Estrogen patch

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Vivelle-dot, an estrogen patch

The estrogen patch (oestrogen patch) is a delivery system for estradiol, which is used as hormone replacement therapy to treat the problems of menopause, such as hot flashes and vaginal dryness, or to prevent osteoporosis. They are also used in hormone replacement therapy for transgender women. The estrogen is given transdermally rather than via oral tablets, meaning that the estrogen patch carries similar risks and benefits that conventional forms of estrogen-only hormone replacement therapy have, but there are also important differences.

The route of administration of estrogens may have implications for adverse effects. For example, transdermal estrogen bypasses the liver so avoids the liver effects that occur with use of oral medications, and has slightly different effects on triglycerides and cholesterol than oral estrogens. Also, the specific type of estrogen is of importance, with transdermal 17-beta estradiol not having the increased risk of venous thromboembolism seen with ethinyl estradiol.

Administration[edit]

Applied twice weekly or weekly, depending on the brand, to fatty areas of the skin which crease less, preferably the lower abdomen or buttocks. Never to the breasts.

Formulations[edit]

Transdermal estradiol patches marketed in the United States[1]

Brand
name
Forms (µg/day) Duration Type Size (cm2) Estradiol (mg) Levels
(pg/mL)
Launch
(year)
Hits Refs
Alora 25, 50, 75, 100 3–4 days Matrix 9, 18, 27, 36 0.77, 1.5, 2.3, 3.1 43–144 1996 42,300 [2][3]
Climara 25, 37.5, 50, 60, 75, 100 7 days Matrix 6.5, 9.375, 12.5, 15, 18.75, 25 2, 2.85, 3.8, 4.55, 5.7, 7.6 17–174 1994 110,000 [4][5]
Climara Proa E2 (45) + LNG (15) 7 days Matrix 22 4.4 27–54 2003 23,400 [6][7]
CombiPatcha E2 (50) + NETA (14, 25) 3–4 days Matrix 9, 16 0.62, 0.51 27–71 1998 33,500 [8][9]
Esclimc 25, 37.5, 50, 75, 100 3–4 days Matrix 11, 16.5, 22, 33, 44 5, 7.5, 10, 15, 20 16–124 1998 31,800 [10][11]
Estradermc 50, 100 3–4 days Reservoir 10, 20 E2 (4, 8 mg) + EtOH (0.3, 0.6 mL) 32–73 1986 60,200 [12][13]
Estradiolb 25, 37.5, 50, 75, 100 3–4 days Matrix 2.5, 3.75, 5, 7.5, 10 0.41, 0.62, 0.82, 1.23, 1.64 30–145 1996 [14][15]
Estradiolb 25, 37.5, 50, 75, 100 7 days Matrix 7.75, 11.625, 15.5, 18.6, 23.25, 31 0.97, 1.46, 1.94, 2.33, 2.91, 3.88 17–174 2000 [16][17]
FemPatchc 25 7 days Matrix 30 ND ND ND 18,200 [18]
Menostar 14 7 days Matrix 3.25 1 13–21 2004 21,300 [19][20]
Minivelle 25, 37.5, 50, 75, 100 3–4 days Matrix 1.65, 2.48, 3.3, 4.95, 6.6 0.41, 0.62, 0.83, 1.24, 1.65 30–117 2012 15,100 [21][22]
Vivelled 25, 37.5, 50, 75, 100 3–4 days Matrix 7.25, 11, 14.5, 22, 29 2.17, 3.28, 4.33, 6.57, 8.66 30–145 2000 91,900 [23][24]
Vivelle-Dot 25, 37.5, 50, 75, 100 3–4 days Matrix 2.5, 3.75, 5, 7.5, 10 0.39, 0.585, 0.78, 1.17, 1.56 30–145 1996 68,900 [25][26]
a = Combined with a progestin. b = Generic (of Vivelle-Dot, Climara; by Mylan). c = Discontinued. d = Partially discontinued (strikethroughed are the specific discontinued forms).

Brand names[edit]

  • Alora (United States)
  • Climara (United States)
  • Dermestril (United Kingdom)
  • Elleste Solo (United States)
  • Estraderm (United Kingdom)
  • Estradot (United Kingdom)
  • Evorel (United Kingdom)
  • Fematrix (United Kingdom)
  • FemPatch (United States)
  • FemSeven (United Kingdom)
  • Menostar (United States)
  • Minivelle (United States)
  • Vivelle (United States)
  • Vivelle-Dot (United States)

Patches with progestogens[edit]

Some patch systems for hormone replacement therapy consist of a continuous estrogen patch in addition to an intermittent patch containing a progestogen (progestin), in order to decrease disturbances in the endometrium of the uterus. The combination of estrogen and progestogen make them somewhat similar to the contraceptive patch. For example, Sequidot consists of a continuous estradiol patch in addition to a norethisterone patch that is worn 14 days in each 28-day cycle.[27]

See also[edit]

References[edit]

  1. ^ "Drugs@FDA: FDA Approved Drug Products". United States Food and Drug Administration. Retrieved 26 July 2018.
  2. ^ https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=020655
  3. ^ https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/020655s020lbl.pdf
  4. ^ https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=020375
  5. ^ https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/020375s034lbl.pdf
  6. ^ https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=021885
  7. ^ https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/021258s011lbl.pdf
  8. ^ https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=020870
  9. ^ https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/020870s023lbl.pdf
  10. ^ https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=020847
  11. ^ https://www.accessdata.fda.gov/drugsatfda_docs/label/1998/20847lblmd.pdf
  12. ^ https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=019081
  13. ^ https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/019081s043lbl.pdf
  14. ^ https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=201675
  15. ^ https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d28bec8f-762e-4f05-a20d-96a42970d6a7
  16. ^ https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=075182
  17. ^ https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=e7e6da3b-8485-1382-61c9-e9b369018b98
  18. ^ https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=020417
  19. ^ https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=021674
  20. ^ https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/020375s035lbl.pdf
  21. ^ https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=203752
  22. ^ https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/203752s009lbl.pdf
  23. ^ https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=021167
  24. ^ https://www.accessdata.fda.gov/drugsatfda_docs/label/2000/20323S23lbl.pdf
  25. ^ https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=020538
  26. ^ https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/020538s035lbl.pdf
  27. ^ Drugs.com > Sequidot. Retrieved March 2014

External links[edit]