Sandrena Gel (℞)
0.1% (0.5mg) Gel
(℞) Prescription required. Product of UK/EU. Shipped from United Kingdom. Divigel is also marketed internationally under the name Sandrena Gel.
0.1% (0.25mg) Gel
(℞) Prescription required. Product of Canada. Shipped from Canada.
To comply with Canadian International Pharmacy Association regulations you are permitted to order a 3-month supply or the closest package size available based on your personal prescription. read more
(es tra dye' ole)Estradiol increases the risk that you will develop endometrial cancer (cancer of the lining of the uterus [womb]). The longer you use estradiol, the greater the risk that you will develop endometrial cancer. If you have not had a hysterectomy (surgery to remove the uterus), you should be given another medication called a progestin to take with transdermal estradiol. This may decrease your risk of developing endometrial cancer but may increase your risk of developing certain other health problems, including breast cancer. Before you begin using transdermal estradiol, tell your doctor if you have or have ever had cancer and if you have unusual vaginal bleeding. Call your doctor immediately if you have abnormal or unusual vaginal bleeding during your treatment with transdermal estradiol. Your doctor will watch you closely to help ensure you do not develop endometrial cancer during or after your treatment. In a large study, women who took estrogens (a group of medications that includes estradiol) by mouth with progestins had a higher risk of heart attacks, strokes, blood clots in the lungs or legs, breast cancer, and dementia (loss of ability to think, learn, and understand). Women who use transdermal estradiol alone or with progestins may also have a higher risk of developing these conditions. Tell your doctor if you smoke or use tobacco, if you have had a heart attack or a stroke in the past year, and if you or anyone in your family has or has ever had blood clots or breast cancer. Also tell your doctor if you have or have ever had high blood pressure, high blood levels of cholesterol or fats, diabetes, heart disease, lupus ( a condition in which the body attacks its own tissues causing damage and swelling), breast lumps, or an abnormal mammogram (x-ray of the breast used to find breast cancer). The following symptoms can be signs of the serious health conditions listed above. Call your doctor immediately if you experience any of the following symptoms while you are using transdermal estradiol: sudden, severe headache; sudden, severe vomiting; speech problems; dizziness or faintness; sudden complete or partial loss of vision; double vision; weakness or numbness of an arm or a leg; crushing chest pain or chest heaviness; coughing up blood; sudden shortness of breath; difficulty thinking clearly, remembering, or learning new things; breast lumps or other breast changes; discharge from nipples; or pain, tenderness, or redness in one leg. You can take steps to decrease the risk that you will develop a serious health problem while you are using transdermal estradiol. Do not use transdermal estradiol alone or with a progestin to prevent heart disease, heart attacks, strokes, or dementia. Use the lowest dose of transdermal estradiol that controls your symptoms and only use transdermal estradiol as long as needed. Talk to your doctor every 3 to 6 months to decide if you should use a lower dose of transdermal estradiol or should stop using the medication. You should examine your breasts every month and have a mammogram and a breast exam performed by a doctor every year to help detect breast cancer as early as possible. Your doctor will tell you how to properly examine your breasts and whether you should have these exams more often than once a year because of your personal or family medical history. Tell your doctor if you are having surgery or will be on bedrest. Your doctor may tell you to stop using transdermal estradiol 4 to 6 weeks before the surgery or bedrest to decrease the risk that you will develop blood clots. Talk to your doctor regularly about the risks and benefits of using transdermal estradiol.
- Tear open the pouch with your fingers. Do not use scissors because they may damage the patch. Do not open the pouch until you are ready to apply the patch.
- Remove the patch from the pouch. There may be a silver foil sticker used to protect the patch from moisture inside the pouch. Do not remove this sticker from the pouch.
- Remove the protective liner from the patch and press the sticky side of the patch against your skin in the area you have chosen to wear your patch. Some patches have a liner that is made to peel off in two pieces. If your patch has that type of liner, you should peel off one part of the liner and press that side of the patch against your skin. Then fold back the patch, peel off the other part of the liner and press the second side of the patch against your skin. Always be careful not to touch the sticky side of the patch with your fingers.
- Press down on the patch with your fingers or palm for 10 seconds. Be sure that the patch is firmly attached to your skin, especially around its edges.
- Wear the patch all the time until it is time to remove it. When it is time to remove the patch, slowly peel it off of your skin. Fold the patch in half so that the sticky sides are pressed together and dispose of it safely, so that is out of reach of children and pets.
- Some brands of patches may leave a sticky substance on your skin. In some cases, this can be rubbed off easily. In other cases, you should wait 15 minutes and then remove the substance using an oil or lotion. Read the information that came with your patches to find out what to do if a substance is left on your skin after you remove your patch.
Before using transdermal estradiol,
- tell your doctor and pharmacist if you are allergic to any brand of transdermal estradiol, any other estrogen products, any other medications, or any adhesives. Ask your doctor or pharmacist if you are not sure if a medication you are allergic to contains estrogen.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take. Be sure to mention any of the following: 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), delaviridine (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 (Rifadin, Rimactane, in Rifamate); sertraline (Zoloft);troleandomycin (TAO); verapamil (Calan, Covera, Isoptin, Verelan); and zafirlukast (Accolate). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor what herbal products you are taking, especially St. John's wort.
- tell your doctor if you have or have ever had asthma; seizures; migraine headaches; endometriosis (a condition in which the type of tissue that lines the uterus [womb] grows in other areas of the body); uterine fibroids (growths in the uterus that are not cancer); yellowing of the skin or eyes, especially during pregnancy or while you were using an estrogen product; very high or very low levels of calcium in your blood; 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.
- tell your doctor if you are pregnant or plan to become pregnant, or are breast-feeding. If you become pregnant while using transdermal estradiol, call your doctor.
- if you are using transdermal estradiol to prevent osteoporosis, talk to your doctor about additional ways to prevent the disease such as exercising and taking vitamin D and/or calcium supplements.
- breast pain or tenderness
- weight gain or loss
- hair loss
- redness or irritation of the skin that was covered by the estradiol patch
- swelling, redness, burning, irritation or itching of the vagina
- vaginal discharge
- painful menstrual periods
- changes in mood
- change in sexual desire
- back, neck, or muscle pain
- runny nose or congestion
- darkening of skin on face (may not go away even after you stop using transdermal estradiol)
- unwanted hair growth
- difficulty wearing contact lenses
- bulging eyes
- yellowing of the skin or eyes
- loss of appetite
- joint pain
- stomach tenderness, pain, or swelling
- movements that are difficult to control
- rash, blisters on skin, or other skin changes
- swelling, of the eyes, face, lips, tongue, throat, hands, feet, ankles, or lower legs
- difficulty breathing or swallowing