Estrogen Patch brand comparison
September 5, 2007 11:15 PM   Subscribe

I would like to hear from anyone who has tried both the Vivelle estrogen patch and the Climara estrogen patch at identical dosages, to find out what were the differences between the two brands, which one did you prefer and why. Also, anyone using Vivelle Dot: since it is to be replaced 2 x/wk, how do you divide the weekdays evenly without having to use different days each week?

I was wondering if there were any differences between Vivelle at .0375 mg (the weekly Vivelle patch, not the DOT) and the Climara at .0375 (not generics). Also wondering if women who used Vivelle dot like it--the size sounds very nice, but not sure if I'd want to reapply twice a week, which would be hard to fit into a routine schedule (e.g. sunday/wednesday? )
posted by Lylo to Health & Fitness (4 answers total)
I can't speak to comparisons between Vivelle and Climara, as I've only used the latter, but I want to put in my two cents about patch reapplication in general.

When I used both Climara and its related generics, I found that the adhesive often weakened after about four days' worth of wear, and application of a new patch was necessary anyhow. I would have preferred a brand that built more frequent reapplication into its product.
posted by bijou at 12:04 AM on September 6, 2007

I haven't used Climara, but have used Vivelle dot for years. There is a schedule on the box that tells you what days to reapply. For me I just chose Tuesday & Friday, so it's Tuesday and Friday every week. Whatever day you choose, just look at the box for the other day. I just put it on in the morning when I brush my teeth, and as incredible as it sounds, I've never forgotten. I do think at first, though, I put a little post-it to remind me on my mirror the night before, until I got into the habit. I LOVE the size - you really have no idea that you're wearing it, which was not true with bigger patches. I did use Vivelle regular size patch before they came out with the dot, and although it wasn't awful, I do have real sensitive skin, so by the time I changed it, my skin was uncomfortable. I've never had that experience with the dot. Go for the dot!!
posted by la petite marie at 12:57 PM on September 6, 2007

I've used a Climara patch for almost a decade and only recently tried Estraderm, a twice weekly patch. I am not familiar with Vivelle. Is it only available in the US?

I agree with bijou regarding the weakening adhesive on the seven day patches. But, it has the advantage of a much simpler schedule. Estraderm is measureably larger and requires changing twice weekly. Not good. Where it has the advantage is a more constant hormone level and thus fewer menopausal symptoms.
posted by michswiss at 5:36 AM on September 7, 2007

I just found this on some unknown internet site: It left a lot of unanswered questions, but did explain quite a lot...........
Tuesday, April 18, 2006
Troubleshooting patches: Are all patches the same?
Since all patches currently on the market in the US and elsewhere all contain the same bioidentical estradiol, it would seem obvious that they would be, essentially, interchangeable. Aside from matters of adhesion, they ought to be so equivalent in function that if one fails to work out well for a woman, she might as well give up on the idea. Right?

No. In fact, the adhesive, which is the distinct and patented part of the patch (because the estradiol itself isn't patented), can have a significant impact on the delivery dynamic itself. For that reason, some women may change brands and find that while they had this or that symptom on one patch, their experience is completely different on another brand. In fact, there are two basic adhesive formulations, and these are what drive the differences. Because they are the major sellers of the two types, we'll look at the differences between Climara and Vivelle Dot.

Both of these are "matrix" patches (the hormone is spread through the adhesive and the adhesive is the delivery medium) as opposed to "reservoir" patches (the hormone is in a puddle confined and dispensed by a semipermeable membrane that lies between skin and puddle).

The difference between these two, however, lies in the specific adhesive used and the way the hormone is mixed into it. With Climara (or the regular Vivelle or Esclim), the hormone is evenly mixed into (and dilutes, to some extent) an acrylic adhesive. This dilution effect (more hormone = less sticky) is why the Climara has to have a larger area per hormone quantity delivered. The manufacturer has hit on what seems to be an acceptable middle ground between these two demands, but it may not work out that way for any given woman.

With the Vivelle Dot, however, there are actually two adhesive agents. One is that same acrylic adhesive with the hormone mixed into it. The other is a silicon adhesive that is undiluted and thus can devote its entire strength to sticking. The two adhesives actually chemically repel each other rather than wanting to combine, which results in micro-puddles of the hormone-containing adhesive distributed throughout the (stickier) non-hormonal adhesive. This provides for a better adhesion although it may affect the allergic properties to do with the specific adhesives.

(This is also cited as justification for the assertion that cutting the patch alters its dose delivery, on the premise that many of the micropuddles are cut and "open" along the new edge. I can't image that the scale of this could be of any functional implications, however, and the suggestion that one powder the cut edges to prevent lifting of the patch due to adhesive exposure along the sides would go a long way towards reducing this again.)

There's not necessarily any predictive value in knowing this. Where it is useful is when a woman is having difficulties getting the coverage she wants from a particular patch but wants to continue with the patch form rather than giving it up to try another type of HRT. In these cases, then, switching from one sort of matrix patch to the other may provide a different enough performance. By the same token, women who change brands won't necessarily find them fully interchangeable and this is why
posted by Lylo at 5:10 PM on September 7, 2007

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