Monograph Details

Ob/Gyn > Menopause and HRT
VIVELLE-DOT
Manufacturer
Novartis Pharmaceuticals Corp
Legal Classification
Rx
Pharmacological Class
Estrogen.
Generic Name
Estradiol 0.025mg/day, 0.0375mg/day, 0.05mg/day, 0.075mg/day, 0.1mg/day; transdermal patch.
Also
VIVELLE
Indications
Moderate to severe vasomotor symptoms of menopause. Vulvar or vaginal atrophy. Postmenopausal osteoporosis prevention. Hypoestrogenism.
Children
Not recommended.
Adults
Apply to clean, dry, intact skin (not to breasts or waist); rotate application sites. Apply Vivelle to trunk, Vivelle-Dot to lower abdomen. Menopause: Initially one 0.0375mg/day patch twice weekly. Osteoporosis: initially one 0.025mg/day patch twice weekly. Hypoestrogenism: see literature. With intact uterus: usually give cyclically (3 weeks on, 1 week off); without uterus: may give continuously. Transferring from oral estrogens: apply 1st patch up to 1 week after last oral dose. Adjust after at least 1 month. Reevaluate periodically.
Contraindications
Undiagnosed abnormal genital bleeding. Thrombophlebitis. Thromboembolic disorders. Breast or estrogen-dependent carcinoma. Hepatic dysfunction. Pregnancy (Cat.X).
Precautions
Patients with an intact uterus should almost always receive a progestin to avoid endometrial hyperplasia. Familial hyperlipoproteinemia. History of breast cancer. Hepatic insufficiency. Conditions aggravated by fluid retention. Endometriosis. Gallbladder disease. Bone disease associated with hypercalcemia. Do initial complete physical and repeat yearly (include Pap smear, mammogram, BP). Discontinue if jaundice occurs and during immobilization, or 2 weeks before surgery associated with increased risk of thromboembolism. Nursing mothers.
Adverse Reactions
See literature. Headache, local irritation, fluid retention, breakthrough bleeding, mastodynia, nausea, abdominal cramps, migraine, weight changes, chloasma, back pain; increased risk of estrogen-dependent carcinoma, thromboembolism.
How Supplied
Vivelle—8
Vivelle-Dot—8, 24
Additional Resources
Related Prescribing Note