{"id":7596,"date":"2021-02-25T09:26:54","date_gmt":"2021-02-25T09:26:54","guid":{"rendered":"https:\/\/zeepedia.com\/?p=7596"},"modified":"2021-05-22T14:44:43","modified_gmt":"2021-05-22T14:44:43","slug":"divigel","status":"publish","type":"post","link":"https:\/\/zeepedia.com\/medical\/medicines\/divigel\/","title":{"rendered":"Divigel &#8211; Estradiol uses, dose and side effects"},"content":{"rendered":"\n<p> 0.5 mg and 1 mg gel\u00a0<br>Estradiol<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">1. What Divigel is and what it is used for<\/h2>\n\n\n\n<p>Divigel is a preparation used for hormonal&nbsp;substitution therapy&nbsp;(&nbsp;HormoneReplacement&nbsp;Therapy,&nbsp;HRT&nbsp;).&nbsp;It contains the female sex hormone&nbsp;estrogen.<\/p>\n\n\n\n<p>Divigel is used to:<br><\/p>\n\n\n\n<p><strong>Relieve symptoms during and after menopause<\/strong><\/p>\n\n\n\n<p>When menstruation ends (&nbsp;menopause&nbsp;), the woman&#8217;s&nbsp;estrogen&nbsp;drops.&nbsp;It can cause discomfort such as a feeling of warmth on the face, neck, and breasts (&#8220;hot flashes&#8221;).&nbsp;Divigel relieves these symptoms after&nbsp;menopause.&nbsp;Divigel should only be used if the problems cause problems in daily life.<\/p>\n\n\n\n<p>Talk to your doctor if you do not feel better or if you feel worse.<br><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">2. What you need to know before using Divigel<\/h2>\n\n\n\n<p><strong>Medical background and regular check-ups<\/strong><\/p>\n\n\n\n<p>The use of&nbsp;HRT&nbsp;involves risks that must be taken into account when deciding to start treatment or continue an ongoing treatment.<br><\/p>\n\n\n\n<p>Experience is limited for the treatment of women whose menstruation has stopped prematurely (when the ovaries have stopped working or the uterus has been removed).&nbsp;If you belong to that group, the risks of&nbsp;HRT&nbsp;may be different.&nbsp;Talk to your doctor.<br><\/p>\n\n\n\n<p>Before starting treatment (or resuming treatment), your doctor will ask about your own, and your family&#8217;s, medical background.&nbsp;Your doctor may do a general medical and gynecological examination, which also includes an examination of your breasts.<\/p>\n\n\n\n<p>Once you have started treatment, you should go for regular medical check-ups, at least once a year.&nbsp;During these check-ups, you should discuss with your doctor the benefits and risks of continued treatment.<br><\/p>\n\n\n\n<p><strong>Check your breasts regularly<\/strong>&nbsp;to detect changes (see &#8220;Breast Cancer&#8221; below).<\/p>\n\n\n\n<p>Perform regular breast examinations according to your doctor&#8217;s recommendations.<br><\/p>\n\n\n\n<p><strong>Do not use Divigel<\/strong>&nbsp;:<\/p>\n\n\n\n<p>If any of the following applies to you.&nbsp;If you are not sure, talk to your doctor before taking Divigel.<br><\/p>\n\n\n\n<p>Do not use Divigel:<\/p>\n\n\n\n<p>-If you have or have had&nbsp;<strong>breast cancer<\/strong>&nbsp;or there is a suspicion that you may have it<\/p>\n\n\n\n<p>-If you have or have had&nbsp;<strong>estrogen-dependent cancer<\/strong>, such as cancer of the uterine lining (endometrium), or if there is a suspicion of such cancer.<\/p>\n\n\n\n<p>-If you have&nbsp;<strong>unexpected<\/strong>&nbsp;genital bleeding&nbsp;that has not been investigated by a doctor.<\/p>\n\n\n\n<p>-If you have&nbsp;<strong>endometrial hyperplasia<\/strong>&nbsp;(severe thickening of the uterine lining) and are not treated for it.<\/p>\n\n\n\n<p>-If you have or have had a&nbsp;<strong>blood clot in a vein<\/strong>&nbsp;(venous&nbsp;thromboembolism&nbsp;), in your legs (deep&nbsp;vein thrombosis&nbsp;), or your lungs (&nbsp;pulmonary embolism&nbsp;).<\/p>\n\n\n\n<p>-If you have a&nbsp;<strong>coagulation disorder<\/strong>, a condition with an increased risk of blood clots (lack of protein C, protein S, or antithrombin).<\/p>\n\n\n\n<p>-If you have or have had a disease caused by blood clots in the&nbsp;arteries&nbsp;are as&nbsp;<strong>heart attack,&nbsp;stroke&nbsp;<\/strong>(stroke), or&nbsp;<strong>angina<\/strong>.<\/p>\n\n\n\n<p>-If you have or have had any&nbsp;<strong>liver disease<\/strong>&nbsp;and still have abnormal liver values.<\/p>\n\n\n\n<p>-If you have&nbsp;<strong>porphyria<\/strong>, a rare inherited blood disorder.