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VIVELLE-DOT (ESTRADIOL)
- Primary ovarian failure
- Vasomotor symptoms associated with menopause
- Atrophic vaginitis associated with menopause
- Atrophy of vulva
- Female hypogonadism
- Hypoestrogenism due to bilateral oophorectomy
- Post-menopausal osteoporosis prevention
- Vivelle-dot Transdermal Patch
- Minivelle Transdermal Patch
- Estradiol Semiweekly Transdermal Patch
- Dotti Transdermal Patch
- Alora Transdermal Patch
- Alora Transderm Patch
- By Indication
0.025 mg/24 hr transdermal patch
- Apply 1 patch by transdermal route twice weekly cyclically, 3 weeks on and 1 week off
0.0375 mg/24 hr transdermal patch
- Apply 1 patch by transdermal route twice weekly cyclically, 3 weeks on and 1 week off
0.05 mg/24 hr transdermal patch
- Apply 1 patch by transdermal route twice weekly
0.075 mg/24 hr transdermal patch
- Apply 1 patch by transdermal route twice weekly cyclically, 3 weeks on and 1 week off
0.1 mg/24 hr transdermal patch
- Apply 1 patch by transdermal route twice weekly
0.025 mg/24 hr transdermal patch
- Apply 1 patch by transdermal route twice weekly cyclically, 3 weeks on and 1 week off
0.0375 mg/24 hr transdermal patch
- Apply 1 patch by transdermal route twice weekly cyclically, 3 weeks on and 1 week off
0.05 mg/24 hr transdermal patch
- Apply 1 patch by transdermal route twice weekly
0.075 mg/24 hr transdermal patch
- Apply 1 patch by transdermal route twice weekly cyclically, 3 weeks on and 1 week off
0.1 mg/24 hr transdermal patch
- Apply 1 patch by transdermal route twice weekly
0.025 mg/24 hr semiweekly transdermal patch
- Apply 1 patch by transdermal route twice weekly cyclically, 3 weeks on and 1 week off
0.0375 mg/24 hr semiweekly transdermal patch
- Apply 1 patch by transdermal route twice weekly cyclically, 3 weeks on and 1 week off
0.05 mg/24 hr semiweekly transdermal patch
- Apply 1 patch by transdermal route twice weekly
0.075 mg/24 hr semiweekly transdermal patch
- Apply 1 patch by transdermal route twice weekly cyclically, 3 weeks on and 1 week off
0.1 mg/24 hr semiweekly transdermal patch
- Apply 1 patch by transdermal route twice weekly
0.025 mg/24 hr transdermal patch
- Apply 1 patch by transdermal route twice weekly cyclically, 3 weeks on and 1 week off
0.0375 mg/24 hr transdermal patch
- Apply 1 patch by transdermal route twice weekly cyclically, 3 weeks on and 1 week off
0.05 mg/24 hr transdermal patch
- Apply 1 patch by transdermal route twice weekly
0.075 mg/24 hr transdermal patch
- Apply 1 patch by transdermal route twice weekly cyclically, 3 weeks on and 1 week off
0.1 mg/24 hr transdermal patch
- Apply 1 patch by transdermal route twice weekly
0.025 mg/24 hr transdermal patch
- Apply 1 patch by transdermal route twice weekly cyclically, 3 weeks on and 1 week off
0.05 mg/24 hr transdermal patch
- Apply 1 patch by transdermal route twice weekly
0.075 mg/24 hr transdermal patch
- Apply 1 patch by transdermal route twice weekly cyclically, 3 weeks on and 1 week off
0.1 mg/24 hr transdermal patch
- Apply 1 patch by transdermal route twice weekly
0.025 mg/24 hr transdermal patch
- Apply 1 patch by transdermal route twice weekly cyclically, 3 weeks on and 1 week off
0.05 mg/24 hr transdermal patch
- Apply 1 patch by transdermal route twice weekly
0.075 mg/24 hr transdermal patch
- Apply 1 patch by transdermal route twice weekly cyclically, 3 weeks on and 1 week off
0.1 mg/24 hr transdermal patch
