{"id":8436,"date":"2021-03-12T09:32:20","date_gmt":"2021-03-12T09:32:20","guid":{"rendered":"https:\/\/zeepedia.com\/?p=8436"},"modified":"2023-01-07T09:59:52","modified_gmt":"2023-01-07T09:59:52","slug":"estalis","status":"publish","type":"post","link":"https:\/\/zeepedia.com\/medical\/medicines\/estalis\/","title":{"rendered":"Estalis &#8211; Norethisterone Acetate Uses, Dose And Side Effects"},"content":{"rendered":"\n<p>Estalis 50 micrograms \/ 250 micrograms \/ 24 hours&nbsp;transdermal patch&nbsp;<br>estradiol\/norethisterone acetate<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">1. What Estalis Is And What It Is Used For<\/h2>\n\n\n\n<p>Estalis is a preparation used for hormonal\u00a0substitution therapy\u00a0(\u00a0HormoneReplacement\u00a0Therapy,\u00a0HRT\u00a0).\u00a0It contains two female sex hormones;\u00a0estrogen\u00a0and\u00a0progestogen. Estalis is used in women whose menstruation has stopped (\u00a0menopause\u00a0) at least 12 months after their last natural menstruation.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Estalis Is Used To:<\/h2>\n\n\n\n<p><strong>Relieve symptoms during and after menopause<\/strong><\/p>\n\n\n\n<p>When menstruation ceases (\u00a0menopause\u00a0), a woman&#8217;s\u00a0estrogen\u00a0drops.\u00a0It can cause problems such as sweating and hot flashes, sleep problems, irritation, and dryness in the vagina.\u00a0Estalis relieves these symptoms after\u00a0menopause.\u00a0Estalis should only be used if the problems cause problems in daily life.<br>Estalis relieves these symptoms after\u00a0menopause.\u00a0Estalis should only be used if the problems cause problems in daily life.<\/p>\n\n\n\n<p><strong>Prevent osteoporosis<\/strong><\/p>\n\n\n\n<p>After&nbsp;menopause,&nbsp;some women suffer from osteoporosis.&nbsp;Discuss all possible options with your doctor.<\/p>\n\n\n\n<p>If you have an increased risk of\u00a0fractures\u00a0(bone fractures) and other medicines that are not suitable for you, you can use Estalis to prevent osteoporosis after\u00a0menopause.<\/p>\n\n\n\n<p>The estrogen\u00a0and\u00a0progestogen\u00a0contained in Estalis may also be approved for treating other diseases not mentioned in this product information.\u00a0Ask your doctor, pharmacist, or another healthcare professional if you have further questions, and always follow their instructions.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">2. What You Need To Know Before using Estalis<\/h2>\n\n\n\n<h2 class=\"wp-block-heading\">Do Not Use Estalis<\/h2>\n\n\n\n<p><strong>Medical background and regular check-ups<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>The use of\u00a0HRT\u00a0involves risks that must be considered when deciding to start or continue an ongoing treatment.<\/li><li>Experience is limited for treating women whose menstruation has stopped prematurely (when the ovaries have stopped working or the uterus has been removed).\u00a0If you belong to that group, HRT&#8217;s risks may differ.\u00a0Talk to your doctor.<\/li><li>Before starting treatment (or resuming treatment), your doctor will ask about your and your family&#8217;s medical background.\u00a0Your doctor may do a general medical and gynaecological examination, including an examination of your breasts.<\/li><li>Once you have started treatment, you should go for regular medical check-ups at least once a year.\u00a0During these check-ups, you should discuss with your doctor the benefits and risks of continued treatment.<\/li><\/ul>\n\n\n\n<p>Perform regular breast examinations according to your doctor&#8217;s recommendations.<br><strong>Do not use Estalis<\/strong><\/p>\n\n\n\n<p>If any of the following apply to you.\u00a0If you are not sure,\u00a0<strong>talk to your doctor<\/strong>\u00a0before using Estalis.<\/p>\n\n\n\n<p>Do not use Estalis:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>If you have or have had\u00a0breast cancer\u00a0or there is a suspicion that you may have it.<\/li><li>If you have or have had\u00a0estrogen-dependent cancer, such as cancer of the lining of the uterus (endometrium), or if there is a suspicion of such cancer.<\/li><li>If you have\u00a0unexpected genital bleeding\u00a0that a doctor has not investigated.<\/li><li>If you have\u00a0endometrial hyperplasia\u00a0(severe thickening of the uterine lining) and are not being treated for it.