<\/p>\n\n\n\n<p>-if you are allergic to estradiol or any of the other ingredients of this medicine (listed in section 6).<\/p>\n\n\n\n<p>If any of the above affects you the first time you use Divigel, stop taking Divigel and contact your doctor immediately.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Warnings and cautions<\/h2>\n\n\n\n<p>-Talk to your doctor or pharmacist before using Divigel.&nbsp;Talk to your doctor if you have or have had any of the following problems before starting treatment.&nbsp;They may recur or worsen during treatment with Divigel.&nbsp;Should this occur, have more frequent check-ups with a doctor.&nbsp;if you have any disease affecting the lining of the uterus, as well as muscle knots (&nbsp;fibroids&nbsp;),&nbsp;endometriosis,&nbsp;or have had&nbsp;endometrial hyperplasia(severe thickening of the uterine lining).<\/p>\n\n\n\n<p>-if you have an increased risk of getting a blood clot (see below &#8220;Blood clots in a vein (&nbsp;thrombosis&nbsp;)&#8221;)<\/p>\n\n\n\n<p>-if any close relative has had breast cancer or other estrogen-dependent cancer.<\/p>\n\n\n\n<p>-high&nbsp;blood pressure<\/p>\n\n\n\n<p>liver disease eg liver adenoma (benign&nbsp;tumor&nbsp;)<\/p>\n\n\n\n<p>&#8211;&nbsp;diabetes<\/p>\n\n\n\n<p>gallstones<\/p>\n\n\n\n<p>-if you get a&nbsp;migraine&nbsp;or severe headache<\/p>\n\n\n\n<p>-if you have systemic&nbsp;<em>lupus erythematosus<\/em>&nbsp;(&nbsp;SLE&nbsp;) &#8211; an&nbsp;autoimmune&nbsp;disease that affects many organs in the body<\/p>\n\n\n\n<p>&#8211;&nbsp;epilepsy<\/p>\n\n\n\n<p>&#8211;&nbsp;asthma<\/p>\n\n\n\n<p>otosclerosis (ossification of the middle ear leading to a hearing loss)<\/p>\n\n\n\n<p>&#8211;&nbsp;hypertriglyceridemia&nbsp;(elevated blood lipids)<\/p>\n\n\n\n<p>fluid accumulation due to heart or kidney disease<\/p>\n\n\n\n<p>Hereditary&nbsp;angioedema&nbsp;(a rare, hereditary disease with painful swelling of the skin, mucous membranes of the gastrointestinal tract or respiratory tract)<br><\/p>\n\n\n\n<p><strong>You should contact a doctor immediately and discontinue treatment if any of the following occur<\/strong>&nbsp;:<\/p>\n\n\n\n<p>-Some of what is mentioned in the section &#8220;Do not use Divigel&#8221;.<\/p>\n\n\n\n<p>-If skin or whites of the eyes turn yellow (jaundice);&nbsp;it may be a symptom of liver disease<\/p>\n\n\n\n<p>-If your&nbsp;blood pressure&nbsp;rises sharply (symptoms may be headache, fatigue, or dizziness)<\/p>\n\n\n\n<p>-If you get migraine-like headaches for the first time<\/p>\n\n\n\n<p>-If you get pregnant<\/p>\n\n\n\n<p>-If you get symptoms of blood clots, like<\/p>\n\n\n\n<p>\u2022 painful swelling and redness of the legs<\/p>\n\n\n\n<p>\u2022 sudden chest pain<\/p>\n\n\n\n<p>\u2022 difficulty breathing<\/p>\n\n\n\n<p>For further information, see below &#8220;Blood clots in a vein (&nbsp;thrombosis&nbsp;)&#8221;<\/p>\n\n\n\n<p><strong>Note<\/strong>&nbsp;: Divigel is not a contraceptive.&nbsp;If it is less than 12 months since your last period, or if you are under 50, you may still need to use contraception to avoid pregnancy.&nbsp;Consult your doctor.<br><\/p>\n\n\n\n<p><strong>HRT&nbsp;and cancer<\/strong><\/p>\n\n\n\n<p><strong>Severe thickening of the uterine lining (&nbsp;endometrial hyperplasia&nbsp;) and cancer of the uterine lining (endometrial cancer use<\/strong><\/p>\n\n\n\n<p>The use of&nbsp;HRT&nbsp;with&nbsp;estrogen&nbsp;alone&nbsp;increases the risk of severe thickening of the uterine lining and cancer of the uterine lining.<\/p>\n\n\n\n<p>By taking&nbsp;progestogen&nbsp;as a supplement to&nbsp;estrogen&nbsp;for at least 12 days in each 28-day cycle, you are protected against this extra risk.&nbsp;The doctor will prescribe the&nbsp;progestogen&nbsp;if you have your uterus left.&nbsp;If your uterus has undergone surgery (&nbsp;hysterectomy&nbsp;), you should consult your doctor if you can take the medicine without t&nbsp;a progestogen.<\/p>\n\n\n\n<p>For women with the uterus left who do not take&nbsp;HRT, an average of 5 out of 1,000 women aged 50-65 will be diagnosed with endometrial cancer.<\/p>\n\n\n\n<p>For women aged 50-65 who have the uterus left and who take&nbsp;HRT&nbsp;with estrogen alone, between 10 and 60 women out of 1,000 users will be diagnosed with endometrial cancer (ie between 5 and 55 extra cases), depending on&nbsp;dose&nbsp;one and how as long as it is taken.