- Apply 1 patch by transdermal route twice weekly
Atrophic vaginitis associated with menopause
- Apply 1 patch by transdermal route twice weekly
- Apply 1 patch by transdermal route twice weekly cyclically, 3 weeks on and 1 week off
Atrophy of vulva
- Apply 1 patch by transdermal route twice weekly
- Apply 1 patch by transdermal route twice weekly cyclically, 3 weeks on and 1 week off
Female hypogonadism
- Apply 1 patch by transdermal route twice weekly
- Apply 1 patch by transdermal route twice weekly cyclically, 3 weeks on and 1 week off
Hypoestrogenism due to bilateral oophorectomy
- Apply 1 patch by transdermal route twice weekly
Post-menopausal osteoporosis prevention
- Apply 1 patch by transdermal route twice weekly
- Apply 1 patch by transdermal route twice weekly cyclically, 3 weeks on and 1 week off
Primary ovarian failure
- Apply 1 patch by transdermal route twice weekly
- Apply 1 patch by transdermal route twice weekly cyclically, 3 weeks on and 1 week off
Vasomotor symptoms associated with menopause
- Apply 1 patch by transdermal route twice weekly
- Apply 1 patch by transdermal route twice weekly cyclically, 3 weeks on and 1 week off
- anastrozole
- Arimidex
- Aromasin
- Cyklokapron
- exemestane
- Femara
- letrozole
- Lysteda
- tranexamic acid
Contraindicated
- None
Severe
Moderate
- A-hydrocort
- A-methapred
- Alagesic Lq
- amobarbital
- Amytal
- Anucort-hc
- Anusol-hc
- Aristospan Intra-articular
- Aristospan Intralesional
- Ascomp With Codeine
- Belladonna-phenobarbital
- betamethasone acet & sod phos
- Bivigam
- Brevital
- budesonide
- Bupap
- butabarbital
- Butalbital Compound W/codeine
- Butalbital Compound-codeine
- butalbital-acetaminop-caf-cod
- butalbital-acetaminophen
- butalbital-acetaminophen-caff
- butalbital-aspirin-caffeine
- Butisol
- Capacet
- Carimune Nf Nanofiltered
- Celestone Soluspan
- Cerebyx
- codeine-butalbital-ASA-caff
- Colocort
- Cortef
- Cortenema
- Cortifoam
- cortisone
- Depo-medrol
- dexamethasone
- Dexamethasone Intensol
- dexamethasone sodium phos (PF)
- dexamethasone sodium phosphate
- Dexpak 10 Day
- Dexpak 13 Day
- Dexpak 6 Day
- Dilantin
- Dilantin Extended
- Dilantin Infatabs
- Dilantin Kapseal
- Dilantin-125
- Donnatal
- Entocort Ec
- Esgic
- ethotoin
- Evista
- Ez Use Joint-tunnel-trigger
- Fioricet
- Fioricet With Codeine
- Fiorinal
- Fiorinal-codeine #3
- First-duke's
- First-mary's Mouthwash
- Flebogamma Dif
- Flo-pred
- fludrocortisone
- fosphenytoin
- Gamastan S/d
- Gammagard Liquid
- Gammagard S-d (iga < 1 Mcg/ml)
- Gammagard S/d
- Gammaked
- Gammaplex
- Gamunex-c
- Grx Hicort 25
- Hemril-30
- Hizentra
- hydrocortisone
- hydrocortisone acetate
- hydrocortisone sod succ (PF)
- hydrocortisone sod succinate
- immune glob(IgG)(hum)-maltose
- immune globulin (human) (IgG)
- immune globulin(hum),capr(IgG)
- Kenalog
- Luminal
- Margesic
- Marten-tab
- Medrol
- Medrol (pak)
- methohexital
- methylprednisolone
- methylprednisolone acetate
- methylprednisolone sod suc(PF)
- methylprednisolone sodium succ
- methylprednisolone-bupivacaine
- Millipred
- Millipred Dp
- Mysoline
- Nembutal Sodium
- nystatin-hydrocortisone-diphen
- nystatin-TCN-HC-diphenhydramin
- Octagam
- Orapred
- Orapred Odt
- Pediapred
- Peganone
- pentobarbital sodium
- phenobarb-hyoscy-atropine-scop
- phenobarbital
- phenobarbital sodium
- Phenytek
- phenytoin
- phenytoin sodium
- phenytoin sodium extended
- Physicians Ez Use M-pred
- prednisolone
- prednisolone acetate
- prednisolone sodium phosphate
- prednisone