<\/li><li>If you have or have had a\u00a0blood clot in a vein\u00a0(venous\u00a0thromboembolism\u00a0), in your legs (deep\u00a0vein thrombosis\u00a0), or in your lungs (\u00a0pulmonary embolism\u00a0).<\/li><li>If you have a\u00a0coagulation disorder,\u00a0a condition with an increased risk of blood clots (lack of\u00a0protein\u00a0C,\u00a0protein\u00a0S, or antithrombin).<\/li><li>If you have or have had a disease caused by blood clots in the\u00a0arteries\u00a0are as\u00a0heart attack,\u00a0stroke\u00a0(stroke), or\u00a0angina.<\/li><li>If you have or have had any\u00a0liver disease\u00a0and still have abnormal liver values.<\/li><li>If you have\u00a0porphyria,\u00a0a rare inherited blood disorder.<\/li><li>If you are\u00a0allergic\u00a0to\u00a0estradiol, norethisterone,<strong> <\/strong>or any of the other ingredients of this medicine (see section 6 Contents of the pack and other information).<\/li><\/ul>\n\n\n\n<p>If any of the above affects you the first time you use Estalis, stop using Estalis 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 if you have or have had any of the following problems before starting treatment.&nbsp;They may recur or worsen during treatment with Estalis.&nbsp;Should this occur, have more frequent check-ups with a doctor.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>If you have any disease affecting the lining of the uterus, as well as muscle knots (\u00a0fibroids\u00a0),\u00a0endometriosis,\u00a0or have had\u00a0endometrial hyperplasia\u00a0(severe thickening of the uterine lining)<\/li><li>If you have an increased risk of getting a blood clot (see below &#8220;Blood clots in a vein (\u00a0thrombosis\u00a0)&#8221;)<\/li><li>If a close relative has had breast cancer or other estrogen-dependent cancer<\/li><li>High\u00a0blood pressure<\/li><li>Liver disease, e.g.\u00a0liver adenoma (benign\u00a0tumour)<\/li><li><a href=\"https:\/\/zeepedia.com\/medical\/diseases\/diabetes-type-1\/\">Diabetes<\/a><\/li><li>Gallstone disease<\/li><li>If you get a\u00a0migraine\u00a0or severe headache<\/li><li>If you have <a href=\"https:\/\/zeepedia.com\/medical\/diseases\/sle\/\">systemic lupus erythematosus<\/a> (\u00a0SLE\u00a0) &#8211; an\u00a0autoimmune\u00a0disease that affects many organs in the body<\/li><li>Epilepsy<\/li><li>Asthma<\/li><li>Otosclerosis (ossification of the middle ear leading to hearing loss)<\/li><li>Hypertriglyceridemia\u00a0(elevated blood lipids)<\/li><li>Fluid retention due to heart or kidney disease<\/li><li>A condition called\u00a0hypothyroidism\u00a0(your\u00a0thyroid gland\u00a0does not produce enough thyroid hormone), and you are taking thyroid hormone as a replacement therapy<\/li><li>A condition called hereditary\u00a0angioedema\u00a0or if you have experienced rapid swelling of the hands, feet, face, lips, eyes, tongue, throat (difficulty breathing), or the gastrointestinal tract.<\/li><\/ul>\n\n\n\n<p><strong>You should contact a doctor immediately and discontinue treatment if any of the following occur:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Some of the things mentioned in the section &#8216;Do not use Estalis&#8217;<\/li><li>If the skin or whites of the eyes turn yellow (jaundice);\u00a0it may be a symptom of liver disease<\/li><li>If your\u00a0blood pressure\u00a0rises sharply (symptoms may include headache, fatigue, or dizziness)<\/li><li>If you are experiencing migraine-like headaches for the first time<\/li><li>If you become pregnant<\/li><li>If you get symptoms of a blood clot, such as<ul><li>Painful swelling and redness of the legs<\/li><li>Sudden chest pain<\/li><li>Breathing difficulties further information, see below &#8220;Blood clots in a vein (\u00a0thrombosis\u00a0)&#8221;<\/li><\/ul><\/li><\/ul>\n\n\n\n<p><strong>Note:<\/strong>\u00a0Estalis is not a contraceptive.\u00a0If 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.\u00a0Consult your doctor.<br><strong>HRT\u00a0and cancer<\/strong><br><strong>Severe thickening of the uterine lining (\u00a0endometrial hyperplasia\u00a0) and cancer of the uterine lining (endometrial cancer)<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Using\u00a0HRT\u00a0with\u00a0estrogen\u00a0alone\u00a0increases the risk of severe thickening of the uterine lining and cancer of the uterine lining.<\/li><li>The\u00a0progestogen in Estalis protects you against this additional risk.<\/li><li>For women with the uterus left, who do not take\u00a0HRT, an average of 5 out of 1,000 women aged 50-65 will be diagnosed with endometrial cancer.