What is Divigel?Divigel contains an estrogen hormone called estradiol. It is used after menopause to reduce moderate to severe hot flashes.
What is the most important information I should know about Divigel?Estrogens increase the chance of getting cancer of the uterus. Report any unusual vaginal bleeding right away while you are taking estrogens. Vaginal bleeding after menopause (the end of monthly menstrual periods) may be a warning sign of cancer of the uterus. Your healthcare provider should check any unusual vaginal bleeding to find out the cause.
Do not use estrogens, with or without progestins, to prevent heart disease, heart attacks, or strokes. Doing so may increase your risk of heart attack, stroke, breast cancer, and blood clots.
Do not use estrogens, with or without progestins, to prevent dementia. Doing so may increase your risk of dementia.
You and your healthcare provider should talk regularly about whether you still need treatment with Divigel.
Who should not take Divigel?Do not start using Divigel if you have unusual vaginal bleeding or if you currently have or have had certain cancers. Estrogens many increase the chances of getting certain types of cancers, including cancer of the breast or uterus.
Do not begin treatment with Divigel if you had a stroke or heart attack in the past year, currently have or have had blood clots or liver problems, or if you're allergic to any of the ingredients in Divigel, or if you think you may be pregnant.
What should I tell my doctor before I take the first dose of Divigel?Tell your doctor about all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with Divigel. Talk to your doctor about your complete medical history, especially if you have certain conditions such as asthma (wheezing), epilepsy (seizures), migranes, endometriosis, lupus, problems with your heart, liver, thyroid, or kidneys, or have high calcium levels in your blood.
Tell your doctor if you're breastfeeding because the hormone in Divigel can pass into your breastmilk. Your doctor should also know if you are going to have surgery or will be on bedrest.
What is the usual dosage?The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.
Adults: Divigel should be used once daily starting with the lowest possible dose and only as long as needed. Generally, women should be started at 0.25 gram daily.
Subsequent dose adjustments may be made based upon the individual response. Talk to your healthcare provider regularly (every 3 to 6 months) about how well that dose is working for you and if you still need it.
How should I take Divigel?Divigel should be applied once a day, around the same time each day. Apply Divigel to clean, dry, and unbroken (without cuts or scrapes) skin.
Apply Divigel to either your left or right upper thigh. Rotate between your left and right upper thigh each day to help prevent skin irritation.
Before applying the medication, wash and dry your hands thoroughly. Sit in a comfortable position. Tear the Divigel packet and using your thumb and index finger, squeeze out the contents onto the skin of your upper thigh. Gently spread the gel in a thin layer on your upper thigh over an area of about 5 x 7 inches.
It is not necessary to massage or rub in Divigel. Allow the gel to dry completely before dressing. Try to keep the gel dry for as long as possible. If you take a bath or shower, apply Divigel after your skin is dry. The application site should be completely dry before dressing or swimming.
Dispose of the empty Divigel packet in the trash. Wash your hands with soap and water immediately after applying Divigel to remove any remaining gel and reduce the chance of transferring Divigel to other people.
What should I avoid while taking Divigel?Do not apply Divigel to your face, breast, or irritated skin. Never apply Divigel in or around the vagina.
Avoid getting Divigel in your eyes. If this happens, flush your eyes right away with lukewarm water.
Do not allow others to apply the gel for you. However, if that is necessary, the individual should wear disposable plastic gloves. Do not allow others to come in contact with the area of skin where you applied the gel for at least 1 hour after you apply Divigel.
Divigel contains alcohol, and is flammable. Avoid fire, flame or smoking until the gel has dried.
What are possible food and drug interactions associated with Divigel?If Divigel is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Divigel with the following: carbamazepine, clarithromycin, erythromycin, grapefruit juice, itraconazole, ketoconazole, phenobarbital, rifampin, ritonavir, and St. John's wort.
What are the possible side effects of Divigel?Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.
Side effects may include: bloating, breast pain, enlargement of benign tumors of the uterus (fibroids), fluid retention, hair loss, headache, high blood pressure, high blood sugar, irregular vaginal bleeding or spotting, liver problems, nausea and vomiting, stomach/abdominal cramps, vaginal yeast infections
Less common but serious side effects may include: cancer of the breast, uterus, or ovaries, stroke, heart attack, blood clots, dementia, gallbladder disease
Symptoms of serious reactions include breast lumps, changes in speech, changes in vision, vomiting, chest pain, dizziness and faintness, pain in your legs, severe headaches, shortness of breath, and unusual vaginal bleeding. Call your doctor immediately if any of these occur.
Can I receive Divigel if I am pregnant or breastfeeding?Divigel should not be used during pregnancy or breastfeeding.
What should I do if I miss a dose of Divigel?If you miss a dose, do not double the dose the next day. If your dose is less than 12 hours away, it is best to wait and apply your normal dose the next day. If it is more than 12 hours until the next dose, apply the dose you missed and continue your normal dosing schedule the next day.
Do not apply Divigel more than once a day. Do not open a new packet if you accidentally spill some of the contents of Divigel packet. Wait and apply your normal dose the next day.
How should I store Divigel?Store at room temperature.
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