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Estradiol and Levonorgestrel (Transdermal)

Generic name: estradiol and levonorgestrel (transdermal) [ess-tra-DY-ol-and-LEE-vo-nor-JESS-trell]

Brand name: Climara Pro
Form of dosage: transdermal film, extended release (0.045–0.015 mg/24 hours) 

Drug classes: Combinations of sex hormones

What is Estradiol and Levonorgestrel (Transdermal)?

Estradiol regulates many bodily processes. Levonorgestrel regulates ovulation and menstruation and is an important female hormone.Combination medicine Estradiol-levonorgestrel treats menopause symptoms like hot flashes and prevents osteoporosis in women who are menopausal.This medication guide does not list all possible uses for estradiol or levonorgestrel.

Side effects of Estradiol and Levonorgestrel (Transdermal)

If you experience any of the following symptoms of an allergy: difficulty breathing, hives, or swelling in your lips, face, throat, tongue, or mouth, seek emergency medical attention.

Levonorgestrel and estradiol can cause severe side effects. If you experience:

  • Heart attack symptoms: chest pain, pressure or pain in your shoulder or jaw, nausea, and sweating.
  • Signs of stroke: sudden numbness, weakness, or headache (especially on one side), slurred or shaky speech, or problems with balance or vision;
  • Signs of blood clots: sudden vision loss, chest pain that stabs, shortness of breath, blood in the cough, or pain or heat in both legs.
  • Memory problems, confusion, and unusual behaviors;
  • Unusual vaginal bleeding and pelvic pain
  • A lump on your breast, or
  • High levels of calcium are accompanied by nausea, vomiting, and constipation. Other symptoms include muscle weakness, pain in the bones, fatigue, or increased thirst.

Some of the common side effects associated with estradiol or levonorgestrel include:

  • Nausea, vomiting, bloating, and stomach cramps;
  • Fluid retention (swelling, rapid weight gain);
  • Headache;
  • Breast pain
  • Redness or irritation at the site of wearing the patch;
  • Hair loss on the scalp
  • Bleeding, vaginal itching, or discharge.

There may be other side effects. For medical advice on side effects, call your doctor.Report any adverse reactions by calling the FDA at 1-800-FDA-1088.


Estradiol or levonorgestrel should be avoided if a woman has had a hysterectomy, suffers from undiagnosed bleeding in the vaginal area, has liver disease or bleeding disorders, is undergoing major surgery, or has had heart attacks, strokes, blood clots, cancer of the breast, uterus/cervix, or vagina.Avoid using it if pregnant.Estradiol or levonorgestrel can increase the risk that you will develop a condition that may result in uterine carcinoma. Do not ignore any abnormal vaginal bleeding.This medicine should not be taken to treat strokes or dementia.

Before you take this drug

This medicine should not be used if:

  • Unusual vaginal bleeding not checked by your doctor
  • Liver disease
  • A bleeding disorder;
  • An individual with a history of stroke, heart attack or blood clot should seek medical advice immediately.
  • A history of cancers of the breast, uterus, cervix, or vagina

If you're pregnant, do not take estradiol or levonorgestrel. Inform your doctor immediately if a pregnancy occurs during treatment.This medicine increases your risk of blood clots and stroke. This medicine can increase your risk of blood clots, strokes, and heart attacks.This medicine can actually increase the risk of heart disease, stroke, or dementia.

If you've ever:

  • Heart disease
  • If you have liver disease or yellowing of the skin, it could be caused by pregnancy and/or taking hormones.
  • Hereditary Angioedema
  • Kidney disease
  • Gallbladder Disease
  • Asthma;
  • Epilepsy
  • Lupus;
  • Porphyria
  • Endometriosis or uterine fibroid tumors;
  • A thyroid disease;
  • High levels of calcium are found in the blood.

Estradiol can increase the risk of breast cancer, uterine cancer, or ovarian cancer. Speak to your doctor regarding this possibility.Levonorgestrel and estradiol may slow down the production of breast milk. Inform your doctor that you are breastfeeding.

How to take Estradiol and Levonorgestrel (Transdermal)?

Read all the instructions or guides that come with your medication and follow all the directions. Follow the directions on your prescription label.The skin patch should be applied to a clean and dry area of your lower abdomen. Wear the patch around the clock for a week. Each time you change the patch, choose a different area on your lower abdomen. Skin that is oily or irritated should be avoided.To stay on track, change your patches on the same date each week.Apply a patch of skin to the breasts only. Apply a skin patch only where you are sure it will not be removed by clothing.Try pressing it into position for ten seconds if a patch comes off. You can apply another patch if the first one does not adhere.

You may have to temporarily stop taking estradiol or levonorgestrel if you are going through major surgery, long-term bed rest, or need a lot of rest. You should let any doctor who treats you know that you use estradiol or levonorgestrel.You should have your doctor check on you regularly to see if this is a treatment that should be continued. You should self-examine for lumps in your breasts every month and get regular mammograms when using estradiol or levonorgestrel.Keep patches away from heat and moisture at room temperature. Store each patch separately in the pouch.Fold the skin patch in half after removing it. This will help it stick together. The folded patch should be thrown away in an area that children and animals cannot reach.

What happens if I miss the dose?

If it is almost time for your next dose, skip the one you missed.

What happens if I overdose?

Call 1-800-222-1222 for poison help or seek immediate medical attention.

What should be avoided?

Smoking is harmful. While using levonorgestrel or estradiol, your chances of getting a blood clot, stroke, or heart attack are greatly increased.Wearing the patch on your body is not a good idea.Grapefruit can cause unwanted side effects when combined with levonorgestrel or estradiol. Use grapefruit-based products as little as possible.

Interaction with other drug

It is sometimes not safe to take certain drugs at the same time. Some medications can cause side effects that increase or decrease the effectiveness of another drug you are taking.Estradiol and levonorgestrel can be affected by many drugs. These include prescription drugs, over-the-counter medications, vitamins, and herbal products. This list does not include all interactions. Inform your doctor of all medications you are currently taking and those that you will stop or start using.