<\/li><li>For women aged 50-65 who have the uterus left and who take\u00a0HRT\u00a0with\u00a0estrogen alone, between 10 and 60 women out of 1,000 users will be diagnosed with endometrial cancer (i.e. between 5 and 55 extra cases), depending on\u00a0dose\u00a0one and how as long as it is taken.<\/li><\/ul>\n\n\n\n<p><strong>Irregular bleeding<\/strong><\/p>\n\n\n\n<p>Irregular spotting or spotting may occur during the first 3 &#8211; 6 months of using Estalis.<\/p>\n\n\n\n<p>But about the bleeding<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Lasts longer than 6 months<\/li><li>Starts after using Estalis for 6 months<\/li><li>Continues after you stop using Estalis<\/li><\/ul>\n\n\n\n<p><strong>you should see a doctor as soon as possible.<\/strong><\/p>\n\n\n\n<p><strong>Breast cancer<\/strong><\/p>\n\n\n\n<p>Data show that hormone replacement therapy (\u00a0HRT\u00a0) with a combination of\u00a0estrogen-progestogen\u00a0or with\u00a0estrogen\u00a0alone\u00a0increases the risk of breast cancer.\u00a0The increased risk depends on how long you use\u00a0HRT.\u00a0The increased risk is seen within 3 years.\u00a0When treatment is stopped, the increased risk decreases over time, but it can persist for 10 years or more if you have used\u00a0HRT\u00a0for more than 5 years.<\/p>\n\n\n\n<p><em>Comparison<\/em><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Of 1,000 women aged 50 to 54 who do not take\u00a0HRT, an average of 13 to 17 will be diagnosed with breast cancer over 5 years.<\/li><li>In women who are 50 years old and start taking\u00a0HRT\u00a0with\u00a0estrogen\u00a0alone\u00a0for 5 years, 16-17 cases per 1,000 users (i.e. 0-3 extra cases) will occur.<\/li><li>In women who are 50 years old and start taking\u00a0HRT\u00a0with\u00a0estrogen-progestogen\u00a0for 5 years, there will be 21 cases per 1,000 users (i.e. 4-8 different cases).<\/li><li>Among women aged 50\u201359 who do not use\u00a0HRT, an average of 27 out of 1,000 will be diagnosed with breast cancer over 10 years.<\/li><li>In women who are 50 years old and start taking\u00a0HRT\u00a0with\u00a0estrogen\u00a0alone\u00a0for 10 years, 34 cases per 1,000 users (i.e. 7 extra cases) will occur.<\/li><li>In women who are 50 years old and start taking\u00a0HRT\u00a0with\u00a0estrogen-progestogen\u00a0for 10 years, 48 \u200b\u200bcases per 1,000 users (i.e. 21 extra cases) will occur.<\/li><\/ul>\n\n\n\n<p><strong>Check your breasts regularly.&nbsp;Contact a doctor if you notice changes such as:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Indentations or pits<\/li><li>Changes in the nipple<\/li><li>Nodules you can see or feel<\/li><\/ul>\n\n\n\n<p>It is also recommended that you participate in a mammography examination when you are called to do so.\u00a0At the mammogram, you must tell the nurse\/healthcare professional who examines that you are using\u00a0HRT, as this medicine may increase the density of the breasts.\u00a0An increased breast density can make detecting lumps on mammography images more difficult.<\/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 rare than breast cancer.\u00a0Use of\u00a0HRT\u00a0with\u00a0estrogen\u00a0alone\u00a0or combined\u00a0estrogen-progestogen\u00a0has been associated with a slightly increased risk of ovarian cancer.<br><\/p>\n\n\n\n<p>The risk of ovarian cancer varies with age.\u00a0For example, the diagnosis of ovarian cancer will be made on about 2 women out of 2,000 aged 50 to 54 who do not take\u00a0HRT\u00a0for 5 years.\u00a0For women who have taken\u00a0HRT\u00a0for 5 years, there will be about 3 cases per 2,000 users (i.e. about 1 extra case).<\/p>\n\n\n\n<p><strong>How\u00a0HRT\u00a0affects the heart and blood circulation<\/strong><\/p>\n\n\n\n<p><strong>Blood clots in a vein (&nbsp;thrombosis&nbsp;)<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>The risk of\u00a0<strong>blood clots in the veins<\/strong>\u00a0is 1.3\u20133 times higher for women who take\u00a0HRT than those who do not, especially during the first year of treatment.<\/li><li>Blood clots can be serious.\u00a0If a blood clot ends up in the lungs, it can cause chest pain, shortness of breath, collapse or even lead to death.<\/li><li>You are more likely to get a blood clot in a vein if the following apply to you.