Climara

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

What is Climara?

Estradiol is a form of estrogen, a female hormone the 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.

Climara skin patches are also used to treat ovarian disorders, infertility, and abnormal vaginal bleeding. Some estradiol skin patches are used to prevent postmenopausal osteoporosis. Skin patches release the drug slowly, and it is absorbed through your skin.

Climara may also be used for purposes other than those listed.

Important information about Climara

Do not use Climara if you have 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 with 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.

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 need a dose adjustment or special tests to safely use Climara.

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. Talk with 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. Climara 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 Climara. Estradiol can pass into breast milk and may harm a nursing baby. Climara may also slow breast milk production. Do not use if you are breast-feeding a baby.

How should I use Climara?

Use Climara exactly as it was prescribed for you. Do not use Climara 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 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. If it is almost time to apply your next patch, skip the missed dose and apply a patch at the next regularly scheduled time. Do not use extra patches to make up the missed dose.

What happens if I overdose?

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

What should I avoid while using Climara?

Avoid using other estrogen products without your doctor's advice.

Climara side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty 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.

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.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

What other drugs will affect Climara?

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);

This list is not complete and there may be other drugs that can interact with Climara. Tell your doctor about all the prescription 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 telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about Climara.

What does my medication look like?

Estradiol transdermal skin patches are available with a prescription under the brand names Alora, Climara, Esclim, Estraderm, Fempatch, Menostar, and Vivelle. Other brand and generic formulations may also be available. Ask your pharmacist any questions you have about Climara, especially if it is new to you.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Climara only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2008 Cerner Multum, Inc. Version: 7.01. Revision Date: 02/25/2008 9:10:34 AM.

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