Drugs A - Z

Estradiol Transdermal patch - biweekly

It is mostly used as hormone replacement in menopausal women

Generic Name: estradiol topical  |  Brand Name: Divigel 0.5 mg/packet

Brand Names: Divigel 0.5 mg/packet, Estrogel, Divigel 0.25 mg/packet, Evamist, Elestrin, Divigel 1 mg/packet

There is an FDA Alert for this drug. Click here to view it.

  • Estrogens increase the risk of endometrial cancer in postmenopausal women. (See Endometrial Cancer under Cautions.)
  • Do not use estrogens with or without progestins for prevention of cardiovascular disease (see Cardiovascular Risk Reduction under Uses and Cardiovascular Disorders under Cautions) or dementia (see Alzheimer's Disease under Uses).
  • The Women’s Health Initiative (WHI) study of estrogen alone reported increased risks of stroke and DVT in postmenopausal women receiving approximately 7 years of therapy with conjugated estrogens 0.625 mg daily.
  • The WHI study of estrogen plus progestin reported increased risks of MI, stroke, invasive breast cancer, pulmonary embolism, and DVT in postmenopausal women receiving >5 years of therapy with conjugated estrogens 0.625 mg in conjunction with medroxyprogesterone acetate 2.5 mg daily.
  • The WHI Memory Study (WHIMS) reported increased risk of developing probable dementia in postmenopausal women ≥65 years of age receiving long-term therapy (4–5 years) with conjugated estrogens in conjunction with medroxyprogesterone acetate or conjugated estrogen alone. Not known whether this finding also applies to younger postmenopausal women.
  • Other dosages of conjugated estrogens with medroxyprogesterone and other combinations or dosage forms of estrogens with progestin not studied in WHI trials; in absence of comparable data, assume risks are similar.
  • Prescribe estrogens (with or without progestins) at the lowest effective dose and for the shortest duration consistent with treatment goals and risks for the individual woman.

What is this medicine?

ESTRADIOL (es tra DYE ole) skin patches contain an estrogen. It is mostly used as hormone replacement in menopausal women. It helps to treat hot flashes and prevent osteoporosis. It is also used to treat women with low estrogen levels or those who have had their ovaries removed.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:
  • abnormal vaginal bleeding
  • blood vessel disease or blood clots
  • breast, cervical, endometrial, ovarian, liver, or uterine cancer
  • dementia
  • diabetes
  • gallbladder disease
  • heart disease or recent heart attack
  • high blood pressure
  • high cholesterol
  • high level of calcium in the blood
  • hysterectomy
  • kidney disease
  • liver disease
  • migraine headaches
  • protein C deficiency
  • protein S deficiency
  • stroke
  • systemic lupus erythematosus (SLE)
  • tobacco smoker
  • an unusual or allergic reaction to estrogens, other hormones, medicines, foods, dyes, or preservatives
  • pregnant or trying to get pregnant
  • breast-feeding

How should I use this medicine?

This medicine is for external use only. Follow the directions on the prescription label. Tear open the pouch, do not use scissors. Remove the stiff protective liner covering the adhesive. Try not to touch the adhesive. Apply the patch, sticky side to the skin, to an area that is clean, dry and hairless. Avoid injured, irritated, calloused, or scarred areas. Do not apply the skin patches to your breasts or around the waistline. Use a different site each time to prevent skin irritation. Do not cut or trim the patch. Do not stop using except on the advice of your doctor or health care professional. Do not wear more than one patch at a time unless you are told to do so by your doctor or health care professional.

Contact your pediatrician regarding the use of this medicine in children. Special care may be needed.

A patient package insert for the product will be given with each prescription and refill. Read this sheet carefully each time. The sheet may change frequently.

What if I miss a dose?

If you miss a dose, apply it as soon as you can. If it is almost time for your next dose, apply only that dose. Do not apply double or extra doses.

What may interact with this medicine?

Do not take this medicine with any of the following medications:
  • aromatase inhibitors like aminoglutethimide, anastrozole, exemestane, letrozole, testolactone

This medicine may also interact with the following medications:

  • carbamazepine
  • certain antibiotics used to treat infections
  • certain barbiturates used for inducing sleep or treating seizures
  • grapefruit juice
  • medicines for fungus infections like itraconazole and ketoconazole
  • raloxifene or tamoxifen
  • rifabutin, rifampin, or rifapentine
  • ritonavir
  • St. John's Wort


Last Updated: March 21, 2012
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