Estraderm is a prescription medication used to treat symptoms of menopause including hot flashes and vaginal dryness. It is used to treat conditions in which a woman's ovaries do not produce enough estrogen naturally (hypoestrogenism). It is also used to help prevent osteoporosis after menopause. 

Estraderm contains estradiol, which is a form of the hormone estrogen. It replaces estrogen that is not naturally produced by the ovaries.

This medication comes as a transdermal patch. It is usually applied twice a week. 

Common side effects of Estraderm include redness and irritation at the application site. 

Estraderm is a prescription medication used to treat symptoms of menopause including hot flashes and vaginal dryness. It is used to treat conditions in which a woman's ovaries do not produce enough estrogen naturally (hypoestrogenism). It is also used to help prevent osteoporosis after menopause. 

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

• Novartis Pharmaceuticals Corporation

Serious side effects have been reported with Estraderm. See the “Estraderm Precautions” section.

Common side effects of Estraderm include the following:

• Redness and irritation at the application site
• Headache
• Breast Pain
• Irregular Vaginal Bleeding or Spotting
• Stomach/Abdominal Cramps, Bloating
• Nausea and Vomiting
• Hair Loss

This is not a complete list of Estraderm side effects. Ask your doctor or pharmacist for more information.

Tell your doctor if you have any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• Amiodarone (Cordarone, Pacerone)
• Antifungals such as itraconazole (Sporanox) and ketoconazole (Nizoral)
• Aprepitant (Emend)
• Carbamazepine (Carbatrol, Epitol, Tegretol)
• Cimetidine (Tagamet)
• Clarithromycin (Biaxin)
• Cyclosporine (Neoral, Sandimmune)
• Dexamethasone (Decadron, Dexpak)
• Diltiazem (Cardizem, Dilacor, Tiazac, others)
• Erythromycin (E.E.S, Erythrocin)
• Fluoxetine (Prozac, Sarafem)
• Fluvoxamine (Luvox)
• Griseofulvin (Fulvicin, Grifulvin, Gris-PEG)
• Lovastatin (Altocor, Mevacor)
• Medications for human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) such as atazanavir (Reyataz), delavirdine (Rescriptor), efavirenz (Sustiva), indinavir (Crixivan), lopinavir (in Kaletra), nelfinavir (Viracept), nevirapine (Viramune), ritonavir (Norvir, in Kaletra), and saquinavir (Fortovase, Invirase)
• Medications for thyroid disease
• Nefazodone
• Other medications that contain estrogen
• Phenobarbital
• Phenytoin (Dilantin, Phenytek); rifabutin (Mycobutin)
• Rifampin 
• Sertraline (Zoloft)
• Troleandomycin (TAO)
• Verapamil (Calan, Covera, Isoptin, Verelan)
• Zafirlukast (Accolate)
• St. John's Wort

This is not a complete list of Estraderm drug interactions. Ask your doctor or pharmacist for more information.

Serious side effects have been reported with Estraderm including the following:

• bulging eyes
• yellowing of the skin or eyes
• itching
• loss of appetite
• fever
• joint pain
• stomach tenderness, pain, or swelling
• movements that are difficult to control
• hives
• rash or blisters on the skin
• swelling, of the eyes, face, lips, tongue, throat, hands, feet, ankles, or lower legs
• hoarseness
• wheezing
• difficulty breathing or swallowing

Do not use Estraderm if you:

• are allergic to Estraderm or to any of its ingredients
• have abnormal vaginal bleeding
• have a known or suspected history of breast cancer
• have a known or suspected estrogen-dependent cancer
• currently have or have a history of blood clots
• had a stroke or heart attack in the recent past (for example in the past year).
• have liver disease
• are pregnant or possibly pregnant

Grapefruit and grapefruit juice may interact with Estraderm and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor.

