What is VIVELLE DOT?
VIVELLE DOT is a female hormone usually given to women who no longer are able to produce the proper amount of hormones such as estrogen. It can help control moderate to severe symptoms of menopause, including hot flashes, night sweats, vaginal dryness and atrophy. VIVELLE DOT also helps reduce the risk of postmenopausal osteoporosis, which is a major health concern for women after menopause.

Is There a Generic for VIVELLE DOT?
Generic Name: ESTRADIOL (es-tra-DYE-ol)
All generic medications are approved by the U.S. Food and Drug Administration (FDA) before they can be prescribed or sold over-the-counter. According to the FDA, it must use the same active ingredient as the brand name drug and it must meet the same quality and safety standards. Additionally, the FDA requires that a generic drug be the same as a brand name drug in dosage, safety, strength, the way it works, the way it is taken and intended use.
The only differences between generics and their brand-name counterparts are that generics are less expensive because it does not incur the costs of research and development of the drug. The medication may also look slightly different, as trademarks laws prevent generic medications from looking exactly like the brand-name drug.
Note: The generic VIVELLE DOT patches are larger and oval in shape.

Why Should I Use VIVELLE DOT?
The following are benefits for using VIVELLE DOT.

• #1 prescribed brand-name bioidentical estrogen therapy
• help you control your moderate to severe hot flashes, night sweats, and vaginal dryness and atrophy associated with menopause
• helps protect your bones from postmenopausal osteoporosis (thin, weak bones).
• easy to use - translucent patch is the smallest, most discreet patch available. And it sticks with you — during exercise, in the shower, even in the pool
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Talk to your doctor and see if VIVELLE DOT is right for you.

Before You Start Using VIVELLE DOT
All estrogen therapies carry risk because they can increase the chances of getting cancer of the uterus (womb). You should report any unusual vaginal bleeding right away while you are taking estrogens. Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb).
Do not use estrogens (with or without progestins) to prevent heart disease, heart attacks or strokes. Using estrogens (with or without progestins) may increase your chances of getting heart attacks, strokes, breast cancer, and blood clots. Using estrogens may increase your risk of dementia (decline in memory and thinking skills).
VIVELLE DOT (estrogen therapy) should not be used if you:

• are allergic to CombiPatch or any of its ingredients
• have unusual vaginal bleeding
• currently have or have had certain cancers, including cancer of the breast or uterus
• had a stroke or heart attack in the recent past (for example, in the past year)
• currently have or have had blood clots
• currently have or have had liver problems
• may be pregnant

To make sure you can safely use VIVELLE DOT, tell your doctor if you have any of these other conditions:

• high blood pressure, angina, or heart disease
• high cholesterol
• liver disease
• kidney disease
• asthma
• epilepsy or other seizure disorder
• migraines
• diabetes
• depression
• gallbladder disease
• if you have had your uterus removed (hysterectomy)

What Are the Possible Side Effects of VIVELLE DOT?
All medications may cause side effects, but usually patients have no, or minor, side effects. Common side effects of VIVELLE DOT may include:

• headaches
• breast tenderness
• back pain

Less serious side effects may include:

• nausea, vomiting, loss of appetite;
• swollen breasts;
• acne or skin color changes;
• decreased sex drive, impotence, or difficulty having an orgasm;
• migraine headaches or dizziness;
• vaginal pain, dryness, or discomfort;
• swelling of your ankles or feet;
• depression; or
• changes in your menstrual periods, break-through bleeding

Serious side effects may include:

• chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling
• sudden numbness or weakness, especially on one side of the body
• sudden severe headache, confusion, problems with vision, speech, or balance
• pain or swelling in your lower leg
• abnormal vaginal bleeding
• pain, swelling, or tenderness in your stomach
• jaundice (yellowing of the skin or eyes)
• a lump in your breast

Dose of VIVELLE DOT
The dosage for VIVELLE DOT will be different for each patient. Closely follow the directions on the label. If your dose is different, do not change it unless your doctor tells you to do so. The amount of medication 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

Storage of VIVELLE DOT

• Store VIVELLE DOT in a closed container at room temperature, away from heat, moisture, and direct light
• 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

What Happens If I Miss a Dose of VIVELLE DOT?

If you forget to wear or change a VIVELLE DOT 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.

What Happens If I Overdose?
If overdose is suspected, contact a poison control center or emergency room immediately.

• US residents can call the US National Poison Hotline at 1-800-222-1222
• Canada residents can call a provincial poison control center