<br><\/p>\n\n\n\n<p><strong>Irregular bleeding<\/strong><\/p>\n\n\n\n<p>If your doctor has prescribed progestogen tablets in addition to Divigel, you will usually have to bleed once a month (so-called dropout bleeding).&nbsp;But if you get unexpected bleeding or splashing bleeding in addition to your monthly bleeding and these:<\/p>\n\n\n\n<p>&#8211; lasts longer than 6 months<\/p>\n\n\n\n<p>&#8211; starts after taking Divigel for 6 months<\/p>\n\n\n\n<p>&#8211; continues after you have stopped using Divigel<\/p>\n\n\n\n<p><strong>you should see a doctor as soon as possible<\/strong>&nbsp;.<br><\/p>\n\n\n\n<p><strong>Breast cancer<\/strong><\/p>\n\n\n\n<p>Data show that hormone replacement therapy (&nbsp;HRT&nbsp;) with a combination of estrogen-progestogen&nbsp;or with&nbsp;estrogen&nbsp;alone, increases the risk of breast cancer.&nbsp;The increased risk depends on how long you use&nbsp;HRT.&nbsp;The increased risk is seen within 3 years.&nbsp;When treatment is stopped, the increased risk decreases over time, but it can persist for 10 years or more if you have used&nbsp;HRT&nbsp;for more than 5 years.<br><\/p>\n\n\n\n<p><em>Comparison<\/em><\/p>\n\n\n\n<p>Of 1,000 women aged 50\u201354 who do not take&nbsp;HRT, an average of 13 to 17 will be diagnosed with breast cancer over a 5-year period.<\/p>\n\n\n\n<p>In women who are 50 years old and start taking&nbsp;HRT&nbsp;with&nbsp;estrogen&nbsp;alone&nbsp;for 5 years, 16-17 cases per 1,000 users (ie 0-3 extra cases) will occur.<\/p>\n\n\n\n<p>In women who are 50 years old and start taking&nbsp;HRT&nbsp;with estrogen-progestogen&nbsp;for 5 years, there will be 21 cases per 1,000 users (ie 4-8 extra cases).<\/p>\n\n\n\n<p>Among women aged 50-59 who do not take&nbsp;HRT, an average of 27 out of 1,000 will be diagnosed with breast cancer over a 10-year period.<\/p>\n\n\n\n<p>In women who are 50 years old and start taking&nbsp;HRT&nbsp;with&nbsp;estrogen&nbsp;alone&nbsp;for 10 years, 34 cases per 1,000 users (ie 7 extra cases) will occur.<\/p>\n\n\n\n<p>In women who are 50 years old and start taking&nbsp;HRT&nbsp;with estrogen-progestogen&nbsp;for 10 years, 48 \u200b\u200bcases per 1,000 users (ie 21 extra cases) will occur.<br><\/p>\n\n\n\n<p><strong>Check your breasts regularly.&nbsp;Contact a doctor if you notice changes such as&nbsp;<\/strong><strong>:<\/strong><\/p>\n\n\n\n<p>Retractions or pits<\/p>\n\n\n\n<p>Changes in the nipple<\/p>\n\n\n\n<p>Tubers that you can see or feel.<\/p>\n\n\n\n<p>It is also recommended that you participate in a mammography examination when you are called to it.&nbsp;At the mammogram, it is important that you tell the nurse \/ healthcare professional who performs the examination that you are using&nbsp;HRT, as this medicine may increase the density of the breasts.&nbsp;An increased density in the breasts can make it more difficult to detect lumps on the mammography images.<br><\/p>\n\n\n\n<p><strong>Ovarian cancer (&nbsp;ovarian cancer&nbsp;)<\/strong><\/p>\n\n\n\n<p>Ovarian cancer is rare &#8211; much more rare than breast cancer.&nbsp;Use of&nbsp;HRT&nbsp;with&nbsp;estrogen&nbsp;alone&nbsp;or combineestrogen-progestogenen&nbsp;has been associated with a slightly increased risk of ovarian cancer.<\/p>\n\n\n\n<p>The risk of ovarian cancer varies with age.&nbsp;The diagnosis of ovarian cancer will, for example, be made on about 2 women out of 2,000 aged 50 to 54 who do not take&nbsp;HRT&nbsp;for a 5-year period.&nbsp;For women who have taken&nbsp;HRT&nbsp;for 5 years, there will be about 3 cases per 2,000 users (ie about 1 extra case).<br><\/p>\n\n\n\n<p><strong>How&nbsp;HRT&nbsp;affects the heart and blood circulation<\/strong><br><\/p>\n\n\n\n<p><strong>Blood clots in a vein (&nbsp;thrombosis&nbsp;)<\/strong><\/p>\n\n\n\n<p>The risk of&nbsp;<strong>blood clots in the veins<\/strong>&nbsp;is 1.3\u20133 times higher for women who take HRT than for those who do not, especially during the first year of treatment.<\/p>\n\n\n\n<p>Blood clots can be serious.&nbsp;If a blood clot ends up in the lungs, it can cause chest pain, shortness of breath, collapse or even lead to death.<\/p>\n\n\n\n<p>You are more likely to get a blood clot in a vein if any of the following apply to you.