Uses & Indications
Menostar is a low-dose transdermal estradiol patch specifically approved for the prevention of postmenopausal osteoporosis in women who are at significant risk and are not candidates for non-estrogen therapies. Unlike other estradiol patches, Menostar is not indicated for treating menopausal symptoms such as hot flashes or vaginal dryness.
Menostar delivers a controlled, consistent dose of estradiol to help maintain bone density and reduce the risk of fractures related to osteoporosis.
How It Works
Menostar contains 17β-estradiol, a bioidentical form of estrogen. It works by:
- Inhibiting bone resorption through its action on osteoclasts
- Promoting bone formation balance
- Maintaining calcium homeostasis
Delivered transdermally, Menostar bypasses the gastrointestinal tract and liver, minimizing first-pass metabolism, resulting in steady blood levels of estradiol with fewer side effects compared to oral estrogen.
Dosage and Administration
- Dose: 14 micrograms of estradiol per day
- Application: Once weekly
- Application site: Clean, dry, hairless skin on the lower abdomen or buttocks
- Rotate sites to avoid skin irritation
- Do not cut the patch
Patients should apply the patch at the same day each week and avoid placing it on breasts or areas exposed to sunlight.
Side Effects
Common side effects include:
- Skin irritation or redness at the patch site
- Breast tenderness
- Headache
- Nausea
- Mild fluid retention or bloating
Serious side effects (rare):
- Venous thromboembolism (blood clots)
- Stroke
- Gallbladder disease
- Increased risk of certain cancers (breast, endometrial)
Warnings and Precautions
- Use the lowest effective dose for the shortest duration possible.
- Consider adding a progestin in women with an intact uterus to reduce the risk of endometrial hyperplasia or cancer.
- Not recommended for women with a history of hormone-sensitive cancers or thromboembolic disorders.
- Monitor blood pressure, lipid profile, and breast health regularly.
- Avoid use during pregnancy or breastfeeding.
Drug Interactions
- Enzyme inducers such as carbamazepine, phenytoin, and rifampin may reduce estradiol levels.
- CYP3A4 inhibitors such as ketoconazole or erythromycin may increase estradiol effects.
- May interact with thyroid hormone, corticosteroids, and anticoagulants.
FAQs
1. Is Menostar effective for hot flashes?
No, Menostar’s low dose is insufficient for treating menopausal vasomotor symptoms.
2. Do I need to take a progestin with Menostar?
Generally not necessary due to low estradiol dose, but some clinicians may recommend it if the uterus is intact.
3. How long can I use Menostar?
Duration depends on individual risk factors and physician recommendations. Regular evaluations are essential.
4. What if the patch falls off?
Apply a new patch and continue the regular schedule.
