Proper Use

Drug information provided by: Merative, Micromedex®

It is very important that you use this medicine exactly as directed by your doctor. Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered. To do so may cause unwanted side effects.

This medicine is to be used only in the vagina. Use it at bedtime unless your doctor tells you otherwise.

This medicine comes with a patient information leaflet. Read and follow these instructions carefully. Ask your doctor if you have any questions.

To use the vaginal ring:

  • This medicine is contained in a ring that you or your caregiver will put into your vagina. The ring will slowly release small amounts of medicine for your body to absorb. Your caregiver will show you how to insert the ring.
  • Do not remove the ring from the sealed pouch until you are ready to use it.
  • Once the ring is in place inside your vagina, you should not be able to feel it. If you feel uncomfortable, the ring may not be inserted far enough. Gently push the ring farther into your vagina. If you feel pain, talk to your doctor.
  • You will leave the ring inside for 90 days (3 months), unless your doctor tells you a different schedule. After that time, remove the ring and insert a new one. If you forget to remove the ring after 90 days, call your doctor for instructions.
  • The ring may move down into the lower part of your vagina accidently. This can happen if you strain to have a bowel movement. Use your finger to gently push the ring back into place. If the ring comes all the way out of your vagina, rinse it off with warm water and put it back in. Call your doctor if the ring comes out several times.
  • If you need to remove the ring, hook your finger through the ring and pull it out.

To use the Imvexxy™ vaginal insert:

  • The insert should be used only in your vagina. Do not swallow.
  • Keep your hands clean and dry while handling the insert.
  • Push an insert through the foil of the blister package and hold it with the larger end between your fingers.
  • You may choose to put the insert into your vagina using the lying down or standing up position. Put the insert about 2 inches into your vagina, with the smaller end up, using your finger.
  • Most women will start by using a new insert every day for two weeks, then change to using a new insert only 2 days each week. Carefully follow the schedule that your health caregiver tells you to.

To use the Vagifem® vaginal insert:

  • The tablet should be used only in your vagina. Do not swallow the tablet.
  • Each vaginal tablet comes packaged inside an applicator. Do not take the tablet out of the applicator. If the tablet comes out of the applicator but has not fallen out of the package, carefully put it back into the applicator for insertion. If the tablet falls out of the applicator, throw it away and use a new applicator that still has the tablet inside it.
  • Keep your hands clean and dry while handling the tablet.
  • Take the applicator out of the plastic wrap before using it.
  • Use the applicator only one time and then throw it away. Use a new applicator for each dose.
  • Most women will start by inserting a new tablet every day for two weeks, then change to inserting a new tablet only 2 days each week. Carefully follow the schedule that your health caregiver tells you to.

To use the Divigel®:

  • Open the packet and use the entire contents of a packet on the skin of either right or left upper thigh once a day.
  • Apply the gel to the right or left upper thigh on alternate days to avoid potential skin irritation.
  • Do not apply the gel on the face, breasts, or irritated skin or in or around the vagina.
  • Allow the gel to dry after application before dressing. Avoid fire, flame, or smoking until the gel has dried.
  • Do not wash the application site within 1 hour after applying the gel.
  • Avoid getting the gel into your eyes. Wash your hands after each application.

Do not eat grapefruit or drink grapefruit juice while you are using this medicine. Grapefruit and grapefruit juice may change the amount of this medicine that is absorbed in the body.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For vaginal dosage form (gel):
    • For atrophic vaginitis, hot flashes, and other symptoms caused by menopause:
      • Adults—At first, 0.25 grams applied on the skin of either right or left upper thigh once a day. Your doctor may adjust your dose as needed up to a maximum of 1.25 grams once a day.
      • Children—Use is not recommended.
  • For vaginal dosage form (ring):
    • For atrophic vaginitis, hot flashes, and other symptoms caused by menopause:
      • Adults—One vaginal ring inserted into the vagina for 3 months. Your doctor may adjust your dose as needed.
      • Children—Use is not recommended.
  • For vaginal dosage form (insert):
    • For treatment of atrophic vaginitis caused by menopause:
      • Adults—10 micrograms (mcg) or one insert into the vagina once a day for 2 weeks, followed by one insert 2 times a week.
      • Children—Use is not recommended.
    • For treatment of painful sexual intercourse caused by menopause:
      • Adults—At first, 4 micrograms (mcg) or one insert into the vagina once a day for 2 weeks, followed by one insert 2 times a week (every 3 to 4 days). Your doctor may adjust your dose as needed.
      • Children—Use is not recommended.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Wrap the used vaginal ring in tissue or toilet paper and throw it in the trash can. Do not flush it down the toilet.

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Portions of this document last updated: April 01, 2024

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