Menopause Home > Specific Safety Concerns With Vivelle-Dot

Specific Precautions and Warnings for Vivelle-Dot

Some of the warnings and precautions to be aware of prior to using Vivelle-Dot include the following:
  • For women who still have a uterus (who have not had a hysterectomy), taking Vivelle-Dot alone (without a progestin) increases the risk of endometrial cancer (cancer of the lining of the uterus). Women who still have a uterus should take Vivelle-Dot with a progestin medication.
  • Let your healthcare provider know if you have abnormal vaginal bleeding (such as very heavy bleeding or bleeding between periods) while taking Vivelle-Dot, as this may be a sign of precancerous or cancerous changes in the uterus. Your healthcare provider can perform the necessary tests to rule out cancer.
  • Estrogens (such as Vivelle-Dot) should never be used to prevent heart disease (see Hormone Replacement Therapy and Heart Health for more information), as they are not effective for this use.
  • Studies have shown that estrogen hormone replacement therapy (such as Vivelle-Dot) increases the risk of strokes and blood clots in the legs.
  • Your healthcare provider should make sure that you are appropriately treated for any risk factors for heart disease (such as high blood pressure, high cholesterol, diabetes, obesity, or smoking) or blood clots before you take Vivelle-Dot. When possible, Vivelle-Dot should be stopped four to six weeks before many surgeries, in order to help prevent blood clots.
  • Estrogen drugs (such as Vivelle-Dot) used with or without a progestin may increase the risk of breast cancer. Proper screening and monitoring (as determined by your healthcare provider), such as yearly mammograms and monthly breast self-exams, is recommended.
  • Estrogen drugs (such as Vivelle-Dot) used with or without a progestin seem to increase the risk of dementia. In no case should Vivelle-Dot be used to prevent or treat dementia (it is not effective for this use).
  • Vivelle-Dot may worsen epilepsy, porphyria, asthma, diabetes, migraine headaches, lupus, and hepatic hemangiomas.
  • Women who take estrogen (such as Vivelle-Dot) have an increased risk for gallbladder disease.
  • Let your healthcare provider know right away if you notice any vision changes. This can signal a blood clot in the retina, a possible side effect of Vivelle-Dot.
  • Vivelle-Dot can cause high blood pressure (hypertension) or high triglycerides in some women. Your healthcare provider should monitor you for these problems.
  • If you have had jaundice (yellowing of the whites of the eyes or skin) due to estrogens or pregnancy in the past, it is possible that Vivelle-Dot will cause similar problems to recur. If this happens, your healthcare provider will probably advise you to stop taking Vivelle-Dot.
  • If you have an underactive thyroid (hypothyroidism), Vivelle-Dot may increase your body's requirement for thyroid hormones. Your healthcare provider should monitor you and adjust the dose of your thyroid medications as necessary.
  • Vivelle-Dot can cause fluid retention. This can cause problems for people with congestive heart failure (CHF) or kidney problems.
  • Vivelle-Dot should be used with caution in people who have low calcium levels in the blood (known medically as hypocalcemia).
  • It is not clear whether Vivelle-Dot increases the risk of ovarian cancer. Some studies have shown an increased risk, while others have not.
  • Vivelle-Dot can make endometriosis symptoms worse.
  • Vivelle-Dot can interact with a number of different medications (see Vivelle-Dot Drug Interactions for more information).
  • Vivelle-Dot should not be used during pregnancy (see Vivelle-Dot and Pregnancy).
  • Vivelle-Dot does pass through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, discuss this with your healthcare provider prior to using the drug (see Vivelle-Dot and Breastfeeding).
Written by/reviewed by:
Last reviewed by: Kristi Monson, PharmD;
Last updated/reviewed:
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