Vivelle vs. Vivelle dot

My doctor gave me a sample of the Vivelle 0.1 mg dot, then when I picked up the prescription he wrote, I got the Vivelle 0.1 bigger patch. The first patch from the prescription worked good, the sticky glue was around the edges after about half the day it was black sticky glue around the edges and it worked good much better than the dot as far as hot flashes relief and overall feeling better. I looked at the two boxes and noticed the dot has 1.56 mg of estradiol. The regular Vivelle has 8.66 mg of estradiol quite a big difference. I noticed I felt better with the Vivelle and had no symptoms of menapause at all, as long as I can get the patch to stick. The first two patches stuck good, the next two just fell off after a bath and stayed wrinkled and you never could see the sticky gum on the edges like the first two, so I am convinced those were bad patches. So I'm going to change it again this morning and I did notice with the Vivelle dot, that I had at least two hot flashes a day. With the bad patches, I have no energy, feel awful and stay hot all day and sweat bad at night, so I'm sleeping in practically nothing. The two bad patches were worn on my thigh and the good patch was worn on my backside. I used a hair dryer this morning to get it to stick and it's starting to wrinkle all ready so I'm wondering if this is a bad batch. I am wondering about the difference in the dosages of the dot vs the regular patch. Any views on this would be great, I'm going back to work in a week and I can't go to work feeling bad, I can barely get up to go to the bathroom, my nails start breaking and my arthritis in my joints is killing me so I know it's low estrogen. Is there a pill that I could take that has the same amount of estrogen so I know it'll get in my system without wrinkling and falling off? Somebody please help, I'm running out of clothes and my family wants the heat on and I have the air conditioning on plus staying on the couch because I can't get up like this. beth

TAH 12/17/02 severe endometrosis

Okay, after two hours of wearing the new patch, I feel a little better, still hot, but not as bad, of course I'm wearing less clothes, It's 40 degrees outside and my DH says it's cold and I feel good outside. The patch is not sticking good and wrinkly and the first two I wore did not do this. The pharmacist says I need to ask the Dr. and that the special ordered the patches (Just for Me!!!!) and that it's not their problem and it's too soon to get a refill or another box because of Insurance. I'll pay the difference but he says I need to call the Dr. What is up with Kmart? So now what do I do? I've taken black cohosh which is what I took before my surgery and after the second day, it worked good. But that's not fixing the problem. Someone told me to try Aloe Vera. Does that work? beth

TAH 12/17/02 severe endo, lost one ovary with endo five years before, i had them take the last one because I was afraid the endo would grow back

Beth,
Sounds like you're having a rough time. I noticed your thread because I posted one last week with the exact title! I received the V dot sample from my doc but when I picked up the prescription, it was regular Vivelle. I took it back and had the pharmacy call my doc...changing from Premarin to the patch was enough for one week! Anyway... last week, the wonderful women here assured me that the dot and the regular deliver the same estradiol dose. I confirmed that on the Vivelle website. The difference you are experiencing may be related to where you are placing the patch. The directions say abdomen. I know a lot of sisters here do hip and backside because it delivers a higher dosage. I don't know about the thigh, but I'm guessing that maybe the "bad" patches on the thigh may be because the tissue on the thigh doesn't absorb and disseminate the hormone as effectively. I'm finding (in my second week as a patch wearer) that the placement can make a difference. I've been putting it on my abdomen and put it a little low yesterday. It is stuck at the end of my hyst scar, where I crease a bit when sitting. This results in a little wrinkling of the patch - I've definitely noticed that this affects my estrogen, it's a little lower. As with most new things, I think it will take some time to get good at this patch thing. I do think that it will work out for me (fingers crossed) it's already way better than the Premarin. Keep your chin up, I know the experts will be by to give you their advice soon.

Leslie

I've been using the dot patch for awhile now, .05 to start and now .075. I learned that I should be sure not to place the patch on my belly when it is the most stretched...like when I'm sitting, otherwise I get lots of wrinkles when I'm in a standing postion. Also I prepare the area by rubbing it with an alchol pad. That way I'm sure there is no lotion or bath gel residue to interfere with the patch adhesive. It does matter where you stick it. You get an increased dose when placed on your hip or fanny. I've never heard of the thigh as a possible location. Also be sure to rotate locations on your belly each time you change. You can get some good tips on using the patch at the website: Survivors Guide to Surgical Menopause and by doing a search on this site too.

