ESTRADIOL (TWICE WEEKLY) (Generic for VIVELLE-DOT)

This medication is for external use only. Use it as directed on the prescription label. Apply the patch, sticky side to the skin, to an area that is clean, dry and hairless. Do not cut or trim the patch. Do not wear more than 1 patch at a time. Remove the old patch before using a new patch. Use a different site each time to prevent skin irritation. Keep using it unless your care team tells you to stop.
This medication comes with INSTRUCTIONS FOR USE. Ask your pharmacist for directions on how to use this medication. Read the information carefully. Talk to your pharmacist or care team if you have questions.
A patient package insert for the product will be given with each prescription and refill. Be sure to read this information carefully each time.
Talk to your care team about the use of this medication in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.

Visit your care team for regular checks on your progress. You will need a regular breast and pelvic exam and Pap smear while on this medication. You should also discuss the need for regular mammograms with your care team, and follow his or her guidelines for these tests.
This medication can make your body retain fluid, making your fingers, hands, or ankles swell. Your blood pressure can go up. Contact your care team if you feel you are retaining fluid.
If you have any reason to think you are pregnant, stop taking this medication right away and contact your care team.
Smoking tobacco increases the risk of getting a blood clot or having a stroke while you are taking this medication, especially if you are older than 35 years.
If you wear contact lenses and notice visual changes, or if the lenses begin to feel uncomfortable, consult your eye care specialist.
This medication can increase the risk of developing a condition (endometrial hyperplasia) that may lead to cancer of the lining of the uterus. Taking progestins, another hormone medication, with this medication lowers the risk of developing this condition. Therefore, if your uterus has not been removed (by a hysterectomy), your care team may prescribe a progestin for you to take together with your estrogen. You should know, however, that taking estrogens with progestins may have additional health risks. You should discuss the use of estrogens and progestins with your care team to determine the benefits and risks for you.
If you are going to need surgery, an MRI, CT scan, or other procedure, tell your care team that you are using this medication. You may need to remove the patch before the procedure.
Contact with water while you are swimming, using a sauna, bathing, or showering may cause the patch to fall off. If your patch falls off reapply it. If you cannot reapply the patch, apply a new patch to another area and continue to follow your usual dose schedule.

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.

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Keep out of the reach of children and pets.
Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F). Keep this medication in the original pouch until you are ready to use it. Get rid of any unused medication after the expiration date.
Get rid of used patches properly. Since used patches may still contain active medication, fold the patch in half so that it sticks to itself before throwing it away. Put it in the trash where children and pets cannot reach it.
It is important to get rid of the medication as soon as you no longer need it, or it is expired. You can do this in two ways:
-Take the medication to a medication take-back program. Check with your pharmacy or law enforcement to find a location.
-If you cannot return the medication, ask your pharmacist or care team how to get rid of this medication safely.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.