dosage
The lowest effective dose and the shortest possible duration of therapy should be used for both initiation and continuation of treatment of postmenopausal symptoms.
DERMESTRIL can be used both cyclically and continuously.
In women with an intact uterus, regardless of the estrogen treatment regimen chosen, the addition of a progestogen for at least 12 to 14 days per cycle is mandatory to significantly reduce the risk of estrogen-induced endometrial hyperplasia. The addition of a progestogen is not recommended in women with a hysterectomy unless endometriosis is diagnosed (see 4.4 Warnings and Precautions for Use).
Options for estrogen monotherapy or combination therapy with estrogen and progestin:
a) Cyclic or cyclic sequential course: 21-day course of treatment with DERMESTRIL followed by a 7-day break in use. For women with a uterus, gestagen is also administered sequentially in the last 12 to 14 days of therapy.
b) Continuous or continuous
sequential: continuous use of DERMESTRIL. For women with a uterus, progestogen is also administered sequentially on days 12-14 of each 28-day cycle.
As a progestational supplement, for example: For example, norethisterone, norethisterone acetate, medroxyprogesterone acetate, or progesterone may be used (see specific information and instructions for use of individual products for additional information).
DERMESTRIL is applied to the skin twice a week (every 4 or 3 days) on the thigh, upper quadrant of the buttocks, lumbar region or abdomen and should never be applied to or near the breasts. The area of application of the patch should be changed with each new patch. Application areas below the waist, where the skin has few folds, work well. The selected area of skin should be clean, oil-free, dry and undamaged.
When gluing plaster, it is necessary to ensure good adhesion by applying strong pressure over its entire surface and along the edges. The absorption capacity of the skin is a factor that determines the rate of release of estradiol from DERMESTRIL. Application to other (higher) areas of the skin other than those listed above is not recommended as this may interfere with the release of estradiol.
When applied correctly, the patch adheres easily to the skin within the required 3-4 days. If the patch partially or completely detaches from the skin prematurely (before 4–3 days), it should be replaced with a new patch. Every 4 or 3 days, the used patch is replaced with a new one.
You can take a bath or shower as long as the patch is applied correctly. However, after a very hot bath or sauna, the patch may come off. In this case, it should be replaced with a new one (as described above). If possible, sauna visits should be carried out on days when plaster replacement is still planned.
Start of therapy
In postmenopausal women who are not currently receiving estrogen treatment, estrogen monotherapy or chronic combined HRT, treatment with DERMESTRIL can be started at any time. Women currently receiving sequential estrogen-progestogen therapy should complete their current treatment cycle before starting treatment with DERMESTRIL. The first day after completion of the previous treatment (for continuous use) or the first day after a break in treatment (for cyclic use) is the appropriate time to start a new cycle of treatment with DERMESTRIL.
If you forget to use the patch, you should start a new cycle of treatment with DERMESTRIL. please do so to reschedule this event as soon as possible. The next change of the patch should be carried out according to the initial treatment regimen. Interrupting treatment may increase the likelihood of symptoms returning and cause withdrawal bleeding or spotting.
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