Divigel
Divigel is a hormone replacement therapy gel that contains estrogen to relieve menopause symptoms and prevent bone thinning.
How to Use
Dosage
The usual dose is 0.5-1.5 grams of gel once a day, preferably at the same time each day.
Method
Apply the gel to the skin of the lower abdomen, buttocks, or thighs. Make sure the skin is clean and dry. Change the application site regularly. Do not apply to breasts, face, irritated skin, or the vagina. Open the sachet, squeeze out the gel, and spread it lightly over an area about two palm-sizes. Let it dry for a few minutes before dressing. Do not wash the area for at least an hour. Avoid contact with eyes and wash hands thoroughly after application. Keep the treated area covered if others, especially children, might touch it.
The maximum daily dose is 1.5 grams of gel.
Possible Side Effects
- •Breast tenderness or swelling.
- •Headache, dizziness.
- •Body swelling, weight changes.
- •Unusual vaginal bleeding or discharge.
- •Itching or irritation in the genital area.
- •Feeling sick (nausea), vomiting, stomach cramps, gas.
- •Skin irritation, itching, or pain where applied; sweating more than usual.
- •Feeling down (depression), nervous, or sleepy.
- •Hot flashes.
- •Migraines; changes in touch sensation.
- •Mood changes, anxiety, trouble sleeping.
- •Benign growths in breast or womb lining; breast enlargement; womb lining overgrowth.
- •Increased hunger; heart palpitations; constipation.
- •Acne, hair loss, dry skin; joint or muscle pain.
- •Increased need to urinate; feeling very tired.
- •Severe allergic reactions (hives, painful red skin lumps).
- •Blood clots in veins; high blood pressure; changes in liver/gallbladder function.
- •Difficulty with contact lenses; painful or PMS-like periods.
- •Swelling (angioedema) getting worse; high cholesterol.
- •Feeling overly happy, restless, or shaky; dry eyes.
- •Problems with blood flow in the brain; inflammation of veins; skin bruising.
- •Shortness of breath; runny nose; stomach upset.
- •Yellowing of the skin (jaundice); various skin changes (rashes, lumps, increased hair).
- •Bladder or urinary problems; unusual lab results; weakness, fever, feeling unwell.
Important Warnings
- Do not use if you have or have had breast cancer or cancer related to estrogen (like uterine cancer), or if these are suspected.
- Do not use if you have unexplained vaginal bleeding.
- Do not use if you have excessive growth of the uterine lining (endometrial hyperplasia) that is not being treated.
- Do not use if you have or have had a blood clot in a vein (like in the leg or lungs).
- Do not use if you have a condition that increases your risk of blood clots (like protein C, protein S, or antithrombin deficiency).
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- Do not use if you have or recently had a disease caused by a blocked artery (like a heart attack, stroke, or angina).
- Do not use if you have liver disease and your liver values are still high.
- Do not use if you have a rare inherited blood disorder called porphyria.
- Do not use if you are allergic to estradiol hemihydrate or any other ingredient in Divigel.
- Stop immediately and contact your doctor if you become pregnant.
- Stop immediately and contact your doctor if your skin or eyes turn yellow (jaundice).
- Stop immediately and contact your doctor if you get severe allergic reactions like swelling of the face, tongue, or throat, or have trouble breathing.
- Stop immediately and contact your doctor if your blood pressure rises significantly, causing headaches, tiredness, or dizziness.
- Stop immediately and contact your doctor if you get a migraine-like headache for the first time.
- Stop immediately and contact your doctor if you notice signs of a blood clot (e.g., painful swelling/redness in a leg, sudden chest pain, difficulty breathing).
- Avoid skin-to-skin contact with others, especially children, on the application area until the gel is dry and covered, as estradiol can transfer and cause unexpected puberty signs in children. Wash hands after applying.
Use in Elderly Patients
The classification depends on the dosage form. Systemic use (for example estrogen patch, tablet, gel): Avoid use in older adults. In systemic use, consider potential adverse effects, such as risk of cardiovascular diseases and venous thromboembolism. Consider potential interactions. Topical treatment of the vagina: Suitable for older adults. No significant systemic absorption. (updated 21.10.2024)