\u00a0Tell your doctor if any of the following apply to you:<ul><li>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;)<\/li><li>You are severely overweight (\u00a0BMI\u00a0over 30 kg \/ m\u00a0<sup>2<\/sup>\u00a0) <\/li><li>You have a coagulation disorder that requires long-term treatment with drugs that prevent blood clots.<\/li><\/ul><\/li><li>If a close relative has had a blood clot in the bone, lung, or another organ<ul><li>You have\u00a0SLE\u00a0(systemic lupus erythematosus)<\/li><li>You have cancer<\/li><\/ul><\/li><li>The symptoms of a blood clot are described in the section &#8220;You should contact a doctor immediately and stop the treatment&#8221;.<\/li><\/ul>\n\n\n\n<p><em>Comparison<\/em><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>For women in their 50s who do not take\u00a0HRT, an average of 4-7 out of 1,000 people are expected to have a blood clot in a vein over 5 years.<\/li><li>For women in their 50s who have taken\u00a0HRT\u00a0with\u00a0estrogen-progestogen\u00a0for more than 5 years, 9-12 out of 1,000 users are expected to get a blood clot in a vein (i.e. 5 different cases).<\/li><li>Whether varicose veins increase the risk of blood clots ( venous thrombosis ) is not known.<\/li><\/ul>\n\n\n\n<p><strong>Heart disease (heart attack)<\/strong><\/p>\n\n\n\n<p>There is no evidence that\u00a0HRT\u00a0prevents heart attacks. For women over 60 who take\u00a0HRT\u00a0with\u00a0estrogen-progestin, the risk of developing heart disease is slightly higher than those who do not take\u00a0HRT.<\/p>\n\n\n\n<p>If you have had a heart attack or angina (\u00a0<em>angina pectoris<\/em>\u00a0), talk to your doctor about the benefits and risks of using Estalis.<\/p>\n\n\n\n<p><strong>Stroke&nbsp;(apoplexy)<\/strong><\/p>\n\n\n\n<p>The risk of\u00a0stroke\u00a0is about 1.5 times higher for those who take\u00a0HRT\u00a0compared to those who do not.\u00a0The risk of\u00a0stroke\u00a0is age-dependent. Therefore, the number of stroke cases\u00a0increases\u00a0due to the use of\u00a0HRT\u00a0with 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\u00a0HRT, an average of 8 out of 1,000 people is expected to have a\u00a0stroke\u00a0over 5 years.<\/p>\n\n\n\n<p>For women in their 50s who have taken\u00a0HRT\u00a0for more than 5 years, 11 out of 1,000 users are expected to have a\u00a0stroke\u00a0(i.e. 3 extra cases)<\/p>\n\n\n\n<p><strong>Other conditions<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>HRT\u00a0can cause fluid to accumulate in the body (\u00a0edema\u00a0), especially in patients who already suffer from impaired heart or kidney function.<\/li><li>HRT\u00a0may increase blood fat levels (triglycerides), which for women with elevated levels of blood fats may lead to\u00a0inflammation\u00a0of the pancreas (\u00a0pancreatitis\u00a0).\u00a0This can cause <ul><li>Nausea<\/li><li>Vomiting<\/li><li>Upper abdomen pain<\/li><li><a href=\"https:\/\/zeepedia.com\/medical\/diseases\/cold\/\">Fever<\/a><\/li><\/ul><\/li><li>Using\u00a0HRT\u00a0does not prevent memory loss.\u00a0The risk of memory loss may be slightly higher in women who start using\u00a0HRT\u00a0after age 65.\u00a0Consult your doctor.<\/li><li>All medicines used on the skin (such as\u00a0patches\u00a0) can cause allergic skin reactions.\u00a0Although it is very rare, you should inform your doctor if you have severe allergic reactions to any of the ingredients in the patch.<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Other medicines and Estalis<\/h2>\n\n\n\n<p>Some medicines can affect the effect of Estalis, which can lead to irregular bleeding.&nbsp;The following applies:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Medicines for\u00a0<strong>epilepsy<\/strong>\u00a0(e.g. phenobarbital,\u00a0phenytoin,\u00a0and carbamazepine)<\/li><li>Medicines for\u00a0<strong>tuberculosis<\/strong>\u00a0(eg rifampicin, rifabutin)<\/li><li>Drugs for\u00a0<strong>HIV\u00a0&#8211;\u00a0infection<\/strong>\u00a0(for example, nevirapine, efavirenz, ritonavir, and nelfinavir telaprevir)<\/li><li>A herbal medicine containing\u00a0St. John&#8217;s wort\u00a0(\u00a0Hypericum perforatum\u00a0)<\/li><li>Other\u00a0anti-infective medicines\u00a0(e.g.\u00a0ketoconazole, erythromycin)<\/li><\/ul>\n\n\n\n<p>Tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription and herbal remedies.<\/p>\n\n\n\n<p><strong>Results from blood tests 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 using Estalis as it may affect the results of some tests.