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Estradiol/norethindrone (Absorbed through the skin)

Estradiol (es-tra-DYE-ol), Norethindrone (nor-ETH-in-drone)

Treats hot flashes and vaginal problems during menopause. Also supplements estrogen in women who do not have enough.

Brand Name(s):

Combipatch

There may be other brand names for this medicine.

When This Medicine Should Not Be Used:

This medicine is not right for everyone. Do not use if you had an allergic reaction to estradiol or norethindrone, if you are pregnant or breastfeeding, or if you have liver disease. Do not use if you have had breast cancer or problems with blood clots (such as deep vein thrombosis or stroke).

How to Use This Medicine:

Patch

  • Your doctor will tell you how many patches to use, where to apply them, and how often to apply them. Do not use more patches or apply them more often than your doctor tells you to. This medicine patch is usually changed 2 times a week. Your personal schedule may be different.
  • Wash your hands with soap and water before and after applying a patch.
  • Leave the patch in its sealed wrapper until you are ready to put it on. Tear the wrapper open carefully. NEVER CUT the wrapper or the patch with scissors. Do not use any patch that has been cut by accident.
  • The patient instructions will show the body areas where you can wear the patch. When putting on each new patch, choose a different place within these areas. Do not put the new patch on the same place you wore the last one. Be sure to remove the old patch before applying a new one.
  • Place the patch on your lower abdomen (below the waist). Do not use oil, lotion, or powder on the skin where you place the patch. Do not put the patch over burns, cuts, or irritated skin.
  • Press the patch firmly in place with your hand for about 10 seconds.
  • Wear the patch at all times until it is time to put on a new one. Do not expose the patch to the sun for long periods of time.
  • After you remove an old patch, if you have any adhesive left on your skin, allow it to dry for 15 minutes. Then gently rub the sticky area with oil or lotion to remove the adhesive. It is best to change your patch on the same days of each week to help you remember.
  • You may take a bath, shower, or swim while wearing a patch.
  • If a patch falls off, just put it back on a different area. If the patch does not stick completely, put on a new patch, but continue to follow your original schedule for changing to a new one.
  • Fold the used patch in half with the sticky side together. Place it in a sturdy childproof container. Throw this container in the trash, out of the reach of children and pets. Do not flush the patch down the toilet.
  • Missed dose:If you forget to wear or change a 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. Never wear 2 patches at the same time.
  • Store the unopened pouches at room temperature for up to 6 months. Do not store the patch unless it is in the foil pouch.

Drugs and Foods to Avoid:

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

  • Some foods and medicines can affect how CombiPatch® works. Tell your doctor if you are using St. John's wort, carbamazepine, clarithromycin, erythromycin, itraconazole, ketoconazole, phenobarbital, rifampin, or ritonavir.
  • Do not eat grapefruit or drink grapefruit juice while you are using this medicine.

Warnings While Using This Medicine:

  • Pregnancy after menopause is not likely, but if you think you could be pregnant, tell your doctor. This medicine could harm an unborn baby.
  • Tell your doctor if you have had a heart attack, bleeding problems, or any kind of cancer.
  • Tell your doctor if you have kidney disease, heart disease, asthma, diabetes, endometriosis, epilepsy, migraine headaches, porphyria, lupus, an underactive thyroid, high blood pressure, or high cholesterol. Tell your doctor if you have ever had liver problems caused by pregnancy or estrogen, or if you smoke.
  • Do not use this medicine if you have had a hysterectomy (had your uterus removed).
  • This medicine may cause the following problems:
    • Higher risk of heart attack, stroke, or blood clots
    • Higher risk of endometrial cancer, breast cancer, or uterine cancer
    • Higher risk of dementia, especially in women 65 years of age and older
    • Gallbladder disease
    • High levels of calcium in your blood
  • You may need to stop using this medicine for a few weeks before and after you have surgery or if you need to stay in bed for a long time, because of the risk of blood clots.
  • Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments. You should have regular pelvic exams, breast exams, and mammograms as directed by your doctor.
  • Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:

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

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
  • Breast lumps
  • Chest pain that may spread, trouble breathing, nausea, unusual sweating, fainting
  • Chest pain, trouble breathing, or coughing up blood
  • Numbness or weakness on one side of your body, sudden or severe headache, problems with vision, speech, or walking
  • Sudden or severe stomach pain, nausea, or vomiting
  • Swelling in your hands, ankles, or feet
  • Unusual or unexpected vaginal bleeding or heavy bleeding
  • Vision changes, vision loss, double vision, migraine headache

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

  • Light, irregular vaginal bleeding or spotting
  • Mild nausea, stomach pain, or upset stomach
  • Redness or irritation where the patch was applied
  • Swollen or tender breasts

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

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088


Last Updated: 9/4/2014


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