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Generic Name: estradiol transdermal (ess tra DY ol tranz DERM al)
Brand Names: Alora, Climara, Esclim, Estraderm, Fempatch, Menostar, Vivelle, Vivelle-Dot

Climara : Important Information

• Do not use Climara if you suffer from any of the following conditions: a history of stroke or blood clot, circulation problems, a bleeding disorder, a hormone-related cancer such as breast or uterine cancer, or abnormal vaginal bleeding.
• Climara can cause birth defects in an unborn baby. Do not use if you are pregnant. Use an effective form of birth control and tell your doctor if you become pregnant during treatment.
• Estradiol increases your risk of developing endometrial hyperplasia, a condition that may lead to cancer of the uterus. Taking progestins while using estradiol may lower this risk. If your uterus has not been removed, your doctor may prescribe a progestin for you to take while you are using Climara.
• Long-term estradiol treatment may increase your risk of breast cancer, heart attack, or stroke. Talk to your doctor about your individual risks before using estradiol long-term. Your doctor should check your progress on a regular basis (every 3 to 6 months) to determine whether you should continue this treatment.
• Have regular physical exams and self-examine your breasts for lumps on a monthly basis while using Climara.

What is Climara?

• Estradiol is a form of estrogen, a female sex hormone, that regulates many processes in the body.
• Climara skin patches are used to treat certain symptoms of menopause such as dryness, burning, and itching of the vaginal area. Climara also reduces urgency or irritation of urination. Estradiol skin patches are also used to treat ovarian disorders, infertility, and abnormal vaginal bleeding. Some estradiol skin patches are used to prevent postmenopausal osteoporosis. Transdermal skin patches release the drug slowly, and it is absorbed through your skin.
• Climara may also be used for purposes other than those listed in this medication guide.

What to Discuss before Using Climara  

• Do not use Climara if you have:
  • a bleeding or blood-clotting disorder
  • a history of stroke or circulation problems
  • abnormal vaginal bleeding that a doctor has not checked or
  • any type of breast, uterine, or hormone-dependent cancer
• Before using Climara, tell your doctor if you have:
  • high blood pressure, angina, or heart disease
  • high cholesterol or triglycerides
  • liver disease
  • kidney disease
  • asthma
  • epilepsy or other seizure disorder
  • migraines
  • diabetes
  • depression
  • gallbladder disease or
  • if you have had your uterus removed (hysterectomy).
• If you have any of these conditions, you may not be able to use Climara, or you may need a dosage adjustment or special tests during treatment
• Estradiol increases your risk of developing endometrial hyperplasia, a condition that may lead to cancer of the uterus. Taking progestins while using estradiol may lower this risk. If your uterus has not been removed, your doctor may prescribe a progestin for you to take while you are using Climara.
• Long-term estradiol treatment may increase your risk of stroke. Consult your doctor about your individual risks before using estradiol long-term. Your doctor should check your progress on a regular basis (every 3 to 6 months) to determine whether you should continue this treatment.
• FDA pregnancy category X: This medication can cause birth defects. Do not use Climara if you are pregnant. Tell your doctor right away if you become pregnant during treatment. Use an effective form of birth control while you are using this medication. Estradiol can pass into breast milk and may harm a nursing baby. This medication may also slow breast milk production. Do not use if you are breast-feeding a baby.

Climara Dosage Method

• Use Climara exactly as it was prescribed to you. Do not use the medication in larger amounts, or use it for longer than recommended by your doctor. Follow the instructions on your prescription label.
• Apply the skin patch to clean, dry skin on your stomach, lower back, or buttocks. Choose a different spot within these skin areas each time you apply a new patch. Avoid skin that is oily, irritated, or damaged
• Press the patch in place firmly for about 10 seconds, especially around the edges.
• Do not apply a skin patch to your breasts. Do not apply a patch where it might be rubbed off by tight clothing, such as under an elastic waistband.
• If a patch falls off, try putting it back on to a different skin area, pressing the patch into place for 10 seconds. If the patch will not stick, you may apply a new one.
• Have regular physical exams and self-examine your breasts for lumps on a monthly basis while using Climara.
• Store this medication at room temperature away from moisture and heat.

Miss a dose: Problems?

Apply a skin patch as soon as you remember. If it is almost time to apply your next patch, skip the missed dose and apply the patch at the next regularly scheduled time. Do not use extra patches to make up the missed dose.

Climara Overdose?

• Seek emergency medical attention if you think you have used too much of this medicine. Symptoms of Climara overdose may include nausea, vomiting, and vaginal bleeding.

Avoid During Treatment

• Avoid using other vaginal products without your doctor's advice.

Climara Side Effects

• Get emergency medical help if you notice any of these signs of an allergic reaction: hives, difficulty in breathing, swelling of your face, lips, tongue, or throat.
• Call your doctor at once if you have any of these serious side effects:
  • 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 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) or
  • a lump in your breast
• Other less serious side effects are more likely to occur, are:
  • 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
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs to avoid while undergoing treatment

• Before using Climara, tell your doctor if you are using any of the following drugs:
  • St. John's wort
  • phenobarbital (Luminal, Solfoton)
  • a blood thinner such as warfarin (Coumadin)
  • ritonavir (Norvir)
  • carbamazepine (Carbatrol, Tegretol)
  • rifampin (Rifadin, Rifater, Rifamate, Rimactane) or
  • Antibiotics such as clarithromycin (Biaxin), erythromycin (E-Mycin, E.E.S., Erythrocin, Ery-Tab), ketoconazole (Nizoral), or itraconazole (Sporanox)

If you are using any of these drugs, you may not be able to use Climara or you may need dosage adjustments or undergo special tests during treatment.

There may be other drugs not listed that can affect Climara. Tell your doctor about all the prescriptions and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without informing your doctor.

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