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Pregnancy And Breastfeeding<\/h2>\n\n\n\n<p>Estalis is intended for women whose menstruation has stopped.\u00a0If you become pregnant, stop using Estalis and consult a doctor. Do not use Estalis while breastfeeding.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Driving And Using Machines<\/h2>\n\n\n\n<p>No effects on the ability to drive and use machines have been reported with Estalis.<\/p>\n\n\n\n<p>You are responsible for assessing whether you can drive a motor vehicle or perform work requiring sharpened attention.\u00a0One of the factors that can affect your ability in these respects is the use of drugs due to their effects and\u00a0side effects.\u00a0Descriptions of these effects and\u00a0side effects\u00a0can be found in other sections.\u00a0Read all the information in this leaflet for guidance.\u00a0If you are not sure, talk to your doctor or pharmacist.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">How To Use Estalis<\/h2>\n\n\n\n<p>Always use this medicine exactly as your doctor has told you.\u00a0Your doctor will strive to use the lowest\u00a0dose, which will give you relief of symptoms, and to use Estalis for the shortest possible time.\u00a0Talk to your doctor if you do not get any relief from the symptoms or feel the\u00a0dose\u00a0is too high.<\/p>\n\n\n\n<p><strong>When to start treatment with Estalis<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Suppose you do not have any other hormone replacement therapy ( patches or tablets) or have used continuous combined hormone replacement therapy (where estrogen and progestin are given continuously ). In that case, you can start Estalis at the appropriate time.<\/li><li>If you are switching from a cyclic or sequential hormone replacement therapy, you should continue with ongoing treatment until the cycle is completed before starting estrogen\/progestogen therapy.\u00a0The appropriate time to start estrogen\/progestagen therapy is the first day of bleeding or seven days after the end of the previous treatment cycle.<\/li><\/ul>\n\n\n\n<p><strong>When to apply the Estalis patch<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>The Estalis patch should be replaced twice weekly (every three to four days).\u00a0It is best to always change the patch on the same day of the week each week (e.g. Monday and Thursday).\u00a0On the inside of the Estalis package, there is space to note down your dosing schedule.\u00a0Select the two-day schedule that you intend to follow.\u00a0Always\u00a0change patches\u00a0on the two days of the week you have marked.<\/li><li>The Estalis patch should always be on until it is time to replace it with a new\u00a0patch.<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Where Should Estalis Be Attached?<\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Attach the patch to the lower abdomen below the waist.\u00a0<\/strong>Avoid the waist, as the clothes can cause the patch to wear away.<\/li><li>You may need to try different places when you apply a new\u00a0patch\u00a0to find places that feel most comfortable and where clothes do not rub on the patch.<\/li><li><strong>Never attach Estalis to your breasts.<\/strong><\/li><li>When changing\u00a0patches, attach the new patch to another spot on the lower abdomen.\u00a0Do not apply the patch in the same place twice in a row.\u00a0It should take at least a week before the same skin surface is used again.<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">How Should Estalis Be Attached?<\/h2>\n\n\n\n<p>If you store the patches in the refrigerator, allow the patch to reach room temperature before applying it to the skin.<\/p>\n\n\n\n<p>Before applying Estates, make sure the skin is:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Clean, dry, and cool<\/li><li>Free from powder, oil, moisturizer, or skin lotion<\/li><li>Free from damage and irritation.<\/li><\/ul>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td><a href=\"https:\/\/www.fass.se\/LIF\/product?userType=2&amp;nplId=19980306000097#\" rel=\"noopener\"><\/a><br><\/td><td>Each&nbsp;patch&nbsp;is individually packaged in a protective envelope.&nbsp;Tear up this envelope at the mark (do not use scissors as you may damage the patch) and remove the patch.&nbsp;Attach the patch immediately after opening the envelope and removing the protective film.