Lyllana
Lyllana (estradiol patch) is a twice-weekly hormonal patch that treats moderate-to-severe vasomotor symptoms, like hot flashes and night sweats, due to menopause. It also helps prevent bone loss (osteoporosis) after menopause. The patch is a type of hormone replacement therapy. One of the benefits of Lyllana (estradiol patch) compared to oral estrogen pills is that it might cause fewer side effects. But it can still cause common side effects like breast tenderness, headaches, and back pain.
What is Lyllana (estradiol patch)?
What is Lyllana (estradiol patch) used for?
Hot flashes, night sweats, and flushes caused by menopause
How Lyllana (estradiol patch) works
Lyllana (estradiol patch) is an estrogen replacement. It replaces the natural estrogen your body loses during menopause. Replacing estrogen helps to prevent bone loss and relieves vasomotor menopause symptoms like hot flashes and night sweats.
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What are the side effects of Lyllana (estradiol patch)?
Common Side Effects
- 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%)
Other Side Effects
- Constipation
- Flu-like symptoms
- Pain in arms or legs
- Neck pain
- Other pain in body
- Anxiety
- Trouble sleeping
- Nausea
- Vomiting
- Stomach cramps
- Migraine
- Dizziness
Serious Side Effects
- Heart attack: chest pain or tightness, pain that radiates up to your shoulder, arm, neck, or jaw
- Stroke: sudden trouble talking, trouble walking, numbness on one side of your body or face, severe headache, confusion
- Deep vein thrombosis (blood clot in the leg): leg cramp, swelling, pain, muscle tightness
- Pulmonary embolism (blood clot in the lung): cough, chest pain, trouble breathing, racing heart
- Cancer: lumps, pain, swelling, or changes in the breasts; swollen lymph nodes, unusual or heavy vaginal bleeding, bloating, extreme tiredness, stomach-area pain
- Gallbladder problems: stomach pain, nausea or vomiting that doesn't go away, fever, yellowing of the skin and eyes (jaundice)
- Severe allergic reaction: hives, swelling in the face or throat, trouble breathing, stomach pain, vomiting
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Blood clot—pain, swelling, or warmth in the leg, shortness of breath, chest pain
- Breast tissue changes, new lumps, redness, pain, or discharge from the nipple
- Gallbladder problems—severe stomach pain, nausea, vomiting, fever
- Increase in blood pressure
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- Stroke—sudden numbness or weakness of the face, arm, or leg, trouble speaking, confusion, trouble walking, loss of balance or coordination, dizziness, severe headache, change in vision
- Unusual vaginal discharge, itching, or odor
- Vaginal bleeding after menopause, pelvic pain
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
Pros and cons of Lyllana (estradiol patch)
Pros
Typically has fewer side effects than oral estrogen pills
Delivers a consistent dose of estrogen over time
Good option if you have trouble swallowing pills
Available in different strengths, allowing you to customize your dose
Cons
Commonly causes headache, breast tenderness, and back pain
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
Pharmacist tips for Lyllana (estradiol patch)
Mark the two days per week on your calendar that you'll apply Lyllana (estradiol patch). You'll need to change your patch every 3 to 4 days. Remove your old patch before applying a new one.
It's best to avoid applying Lyllana (estradiol patch) at your waistline, since tight clothing can cause the patch to fall off.
When replacing Lyllana (estradiol patch), use a different area of the skin each time to lower the risk of irritation. Don't use the same area for at least 1 week.
After you remove Lyllana (estradiol patch), fold together the sticky sides of the used patch before throwing it away. This helps prevent exposing others to any medication left on the patches. Don't flush them down the toilet.
If any adhesive stays on your skin after removing Lyllana (estradiol patch), let the area dry for 15 minutes and then gently rub it off with some oil or lotion.
Showering shouldn't cause Lyllana (estradiol patch) to fall off. But if it does, try reapplying it to another area on your lower stomach or buttocks. If it won't stick, use a new patch, but stay on your regular schedule.
If you forget to apply Lyllana (estradiol patch), put one on as soon as you remember. Then, continue with your usual schedule.
Let your prescriber know if you experience unusual vaginal bleeding, lumps in your breast, changes to your vision, or severe headaches after starting Lyllana (estradiol patch). These are more serious side effects and could be a sign of a bigger health problem.
