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Vivelle-Dot
Vivelle-Dot is a hormone replacement therapy (HRT) patch containing estradiol, a form of estrogen. It is primarily used to manage symptoms of menopause, such as hot flashes, night sweats, and vaginal dryness, as well as to prevent osteoporosis in postmenopausal women. The transdermal patch provides a continuous delivery of estradiol through the skin, helping to maintain balanced hormone levels.
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Frequently Asked Questions
How often should I change my Vivelle-Dot patch?
The patch should be changed twice a week, every 3 to 4 days.
Can I bathe or swim while wearing the Vivelle-Dot patch?
Yes, you can bathe, swim, or shower while wearing the patch, but it’s important to ensure the patch is securely adhered to the skin.
What should I do if my Vivelle-Dot patch falls off?
If the patch falls off, try reapplying it to a different area of the skin. If it doesn’t stick, replace it with a new patch and continue your regular schedule.
Is Vivelle-Dot safe for long-term use?
Long-term use of hormone replacement therapy should be evaluated carefully. Your doctor will monitor you regularly to determine whether ongoing use is appropriate, particularly considering the risks of cardiovascular disease and cancer.
Can Vivelle-Dot help with preventing osteoporosis?
Yes, Vivelle-Dot is approved for preventing osteoporosis in postmenopausal women, especially those at high risk of fractures due to bone loss.
Comprehensive Drug Guide
How Does Vivelle-Dot Work?
Vivelle-Dot works by delivering estradiol, a bioidentical form of estrogen, through the skin into the bloodstream. This helps replenish the decreased levels of estrogen in menopausal and postmenopausal women, alleviating symptoms like hot flashes, night sweats, and vaginal dryness. It also helps maintain bone density, reducing the risk of osteoporosis.
Common Dosages
- 0.025 mg/day
- 0.0375 mg/day
- 0.05 mg/day
- 0.075 mg/day
- 0.1 mg/day The patches are typically applied twice weekly.
Typical Dosing
- The usual starting dose for treating menopausal symptoms is 0.0375 mg/day, with adjustments based on the patient’s response.
- For osteoporosis prevention, the typical dose is 0.025 mg/day.
- Patches are applied twice a week, with each patch worn for 3-4 days.
Typical Dosing
FDA Approved Indications
- Treatment of moderate to severe vasomotor symptoms due to menopause (e.g., hot flashes and night sweats)
- Treatment of vulvar and vaginal atrophy due to menopause
- Prevention of postmenopausal osteoporosis
Who Shouldn't Take Vivelle-Dot?
- Breast cancer or a history of breast cancer
- Known or suspected estrogen-dependent neoplasia
- Active or recent thromboembolic disease (e.g., deep vein thrombosis or pulmonary embolism)
- Liver dysfunction or disease
- Known hypersensitivity to estradiol or any component of the patch
Advice From The Pharmacist
- Apply the Vivelle-Dot patch to clean, dry skin on the lower abdomen or buttocks. Do not apply it to the breasts.
- Rotate the application sites to avoid skin irritation.
- If the patch falls off, try reapplying it to a different area. If it does not adhere, replace it with a new patch.
- Do not expose the patch to direct sunlight, as heat may affect its release of estradiol.
- Inform your doctor of any upcoming surgeries, as hormone therapy may increase the risk of blood clots.
Side Effects of Vivelle-Dot
Common Side Effects
- Skin irritation at the application site
- Breast tenderness
- Headache
- Nausea
- Bloating
Uncommon/Severe Side Effects
- Blood clots (e.g., deep vein thrombosis or pulmonary embolism)
- Stroke or heart attack
- Breast or uterine cancer
- High blood pressure
Risks and Warnings of Vivelle-Dot
- Cardiovascular Risks: Estrogen therapy has been associated with an increased risk of stroke, heart attack, and blood clots, particularly in older women.
- Breast Cancer Risk: Long-term use of estrogen therapy may increase the risk of breast cancer. Women using Vivelle-Dot should undergo regular breast exams and mammograms.
- Endometrial Cancer Risk: Estrogen-only therapy increases the risk of endometrial cancer in women with an intact uterus. Adding a progestin can reduce this risk.
- Liver Concerns: Estrogen therapy may lead to liver problems. Monitoring liver function may be necessary in women with existing liver conditions.
Interactions with Vivelle-Dot
Common Drug Interactions
- Blood Thinners (Warfarin): Estrogen can decrease the effectiveness of anticoagulants, leading to an increased risk of clot formation.
- Thyroid Medications: Estrogen can alter the levels of thyroid hormones, and adjustments to thyroid medications may be necessary.
- Corticosteroids: Estrogen can increase the effects of corticosteroids, potentially leading to side effects such as fluid retention or increased blood pressure.
Alternatives to Vivelle-Dot
- Estrace (estradiol): A tablet form of estradiol for hormone replacement therapy.
- Climara (estradiol patch): Another transdermal patch option for hormone replacement therapy.
- Premarin (conjugated estrogens): An estrogen-only oral medication used to manage menopausal symptoms.
- Duavee (conjugated estrogens/bazedoxifene): A combination therapy that includes estrogen and a selective estrogen receptor modulator (SERM), used for managing menopausal symptoms and preventing osteoporosis.