Before taking Estraderm, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to Estraderm or to any of its ingredients
• have or have ever had asthma
• have seizures
• have migraine headaches
• have a known or suspected history of breast cancer
• have a known or suspected estrogen-dependent cancer
• currently have or have a history of blood clots
• had a stroke or heart attack in the recent past (for example in the past year).
• have endometriosis (a condition in which the type of tissue that lines the uterus [womb] grows in other areas of the body)
• have uterine fibroids (growths in the uterus that are not cancer)
• have or have had yellowing of the skin or eyes, especially during pregnancy or while you were using an estrogen product
• have very high or very low levels of calcium in your blood
• have porphyria (condition in which abnormal substances build up in the blood and cause problems with the skin or nervous system) or gallbladder, thyroid, pancreas, liver or kidney disease
• are pregnant or breastfeeding

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

Estraderm should not be used during pregnancy. There appears to be little or no increased risk of birth defects in children born to women who inadvertently used estrogens during early pregnancy. Talk to your doctor right away if you become pregnant while taking Estraderm.

Tell your doctor if you are breastfeeding or plan to breastfeed.

Estrogen can decrease the quality or quantity of breast milk. Caution should be taken when Estraderm is given to a nursing women. 

Use Estraderm exactly as prescribed.

This medication is available as a transdermal patch. It is usually applied twice a week. 

•  Apply the adhesive side of the system to a clean, dry area of the skin on the trunk of the body (including the buttocks and abdomen). The site selected should be one that is not exposed to sunlight. Some women may find that it is more comfortable to wear Estraderm on the buttocks. 
• Do not apply Estraderm to your breasts. 
• Rotate the application sites, with an interval of at least 1 week allowed between applications to a particular site. The area selected should not be oily, damaged, or irritated.
• Avoid the waistline, since tight clothing may rub the system off.
• Apply the system immediately after opening the pouch and removing the protective liner.
• Press the system firmly in place with the palm of your hand for about 10 seconds, making sure there is good contact, especially around the edges.
• Wear the Estraderm system continuously until it is time to replace it with a new system.
• You may wish to experiment with different locations when applying a new system, to find ones that are most comfortable for you and where clothing will not rub on the system.

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The dose your doctor recommends may be based on the following:

• the condition being treated
• other medical conditions you have
• other medications you are taking
• how you respond to this medication

Estraderm is currently available in two dosage forms – 0.05 mg and 0.1 mg. Patients should be started at the lowest dose. 

The recommended starting dose of Estraderm (estradiol) transdermal patches for the treatment of menopause symptoms is 0.05 applied to the skin twice weekly.

The recommended starting dose of Estraderm (estradiol) transdermal patches for the prevention of osteoporosis in women after menopause is 0.05 mg/day dosage as soon as possible after menopause. The dosage may be adjusted if necessary. 

If you use too much Estraderm, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

If Estraderm is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

Keep this and all medicines out of the reach of children.

ESTROGENS INCREASE THE RISK OF ENDOMETRIAL CANCER.

Close clinical surveillance of all women taking estrogens is important. Adequate diagnostic measures, including endometrial sampling when indicated, should be undertaken to rule out malignancy in all cases of undiagnosed persistent or recurring abnormal vaginal bleeding. There is no evidence that the use of “natural” estrogens results in a different endometrial risk profile than synthetic estrogens at equivalent estrogen doses. (See WARNINGS, Malignant Neoplasms,Endometrial Cancer.)

CARDIOVASCULAR AND OTHER RISKS

Estrogens and progestins should not be used for the prevention of cardiovascular disease or dementia. 

The Women’s Health Initiative (WHI) study reported increased risks of myocardial infarction, stroke, invasive breast cancer, pulmonary emboli, and deep vein thrombosis in postmenopausal women (50 to 79 years of age) during 5 years of treatment with oral conjugated estrogens (CE 0.625 mg) combined with medroxyprogesterone acetate (MPA 2.5 mg) relative to placebo (see CLINICAL PHARMACOLOGY, Clinical Studies).

The Women’s Health Initiative Memory Study (WHIMS), a substudy of WHI, reported increased risk of developing probable dementia in postmenopausal women 65 years of age or older during 4 years of treatment with oral conjugated estrogens plus medroxyprogesterone acetate relative to placebo. It is unknown whether this finding applies to younger postmenopausal women. 

Other doses of oral conjugated estrogens with medroxyprogesterone acetate, and other combinations and dosage forms of estrogens and progestins were not studied in the WHI clinical trials and, in the absence of comparable data, these risks should be assumed to be similar. Because of these risks, estrogens with or without progestins should be prescribed at the lowest effective doses and for the shortest duration consistent with treatment goals and risks for the individual woman.