Vivelle Dot (Estradiol-17B)

Vivelle-Dot (Estradiol Transdermal System) Medication Information

Uses

Vivelle-Dot is a prescription transdermal system (patch) that contains the medication estradiol, a form of estrogen.  

Vivelle-Dot may be used after menopause for the following purposes:

• Reduce moderate to severe hot flashes.  Hot flashes can happen when estrogen levels drop due to menopause (the end of menstrual periods).
• Treatment of moderate to severe vaginal atrophy.  With vaginal atrophy, the walls of the vagina may become thin, dry, and irritated, and can make sex painful.
• Reduce your chance of osteoporosis (thinning, weak bones).

Vivelle-Dot may also be prescribed before menopause in women with certain medical conditions.

Dosage

Vivelle-Dot is a patch that releases a type of estrogen (estradiol) into the skin over 3 to 4 days.  It comes in packs of 8 patches and is available in five different strengths:

• 0.025 mg per day
• 0.0375 mg per day
• 0.05 mg per day
• 0.075 mg per day
• 0.1 mg per day

Change your Vivelle-Dot patch two times a week or exactly as instructed by your doctor.  

The Vivelle-Dot package has a calendar to help you keep track of the two days per week that you will change your patch.

Precautions

Vivelle-Dot contains a form of estrogen, which may have serious health risks.

Vivelle-Dot may not be safe for women with certain conditions.  Before using Vivelle-Dot, be sure to tell your doctor if you’ve had:

• Unusual vaginal bleeding
• Stroke or heart attack
• Cancer
• Blood clots or bleeding problems
• Liver problems
• Upcoming surgery
• Allergic reaction to Vivelle-Dot or its ingredients

Side Effects

Vivelle-Dot has the potential for common, mild side effects but could also cause rare, severe side effects.

Less serious but common side effects include:

•  Headache
•  Breast pain
•  Irregular vaginal bleeding or spotting
•  Abdominal bloating or discomfort
•  Nausea and vomiting
•  Hair loss
•  Skin irritation 

Some serious side effects of Vivelle-Dot may rarely occur.*  A few examples include:

• Heart attack
• Stroke
• Blood clots
• Dementia
• Breast, uterine, or ovarian cancer
• High blood pressure

For more information on the possible side effects of Vivelle-Dot, talk with your doctor or pharmacist.

*See the FAQ section below for information on how to reduce your chances of severe side effects.

Interactions

Some drug interactions can happen with products that replace estrogen.  These interactions could increase the risk of side effects. A few examples include:

• Clarithromycin
• Ketoconazole
• Ritonavir

Grapefruit and grapefruit juice can also increase the risk of side effects and should be avoided.

Talk with your doctor or pharmacist before taking any other medications or herbal supplements with Vivelle-Dot.

Storage

Store Vivelle-Dot in its original packaging at room temperature (77°F or 25°C). 

Pharmacists Tips

• Apply Vivelle-Dot to clean, dry skin on your lower abdomen or buttocks. The skin must be free of any lotions or oils for the patch to stick.
• When you change your patch, don’t use the same exact spot.  Choose a different area each time to reduce your chance of your skin irritation.
• Avoid placing Vivelle-Dot patches on the waistline because clothes may rub or loosen the patch.

Vivelle-Dot FAQs

Will Vivelle-Dot come off in the shower or swimming pool?

It shouldn’t.  Vivelle-Dot usually stays on while bathing or swimming.  If your patch falls off, reapply it.  If you cannot reapply the same patch, apply a new one to a different spot, then continue your regular schedule.

What can I do to prevent serious side effects from Vivelle-Dot?

Talk with your doctor regularly about whether or not you should continue using Vivelle-Dot.  You must get preventative screenings and do your part to support your health.

• Keep your regular doctor visits, including all pelvic exams and mammograms.
• Talk with your doctor about ways to reduce your heart disease risk, such as controlling your blood pressure, cholesterol, and weight.
• If you smoke, quit or ask your doctor for help quitting. 
• If your hot flashes are mild and you use Vivelle-Dot to treat vaginal symptoms, talk with your doctor about whether a different product would be safer for you.

What should I do if I forget to change my Vivelle-Dot patch?

If you forget to change your patch, apply a new one as soon as you remember.  Then, continue your normal schedule.  There is no need to reset the day that you change your next patch.

Related Drugs

• Climara
• Combipatch
• Divigel
• Estring
• Premarin Vaginal Cream
• Premarin
• Prempro
• Vagifem

References

1. Vivelle-Dot Prescribing Information.  East Hanover, NJ: Novartis Pharmaceuticals Corporation; 2017.  https://www.novartis.us/sites/www.novartis.us/files/Vivelle_DOT.pdf, Accessed December 2, 2020
2. Facts about menopausal hormone therapy. National Heart, Lung, and Blood Institute; 2005. https://www.nhlbi.nih.gov/files/docs/pht_facts.pdf Accessed December 3, 2020.