Go to your follow-up appointments so you and your prescriber can discuss whether you still need to use Lyllana (estradiol patch).
How to apply Lyllana (estradiol patch):
Open the pouch and peel off half of the protective backing without touching the sticky side.
Hold the other half of the backing and apply the sticky side to clean, dry, hairless skin on your lower stomach or buttocks. Never apply it to your breasts or broken skin (e.g., cuts, scrapes, wounds).
While holding the sticky side down, fold the patch back to peel off the second half of the protective liner.
Press the patch firmly onto your skin for 10 seconds with the palm of your hand. Run your finger along the edges to make sure it sticks well.
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Frequently asked questions about Lyllana (estradiol patch)
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What are the risks and warnings for Lyllana (estradiol patch)?
Lyllana (estradiol patch) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Blood clots and related complications (e.g., heart attack, stroke)
Risk factors: Personal or family history of blood clots | High blood pressure | Diabetes (high blood sugar) | High cholesterol | Tobacco use | Considered obese | Systemic lupus erythematosus (SLE)
Lyllana (estradiol patch) can raise the risk of blood clots. These clots can block the blood flow to other parts of the body, like the leg, lungs, heart, or brain. Some clots can lead to dangerous complications, like heart attack or stroke.
Get emergency help right away if you have any signs of a blood clot.
Brain: weakness or numbness in your arms, legs, or face on one side of the body, trouble speaking, blurred vision, dizziness, loss of balance, trouble walking, or confusion
Eyes: trouble seeing, bulging eye, double vision
Heart: chest pain, sweating, nausea, or dizziness
Lungs: trouble breathing, chest pain, or cough
Legs: cramps, swelling, pain, or muscle tightness
If you need to have surgery, tell your care team you're taking Lyllana (estradiol patch). They might have you stop taking it 4 to 6 weeks before surgery to lower your risk of blood clots.
Uterine (endometrial) cancer
Risk factors: Using Lyllana (estradiol patch) without progestin for people with a uterus | Long-term use of Lyllana (estradiol patch)
Vaginal bleeding after menopause can be a warning sign of uterine (endometrial) cancer, so let your prescriber know if you notice any unusual bleeding. Using estrogen replacement therapy, like the Lyllana (estradiol patch), for more than a year can raise your risk of this cancer. If you still have your uterus, taking another hormone called a progestin along with Lyllana (estradiol patch) can help lower this risk. Progestin works by balancing estrogen's effects and slowing the growth of the uterine lining.
Breast cancer
Risk factors: Personal or family history of breast cancer | Using estrogen and progestin together | Long-term use of Lyllana (estradiol patch)
Taking Lyllana (estradiol patch) with a progestin can raise your risk of breast cancer. The longer you use them, the higher the risk. That's why it's best to use this medication for the shortest time needed. You should have a breast exam every year with a healthcare professional and do monthly self-exams to check for any changes. In addition, check with your prescriber about when to schedule mammograms. Call your prescriber if you notice any abnormal changes or feel lumps, pain, or swelling in your breasts.
Ovarian cancer
Risk factors: Using estrogen and progestin together
Taking Lyllana (estradiol patch) with a progestin might raise your risk of ovarian cancer. If you're concerned about this risk, talk to your prescriber. Let your prescriber or gynecologist know if you have unusual vaginal bleeding, vaginal discharge, or pelvic pain, as these could be signs of ovarian cancer.
Dementia
Risk factors: Older adults
Gallbladder and liver problems
Risk factors: History of liver problems or jaundice
Lyllana (estradiol patch) can cause gallbladder problems, and some people have even needed to have their gallbladder removed after starting this medication. If you have stomach pain, nausea or vomiting that won't go away, fever, or yellowing of the skin and eyes (jaundice), tell your prescriber right away or get medical attention.
Since Lyllana (estradiol patch) is broken down by your liver, you might have more side effects if your liver isn’t working properly. If you have or have had any problems with your liver, including liver issues during pregnancy, you shouldn't use this medication.
Vision problems
Although very rare, some people taking estrogens had vision problems from a blood clot in the eye. Stop taking Lyllana (estradiol patch) right away and tell your prescriber if you have sudden vision loss, bulging eyes, double vision, or migraines.