- Prednisone Intensol
- primidone
- Privigen
- Proctocort
- raloxifene
- Rayos
- Rectacort-hc
- secobarbital sodium
- Seconal Sodium
- Solu-cortef
- Solu-cortef (pf)
- Solu-medrol
- Solu-medrol (pf)
- Tencon
- triamcinolone acetonide
- triamcinolone hexacetonide
- triamcinolone-lidocaine
- Uceris
- Veripred 20
- Zebutal
- Abnormal uterine bleeding
- Acute myocardial infarction
- Antithrombin III deficiency
- Carcinoma of breast
- Cerebrovascular accident
- Deep venous thrombosis
- Disease of liver
- Estrogen-dependent neoplasm
- Predisposition to thrombosis
- Protein C deficiency disease
- Thromboembolic disorder
- Thrombotic disorder
Contraindicated
- Coronary artery disease
- Endometrial carcinoma
- Hepatic porphyria
- Increased cardiovascular event risk
- Migraine
- Tobacco smoker
- Valvular heart disease
Severe
Moderate
- Diabetes mellitus
- Family history of malignant tumor of breast
- Gallbladder disease
- Hypercholesterolemia
- Hypertension
- Hypertriglyceridemia
- Mammography abnormal
- Seizure disorder
- Unspecified lump in breast
VIVELLE-DOT (ESTRADIOL)
- Primary ovarian failure
- Vasomotor symptoms associated with menopause
- Atrophic vaginitis associated with menopause
- Atrophy of vulva
- Female hypogonadism
- Hypoestrogenism due to bilateral oophorectomy
- Post-menopausal osteoporosis prevention
- Abnormal vaginal bleeding
- Mastalgia
- Peripheral edema
- Weight gain
- Abdominal distension
- Anorexia
- Erythema
- Pharyngitis
- Pruritus of skin
- Sinusitis
More Frequent
Severe
Less Severe
- Gastroenteritis
- Upper respiratory infection
- Back pain
- Bronchitis
- Cervical discharge
- Constipation
- Dizziness
- General weakness
- Headache disorder
- Libido changes
- Migraine
- Nausea
- Neck pain
- Skin irritation
- Vaginitis
- Vomiting
Less Frequent
Severe
Less Severe
Rare / Very Rare
Severe
- Acute myocardial infarction
- Acute pancreatitis
- Amenorrhea
- Anaphylaxis
- Angina
- Angioedema
- Cerebrovascular accident
- Chorea
- Deep venous thrombosis
- Dementia
- Endometrial carcinoma
- Endometrial hyperplasia
- Erythema multiforme
- Erythema nodosum
- Fibrocystic breast disease
- Gallbladder obstruction
- Hepatitis
- Hypertriglyceridemia
- Hypocalcemia
- Involuntary muscle movement
- Malignant epithelial tumor of ovary
- Malignant neoplasm of the ovary
- Menorrhagia
- Neoplasm of breast
- Nipple discharge
- Obstructive hyperbilirubinemia
- Pharyngeal edema
- Pulmonary thromboembolism
- Purpura
- Retinal thrombosis
- Skin rash
- Thromboembolic disorder
- Unspecified lump in breast
Less Severe
- Alopecia
- Arthralgias
- Body fluid retention
- Chloasma
- Cramps in legs
- Depression
- Diarrhea
- Dry skin
- Dysmenorrhea
- Dyspepsia
- Dyspnea
- Fallopian tube disorder
- Fatigue
- Flu-like symptoms
- Galactorrhea not associated with childbirth
- Gynecomastia
- Hirsutism
- Hypertension
- Irritability
- Malaise
- Mood changes
- Muscle spasm
- Nervousness
- Oral hypoesthesia
- Palpitations
- Paresthesia
- Pelvic pain
- Skin pigmentation enhancement
- Tongue swelling
- Urticaria
- Uterine cramps
- Uterine leiomyoma
- Varicose veins
- Vertigo
- Vulvovaginal candidiasis
Contraindicated
None
Severe Precaution
None
Management or Monitoring Precaution
Estradiol
May cause premature epiphyseal closure. Prepubertal use may induce vaginal bleeding, premature breast development.
- 1 Day – 18 Years
- May cause premature epiphyseal closure. Prepubertal use may induce vaginal bleeding, premature breast development.
