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[Hurdity]

Hi there all - was looking for updates about my fave patches Estradot and came across this which seems to have gone by unnoticed....I don't think it's already been posted? I've also updated the other thread....

https://thebms.org.uk/2020/01/british-menopause-society-further-update-on-hrt-supply-shortages-27th-january-2020/

Happy reading - things are looking up! As always - even though the manufacturer may not be reporting shortages - just as I am finding with Estradot - there may be shortages further down the supply chain as demand outstrips supply but hopefully docs are only allowing a couple of months at a time for products not apparently in short supply, max 3 months - and then there should be enough for us all

I was going to reproduce in full but it's a bit long!

Hurdity x

[NightNurse]

Thank you for this update Hurdity. I've just come back from the practice nurse who cheerfully told me not Estradot was not available for the foreseeable!  Last autumn there were no Evorel patches so I was changed to Estradot. After a bit of a bumpy start - and excellent advice from Hurdity () and words of support from others on this site, all seems settled and symptoms are minimal and I am coping well.

Today my practice nurse has changed me to gel sachets. She didn't know the equivalent dose of Estradot 100mcg in gel and suggested I "gave it a try" and discover for myself!  I'm all for being self-reliant but I'm not sure this is the best way to go about it.

On the BMS information, it says women taking Evorel 100 patches could change to Estradot 100 - but I've been told there aren't ANY patches currently available.  Nevermind, I'll try the gel. I don't know whether I'm getting Sanrena gel or the Oestragel as the pharmacy has to order it in.

The BMS info suggests 100 mcg patches are equivalent to 4 measures of Oestrogel a day, and suggests application at 2am and 2pm. 

First question, just to confirm: is this 2 measures twice a day?  If so, are they really suggesting waking in the night??  Surely 7am and 7pm would be fine?  I sometimes work 12 hour shifts so would not be able to apply exactly at these times: how much flexibility is there in the time of application?
Second question: if I get Sandrena sachets the amount I would apply would depend on the strength of the gel. The advice suggests 1mg sachet is equivalent to Evorel 50 so I'm guessing two sachets to Estradot 100?

The last question: has anyone any experience of buying patches via an online pharmacy? I can see Estradot is available. Any thoughts or advice?
Thank you! x

[Hurdity]

Hi NightNurse

You're welcome - we like to try to help...

Gauging equivalence is tricky - Dotty recently posted the BMS link elsewhere today and I'll quote her post here:

https://thebms.org.uk/wp-content/uploads/2018/08/HRT-Practical-Prescribing-AUG2018.pdf

Bottom of first page is the equivalent doses x

This gives a rough guide but it does depend how well you absorb it. If it was oestrogel it would be 4 pumps (equivalent to 100 mcg on average) but would be best to start with lower in case you absorb very well. Sandrena is trickier because the advice seems to be that medium dose is 1 sachet of 1 g gel = 1 mg Sandrena whereas with oestrogel two pumps (- the medium dose) gives 1.5 mg in 2.5 g gel (think I've got that right...). I changed from 50 mcg patch to 1 sachet Sandrena ( ie i mg oestrogen) but my flushes came back so I went back to patches.

If you want to stick with patches there should be plenty available of certain types - look at the BMS update and get onto your local pharmacies to find out which they can get. Buying online can be dodgy although some of the reputable ones will take an NHS prescrption but it seems that they are showing patches to be in and out of stock...

Good luck!

Hurdity x

[Katejo]

Thank you for this update Hurdity. I've just come back from the practice nurse who cheerfully told me not Estradot was not available for the foreseeable!  Last autumn there were no Evorel patches so I was changed to Estradot. After a bit of a bumpy start - and excellent advice from Hurdity () and words of support from others on this site, all seems settled and symptoms are minimal and I am coping well.

Today my practice nurse has changed me to gel sachets. She didn't know the equivalent dose of Estradot 100mcg in gel and suggested I "gave it a try" and discover for myself!  I'm all for being self-reliant but I'm not sure this is the best way to go about it.