<\/td><\/tr><tr><td><a href=\"https:\/\/www.fass.se\/LIF\/product?userType=2&amp;nplId=19980306000097#\" rel=\"noopener\"><\/a><br><\/td><td>Hold the patch with the protective film against you, remove one-half of it, and discard it.\u00a0Try not to touch the side with glue because the patch will not stick properly.<\/td><\/tr><tr><td><a href=\"https:\/\/www.fass.se\/LIF\/product?userType=2&amp;nplId=19980306000097#\" rel=\"noopener\"><\/a><br><\/td><td>Hold one-half of the patch and attach the exposed adhesive side to the skin.\u00a0Remove the other part of the protective film and attach the rest of the patch.<\/td><\/tr><tr><td><a href=\"https:\/\/www.fass.se\/LIF\/product?userType=2&amp;nplId=19980306000097#\" rel=\"noopener\"><\/a><br><\/td><td>Squeeze the patch with the palm of your hand for at least 10 seconds so that it adheres firmly, especially around the edges.<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p>When changing\u00a0patches, peel off the patch and fold it double with the adhesive side inwards.\u00a0See section 5, \u201cHow to store Estalis\u201d, for instructions on safely disposing of the patch.\u00a0Do not flush it down the toilet.\u00a0If adhesive remains on the skin after removing the patch, you can remove it by gently rubbing it with an oil-based skin cream or lotion.<br><strong>Other important information<\/strong><\/p>\n\n\n\n<p>Bathing, swimming, showering, and exercising should not affect the patch if applied correctly.\u00a0If the patch should come off, e.g.\u00a0during a bath or shower, shake off the water.\u00a0Let the skin dry and cool, and put the patch back on, but not on the same skin surface (see &#8220;Where should Estalis be attached?&#8221;).<br>Choose a clean, dry, non-lubricated skin surface.\u00a0A new patch can be applied if the patch does not adhere properly to the skin.\u00a0Regardless of which day this occurs, according to the schedule, you should return to changing patches on the same weekdays as usual.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>The patch should be covered if exposed to direct sunlight or tanning beds.\u00a0When bathing, the patch can be placed under the bathing suit.<\/li><li>The patch should not be applied to sweaty skin or immediately after bathing or showering.\u00a0Wait until the skin is dry and cool.<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Estalis Patches How Long To Work?<\/h2>\n\n\n\n<p>You will see your doctor regularly and discuss the benefits and possible risks associated with Estalis and whether you still need treatment.\u00a0<strong>It is important that you make regular return visits and that Estalis is used only for as long as needed.<\/strong><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If You Use More Estalis Than You Should<\/h2>\n\n\n\n<p>You are unlikely to overdose on Estalis (as the patches release drugs continuously).\u00a0If you have taken too much medicine or if, e.g.\u00a0If a child has accidentally taken medicine, contact a doctor, hospital, or the Poison Information Center for risk assessment and advice.<br>The effects of oral\u00a0estrogen\u00a0overdose\u00a0are <\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Breast tenderness<\/li><li>Nausea<\/li><li>Vomiting<\/li><li>Irregular bleeding<\/li><li>Overdose of\u00a0progestogens\u00a0can cause depression, fatigue,\u00a0acne, and increased hair.\u00a0Remove the patch and consult a physician or pharmacist if any of these occur.<\/li><\/ul>\n\n\n\n<p><strong>Do not use a double&nbsp;dose&nbsp;to make up for a forgotten&nbsp;patch.<\/strong><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If You Forget To Use Estalis<\/h2>\n\n\n\n<p>If you have forgotten to change the&nbsp;patch, apply a new one as soon as possible.&nbsp;Regardless of which day this occurs, you must change the&nbsp;patch&nbsp;according to the regular schedule.<\/p>\n\n\n\n<p><strong>Do not use two\u00a0patches\u00a0to compensate for a forgotten\u00a0patch.<\/strong><br><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 using Estalis.&nbsp;You may need to stop using Estalis 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 using Estalis again.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If you stop using Estalis<\/h2>\n\n\n\n<p>When you stop using Estalis, the likelihood of having symptoms and irregular bleeding increases. If this happens after stopping treatment, contact a doctor immediately.