Estradiol
- Severity Level:
2
- Additional Notes: Not indicated during pregnancy; no known dev tox
Contraindicated
None
| General | Excretion Potential | Effect on Infant | Notes |
| None |
Precaution Exists
Estradiol
Limited data indicate higher excretion may occur w/vaginal vs transderm admin
| General | Excretion Potential | Effect on Infant | Notes |
| Evaluate use carefully | Excreted | Not known; no or inclusive data | Limited data indicate higher excretion may occur w/vaginal vs transderm admin |
No Known Risk
None
| General | Excretion Potential | Effect on Infant | Notes |
| None |
Contraindicated
None
Precaution Exists
Estrogenic Agents (systemic)
General-Use lowest possible dose for shortest duration and in combination with a progestin as indicated to reduce the risk of endometrial hyperplasia and breast cancer. Cardiovascular-May increase risk for thromboembolic events. Avoid use in patients with known, suspected, or history of arterial or venous thromboembolic disease. Neuro/Psych-May increase the risk for dementia. Genitourinary-May aggravate urinary incontinence.
| Organ / System | HEP | REN | CARD | ENDO | NEURO / PSYCH | PULM |
| Increased Risk / Adverse Effects | N | N | Y | Y | N | N |
BEERS: Y HEDIS: Y STOPP: Y
No Known Risk
None
- Estrogens, either used alone or with another hormone (progestin), have rarely caused very serious side effects. Discuss the risks and benefits of hormone treatment with your doctor. Estrogens should not be used to prevent heart disease or dementia.<br /><br /> Estrogens can increase the risk of cancer of the uterus (endometrial cancer). Taking a progestin as directed by your doctor can help decrease this risk. Tell your doctor right away if you have any unusual vaginal bleeding.<br /><br /> In postmenopausal women, estrogens can increase the risk of cancer of the ovaries, stroke, dementia, and serious blood clots in the legs. Estrogens alone do not appear to increase the risk of breast cancer when used for up to 7 years. Estrogen, when used with a progestin, can increase the risk of heart disease (such as heart attacks), stroke, serious blood clots in the lungs/legs, dementia, and cancer of the breast/ovaries.<br /><br /> The risk for serious side effects may depend on the dose of estrogen and the length of time it is used. Therefore, this medication should be used at the lowest effective dose and for the shortest amount of time. Discuss the use of this medication with your doctor and check with him/her regularly (for example, every 3 to 6 months) to see if you still need to use this medication.<br /><br />If you will be using this medication long-term, you should have regular complete physical exams (for example, once a year) as directed by your doctor. See also Notes section.
| Atrophic vaginitis associated with menopause | |
| N95.2 | Postmenopausal atrophic vaginitis |
| Atrophy of vulva | |
| N90.5 | Atrophy of vulva |
| Female hypogonadism | |
| E28.39 | Other primary ovarian failure |
| Hypoestrogenism due to bilateral oophorectomy | |
| E89.4 | Postprocedural ovarian failure |
| E89.40 | Asymptomatic postprocedural ovarian failure |
| E89.41 | Symptomatic postprocedural ovarian failure |
| Post-menopausal osteoporosis prevention | |
| Z78.0 | Asymptomatic menopausal state |
| Primary ovarian failure | |
| E28.3 | Primary ovarian failure |
| E28.31 | Premature menopause |
| E28.310 | Symptomatic premature menopause |
| E28.319 | Asymptomatic premature menopause |
| E28.39 | Other primary ovarian failure |
| Vasomotor symptoms associated with menopause | |
| N95.1 | Menopausal and female climacteric states |
| N95.9 | Unspecified menopausal and perimenopausal disorder |
| 0-9 | A-Z |
|---|---|
| E28.3 | Primary ovarian failure |
| E28.31 | Premature menopause |
| E28.310 | Symptomatic premature menopause |
| E28.319 | Asymptomatic premature menopause |
| E28.39 | Other primary ovarian failure |
| E28.39 | Other primary ovarian failure |
| E89.4 | Postprocedural ovarian failure |
| E89.40 | Asymptomatic postprocedural ovarian failure |
| E89.41 | Symptomatic postprocedural ovarian failure |
| N90.5 | Atrophy of vulva |
| N95.1 | Menopausal and female climacteric states |
| N95.2 | Postmenopausal atrophic vaginitis |
| N95.9 | Unspecified menopausal and perimenopausal disorder |
| Z78.0 | Asymptomatic menopausal state |
Formulary Reference Tool