On the BMS information, it says women taking Evorel 100 patches could change to Estradot 100 - but I've been told there aren't ANY patches currently available.  Nevermind, I'll try the gel. I don't know whether I'm getting Sanrena gel or the Oestragel as the pharmacy has to order it in.

The BMS info suggests 100 mcg patches are equivalent to 4 measures of Oestrogel a day, and suggests application at 2am and 2pm. 

First question, just to confirm: is this 2 measures twice a day?  If so, are they really suggesting waking in the night??  Surely 7am and 7pm would be fine?  I sometimes work 12 hour shifts so would not be able to apply exactly at these times: how much flexibility is there in the time of application?
Second question: if I get Sandrena sachets the amount I would apply would depend on the strength of the gel. The advice suggests 1mg sachet is equivalent to Evorel 50 so I'm guessing two sachets to Estradot 100?

The last question: has anyone any experience of buying patches via an online pharmacy? I can see Estradot is available. Any thoughts or advice?
Thank you! x

I have managed to get Evorel Conti from the Independent Pharmacy up to now but availability is intermittent at the moment. I haven't checked today.

[Salad]

Thanks Hurdity

I spoke to Novartis yesterday who said they are releasing Estradot patches to suppliers every week.
One pharmacy told me they couldn't get any until March. The next one i went to said it would take a week.
Fingers crossed the second one is right   

[Goosieloosie]

I've just had the pharmacist ring me from Asda telling me they can't get my Estradot & offered me Estraderm?? I asked if she could please contact Novartis themselves & ask them before I try the alternative. Apparently without even consulting me the pharmacist has rang my GP surgery & got the Estraderm prescription sent over!! Now it seems she couldn't have tried very hard as I only put the prescription in yesterday & I did warn her that there's usually an issue getting hold of them & to contact Novartis if she has bother. I've been on Estradot/utrogestan for 4 yrs now & I'm reluctant to change to Estraderm. Has anyone had this & found it different? How large are the actual patches as Estradot are tiny?

[Hurdity]

Thanks Hurdity

I spoke to Novartis yesterday who said they are releasing Estradot patches to suppliers every week.
One pharmacy told me they couldn't get any until March. The next one i went to said it would take a week.
Fingers crossed the second one is right   

Yes my pharmacist contacted them and they said this too - but unfortunately demand is outstripping supply so they are not getting far enough down the supply chain. Also depends which supplier your pharmacies use - mine come from Alliance and they haven't been able to get any where I live for yonks!

Frustrating to say the least - I haven't had Estradot for several months despite what Novartis are saying!

Hurdity x

[Hurdity]

I've just had the pharmacist ring me from Asda telling me they can't get my Estradot & offered me Estraderm?? I asked if she could please contact Novartis themselves & ask them before I try the alternative. Apparently without even consulting me the pharmacist has rang my GP surgery & got the Estraderm prescription sent over!! Now it seems she couldn't have tried very hard as I only put the prescription in yesterday & I did warn her that there's usually an issue getting hold of them & to contact Novartis if she has bother. I've been on Estradot/utrogestan for 4 yrs now & I'm reluctant to change to Estraderm. Has anyone had this & found it different? How large are the actual patches as Estradot are tiny?

Please look at this thread GoosieLoosie as I did just that - change from Estradot to Estraderm:
https://www.menopausematters.co.uk/forum/index.php/topic,45474.msg732280.html#msg732280

My symptoms were fine with them (ie did not return) - they are just not very user friendly as they are so huge! Elleste are much better and I am happy with these.

Hurdity x

[Goosieloosie]

Thank you Hurdity, I have read the thread & see there is a general shortage of all patches lately unfortunately I called into Asda tonight and spoke with the pharmacist who rang me & I told her I do not want the Estraderm & she is going to ring Novartis in the morning to see if she can source Estradot (fingers crossed) if not she said she'll ring my GP to do me a fresh prescription for Estradot so I can take it elsewhere to try and get hold of them but after reading on here about the shortage I may ask her to get me a prescription for Elleste, I really do not fancy the Estraderm after your experience!! Estradot are so small you forget it's there & I've never had one come off ever. So annoying that these manufacturers cannot simply make more .
Thank you again for pointing me in the direction of the relevant thread. 