&nbsp;Tell your doctor if any of the following apply to you:<\/p>\n\n\n\n<p>-You have not been able to walk or stand for a long time due to a major operation, injury or illness (see also section 3, &#8220;If you need surgery&#8221;)<\/p>\n\n\n\n<p>-You are severely overweight (&nbsp;BMI&nbsp;over 30 kg \/ m2)<\/p>\n\n\n\n<p>-You have or have had a coagulation disorder that requires long-term treatment with drugs that prevent blood clots<\/p>\n\n\n\n<p>-If a close relative has had a blood clot in the leg, lu, ng another organ<\/p>\n\n\n\n<p>-You have&nbsp;SLE&nbsp;(systemic&nbsp;<em>lupus erythematosus<\/em>&nbsp;)<\/p>\n\n\n\n<p>&#8211; You have cancer<\/p>\n\n\n\n<p>The symptoms of a blood clot are described in the section &#8220;You should contact a doctor immediately and stop the treatment&#8221;.<\/p>\n\n\n\n<p><em>Comparison<\/em><\/p>\n\n\n\n<p>For women in their 50s who do not take&nbsp;HRT, an average of 4-7 out of 1,000 people are expected to have a blood clot in a vein over a 5-year period.<\/p>\n\n\n\n<p>For women in their 50s who have taken&nbsp;HRT&nbsp;with&nbsp;estrogen-progestogen&nbsp;for more than 5 years, 9 &#8211; 12 out of 1,000 users are expected to get a blood clot in a vein (ie 5 extra cases)<\/p>\n\n\n\n<p>For women in their 50s without a uterus who take&nbsp;estrogen&nbsp;alone&nbsp;for more than 5 years, 5 &#8211; 8 out of 1,000 users are expected to get a blood clot in a vein (ie 1 extra case).<br><\/p>\n\n\n\n<p><strong>Heart disease (heart attack)<\/strong><\/p>\n\n\n\n<p>There is no evidence that&nbsp;HRT&nbsp;prevents heart attacks.<\/p>\n\n\n\n<p>For women over the age of 60 who take&nbsp;HRT&nbsp;with&nbsp;estrogen-progestin the risk of developing heart disease is slightly higher than those who do not take&nbsp;HRT.&nbsp;For women without a uterus who take&nbsp;estrogen&nbsp;alone, there is no increased risk of developing heart disease.<br><\/p>\n\n\n\n<p><strong>Stroke&nbsp;(apoplexy)<\/strong><\/p>\n\n\n\n<p>The risk of&nbsp;stroke&nbsp;is about 1.5 times higher for those who take&nbsp;HRT&nbsp;compared to those who do not.&nbsp;The risk of&nbsp;stroke&nbsp;is age-dependent, therefore the number of cases of&nbsp;stroke&nbsp;increases&nbsp;due to the use of&nbsp;HRT&nbsp;with increasing age.<\/p>\n\n\n\n<p><em>Comparison<\/em><\/p>\n\n\n\n<p>For women in their 50s who do not take&nbsp;HRT&nbsp;, an average of 8 out of 1,000 people is expected to have a&nbsp;stroke&nbsp;over a 5-year period.<\/p>\n\n\n\n<p>For women in their 50s who have taken&nbsp;HRT&nbsp;for more than 5 years, 11 out of 1,000 users are expected to have a&nbsp;stroke&nbsp;(ie 3 extra cases).<br><\/p>\n\n\n\n<p><strong>Other conditions<\/strong><\/p>\n\n\n\n<p>Using&nbsp;HRT&nbsp;does not prevent memory loss.&nbsp;The risk of memory loss may be slightly higher in women who start using&nbsp;HRT&nbsp;after the age of 65.&nbsp;Consult your doctor.<\/p>\n\n\n\n<p>Women with a tendency to discolour the skin (chloasma) should minimize exposure to sun or ultraviolet radiation when using Divigel.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Other medicines and Divigel<\/h2>\n\n\n\n<p><strong>Other medicines and Divigel<\/strong><\/p>\n\n\n\n<p>Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines, including medicines obtained without a prescription.&nbsp;This also applies to over-the-counter medicines, herbal medicines, or other natural products.<\/p>\n\n\n\n<p>Some medicines can affect the effect of Divigel, which can lead to irregular bleeding.&nbsp;The following applies:<\/p>\n\n\n\n<p>&#8211; Medicines for&nbsp;<strong>epilepsy<\/strong>&nbsp;(eg phenobarbital,&nbsp;phenytoin&nbsp;and carbamazepine)<\/p>\n\n\n\n<p>-Trugs against&nbsp;<strong>tuberculosis<\/strong>&nbsp;(eg rifampicin, rifabutin)<\/p>\n\n\n\n<p>-L\u00e4kemedel against&nbsp;<strong>HIV&nbsp;&#8211;&nbsp;infection<\/strong>&nbsp;(for example, nevirapine, efavirenz, ritonavir, and nelfinavir)<\/p>\n\n\n\n<p>-Natural medicine containing&nbsp;<strong>St. John&#8217;s wort<\/strong>&nbsp;(Hypericum perforatum)<br><\/p>\n\n\n\n<p><strong>Results from blood test analyze<\/strong><\/p>\n\n\n\n<p>If you need to take a blood sample, tell your doctor, or the person taking the blood sample, that you are taking Divigel as it may affect the results of some tests.