\u00a0The doctor needs to investigate the cause of this and rule out possible cancer of the uterus.<\/p>\n\n\n\n<p>After a long treatment break, you should consult a doctor before starting treatment with the patches again.<br>If you have any further questions about the use of this product, ask your doctor or pharmacist.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">4. Possible Estalis Patch Side Effects<\/h2>\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<ul class=\"wp-block-list\"><li>Breast cancer<\/li><li>Severe thickening of the uterine lining (\u00a0endometrial hyperplasia\u00a0) or cancer of the uterine lining (endometrial cancer)<\/li><li>Ovarian cancer (\u00a0ovarian cancer\u00a0)<\/li><li>Blood clots in veins in bones or lungs (venous\u00a0thromboembolism\u00a0)<\/li><li>Heart disease<\/li><li>Stroke\u00a0(apoplexy)<\/li><li>Probable memory loss if treatment with\u00a0HRT is\u00a0started after age 65.<\/li><\/ul>\n\n\n\n<p>See section 2 for more information on these\u00a0side effects.<\/p>\n\n\n\n<p>This medicine can cause side effects like all medicines, although not everybody gets them.<\/p>\n\n\n\n<p>The following\u00a0side effects\u00a0have been reported with Estalis.\u00a0<strong>If these\u00a0side effects\u00a0get worse, talk to your doctor or pharmacist.<\/strong><\/p>\n\n\n\n<p><strong>Very common<\/strong> estalis patch side effects\u00a0(may affect more than 1 user in 10):<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Headache<\/li><li>Skin reaction at the application site<ul><li>Including irritation<\/li><li>Burning<\/li><li>Rash<\/li><li>Dryness<\/li><li>Bleeding<\/li><li>Bruising<\/li><li>Inflammation<\/li><li>Swelling<\/li><li>skin pigmentation<\/li><li>Hives<\/li><li>Blisters<\/li><\/ul><\/li><li>Chest pain\/tenderness<\/li><li>Menstrual pain<\/li><li>Menstrual disorders<\/li><\/ul>\n\n\n\n<p><strong>Common<\/strong> estalis side effects\u00a0(may affect up to 1 in 10 people):<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Dizziness<\/li><li>Nervousness<\/li><li>Insomnia<\/li><li>Mood swings<\/li><li>Nausea<\/li><li><a href=\"https:\/\/zeepedia.com\/medical\/diseases\/flatulence\/\">Flatulence<\/a><\/li><li>Gastrointestinal upset<\/li><li>Diarrhea<\/li><li>Abdominal pain<\/li><li>Acne<\/li><li>Rash<\/li><li>Itching<\/li><li>Dry skin<\/li><li><a href=\"https:\/\/zeepedia.com\/medical\/diseases\/back-hurts\/\">Back pain<\/a><\/li><li>Leg and arm pain<\/li><li>General aches<\/li><li>Weakness<\/li><li>Weight change<\/li><li>Peripheral\u00a0oedema<\/li><li>Breast enlargement<\/li><li>Abnormal breast enlargement abundant menstruation<\/li><li>Discharge<\/li><li>Irregular\u00a0vaginal\u00a0bleeding<\/li><li>Uterine cramps<\/li><li>Inflammation\u00a0of the vagina<\/li><li>Growth of the uterine lining<\/li><li>Depression<\/li><\/ul>\n\n\n\n<p><strong>Uncommon<\/strong>&nbsp;(may affect up to 1 in 100 people):<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Migraine<\/li><li>Dizziness<\/li><li>Vomiting<\/li><li>Discoloration of the skin<\/li><li>Increased\u00a0blood pressure<\/li><li>Varicose veins<\/li><li>Breast cancer<\/li><li>Elevated liver values<\/li><\/ul>\n\n\n\n<p><strong>Rare<\/strong>&nbsp;(may affect up to 1 in 1,000 people):<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Muscle weakness<\/li><li>Blood clots,\u00a0allergic reaction\u00a0(including rash,\u00a0itching,\u00a0and difficulty breathing)<\/li><li>Altered sexual desire<\/li><li>Crawling \/ tingling<\/li><li>Gallstones<\/li><li>Gallbladder disorders<\/li><li>Fluid blisters near the fallopian tubes<\/li><li>Tissue nodules in the uterus<\/li><li>Polyps in the cervix<\/li><\/ul>\n\n\n\n<p><strong>Very rare<\/strong>&nbsp;(may affect up to 1 in 10,000 people):<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Jaundice due to impaired bile flow.<\/li><\/ul>\n\n\n\n<p><strong>No known frequency<\/strong>\u00a0(cannot be calculated from the available data):<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Hair loss<\/li><li>Allergic dermatitis<\/li><li>Severe\u00a0allergic reaction\u00a0including <ul><li>Difficulty breathing <\/li><li>Swelling of the face, tongue, throat, or skin <\/li><li>Dizziness<\/li><li>Hives\u00a0<\/li><\/ul><\/li><\/ul>\n\n\n\n<p><strong>The following&nbsp;side effects&nbsp;have been reported with other HRTs:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>The disease of the gallbladder<\/li><li>Various skin diseases:<ul><li>Dark skin spots, especially on the face and neck, so-called &#8220;pregnancy spots&#8221; (chloasma)<\/li><li>Painful reddish-purple bumps on the skin (erythema nodosum)<\/li><li>Annular redness or sore rash (erythema multiforme)<\/li><\/ul><\/li><li>Impaired memory and thought activity (possible dementia)<\/li><li>Dry eyes<\/li><li>Difficult to wear contact lenses<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">5. How To Store Estalis<\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li>Store in a refrigerator (2 \u00b0 C &#8211; 8 \u00b0 C).