Generally, when estrogen is prescribed for a postmenopausal woman with a uterus, a progestin should also be considered to reduce the risk of endometrial cancer. It is recommended that women who have a uterus and are treated with Menostar receive a progestin for 14 days every 6 to 12 months and undergo an endometrial biopsy at yearly intervals or as clinically indicated in order to detect any endometrial stimulation which might require further clinical action. A women without a uterus does not need a progestin. In some cases, however, hysterectomized women with a history of endometriosis may need a progestin [see Warnings and Precautions (5.2, 5.14)].
Use of estrogen-alone, or in combination with a progestin, should be with the lowest effective dose and for the shortest duration consistent with treatment goals and risks for the individual woman. Postmenopausal women should be re-evaluated periodically as clinically appropriate to determine if treatment is still necessary.
2.1 Prevention of Postmenopausal Osteoporosis
Menostar 14 mcg per day applied to a clean dry area of the lower abdomen once weekly.
2.2 Application of the Menostar Transdermal System
Site Selection
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The adhesive side of Menostar should be placed on a clean, dry area of the lower abdomen or the upper quadrant of the buttock.
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Menostar should not be applied to or near the breasts.
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The sites of application must be rotated, with an interval of at least 1-week allowed between applications to a same site.
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The area selected should not be oily, damaged, or irritated. The waistline should be avoided, since tight clothing may rub the transdermal system off.
Application to areas where sitting would dislodge Menostar should also be avoided.
Application
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Menostar should be applied immediately after opening the pouch and removing the protective liner.
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Menostar should be pressed firmly in place with the fingers for at least 10 seconds, making sure there is good contact, especially around the edges.
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If the system lifts, apply pressure to maintain adhesion.
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In the event that a system should fall off reapply it to a different location. If the system cannot be reapplied, a new system should be applied for the remainder of the 7-day dosing interval.
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Only one system should be worn at any one time during the 7-day dosing interval.
Swimming, bathing, or using a sauna while using Menostar has not been studied, and these activities may decrease the adhesion of the system and the delivery of estradiol.
2.3 Removal of the Menostar Transdermal System
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Removal of the system should be done carefully and slowly to avoid irritation of the skin.
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Should any adhesive remain on the skin after removal of the system, allow the area to dry for 15 minutes. Then gently rubbing the area with an oil-based cream or lotion should remove the adhesive residue.
Used patches still contain some active hormones. Each patch should be carefully folded in half so that it sticks to itself before throwing it away