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Pregnancy, breastfeeding and fertility<\/h2>\n\n\n\n<p>Divigel is intended for women whose menstruation has stopped.&nbsp;If you become pregnant, stop taking Divigel and consult a doctor.<br><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Driving and using machines<\/h2>\n\n\n\n<p>No studies have been performed on the effect of Divigel on the ability to drive or use machines.<\/p>\n\n\n\n<p>You are responsible for assessing whether you are fit to drive a motor vehicle or perform work that requires increased attention.&nbsp;One of the factors that can affect your ability in these respects is the use of drugs due to their effect and\/or&nbsp;side effects&nbsp;.&nbsp;Descriptions of these effects and&nbsp;side effects&nbsp;can be found in other sections.&nbsp;Therefore, always read all the information in this leaflet for guidance.&nbsp;If you are not sure, talk to your doctor or pharmacist.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Divigel contains propylene glycol<\/h2>\n\n\n\n<p>Divigel contains&nbsp;<em>propylene glycol<\/em>&nbsp;, which may cause skin irritation.<br><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">3. How to use Divigel<\/h2>\n\n\n\n<p>Always use Divigel exactly as your doctor has told you.&nbsp;Ask your doctor or pharmacist if you are unsure.<br><\/p>\n\n\n\n<p><strong>When you can start using Divigel<\/strong><\/p>\n\n\n\n<p>You can start using Divigel immediately if:<\/p>\n\n\n\n<p>-You have never used hormone replacement therapy before<\/p>\n\n\n\n<p>-You are switching from a hormone replacement drug that does not cause menstruation<\/p>\n\n\n\n<p>Wait until your period ends if:<\/p>\n\n\n\n<p>-You switch from another type of hormone replacement drug that causes menstruation<\/p>\n\n\n\n<p><strong>If you have not had your uterus removed, your doctor will normally also prescribe medicine containing&nbsp;progestogen<\/strong>.&nbsp;This is usually a tablet that you take 12-14 days during each monthly cycle.&nbsp;After each period of&nbsp;progestogen, you will usually have a bleeding period, such as a menstrual period.<br><\/p>\n\n\n\n<p><strong>How much to use<\/strong><\/p>\n\n\n\n<p>Divigel is available in&nbsp;single-dose containers containing&nbsp;0.5 mg estradiol in 0.5 gram&nbsp;gel&nbsp;or in&nbsp;single-dose containers containing&nbsp;1 mg estradiol in 1 gram&nbsp;gel.<\/p>\n\n\n\n<p>-Each package of Divigel 0.5 mg&nbsp;gel&nbsp;single-dose&nbsp;container contains only 0.5 mg.<\/p>\n\n\n\n<p>-Each package of Divigel 1 mg&nbsp;gel&nbsp;single-dose&nbsp;container contains only 1 mg.<br><\/p>\n\n\n\n<p>Use the amount of Divigel&nbsp;gel&nbsp;prescribed by your doctor.&nbsp;Your doctor will strive to prescribe the lowest effective&nbsp;dose&nbsp;to treat your symptoms in the shortest possible time.&nbsp;Talk to your doctor if you think&nbsp;dose&nbsp;one is too strong or not strong enough.<\/p>\n\n\n\n<p>&#8211; The usual&nbsp;dose&nbsp;is between 0.5 mg and 1.5 mg estradiol per day.<\/p>\n\n\n\n<p>-Use the following 0.5 mg or 1 mg&nbsp;single-dose container,&nbsp;depending on the&nbsp;dose&nbsp;and package&nbsp;size prescribed&nbsp;by your doctor.<\/p>\n\n\n\n<p><em>For a daily&nbsp;dose&nbsp;of 0.5 mg:<\/em>&nbsp;Use a 0.5 g&nbsp;single-dose container<\/p>\n\n\n\n<p><em>For a daily&nbsp;dose&nbsp;of 1 mg<\/em>: There are two options.&nbsp;Use 1 g&nbsp;single-dose container&nbsp;or use two 0.5 g&nbsp;single-dose containers.<\/p>\n\n\n\n<p><em>For a daily&nbsp;dose&nbsp;of 1.5 mg:<\/em>&nbsp;There are two options.&nbsp;Use three 0.5 g&nbsp;single-dose containers&nbsp;or<\/p>\n\n\n\n<p>use a 0.5 g&nbsp;single-dose container&nbsp;and a 1 g&nbsp;single-dose container.<\/p>\n\n\n\n<p>If you are also&nbsp;taking&nbsp;tablets with&nbsp;progestogens&nbsp;, take them as recommended by your doctor.&nbsp;You will usually experience a loss of bleeding after each period of&nbsp;progestogen&nbsp;.<\/p>\n\n\n\n<p><strong>How to apply&nbsp;gel&nbsp;one<\/strong><\/p>\n\n\n\n<p>Divigel should be gently applied to dry and cleansed skin.&nbsp;The drug should not be swallowed.<br><\/p>\n\n\n\n<p><strong>Where to apply&nbsp;gel&nbsp;one<\/strong><\/p>\n\n\n\n<p>-Do not apply&nbsp;gel&nbsp;to your breasts, face or irritated skin.