Hi ladies and thanks for responding to me. I found the dosage difference on the back of the box in the fine print. It says on both boxes 0.1 in the top right hand corner but on the back the Vivelle says 8.66 mg of Estradiol and the dot says 1.56 mg. I'm researching the web site and have sent them an email. We'll see what they say. Tha pharmacist has not got a clue as to what he's doing, so forget him. He wasted my time today. Beth

Hi Beth the Vivelle and Vivelle dot patches use two different technologies to deliver the estradiol through your skin. The regular Vivelle is an older technology and requires more estradiol per patch while delivering a lower percentage of it versus the dot, which contains less estradiol per patch but delivers a higher percentage of it. The number that matters to you is the 0.1 number on the box's corner. That's how many milligrams of estradiol the patch is designed to deliver per day.

For a more technical description of the difference between the two delivery systems here is a link to a discussion by one of Noven's engineers (they developed the Vivelle patches):

http://www.noven.com/resmain02.htm

I hope this clears things up for you.
s,
-Linda

Thanks for the link Suferbabe!!

Vivelle dot worked better for Hot Flashes. Best absorbed via use on buttocks per physician's desk reference. I have trouble getting others to stick to my skin, too. When refilling your prescription, tell the pharmacist not to deviate from what your doctor writes!
You can have MD specify what to use and they have to do what he/she says. I wash the new site with dish soap to remove oils on the skin. This helps the sticking. Also try covering the patch with waterproof tape, 3-M makes a good one. Vivelle dot is smaller and easier to cover up. Tape must be left on or you'll rip the patch off with it. Many happy bubble baths....
Work sometimes takes your mind off the small stuff...you wont have as much time to obsess about how you feel. May sound cold, but it worked for me.

Surferbabe, I see what you're saying. I'm just going to call the doctor Monday and tell him to change it to the dot. I found one in the bathroom trash can last night while dumping the trash in my bathroom and it still had a lot of glue and sticky on it, so I popped it on my belly and didn't have any hot flashes during the night and slept much better. I just need one that sticks good and the regular one doesn't. I like the smaller one too. I was having to use baby oil to get it off but I only had two samples from the doctor. I noticed that you also use testosterone too with your patch. What does that do? I don't have any trouble getting in the mood when my patch is working. The first night when I put on a new one, provided it's a good one and sticks, my husband gets no sleep thanks to me. I'm like a teenager again and my husband is a very restless light sleeper so I bother him during the night. The hospital system I work for is doing a study on testosterone patch for women who are experiencing menapause. Any one here have one? Thanks for everyone here. This is the best thing since Coca Cola!! Beth

TAH 12/17/02

(((Beth))), the testosterone is for energy and libido. Not everyone will find that they need it, but when I was on estrogen alone, after about six months, I was feeling kind of lethargic and 'flat'... DBF said I was 'different, too nice, not spunky'. And I had no interest at all. You are still pretty early in the game, in HRT time, but hopefully your libido will stay as it is and you won't have any need for testosterone.

I did see the announcements for clinical trials of a testosterone patch last year but I did not qualify. One problem was that they only wanted ladies who were not on any other HRT (like estrogen) and there was no way I was giving up my Vivelle dot! The other difficulty was that as a study participant you wouldn't know whether you got the real patch or a placebo... I didn't want to mess around with maybes. I like the gel/creams very much.

One thing I've learned in this process, though, is that we shouldn't ever assume that the HRT we are using today is going to always be the right combination for us... bodies change, needs change. It's in the nature of women to change. Just listen to what your body is telling you and you will be all right.

I do think the dot is definitely a superior patch to the regular Vivelle (so does Noven). I personally have only had one patch in the past year that didn't stick well, and that's only because I went to a concert one night and wore hiphugger jeans, something I never do, and didn't realize that the waistband hit exactly on the patch. It was a very hot night, and when I got home the patch was stuck to the waistband of the jeans.

I peeled it off and re-stuck it on myself with a band-aid over it and it made it until I had to change to the next one. Other than that, I've never had to cover a patch or had one come un-stuck, even through hours in the pool and hot tub.

You can wear the patch anywhere on your tummy, hips or buttocks, but the company's studies have shown that you get about 20% or so more if you wear it on your backside. I also find it sticks better there, possibly because there isn't the 'swelly belly effect' which would cause it to stretch and then wrinkle each day?

I hope that once you get your prescription switched things will be a lot better for you!
s,
-Linda