High triglycerides
Risk factors: High levels of triglycerides
Estrogens like Lyllana (estradiol patch) can raise your blood fat levels (triglycerides), which can lead to heart problems or inflammation of the pancreas. If you experience sudden stomach or back pain, nausea, vomiting, sudden weight loss, or a fast heart rate, contact your prescriber or get medical care right away.
Low thyroid hormone levels (hypothyroidism)
Risk factors: Low thyroid hormone levels
Lyllana (estradiol patch) can affect thyroid hormone levels in your blood. If your thyroid is healthy, your body can adjust and keep your hormone levels normal. But if you take thyroid medication, you may need a higher dose while using Lyllana (estradiol patch). Your prescriber will monitor your thyroid levels during treatment to make sure they stay in a healthy range.
Fluid Retention
Risk factors: History of heart or kidney problems
Using estrogen products like Lyllana (estradiol patch) might cause fluid retention, or edema. The risk is higher if you have heart conditions, like congestive heart failure, or kidney damage. If you notice unusual swelling in any part of your body or sudden weight gain, let your prescriber know. If fluid retention becomes a serious problem, your prescriber might stop your treatment with Lyllana (estradiol patch).
Severe allergic reactions
A few people using Lyllana (estradiol patch) have had severe allergic reactions (anaphylaxis), including hives, itching, and swelling of the lips, tongue, or face. Some also had trouble breathing, stomach pain, or vomiting. Angioedema, which causes swelling of the eyes, face, throat, tongue, hands, legs, or fingers, has also been reported. In serious cases, swelling of the tongue or throat can block your airway, making it hard to breathe. If you have swelling or signs of a severe allergic reaction, get medical help right away.
Worsening of other health conditions
Tell your prescriber about all the medical conditions you have before taking Lyllana (estradiol patch). This medication can make some health conditions worse. This includes asthma, diabetes, epilepsy, migraine, and lupus, among others. It can also affect people with hypoparathyroidism or hereditary angioedema.
More on Lyllana (estradiol patch) warnings
Lyllana (estradiol patch) dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 8 twice-weekly patches of 0.025mg/day | 1 carton | $40.36 | $40.36 |
| 8 twice-weekly patches of 0.0375mg/day | 1 carton | $39.23 | $39.23 |
| 8 twice-weekly patches of 0.05mg/day | 1 carton | $40.06 | $40.06 |
| 8 twice-weekly patches of 0.075mg/day | 1 carton | $34.97 | $34.97 |
| 8 twice-weekly patches of 0.1mg/day | 1 carton | $40.49 | $40.49 |
Typical dosing for Lyllana (estradiol patch)
Your dose will depend on the reason you're taking Lyllana (estradiol patch). Apply 1 patch to the skin on your lower stomach or buttocks twice a week, or every 3 to 4 days.
Menopause symptoms: The typical starting dose is one 0.0375 mg/day patch applied twice a week. Your prescriber might raise your dose based on how well it works for you.
Prevention of osteoporosis after menopause: The typical starting dose is one 0.025 mg mg/day patch applied twice a week.
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How much does Lyllana (estradiol patch) cost?
Lyllana (estradiol patch) contraindications
Abnormal vaginal bleeding
History of breast cancer
Cancer that depends on estrogen for growth
Blood clots or blood clotting conditions
History of stroke or heart attack
Liver problems
What are alternatives to Lyllana (estradiol patch)?
Hot flashes, night sweats, and flushes caused by menopause
Hot flashes and night sweats due to menopause
Vaginal itching, dryness, and burning due to menopause
Low estrogen levels
Breast cancer or prostate cancer in certain people
To prevent bone loss (osteoporosis) after menopause
Hot flashes, night sweats, and flushes caused by menopause
Vaginal dryness and irritation caused by menopause
Low estrogen levels due to certain conditions
Prevention of osteoporosis after menopause
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References
Best studies we foundAmneal Pharmaceuticals LLC. (2024). Lyllana- estradiol patch, extended release [package insert]. DailyMed.
Goldštajn, M. Š., et al. (2023). Effects of transdermal versus oral hormone replacement therapy in postmenopause: A systematic review. Archives of Gynecology and Obstetrics.
Harper-Harrison, G., et al. (2024). Hormone replacement therapy. StatPearls.
Memon, R. J., et al. (2023). Angioedema. StatPearls.
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