\u00a0Store at a maximum of 25 \u00b0 C for 6 months.\u00a0Do not freeze.\u00a0Store in the original packaging (sealed foil envelope).\u00a0Use the patch immediately after opening.<\/li><li>Both unused and used\u00a0patches\u00a0must be stored out of sight and reach of children.<\/li><li>Do not use this medicine after the expiry date stated on the carton after EXP and on the patch envelope after EXP. The expiry date will be the last day of that month.<\/li><li>After the patch has been removed, it should be folded with the adhesive side inwards and stored safely so that children cannot access the patch.\u00a0Return used or unused\u00a0patches\u00a0to pharmacies, preferably in the original packaging.<\/li><\/ul>\n\n\n\n<p>Medicines should not be disposed of via wastewater.\u00a0Ask your pharmacist how to dispose of medicines that are no longer required.\u00a0These 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\">Content Declaration<\/h2>\n\n\n\n<p>Each Estalis 50 \/g \/ 250 \u00b5g \/ 24 h&nbsp;transdermal patch&nbsp;contains estradiol hemihydrate equivalent to 0.51 mg estradiol and 4.80 mg norethisterone acetate in a 16 cm&nbsp;<sup>2<\/sup>patch&nbsp;and releases 50 micrograms of estradiol and 250 micrograms of norethisterone acetate per 24 hours.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>The active substances are estradiol (as hemihydrate) and norethisterone acetate.<\/li><li>The other ingredients are&nbsp;<strong>Adhesive<\/strong>: silicone and acrylic adhesive, povidone, oleic acid, and propylene glycol.&nbsp;<strong>Plaster film<\/strong>: Polyester laminate.&nbsp;<strong>Protective film<\/strong>&nbsp;(removed before application): Polyester film coated with a fluoropolymer.<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">What The Medicine Looks Like And The Contents Of The Pack<\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li>Estalis transdermal\u00a0patch\u00a0is a 16 cm\u00a0<sup>2<\/sup>\u00a0round\u00a0patch\u00a0.\u00a0The patch consists of a pressure-sensitive, adhesive layer that releases the active substances, with a translucent patch film on one side and a protective film on the other.<\/li><li>Estalis 50 \u00b5g \/ 250 \u00b5g \/ 24 hours\u00a0transdermal patches\u00a0are supplied in cartons of 2, 8, or 24\u00a0patches.<\/li><li>Not all pack sizes may be marketed.<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Marketing Authorisation Holder<\/h2>\n\n\n\n<p>Novartis Sverige AB, Box 1218, 164 28 Kista<br><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Estalis Continuous is a treatment called hormone replacement therapy (HRT). It is a stick-on patch containing hormones, estradiol and norethisterone acetate (NETA). <\/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":[2205,2200],"tags":[3580,3582,3583,3581,2212,3576,3578,3579,3577,2905],"class_list":["post-8436","post","type-post","status-publish","format-standard","hentry","category-e","category-medicines","tag-estalis","tag-estalis-dose","tag-estalis-side-effects","tag-estalis-uses","tag-medicine","tag-norethisterone-acetate","tag-norethisterone-acetate-dose","tag-norethisterone-acetate-side-effects","tag-norethisterone-acetate-uses","tag-patch"],"_links":{"self":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/8436","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=8436"}],"version-history":[{"count":76,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/8436\/revisions"}],"predecessor-version":[{"id":43902,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/8436\/revisions\/43902"}],"wp:attachment":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/media?parent=8436"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/categories?post=8436"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/tags?post=8436"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}