Climara

Generic Name: estradiol transdermal (ES tra DYE ole tranz DERM al)
Brand Names: Alora, Climara, Estraderm, Estradiol Patch, Menostar, Vivelle, Vivelle-Dot

What is Climara?

Climara is a skin patch that contains estradiol, a form of estrogen. Estradiol is a female sex hormone that regulates many processes in the body.

Climara transdermal skin patches are used to treat certain symptoms of menopause such as hot flashes, and vaginal dryness, burning, and irritation. Climara is also used to prevent postmenopausal osteoporosis, or to treat ovarian disorders.

Climara skin patches may also be used for purposes not listed in this medication guide.

Important information about Climara

Estradiol can harm an unborn baby or cause birth defects. Do not use if you are pregnant. You should not use Climara if you have any of the following conditions: liver disease, a bleeding disorder, unusual vaginal bleeding, a history of breast or uterine cancer, or if you have ever had a heart attack, stroke, or a blood clot.

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Climara may increase your risk of developing a condition that may lead to uterine cancer. Your doctor may prescribe a progestin while you are using Climara, to help lower this risk. Report any unusual vaginal bleeding right away.

Long-term use of estradiol may increase your risk of breast cancer, heart attack, stroke, or blood clot. Talk with your doctor about your individual risks before using Climara long term.

Have regular physical exams and self-examine your breasts for lumps on a monthly basis while using Climara.

Climara should not be used to prevent heart disease, stroke, or dementia, because this medicine may actually increase your risk of developing these conditions.

Before using Climara

You should not use Climara if you are allergic to estradiol, if you are pregnant, or if you have:

• liver disease;

• a bleeding or blood-clotting disorder;

• a history of heart attack, stroke, or blood clot;

• unusual vaginal bleeding that a doctor has not checked; or

• any type of breast, uterine, or hormone-dependent cancer.

To make sure you can safely use Climara, tell your doctor about all of your medical conditions, especially:

• heart disease;

• risk factors for coronary artery disease (such as diabetes, smoking, being overweight, having high blood pressure or high cholesterol, having a family history of coronary artery disease, or if you have had a hysterectomy);

• hereditary angioedema (an immune system disorder);

• a history of jaundice caused by pregnancy or birth control pills;

• a thyroid disorder;

• kidney disease;

• asthma;

• epilepsy or other seizure disorder;

• migraines;

• endometriosis or uterine fibroid tumors;

• lupus;

• gallbladder disease; or

• high levels of calcium in your blood.

Estradiol may increase your risk of developing a condition that may lead to uterine cancer. Your doctor may prescribe a progestin to take while you are using estradiol, to help lower this risk. Report any unusual vaginal bleeding right away. Long-term use of estradiol may increase your risk of breast cancer, heart attack, stroke, or blood clot. Talk with your doctor about your individual risks before using Climara patches long term.

FDA pregnancy category X. Climara can harm an unborn baby or cause birth defects. Do not use Climara patches if you are pregnant. Tell your doctor right away if you become pregnant during treatment. Use effective birth control while you are using the Climara patch. 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.

See also: Climara pregnancy and breastfeeding warnings (in more detail)

How should I use Climara?

Use Climara exactly as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Apply the Climara 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 Climara patch in place firmly for about 10 seconds, especially around the edges.

Do not apply a Climara 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.

If you need surgery or medical tests or if you will be on bed rest, you may need to stop using this medication for a short time. Any doctor or surgeon who treats you should know that you are using Climara.

Your doctor should check your progress on a regular basis (every 3 to 6 months) to determine whether you should continue this treatment. Self-examine your breasts for lumps on a monthly basis while using Climara.

The Climara patch may burn your skin if you wear the patch during an MRI (magnetic resonance imaging). Remove the patch before undergoing such a test.

Store Climara at room temperature away from moisture and heat.

What happens if I miss a dose?

Apply a skin patch as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra patches to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include severe nausea or vaginal bleeding.

What should I avoid while using Climara?

Grapefruit and grapefruit juice may interact with estradiol and lead to unwanted side effects. Discuss the use of grapefruit products with your doctor.

Climara side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Climara patches: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

• 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, sudden vision changes, problems with speech or balance;

• sudden cough, wheezing, rapid breathing, coughing up blood;

• pain, swelling, warmth, or redness in one or both legs;

• pain, swelling, or tenderness in your stomach;

• jaundice (yellowing of the skin or eyes);

• unusual vaginal bleeding;

• a lump in your breast;

• numbness or tingly feeling around your mouth, fast or slow heart rate, muscle tightness or contraction, overactive reflexes; or

• dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure).

Less serious Climara side effects may include:

• upset stomach, bloating, constipation;

• acne or skin color changes, increased facial hair, thinning scalp hair;

• mild headache, back pain, joint pain;

• cold symptoms such as stuffy nose, sneezing, sinus pain, sore throat;

• breast swelling and tenderness, nipple discharge; or

• changes in your menstrual periods, break-through bleeding.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Climara side effects (in more detail)

What other drugs will affect Climara?

Tell your doctor about all other medicines you use, especially:

• St. John's wort;

• an antibiotic such as clarithromycin (Biaxin), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin, Pediazole), rifabutin (Mycobutin), rifampin (Rifater, Rifadin, Rifamate), rifapentine (Priftin), or telithromycin (Ketek);

• antifungal medication such as itraconazole (Sporanox), ketoconazole (Nizoral), miconazole (Oravig), posaconazole (Noxafil), or voriconazole (Vfend);

• a barbiturate such as butabarbital (Butisol), secobarbital (Seconal), pentobarbital (Nembutal), or phenobarbital (Solfoton);

• heart or blood pressure medication such as nicardipine (Cardene) or quinidine (Quin-G);

• the hepatitis C medications boceprevir (Victrelis) or telaprevir (Incivek);

• HIV/AIDS medication such as atazanavir (Reyataz), delavirdine (Rescriptor), efavirenz (Sustiva, Atripla), etravirine (Intelence), fosamprenavir (Lexiva), indinavir (Crixivan), nelfinavir (Viracept), nevirapine (Viramune), ritonavir (Norvir, Kaletra), or saquinavir (Invirase);

• seizure medication such as carbamazepine (Carbatrol, Equetro, Tegretol), felbamate (Felbatol), oxcarbazepine (Trileptal), phenytoin (Dilantin), or primidone (Mysoline); or

• thyroid replacement therapy, such as levothyroxine (Synthroid, Levothroid, Levoxyl, and others).

This list is not complete and there are many other drugs that can interact with Climara. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.

Where can I get more information?

• Your pharmacist can provide more information about Climara.