[Goosieloosie]

Hurdity, I've just actually realised Elleste solo only comes in 40 or 80 & I'm on Estradot 50?? Elleste won't be any good for me then? 

[NightNurse]

Thanks everyone for the support and advice. 

I'm going to check with my pharmacy what they can actually get hold of and not settle for gel unless absolutely necessary.  It does seem a bit of a faff but I'm prejudging, how do others find it?

I've looked at Independent Pharmacy online and they are currently stocking FemSeven.  It's almost ?72 for three boxes & postage!!! I'm never going to moan about an NHS prescription charge EVER again!  I think FemSeven is the same as Estradot but changed once a week - hence the name and it doesn't appear to be commonly used in UK.  Does anyone have personal experience of it?

I'm also going to share the link from BMS of the guide to equivalence with my practice nurse.  It looks very helpful.

[Hurdity]

Hurdity, I've just actually realised Elleste solo only comes in 40 or 80 & I'm on Estradot 50?? Elleste won't be any good for me then? 

Ah sorry I'd forgotten that - I am on 62.5 so I get 75 prescribed and cut them down, I get prescribed 80 mcg of Elleste. However interestingly I think I absorb more oestrogen from these larger patches than the Estradot so might be worth a try with the 40 mcg but it would be no good if it turned out that your flushes returned! Good luck anyway.

Hurdity x

[Katejo]

Thanks everyone for the support and advice. 

I'm going to check with my pharmacy what they can actually get hold of and not settle for gel unless absolutely necessary.  It does seem a bit of a faff but I'm prejudging, how do others find it?

I've looked at Independent Pharmacy online and they are currently stocking FemSeven.  It's almost ?72 for three boxes & postage!!! I'm never going to moan about an NHS prescription charge EVER again!  I think FemSeven is the same as Estradot but changed once a week - hence the name and it doesn't appear to be commonly used in UK.  Does anyone have personal experience of it?

I'm also going to share the link from BMS of the guide to equivalence with my practice nurse.  It looks very helpful.

Please note that you won't pay Independent Pharmacy's high charges if you send them an NHS prescription. You just pay the standard NHS charge. I have done this twice to get Evorel Conti. I have NHS exemption because of other medication so paid nothing to them. I just ticked the boxes/signed the prescription in the usual way.

[Grumpymum]

Nightnurse - I've had Femseven. I thought they were the patches that were discontinued pending review over their adhesive. I found they just didn't want to stick but I think others succeeded, they are also huge.

Praise to the heavens - I had a call yesterday from my local Boots to say they had got hold of my Estradot 75s! I've only been waiting since about November! I managed to source some 100s just before Christmas in another town and am cutting them down but now running low on them. I have been rather a nuisance to Boots. I rang Novartis who advised me to get my chemist to phone them to find out which day the Estradot stock was going into their warehouse, and then phone the warehouse on that day to order some, and thank goodness Boots diarised it all and came good! Can't wait for this HRT crisis to be over, the stress isn't great!

[Goosieloosie]

Hurdity, I've just actually realised Elleste solo only comes in 40 or 80 & I'm on Estradot 50?? Elleste won't be any good for me then? 

Ah sorry I'd forgotten that - I am on 62.5 so I get 75 prescribed and cut them down, I get prescribed 80 mcg of Elleste. However interestingly I think I absorb more oestrogen from these larger patches than the Estradot so might be worth a try with the 40 mcg but it would be no good if it turned out that your flushes returned! Good luck anyway.

Hurdity x

I'm crossing fingers that Asda have rang Novartis today and they can get me a box of Estradot, luckily I have enough for about 5 week's otherwise I just don't know what to do I didn't actually find the pharmacist very helpful & was annoyed that she contacted my GP to send over a prescription for Estraderm without even consulting me first!! After all I'm not in a terrible rush to get them as I have about 5 week's worth of Estradot left so if she'd contacted me first I could've explained this & told her that I don't mind waiting!!