<\/p>\n\n\n\n<p>-Apply&nbsp;gel&nbsp;one on the lower part of your body or thighs.<\/p>\n\n\n\n<p>-Apply&nbsp;gel&nbsp;one on different sides of the body every day.<br><\/p>\n\n\n\n<p><strong>Follow these instructions:<\/strong><\/p>\n\n\n\n<p>1.Applicera&nbsp;gel is&nbsp;a&nbsp;<strong>once-a-day<\/strong>&nbsp;to the skin on the lower part of your body or thighs.<\/p>\n\n\n\n<p>Spread&nbsp;the gel&nbsp;on a surface 1-2 times the size of your hand<\/p>\n\n\n\n<p>Let the&nbsp;gel&nbsp;dry for a few minutes.<\/p>\n\n\n\n<p>4. Wash your hands after applying&nbsp;the gel.&nbsp;Avoid getting&nbsp;the gel&nbsp;in your eyes.&nbsp;Gel&nbsp;one can irritate your eyes.<\/p>\n\n\n\n<p>5. Do not wash the skin where you have applied the&nbsp;gel&nbsp;for the next hour.<br><\/p>\n\n\n\n<p><strong>If you need surgery<\/strong><\/p>\n\n\n\n<p>If you are going to have an operation, tell your surgeon that you are taking Divigel.&nbsp;You may need to stop taking Divigel for 4 to 6 weeks before surgery to avoid the risk of blood clots (see section 2, \u201cBlood clots in a vein (&nbsp;thrombosis&nbsp;)\u201d).&nbsp;Ask your doctor when it is appropriate to start taking Divigel again.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If you use more Divigel gel than you should<\/h2>\n\n\n\n<p>If you have ingested too much medicine or if e.g.&nbsp;If a child has inadvertently ingested the medicine, contact a doctor, hospital, or the Poison Information Center for risk assessment and advice.&nbsp;You may feel flatulence (gas), feel anxious or irritated, or your breasts may ache.&nbsp;Nausea, vomiting, and bleeding can also occur in some women.&nbsp;Overdose is unlikely with&nbsp;transdermal&nbsp;application (use on the skin).&nbsp;The treatment consists of treating the symptoms.&nbsp;Gel&nbsp;one should be washed off.&nbsp;The symptoms disappear when the treatment is stopped or when the&nbsp;dose is&nbsp;reduced.<\/p>\n\n\n\n<p><\/p>\n\n\n\n<p><strong>If you have swallowed Divigel<\/strong><\/p>\n\n\n\n<p>If you have swallowed Divigel, there is nothing to worry about.&nbsp;But you should inform your doctor.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If you forget to use Divigel<\/h2>\n\n\n\n<p>-Apply the missed&nbsp;dose&nbsp;one when you remember it if you are not more than 12 hours late.<\/p>\n\n\n\n<p>-If you are more than 12 hours late, you can ignore the forgotten&nbsp;dose&nbsp;one.<\/p>\n\n\n\n<p>-Remembering your&nbsp;dose&nbsp;can cause bleeding between your periods.&nbsp;This is called breakthrough bleeding.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If you stop using Divigel<\/h2>\n\n\n\n<p>Continue to use your medicine according to your doctor&#8217;s instructions.&nbsp;Keep using Divigel even if you seem to be getting better.&nbsp;If you quit too soon or quit too suddenly, your problem may return.<\/p>\n\n\n\n<p>If you have any further questions on the use of this product, ask your doctor or pharmacist.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">4. Possible side effects<\/h2>\n\n\n\n<p>Like all medicines, this medicine can cause&nbsp;side effects&nbsp;, although not everybody gets them.<\/p>\n\n\n\n<p><strong>Stop&nbsp;<\/strong><strong>using&nbsp;gel&nbsp;one and see a doctor immediately&nbsp;<\/strong><strong>if you notice any of the following&nbsp;<\/strong><strong>serious&nbsp;side effects&nbsp;are<\/strong>&nbsp;:<\/p>\n\n\n\n<p>-your&nbsp;blood pressure&nbsp;will be elevated<\/p>\n\n\n\n<p>-your skin or whites of the eyes turn yellow (jaundice)<\/p>\n\n\n\n<p>-you suddenly get a migraine-like headache (see section 2)<\/p>\n\n\n\n<p>-you get signs of a blood clot (see section 2)<\/p>\n\n\n\n<p>-you get one of the diseases\/problems<\/p>\n\n\n\n<p><\/p>\n\n\n\n<p> listed in section 2.<br><\/p>\n\n\n\n<p>The following diseases are more common in women who take&nbsp;HRT&nbsp;than those who do not:<\/p>\n\n\n\n<p>\u2022 Breast cancer<\/p>\n\n\n\n<p>\u2022 Severe thickening of the uterine lining (&nbsp;endometrial hyperplasia&nbsp;) or cancer of the uterine lining (endometrial cancer)<\/p>\n\n\n\n<p>\u2022 Ovarian cancer (&nbsp;ovarian cancer&nbsp;)<\/p>\n\n\n\n<p>\u2022 Blood clot in veins in bones or lungs (venous&nbsp;thromboembolism&nbsp;)<\/p>\n\n\n\n<p>\u2022Heart disease<\/p>\n\n\n\n<p>Stroke<\/p>\n\n\n\n<p>\u2022 Probable memory loss, if treatment with&nbsp;HRT is&nbsp;started after the age of 65<\/p>\n\n\n\n<p>See section 2 for more information on these&nbsp;side effects&nbsp;.