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Estradiol transdermal system
Estradiol transdermal system (Estraderm, Vivelle)
Estradiol Transdermal System
(ess-trah-DYE-ohl)
Pregnancy Category: X Alora Climara E₂III Esclim Estraderm FemPatch Vivelle Vivelle-Dot (Rx)

Classification: Estrogen

See Also: See also Estrogens.

Action/Kinetics: This transdermal system allows a constant low dose of estradiol to directly reach the systemic circulation. The system overcomes certain problems associated with PO use, including first-pass hepatic metabolism, GI upset, and induction of liver enzymes. The system is available in various surface areas, release rates, and total estradiol content (the package insert should be carefully consulted). The patches are made either with a reservoir and a rate-controlling membrane or using a matrix where estradiol is embedded in the adhesive, allowing for a translucent, small, thin patch.

Uses: Vasomotor symptoms due to menopause, including hot flashes, night sweats, and vaginal burning, itching, and dryness. Female hypogonadism or castration; atrophic vaginitis or kraurosis vulvae due to deficient endogenous estrogen production; primary ovarian failure; prevention of osteoporosis. Abnormal uterine bleeding due to hormonal imbalance in the absence of organic pathology and only when associated with a hypoplastic or atrophic endometrium.

Side Effects: Skin irritation, URTI, headache, breast tenderness.

How Supplied: Film, Extended Release: 0.025 mg/24 hr, 0.0375 mg/24 hr, 0.05 mg/24 hr, 0.075 mg/24 hr, 0.1 mg/24 hr; Insert, Controlled Release: 0.0075 mg/24 hr

Dosage
•Dermal System Menopausal symptoms.
Initial: Lowest dose needed to control symptoms: One 0.025- or 0.05-mg system applied to the skin twice weekly (if using Alora, Estraderm, Esclim, or Vivelle) or once a week (if using Climara or FemPatch). Adjust dose as necessary to control symptoms. Taper or discontinue dose at 3- to 6-month intervals. Alora is available in strengths to release 0.05-, 0.075-, and 0.1-mg/24 hr. Climara and Estraderm are available in strengths to release 0.05- or 0.1-mg/24 hr. Esclim is available in strengths to release 0.025-, 0.0375-, 0.05-, 0.075-, or 0.1-mg/24 hr. FemPatch is available to release 0.025-mg/24 hr. Vivelle is available in strengths to release 0.0375-, 0.05-, 0.075-, or 0.1-mg/24 hr.
Prevention of osteoporosis.
Initial: 0.05 mg/day as soon as possible after menopause. Adjust dosage to control concurrent menopausal symptoms.