Estradiol/Norethindrone (Absorbed Through The Skin)

Estradiol (es-tra-DYE-ole), Norethindrone (nor-eth-IN-drone)

Treats lack of estrogen and progestin in your body caused by menopause. Estradiol is an estrogen and norethindrone is a progestin. Both are hormones.

Brand Name(s):

Combipatch
There may be other brand names for this medicine.

When This Medicine Should Not Be Used:

You should not use this medicine if you have had an allergic reaction to estrogen or progestin. You should not use if you are pregnant or breastfeeding, if you have any unusual vaginal bleeding, blood clots, or circulation problems, or if you have had a stroke.

How to Use This Medicine:

Patch

• Your doctor will tell you how often to change your patch. You may be told to change your patch twice a week. Try to change your patch on the same days of each week to help you remember when to do it.
• Wear the patch at all times until it is time to put on a new patch.
• The patch is sealed in a pouch. Carefully tear open the pouch when you are ready to put the patch on your skin. Do not cut it.
• A liner covers the sticky side of the patch. Peel off one side of the liner. Try not to touch the sticky side with your fingers.
• Put the sticky side of the patch on a clean and hair-free area on lower stomach (below your panty line). Then peel off the other half of the liner.
• Press the patch against your skin with the palm of your hand and hold for about 10 seconds. Make sure the edges of the patch are tight against your skin.
• Do not put the patch on your waistline or other places where tight clothing may rub it off. Do not place the patch where it would be exposed to sunlight. Do not put the patch on or near your breasts or over any skin folds.
• Pick a different place on your skin each time you put on a new patch, to help prevent skin irritation. Let at least one week go by before putting a patch on the same place that you have used before.
• When you take off your old patch, fold it in half with the sticky sides together. Throw it away where children and pets cannot reach it.
• Swimming, showering, or taking a bath should not affect the patch.
• If the patch comes off, just put it back on in a different spot. If it won't stick, put on a new patch but continue to follow your original schedule for changing your patch.

If a dose is missed:

• Put on a new patch as soon as possible. Put it on a different area of your skin than the old patch. Then go back to your regular schedule for changing your patches.
• Do not put two patches on your skin at the same time.

How to Store and Dispose of This Medicine:

• Store the patches at room temperature. Do not put the patches in direct sunlight or where they could get too hot or cold.
• Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
• Keep all medicine out of the reach of children.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

Warnings While Using This Medicine:

• This medicine is meant to be used by women who have not had a hysterectomy (uterus removed).
• You should not use this medicine if you are pregnant or think you may be pregnant. This medicine may cause birth defects and harm an unborn baby.
• Check with your doctor before using this medicine if you have had breast cancer, cancer of the uterus, or if you have gall bladder, liver, or kidney disease, diabetes, high blood pressure, asthma, migraine headaches, high cholesterol, seizures, heart failure, or depression.
• Regular visits to your doctor (usually every 6 months to 1 year) are needed while using this medicine.
• Large doses of this medicine used over long periods of time may increase the risk of some kinds of cancer. Talk to your doctor about this risk.
• The progestin in the patch helps lower the risk of cancer of the uterus and keeps the lining of the uterus from growing too much (endometrial hyperplasia). Both of these problems can occur when you are treated with estrogens alone.
• Large doses of estrogen may also increase the risk of breast cancer. Your health caregiver should regularly examine your breasts for lumps and other changes. You should examine your breasts every month for lumps and other changes.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Severe headache
• Shortness of breath, coughing up blood
• Sharp pain in your chest or lower leg (calf)
• Lumps in your breast
• Yellowing of your skin or eyes
• Abnormal vaginal bleeding
• Weakness or numbness in an arm or leg
• Sudden changes in your vision
• Pain or swelling in your abdomen

If you notice these less serious side effects, talk with your doctor:

• Nausea, upset stomach
• Fluid retention and weight gain
• Swollen and tender breasts
• Skin redness and irritation where you put the patch

If you notice other side effects that you think are caused by this medicine, tell your doctor.