<\/p>\n\n\n\n<p>During the first months of treatment, breakthrough bleeding, spotting, and breast tenderness or breast enlargement may occur.&nbsp;These are usually temporary and usually disappear with continued treatment.<br><\/p>\n\n\n\n<p>Other side effects:<\/p>\n\n\n\n<p><em>Common&nbsp;<\/em><em>(may affect up to 1 in 10 people)<\/em><\/p>\n\n\n\n<p>&#8211;&nbsp;itchy&nbsp;skin, rash, pain, sweating, swollen feet and swelling of the lower legs<\/p>\n\n\n\n<p>-breasts become sore or painful<\/p>\n\n\n\n<p>-weight gain or weight loss<\/p>\n\n\n\n<p>-headache, dizziness<\/p>\n\n\n\n<p>&#8211; abdominal pain, nausea or nausea, bloating<\/p>\n\n\n\n<p>-blotting or&nbsp;spotting, menstrual disorders<\/p>\n\n\n\n<p>-depression, nervousness, listlessness,<\/p>\n\n\n\n<p>hot flashes<br><\/p>\n\n\n\n<p><em>Uncommon&nbsp;<\/em><em>(may affect up to 1 in 100 people)<\/em><\/p>\n\n\n\n<p>-change of sexual desire and mood, anxiety, insomnia,&nbsp;apathy&nbsp;, emotional instability, impaired concentration, elation,&nbsp;agitation<\/p>\n\n\n\n<p>&#8211;&nbsp;migraine, delusion, tremors<\/p>\n\n\n\n<p>-impaired vision, dry eyes<\/p>\n\n\n\n<p>-high&nbsp;blood pressure, superficial&nbsp;phlebitis, purpura<\/p>\n\n\n\n<p>shortness of breath,&nbsp;rhinitis<\/p>\n\n\n\n<p>benign breast or uterine tumor<\/p>\n\n\n\n<p>-increased appetite, high cholesterol levels in the blood<\/p>\n\n\n\n<p>-increased heart rate<\/p>\n\n\n\n<p>-constipation, indigestion, diarrhea, rectal problems<\/p>\n\n\n\n<p>&#8211;&nbsp;acne, alopecia, dry skin, nail problems, skin nodules, excessive hair growth,, hives (increased itchy rash on the skin), painful red skin nodules (erythema nodosum)<\/p>\n\n\n\n<p>joint pain, muscle cramps<\/p>\n\n\n\n<p>-increased urination frequency\/urination, loss of bladder control, urinary tract infection, discoloration of urine,&nbsp;hematuria<\/p>\n\n\n\n<p>-saint or swollen breasts, abnormal growth of the uterine lining, uterine problems<\/p>\n\n\n\n<p>fatigue, abnormal laboratory values, weakness, fever,&nbsp;flu-like symptoms, general malaise<\/p>\n\n\n\n<p>-allergic reactions (&nbsp;hypersensitivity reactions&nbsp;)<br><\/p>\n\n\n\n<p><em>Rare&nbsp;<\/em><em>(may affect up to 1 in 1,000 people)<\/em><\/p>\n\n\n\n<p>-venous&nbsp;thromboembolism&nbsp;(blood clot)<\/p>\n\n\n\n<p>-hepatic effects and bile effects<\/p>\n\n\n\n<p>-sensitivity to contact lenses<\/p>\n\n\n\n<p>-period pain<\/p>\n\n\n\n<p>-pre-mentally-like syndrome<br><\/p>\n\n\n\n<p>Side effects&nbsp;reported after market introduction with unknown frequency (cannot be calculated from the available data)<\/p>\n\n\n\n<p>-uterine fibroids (benign&nbsp;tumors&nbsp;in the uterus)<\/p>\n\n\n\n<p>hereditary&nbsp;angioedema&nbsp;(rare, hereditary disease with painful swelling of the skin, the lining of the gastrointestinal tract, or the respiratory tract)<\/p>\n\n\n\n<p>-cerebral circulatory disorder<\/p>\n\n\n\n<p>bloating<\/p>\n\n\n\n<p>liver disease that causes yellowing skin<\/p>\n\n\n\n<p>contact rash,&nbsp;eczema<br><\/p>\n\n\n\n<p>If you experience any of these&nbsp;side effects&nbsp;is&nbsp;<strong>to inform your doctor.&nbsp;<\/strong>Your doctor will decide if you should stop using the medicine for a while.<br><\/p>\n\n\n\n<p><strong>Dementia<\/strong><\/p>\n\n\n\n<p>Hormone replacement drugs do not prevent memory loss.&nbsp;There is some evidence of a higher risk of memory loss in women who start using&nbsp;HRT&nbsp;after the age of 65.&nbsp;Talk to your doctor for advice.<\/p>\n\n\n\n<p>The following&nbsp;side effects&nbsp;have been reported with other HRTs:<\/p>\n\n\n\n<p>disease of the gallbladder<\/p>\n\n\n\n<p>-believable dementia in patients over 65 years of age<\/p>\n\n\n\n<p>-different skin diseases:<\/p>\n\n\n\n<p>&#8211; dark skin spots, especially on the face and neck, so-called &#8220;pregnancy spots&#8221; (chloasma)<\/p>\n\n\n\n<p>&#8211; erythema multiforme<\/p>\n\n\n\n<p>purpura due to lack of density or function of&nbsp;vessels&nbsp;(&nbsp;vascular&nbsp;purpura).