CombiPatch dosage: A detailed guide

This article describes CombiPatch’s dosages and strengths and gives details on how to use it. You’ll also find information on cost savings and coupon options for CombiPatch. If you want to know more about CombiPatch, talk with your doctor or pharmacist.

CombiPatch is a brand-name medication that comes as a transdermal patch that you apply to the skin. It isn’t available in a generic version. This article describes dosages of CombiPatch.

Boxed warnings

CombiPatch has boxed warnings about the risks of dementia and serious heart and blood vessel problems. It also has boxed warnings about the risks of breast cancer and endometrial cancer. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

See the end of this article for more information about these warnings.

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Form and strengths of CombiPatch

CombiPatch comes as follows:

• Form: transdermal patch that you apply to the skin on your lower abdomen
• Strengths:
  • 9 cm² size: 0.05 milligrams (mg) of estradiol and 0.14 mg of norethindrone acetate per day
  • 16 cm² size: 0.05 mg of estradiol and 0.25 mg of norethindrone acetate per day

When applied to intact skin, CombiPatch continuously releases the female* sex hormones estradiol, an estrogen, and norethindrone acetate, a progestin.

* Sex and gender exist on spectrums. In this article, we use the term “female” to refer to a person’s sex assigned at birth.

Dosage of CombiPatch

This article describes the recommended dosages for CombiPatch. The drugmaker provides these dosages.

If your doctor prescribes this medication, you should follow the dosage they prescribe. Your doctor will determine the dosage that best meets your needs. Do not change your dosage of CombiPatch without your doctor’s recommendation.

Usual recommended dosages of CombiPatch in adults

Usually, doctors start by prescribing a low dosage of CombiPatch. Then they’ll adjust it over time as needed until the right dosage is reached. Ultimately, your doctor will prescribe the smallest dosage of CombiPatch for the shortest duration needed to give the desired outcome.

CombiPatch is approved for use in females* with a uterus to treat:

• moderate to severe hot flashes or night sweats that occur due to menopause
• moderate to severe symptoms of vaginal atrophy (thinning of the walls of the vagina) due to menopause
• low estrogen due to certain causes, such as hypogonadism (when the body produces little or no sex hormones) or primary ovarian failure (when the ovaries stop working as they usually do before age 40)

* Sex and gender exist on spectrums. In this article, we use the term “female” to refer to a person’s sex assigned at birth.

For all these approved uses, there are two dosing regimens for CombiPatch:

• Continuous combined regimen: CombiPatch is used throughout a 28-day cycle.
• Continuous sequential regimen:
  • For the first 14 days of a 28-day cycle, a different transdermal patch releasing 0.05 mg per day of estradiol (such as Vivelle-Dot) is applied twice per week (every 3–4 days).
  • For the last 14 days of a 28-day cycle, CombiPatch is used.

These regimens for CombiPatch are outlined in more detail in the table below. The doses shown below represent mg of estradiol/norethindrone acetate released by CombiPatch.

Dosage adjustments for CombiPatch

Your doctor will prescribe a dosage of CombiPatch based on several factors. These include:

• the specific condition being treated and how severe it is
• your age
• other health conditions you may have
• other medications you take

Missed dose of CombiPatch

Talk with your doctor or pharmacist right away if you realize you forgot a dose of CombiPatch. They will likely advise you to apply a new CombiPatch as soon as possible.

For tips on how to plan your doses of CombiPatch and avoid missing a dose, read this article. You could also try:

• downloading a reminder app on your phone
• setting an alarm
• putting a note where you’ll see it, such as on your calendar, bathroom mirror, or bedside table

Frequently asked questions

Below are answers to some commonly asked questions about CombiPatch and its dosage.

Does CombiPatch need to be refrigerated before I place my dose?

Yes, the prescribing information recommends that CombiPatch be stored in the refrigerator at a temperature of 36–46°F (2–8°C).

Let the patch come to room temperature before you apply it. Keep CombiPatch in its sealed pouch until you’re ready to use it. Do not store CombiPatch outside of its pouch.

If you have other questions about how to store CombiPatch, talk with your pharmacist or doctor.

Can I place CombiPatch on my buttocks?

No, it’s not recommended that you place CombiPatch on your buttocks.

CombiPatch should be placed on the lower abdomen, below the panty line. This is how CombiPatch was used in studies of the drug. Avoid applying the patch near the waistline because clothing or belts could rub the patch off or make it not work as well.

There are other transdermal patches that are approved for similar uses as CombiPatch that may be applied to the buttocks. For example, Climara Pro is also approved to treat certain symptoms of menopause. It’s applied once per week to the lower abdomen or buttocks. But it has different ingredients than CombiPatch.

For more details about how to use CombiPatch, see the “How CombiPatch is used” section below, or talk with your pharmacist or doctor. Or talk with your doctor about other treatment options.

Is CombiPatch used long term?

Possibly. In some cases, doctors may prescribe CombiPatch as a long-term treatment. If you and your doctor determine that it’s safe and effective for your condition, you may continue to use it for some time.

Still, there are possible risks with using hormone therapy, such as CombiPatch, long term. For example, there may be higher risks of heart and blood vessel problems or certain types of cancer if it’s used for longer periods of time. Due to these risks, your doctor will likely prescribe CombiPatch for the shortest duration and at the lowest dose needed for your condition. Your doctor will likely talk with you every 3–6 months about your treatment.

