This medicine is a female hormone usually given to women who no longer produce the proper amount. It is used to reduce menopause symptoms such as hot flashes or vaginal dryness/discomfort or to prevent bone loss (osteoporosis) in those at high risk. This medicine may be use to treat other conditions as determined by your doctor.
Follow the directions for using this medicine provided by your doctor. This medicine comes with a patient information leaflet. Read it carefully. Ask your doctor, nurse, or pharmacist any questions you may have about this medicine. The patch is usually replaced twice a week (about every 3 to 4 days), or as directed by your doctor. Follow the dosing schedule carefully. Do not open the sealed pouch containing the patch until ready to use. Tear open the pouch (do not use scissors) and remove the patch from the protective liner. Apply the patch to a clean, dry, hairless area of the body as described in the patient information leaflet or on the package. Avoid applying to an area that is oily, irritated, or injured. Do not place the patch on the breast. Avoid applying to the waistline since tight clothing may rub the patch off. Do not put the patch on areas where sitting may loosen it. Do not apply to a site that is exposed to sunlight. If you have any questions about where to apply the patch, contact your doctor, nurse, or pharmacist for instructions. Press the patch firmly against the skin for about 10 seconds to be sure the patch stays on. When it is time to change the patch, remove it slowly, fold in half (sticky sides together), and dispose of it properly. Apply a new patch to a different area to prevent skin irritation. It is best to rotate the areas where the patch is applied, allowing at least 1 week in between applications to the same site. If the area around the patch becomes red, itchy, or irritated, try a new site. If the irritation continues or becomes worse, notify your doctor promptly. Contact with water while bathing, showering, or swimming will not affect the patch. STORE THIS MEDICINE at room temperature below 86 degrees F (30 degrees C), in the original sealed pouch, away from heat, moisture, and light. Use this medicine regularly to receive the most benefit from it. Using this medicine at the same times each week will help you to remember. IF YOU MISS A DOSE OF THIS MEDICINE, use it as soon as possible. If a patch falls off, reapply it or apply a new patch and wear it for the rest of the scheduled period, then resume your usual dosing schedule. Do NOT use 2 doses at once.
WARNING: Estrogens have been reported to increase the chance of womb (endometrial) cancer, especially in women who receive estrogen-only hormone therapy. Estrogens may also increase the risk of cancer of the ovary. Estrogen-containing products should not be used to prevent heart disease or dementia. Estrogen used alone or in combination with another hormone (progestin) can increase the risk for heart disease (including heart attacks), stroke, serious blood clots in the lung (pulmonary embolism) or leg (deep venous thrombosis), cancer of the breast, or dementia. These risks appear to depend on the length of time this medicine is used and the amount of estrogen per dose. Therefore, this medicine should be used for the shortest possible length of time at the lowest effective dose, so you obtain the benefits and minimize the chance of serious side effects from long-term treatment. Consult your doctor or pharmacist for details. Some medicines or medical conditions may interact with this medicine. INFORM YOUR DOCTOR OR PHARMACIST of all prescription and over-the-counter medicine that you are taking. ADDITIONAL MONITORING OF YOUR DOSE OR CONDITION may be needed if you are taking corticosteroids (such as prednisone), seizure medicines (such as phenytoin, carbamazepine, or phenobarbital), "blood thinners" (such as warfarin), certain antifungal medicines (such as ketoconazole or itraconazole), macrolide antibiotics (such as clarithromycin or erythromycin), cimetidine, rifampin, ritonavir, tacrine, or St. John's wort. DO NOT START OR STOP ANY MEDICINE without doctor or pharmacist approval. Inform your doctor of any other medical conditions including any personal or family history of cancer, breast lumps, clotting problems, womb problems (such as uterine fibroids or endometriosis), heart disease (such as high blood pressure, heart attacks, or congestive heart failure), stroke, diabetes, cholesterol/lipid problems, gallbladder problems, low thyroid hormone (hypothyroidism), high blood pressure during pregnancy (toxemia), yellowing of the eyes/skin (cholestatic jaundice) during pregnancy or with past estrogen use, depression, asthma, seizures, migraine headaches, kidney problems, abnormal calcium level in the blood, lupus, growths on the liver, history of tobacco use, excessive weight gain, allergies, pregnancy, or breast-feeding. USE OF THIS MEDICINE IS NOT RECOMMENDED if you have a history of undiagnosed or abnormal vaginal bleeding, certain types of cancers (such as breast cancer), estrogen-dependent growths, history of blood clots or clotting problems, liver problems, certain blood disorders (porphyria), active/recent (within the past year) stroke or heart attack. Contact your doctor or pharmacist if you have any questions or concerns about taking this medicine.
SIDE EFFECTS, that may go away during treatment, include dizziness, headache, breast pain or tenderness, or skin redness/irritation at the application site. If they continue or are bothersome, check with your doctor. CHECK WITH YOUR DOCTOR AS SOON AS POSSIBLE if you experience stomach upset, pain, or bloating; persistent nausea; vomiting; unexplained weight changes; unusual vaginal discharge/itching/odor; increased/decreased interest in sex; or hair loss. CONTACT YOUR DOCTOR IMMEDIATELY if you experience mental/mood changes (such as severe depression, memory loss, or confusion); severe dizziness or fainting; sudden severe headache; one-sided weakness; slurred speech; vision changes (such as a change in contact lens fit, loss of vision, or double vision); chest pain; shortness of breath; pain or swelling of the hands, legs, or feet; calf pain, swelling, or tenderness; breast lumps; nipple discharge; changes in vaginal bleeding (such as spotting, breakthrough bleeding, or prolonged bleeding); seizures; yellowing of eyes or skin; irregular heartbeat; or muscle cramps. AN ALLERGIC REACTION to this medicine is unlikely, but seek immediate medical attention if it occurs. Symptoms of an allergic reaction include rash, itching, swelling, severe dizziness, or trouble breathing. If you notice other effects not listed above, contact your doctor, nurse, or pharmacist. This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your healthcare provider. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include severe nausea and vomiting and excessive vaginal bleeding.
It is important that you and your physician regularly re-evaluate your need for this medicine. Non-drug therapy to help prevent bone loss includes a weight-bearing exercise plan, as well as adequate daily calcium and vitamin D intake. Consult your doctor or pharmacist for more details. DO NOT SHARE THIS MEDICINE with others for whom it was not prescribed. DO NOT USE THIS MEDICINE for other health conditions. KEEP THIS MEDICINE out of the reach of children and pets. AFTER REMOVING THE USED PATCH, fold over with the sticky side together. Discard the patch out of reach of children and pets. IF USING THIS MEDICINE FOR AN EXTENDED PERIOD OF TIME, obtain refills before your supply runs out.