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Vivelle-Dot vs. Divigel

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Vivelle-Dot (estradiol patch) and Divigel (estradiol gel) are both estrogen replacement therapies used to treat menopause symptoms like hot flashes and night sweats. They are in the same medication class and work by replacing the estrogen your body loses during menopause. However, they differ in their application methods and dosing schedules. Vivelle-Dot is a transdermal patch applied to the lower stomach or buttocks twice a week, while Divigel is a topical gel applied to the upper thigh once a day. Vivelle-Dot is available as a generic called Dotti, and Divigel also has a generic version. Common side effects of Vivelle-Dot include headaches and breast pain, while Divigel may cause vaginal yeast infections and breast tenderness. Both medications can increase the risk of blood clots, certain cancers, and other serious health issues, so it's important to discuss these risks with your healthcare provider. You should apply the Vivelle-Dot patch to your lower stomach or buttocks, avoiding the waistline to prevent the patch from falling off.

Vivelle-Dot

(estradiol patch)

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Estradiol gel

(Divigel)

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Summary for Vivelle-Dot

Prescription only

Vivelle-Dot (estradiol patch) is a twice-weekly hormonal patch used to treat menopause symptoms and low estrogen levels. It also helps prevent bone loss (osteoporosis) in people who have gone through menopause. The patch is a form of hormone replacement therapy. The usual dose is one patch applied to the lower stomach or buttocks twice a week, or every 3 to 4 days. Side effects include headache, breast pain, and sinus swelling.

This twice weekly patch is also available as a generic called Dotti.

Indications for Vivelle-Dot

Pros and Cons for Vivelle-Dot

Pros

  • Typically has fewer side effects than oral estrogen pills
  • Relieves multiple menopause symptoms
  • Good option if you have trouble swallowing pills
  • Available in different strengths, allowing you to customize your dose

Cons

  • Commonly causes headache, breast pain, and sinus swelling
  • Need to apply a new patch twice a week
  • Raises your risk of certain cancers, blood clots, and strokes
  • Might need to take it with another hormone called progestin if you have a healthy uterus

Common Side Effects for Vivelle-Dot

  • Headache (up to 50%)
  • Common cold symptoms (up to 20%)
  • Breast tenderness (up to 17%)
  • Sinus swelling (up to 13%)
  • Bleeding in-between periods (up to 11%)
  • Depression (up to 11%)
  • Back pain (up to 11%)
  • Sinus headache (up to 10%)
  • Indigestion (up to 9%)
  • Weight gain (up to 9%)
  • Joint pain (up to 9%)

Warnings for Vivelle-Dot

  • Blood clots and related complications (e.g., heart attack, stroke)
  • Uterine (endometrial) cancer
  • Breast cancer
  • Ovarian cancer
  • Dementia
  • Gallbladder and liver problems
  • Vision problems
  • High triglycerides
  • Low thyroid hormone levels (hypothyroidism)
  • Fluid Retention
  • Severe allergic reactions
  • Worsening of other health conditions

Summary for Divigel

Prescription only

Estradiol gel (Divigel) is a hormone replacement therapy used to treat symptoms of menopause, such as hot flashes and night sweats. It comes as single-use packets, and the dose is applied to the skin on your upper thigh once a day. The gel is available as both a brand-name and a generic medication. Common side effects include vaginal yeast infections, breast tenderness, and abnormal vaginal bleeding.

Indications for Divigel

Pros and Cons for Divigel

Pros

  • Relieves bothersome menopausal symptoms, such as hot flashes and night sweats
  • Applied directly to the skin on the thighs
  • Only need to use once a day
  • Available in multiple strengths to customize your dose

Cons

  • Raises your risk of certain cancers, blood clots, and strokes
  • Risk of exposing others to estrogen through skin contact
  • Might also need to take a progestin medication if you have a uterus
  • Need to wait for the gel to dry completely before bathing, showering, or swimming

Common Side Effects for Divigel

  • Abnormal vaginal bleeding (4-10%)
  • Breast tenderness (3-9%)
  • Common cold symptoms (4-6%)
  • Upper respiratory tract infection (2-6%)
  • Vaginal yeast infection (1-6%)

Warnings for Divigel

  • Risk of blood clot
  • Uterine (endometrial) cancer
  • Breast cancer
  • Dementia
  • Gallbladder and liver problems
  • Changes in calcium levels in the blood
  • Vision problems
  • High triglycerides
  • Low thyroid hormone levels (hypothyroidism)
  • Fluid Retention
  • Worsening of other medical conditions
  • Potential skin-to-skin transfer

Prices with our coupons for Vivelle-Dot vs. Divigel

Price Card Drug Icon
Estradiol3 cartons / 8 twice-weekly patches of 0.05mg/day
$84.47$99.29
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Price Card Drug Icon
Estradiol1 carton / 30 packets of 0.5mg gel
$42.11$171.98
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