<br><\/p>\n\n\n\n<p><strong>Reporting of&nbsp;side effects&nbsp;ar<\/strong><\/p>\n\n\n\n<p>If you get&nbsp;any side effects, talk to your doctor or pharmacist.&nbsp;This also applies to&nbsp;side effects&nbsp;that are not mentioned in this information.&nbsp;You can also report&nbsp;side effectsdirectly (see details below).&nbsp;By reporting&nbsp;side effects&nbsp;, you can help increase drug safety information.<br><\/p>\n\n\n\n<p>The Medical Products Agency<\/p>\n\n\n\n<p>Box 26<\/p>\n\n\n\n<p>751 03 Uppsala<\/p>\n\n\n\n<p><\/p>\n\n\n\n<p><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">5. How to store Divigel<\/h2>\n\n\n\n<p>Keep out of sight and reach of children.<\/p>\n\n\n\n<p>Do not use this medicine after the expiry date which is stated on the carton and unit dose after EXP.&nbsp;The expiration date is the last day of the specified month<br><\/p>\n\n\n\n<p>Do not store above 25 \u00b0 C.<br><\/p>\n\n\n\n<p>Medicines should not be disposed of via wastewater or household waste.&nbsp;Ask your pharmacist how to dispose of medicines no longer required.&nbsp;These measures will help to protect the environment.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">6. Contents of the packaging and other information<\/h2>\n\n\n\n<h2 class=\"wp-block-heading\">What Divigel 0.5 mg gel and Divigel 1 mg gel contain:<\/h2>\n\n\n\n<p>-The active substance is estradiol.&nbsp;There is 0.5 mg (milligrams) or 1.0 mg of estradiol in each&nbsp;single-dose container.<\/p>\n\n\n\n<p>The other ingredients are carbomer 974P, trolamine, propylene glycol,&nbsp;ethanol&nbsp;and purified water.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What the medicine looks like and contents of the pack<\/h2>\n\n\n\n<p>Divigel&nbsp;gel&nbsp;is an alcohol-based&nbsp;gel<\/p>\n\n\n\n<p>-Divigel 0.5 mg&nbsp;gel is&nbsp;supplied in packs of 28 or 91 doses<\/p>\n\n\n\n<p>-Divigel 1 mg&nbsp;gel is&nbsp;supplied in packs of 28 or 91 doses<\/p>\n\n\n\n<p>-Everything pack sizes may not be marketed<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Marketing Authorisation Holder:<\/h2>\n\n\n\n<p>Orion Corporation<\/p>\n\n\n\n<p>Orionv\u00e4gen 1<\/p>\n\n\n\n<p>FI-02200 Espoo<\/p>\n\n\n\n<p>Finland<br><\/p>\n\n\n\n<p><strong>Manufacturer<\/strong>&nbsp;:<\/p>\n\n\n\n<p>Orion Corporation Orion Pharma<\/p>\n\n\n\n<p>Tengstr\u00f6msgatan 8<\/p>\n\n\n\n<p>FI-20360 Turku<\/p>\n\n\n\n<p>Finland<br><\/p>\n\n\n\n<p>For further information on this medicine, please contact your local representative:<\/p>\n\n\n\n<p>Orion Pharma AB, Danderyd<\/p>\n\n\n\n<p>medinfo@orionpharma.com<br><\/p>\n\n\n\n<p><strong>This medicinal product is authorized under the European Economic Area under the names<\/strong>&nbsp;:<br><a href=\"https:\/\/www.fass.se\/LIF\/product?userType=2&amp;nplId=19961108000041#\" rel=\"noopener\">Show larger<\/a><\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td>Denmark<\/td><td>Control<\/td><\/tr><tr><td>France<\/td><td>Delidose<\/td><\/tr><tr><td>Italy, UK<\/td><td>Sandrena<\/td><\/tr><tr><td><br>\n\n<\/td><\/tr><\/tbody><\/table><\/figure>\n","protected":false},"excerpt":{"rendered":"<p>Divigel is a preparation used for hormonal substitution therapy ( HormoneReplacement Therapy, HRT ). It contains the female sex hormone estrogen.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"cybocfi_hide_featured_image":"","footnotes":""},"categories":[2204,2200],"tags":[5416,5418,3093,5415,3558,2212,5417],"class_list":["post-7596","post","type-post","status-publish","format-standard","hentry","category-d","category-medicines","tag-divigel","tag-divigel-side-effects","tag-estradiol","tag-estradiol-gel","tag-gel","tag-medicine","tag-what-is-divigel"],"_links":{"self":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/7596","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/comments?post=7596"}],"version-history":[{"count":4,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/7596\/revisions"}],"predecessor-version":[{"id":10949,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/7596\/revisions\/10949"}],"wp:attachment":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/media?parent=7596"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/categories?post=7596"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/tags?post=7596"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}