Vivelle-Dot Patch: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Vivelle-Dot is a prescription skin patch containing estradiol, a form of estrogen, used to treat menopause symptoms such as hot flashes and vaginal dryness, and to help prevent osteoporosis after menopause. It works by replacing estrogen that the body loses during menopause or when the ovaries do not produce enough naturally. The patch is applied to the skin and changed on a regular schedule as directed by a doctor. It carries certain warnings, including increased risks of uterine cancer, stroke, and blood clots.

What is Vivelle-Dot Patch

Vivelle-Dot is a prescription skin patch that contains the hormone estradiol, a form of estrogen. When applied to the skin, estradiol is absorbed through the skin into the bloodstream. Estrogen is a female sex hormone that is necessary for many processes in the body.

Vivelle-Dot Patch uses

• Treating hot flashes and other menopause symptoms
• Treating vaginal dryness, burning, and irritation caused by menopause
• Preventing osteoporosis (thin, weak bones) after menopause
• Treating certain conditions where the ovaries do not make enough estrogen naturally

Benefits of Vivelle-Dot Patch

• Helps relieve moderate to severe hot flashes associated with menopause
• Helps reduce night sweats and other vasomotor symptoms
• Replaces estrogen lost after menopause through the skin
• Helps relieve symptoms of vulvar and vaginal atrophy, such as dryness and discomfort
• Can help prevent postmenopausal osteoporosis in appropriate women

How Vivelle-Dot Patch works

Vivelle-Dot replaces the natural estrogen your body loses during menopause or when you have low estrogen levels. Replacing estrogen this way helps prevent bone loss and eases menopause symptoms like hot flashes, night sweats, and vaginal dryness.

Vivelle-Dot Patch dosage

Use the patch exactly as your doctor tells you to, and follow the directions on your prescription label. Apply the patch to clean, dry skin on your lower stomach or buttocks; do not apply it to your breasts. Press the patch firmly in place with the palm of your hand for about 10 seconds, and run your finger along the edges to make sure it sticks.

Choose a different application spot each time; wait at least one week before using the same skin area again. Avoid skin that is oily, irritated, damaged, or has cuts. Avoid applying the patch near your waistline, since tight clothing can rub it off. Do not put creams, lotions, oils, or powders on the skin where you plan to apply the patch, or it may not stick.

Change the patch on the same day(s) each week to stay on your regular schedule. If the patch falls off, try sticking it back on; if it won't stick, put on a new patch in a different spot and keep your regular schedule. If you forget to change your patch, apply a new one as soon as you remember, then continue your usual schedule. Do not wear two patches at the same time. Showering should not make the patch fall off.

People with a uterus may use the patch on a cycle (such as three weeks on and one week off), while people without a uterus may use it continuously, as directed by their doctor.

Available forms and strengths

• Transdermal skin patch: 0.025 mg/day, 0.0375 mg/day, 0.05 mg/day, 0.075 mg/day, and 0.1 mg/day

Side effects of Vivelle-Dot Patch

Common

• Headache
• Back pain
• Stuffy nose, sinus pain, sore throat
• Vaginal itching or discharge, changes in menstrual periods, breakthrough bleeding
• Bloating, stomach cramps, nausea, vomiting
• Breast pain or tenderness
• Redness or irritation where the patch was worn
• Thinning scalp hair
• Fluid retention (swelling, rapid weight gain)
• Painful periods
• Vaginal yeast infection

Serious

• Signs of an allergic reaction: hives, difficulty breathing, swelling of face, lips, tongue, or throat
• Heart attack symptoms: chest pain or pressure, pain spreading to jaw or shoulder, nausea, sweating
• Increased blood pressure: severe headache, blurred vision, pounding in neck or ears, anxiety, nosebleed
• Signs of a stroke: sudden numbness or weakness (especially on one side), sudden severe headache, slurred speech, problems with vision or balance
• Signs of a blood clot: sudden vision loss, stabbing chest pain, shortness of breath, coughing up blood, pain or warmth in one or both legs
• Swelling or tenderness in the stomach
• Jaundice (yellowing of skin or eyes)
• Unusual vaginal bleeding or pelvic pain
• A breast lump
• Memory problems, confusion, unusual behavior
• High blood calcium levels: nausea, vomiting, constipation, increased thirst or urination, muscle weakness, bone pain, lack of energy
• Gallbladder disease
• Vision problems, including sudden vision loss or double vision
• Dementia (in older women)

Warnings and precautions

• Using estrogen alone raises your risk of cancer of the uterus (womb). Report any unusual vaginal bleeding to your doctor right away.
• Do not use estrogen-alone or estrogen with progestogen therapy to try to prevent heart disease, heart attacks, strokes, or dementia — these medicines may actually increase your risk of these conditions.
• Using estrogen alone may increase your chances of getting strokes or blood clots.
• Using estrogen with progestogen may increase your chances of getting heart attacks, strokes, breast cancer, or blood clots.
• Using estrogen, with or without progestogen, may increase your chance of getting dementia, based on a study of women 65 years of age and older.
• You should not use this medicine if you have unusual vaginal bleeding that hasn't been checked by a doctor, liver disease, coronary artery disease, a bleeding disorder, or a history of heart attack, stroke, blood clot, or hormone-related cancer.
• Smoking greatly increases your risk of blood clots, stroke, or heart attack while using this medicine.
• Grapefruit products may interact with this medicine and cause unwanted side effects.
• If you need major surgery or will be on long-term bed rest, you may need to stop using this medicine for a short time, since it can increase clotting risk.
• Do not use Vivelle-Dot if you are pregnant. Tell your doctor right away if you become pregnant while using this medicine.
• Estradiol can pass into breast milk and may reduce milk production. Tell your doctor if you are breastfeeding.
• If you have kidney disease, tell your doctor before using this medicine.
• You should not use this medicine if you have liver disease or liver problems, since estrogens may be poorly processed by a damaged liver.

Storage

• Store at 20–25°C (68–77°F) at controlled room temperature.
• Keep each patch in its original sealed protective pouch until ready to use.
• Protect from excessive heat, moisture, and direct sunlight.
• Do not refrigerate or freeze the patches.
• Keep out of reach and sight of children and pets, including used patches.

When to see a doctor

• Get emergency medical help right away if you have signs of a severe allergic reaction, such as hives, trouble breathing, or swelling of the face, lips, tongue, or throat.
• Remove the patch and call your doctor right away if you have signs of a heart attack, high blood pressure, stroke, or blood clot, or if you notice swelling or tenderness in your stomach, yellowing of skin or eyes, unusual vaginal bleeding or pelvic pain, a breast lump, memory problems or confusion, or signs of high blood calcium.
• Call your doctor right away if you notice new breast lumps, unusual vaginal bleeding, changes in vision or speech, sudden new severe headaches, severe chest or leg pain with or without shortness of breath, or swelling of the face and tongue with or without red, itchy bumps.
• If you think you have used too much of this medicine, seek emergency medical attention or contact your local poison control center right away.

Alternatives

• Divigel (Estradiol Gel)
• Estradot (Estradiol Patch)
• Minivelle (Estradiol Patch)
• Climara (Estradiol Patch)