and high blood pressure in some individuals.
Interactions with Divigel
Common Drug Interactions
- Warfarin: Divigel may reduce the effectiveness of anticoagulants like warfarin, increasing the risk of blood clots.
- Thyroid medications: Estrogen therapy can interfere with thyroid hormone replacement therapy, so dose adjustments may be needed.
- Corticosteroids: Concomitant use of Divigel with corticosteroids may increase the risk of side effects such as fluid retention and high blood pressure.
Alternatives to Divigel
- Premarin (conjugated estrogens): Another form of estrogen used to treat menopause symptoms.
- Estrace (estradiol): An oral tablet version of estradiol used for similar indications.
- Climara: A transdermal estrogen patch that delivers estradiol continuously through the skin.
- Vagifem: A low-dose vaginal tablet for treating vaginal atrophy due to menopause.
