Proper Use

Drug information provided by: Merative, Micromedex®

It is very important that you use this medicine only 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 for use on the skin only. Do not get it in your eyes, nose, mouth, breast, or vagina. Do not use it on skin areas that have cuts, scrapes, or burns. If it does get on these areas, rinse it off right away with water.

This medicine comes with a patient information insert and patients instructions. Read and follow the instructions in the insert carefully. Ask your doctor if you have any questions.

Wash your hands with soap and water before and after using this medicine.

To use the patch:

  • Wash your hands with soap and water before and after you use this medicine.
  • Carefully tear open the pouch when you are ready to put the patch on your skin. Do not cut it.
  • Peel off the backing from the patch and apply the patch to a clean, dry, and hair-free area of the lower stomach or upper buttock area. This area must be free of powder, oil, or lotion for the patch to stick on to your skin.
  • Press the patch firmly in place with your hand for about 10 seconds.
  • Do not apply the patch on the breast or over any skin folds. Do not apply the patch on oily, broken, burned, or irritated skin, or areas with skin conditions (eg, birth marks, tattoos). Avoid applying the patch on the waistline or other places where tight clothing may rub it off.
  • Wear the patch at all times until it is time to put on a new patch. Do not expose it to the sun for long periods of time.
  • When replacing your patch, make sure to apply the new patch to a different area of your lower abdomen. Wait at least 1 week before applying a patch to the same area.
  • When changing a patch, slowly peel it off from your skin. If you have any patch adhesive left on your skin, allow it to dry for 15 minutes and gently rub the sticky area with oil or lotion to remove it. It is best to change your patch on the same days of each week to help you remember.
  • You may take a bath, shower, or swim while using this medicine. Doing so will not affect the patch.
  • If a patch falls off, just put it back on a different area. If the patch does not stick completely, put on a new patch but continue to follow your original schedule for changing your patch.
  • To throw away a used patch: Fold the patch in half with the sticky side together and place it in a sturdy child-proof container. Throw this container in the trash away from children and pets. Do not flush the patch down the toilet.

To use the spray:

  • The spray form of this medicine comes in an applicator that delivers a measured amount of estradiol to the skin with each spray. When using a new spray applicator, prime the pump by holding the spray upright and pumping 3 times. Priming is only necessary the first time you use a new spray applicator. Do not prime again.
  • Apply the medicine to clean, dry, and unbroken skin on the inside of the forearm between the elbow and the wrist. Do not apply to open wounds, cuts, abrasions, or rashes. Do not apply the medicine directly to your breasts or in or around the vagina.
  • Allow the medicine to dry for at least 2 minutes before dressing, and at least 1 hour before washing.
  • If your doctor tells you to increase your dose, move the applicator to an area of the skin next to your previous application site, before applying the second or third spray.
  • Do not massage or rub Evamist® spray into your skin.
  • Do not allow your child to touch the area of the arm where the medicine was sprayed. If you cannot avoid being close with your child, wear clothes with long sleeves to cover the application site.
  • If your child comes in direct contact with the arm where the medicine was sprayed, wash your child's skin right away with soap and water.
  • Do not allow your pets to lick or touch the arm where the medicine was sprayed.
  • Always place the protective cover back on the applicator of the spray.
  • Do not use the applicator for more than 56 sprays even though the bottle may not be fully empty. You may not get the correct dose.
  • Apply sunscreen at least 1 hour before applying Evamist®.

To use the gel:

  • The gel form of this medicine comes in a pump. Each time you press the pump you will get the same amount of medication. You may need to prime the pump by pumping 5 times (EstroGel®) or 10 times (Elestrin™) the first time you use it. Follow the patient instructions for the container you use. After you prime the pump, do not press the pump more than 1 time each time you use it.
  • Apply the gel to clean, dry, and unbroken skin. Apply EstroGel® after your bath or shower. If you go swimming. try to leave as much time as possible between using EstroGel® and going swimming. Spread the gel as thinly as possible over the entire area on the inside and outside of your upper arm from your wrist to your shoulder area. Do not apply the medicine directly to your breasts or in or around your vagina. Do not massage or rub in EstroGel®.
  • Do not allow others to come in contact with the area of skin where you applied the gel for at least 1 hour after you use the medicine. Do not allow others to apply the gel for you. Allow the medicine to dry for at least 5 minutes before you get dressed.
  • Do not use EstroGel® for more than 30 doses even the canister may not be fully empty. You may not get the correct dose.
  • Apply sunscreen at least 25 minutes after using the gel. Avoid applying sunscreen on the same application site for 7 days or more.

The gel and spray contain alcohol and are flammable. Avoid using it near an open flame or while smoking.

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 hot flashes and other symptoms caused by menopause:
    • For transdermal dosage form (gel):
      • Adults—
        • Elestrin™: Apply one dose (0.87 grams) of the gel to the upper arm once a day. Your doctor may adjust your dose as needed.
        • EstroGel®: Apply one dose (1.25 grams) of the gel to the arm once a day. Your doctor may adjust your dose as needed.
      • Children—Use is not recommended.
    • For transdermal dosage form (patch):
      • Adults—
        • Climara®: At first, apply one patch (0.025 milligrams (mg)) to the lower stomach or upper buttocks area once a week. Your doctor may adjust your dose as needed.
        • Minivelle® and Vivelle-Dot®: At first, apply one patch (0.0375 milligrams (mg)) to the lower stomach or upper buttocks area 2 times a week (every 3 to 4 days). Your doctor may adjust your dose as needed.
      • Children—Use is not recommended.
    • For transdermal dosage form (spray):
      • Adults—At first, one spray once a day, usually in the morning. Your doctor may adjust your dose as needed.
      • Children—Use is not recommended.
  • For prevention of osteoporosis after menopause:
    • For transdermal dosage form (patch):
      • Adults—
        • Climara®: At first, apply one patch (0.025 milligrams (mg)) to the lower stomach or upper buttock area once a week. Your doctor may adjust your dose as needed.
        • Minivelle® and Vivelle-Dot®: At first, apply one patch (0.025 milligrams (mg)) to the lower stomach or upper buttock area 2 times a week (every 3 to 4 days). Your doctor may adjust your dose as needed.
      • Children—Use is not recommended.
  • For the treatment of low estrogen levels:
    • For transdermal dosage form (patch):
      • Adults—At first, apply one patch (0.025 milligrams (mg)) to the lower stomach or upper buttock area once a week. Your doctor may adjust your dose as needed.
      • Children—Use is not recommended.

Missed Dose

If you forget to wear or change a patch, put one on as soon as you can. If it is almost time to put on your next patch, wait until then to apply a new patch and skip the one you missed. Do not apply extra patches to make up for a 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.

Do not use Evamist® spray if it has been more than 12 hours since you missed your last dose.

Storage

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

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.

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Portions of this document last updated: April 01, 2024

Copyright: © Merative US L.P. 1973, 2024. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.