If you have questions about how long you should use CombiPatch, talk with your doctor. For more details about possible risks of CombiPatch, see the “Boxed warnings for CombiPatch” section below.

How CombiPatch is used

Apply CombiPatch to your lower abdomen twice per week (every 3–4 days). Apply it below the panty line.

Avoid applying CombiPatch near the waistline because clothing or belts could rub the patch off or make it not work as well. Do not apply CombiPatch near your breasts.

Keep the patch in its pouch until you’re ready to apply it. Only apply the patch to clean, dry skin that doesn’t have any oil, lotion, or powder on it. Avoid applying it to any areas that are irritated, injured, or that have birthmarks or tattoos.

Once you’re ready to apply the patch, remove one side of the protective liner and apply the sticky side of the patch to your lower abdomen. Then peel off the other side of the protective liner and press the patch for about 10 seconds so it stays in place.

When you change your patch, remove the old patch and apply the new patch to a different area of your lower abdomen. Wait at least 1 week before you apply a patch to the same area on the lower abdomen. Avoid exposing the patch to the sun for long periods. You can bathe, shower, or swim while wearing the patch.

Patches can still contain medication after use. It’s important to properly dispose of your CombiPatch after it’s been used. To throw away the patch, fold the sticky side of the patch together, place it in a sturdy childproof container and place this container in the trash. Used patches should not be flushed down the toilet.

Be sure to talk with your doctor or pharmacist if you’re having difficulty using your medication. They can offer recommendations about how to use it. You can also find more details about how to use CombiPatch on the product website.

CombiPatch coupon

Visit this page to access Optum Perks coupons and get price estimates for CombiPatch when you use the coupons. These coupons can provide significant savings on your prescription costs.

Note: Optum Perks coupons cannot be used with insurance copays or benefits.

Download the free Optum Perks Discount Card to save up to 80% on some prescription medications.

You can also check the CombiPatch product website for other possible options for cost savings.

Overdose of CombiPatch

It’s important that you do not use more CombiPatch than your doctor prescribes. Doing so can lead to harmful effects.

Symptoms of CombiPatch overdose

Symptoms of an overdose can include:

• nausea and vomiting
• breast tenderness
• stomach pain
• drowsiness and fatigue
• vaginal bleeding

What to do if you use too much CombiPatch

If you think you’ve used too much CombiPatch, call your doctor or pharmacist right away. Or you can call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have severe symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

What to ask your doctor

This article describes the usual recommended dosages for CombiPatch. If your doctor prescribes this medication, they’ll determine the dosage that’s best for you.

Do not change your dosage of CombiPatch without your doctor’s recommendation. You should take CombiPatch exactly as your doctor prescribes it. Let your doctor know if you have concerns or questions about your treatment plan.

Here’s a list of some possible questions you may want to ask your doctor:

• Will the dosage of CombiPatch be changed during my treatment?
• How long will I be prescribed CombiPatch?
• How does my dosage affect my risk of having side effects?
• Does the dosage of CombiPatch need to be changed if I’m taking other drugs with it?

Boxed warnings for CombiPatch

This drug has boxed warnings about the risks of dementia and serious heart and blood vessel problems. It also has boxed warnings about the risks of breast cancer and endometrial cancer. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

CombiPatch contains an estrogen (estradiol) and a progestin (norethindrone acetate).

Risk of dementia: In studies, there was a higher risk of dementia in females* ages 65 years and older who had gone through menopause and received estrogen therapy, with or without a progestin, for several years. Estrogen, with or without a progestin, should not be used to prevent dementia. Tell your doctor if you have symptoms of dementia, such as confusion, changes in mood, or memory problems.

Risk of serious heart and blood vessel problems: In studies, there was a higher risk of blood clots, strokes, and heart attacks in females* ages 50–79 years and older who had gone through menopause and received estrogen therapy, with or without a progestin, for several years. The risk may be higher if you have other conditions, such as high blood pressure, diabetes, or high cholesterol. Estrogen, with or without a progestin, should not be used to prevent heart disease.

Tell your doctor if you’ve had blood clots, a stroke, or a heart attack in the past. Due to this risk, your doctor will likely stop CombiPatch at least 4–6 weeks before certain surgeries or if you are likely to be on bed rest. Your doctor may not prescribe the drug if you have risks for heart and blood vessel problems, or they may recommend ways to lower your risk of heart disease. Seek emergency care or call 911 if you have symptoms of a blood clot, stroke, or heart attack. These may include severe pain in your chest or legs, trouble walking or speaking, numbness, weakness, or an irregular heartbeat.

Risk of breast cancer: In studies, there was a higher risk of breast cancer in females* who received an estrogen plus a progestin. Symptoms of breast cancer may include a breast lump, breast pain, swelling in the breast, or nipple discharge. Due to this risk, your doctor will likely prescribe the lowest effective dose of CombiPatch for the shortest duration needed for your condition. They’ll likely also advise getting yearly breast exams and recommend that you do monthly breast self-exams. Your doctor may also recommend mammograms based on your age and risk for breast cancer.

Risk of endometrial cancer: Endometrial cancer is a type of cancer that starts in the inner lining of the uterus. There is a higher risk of endometrial cancer in females* who have a uterus and use an estrogen without a progestin. The risk may depend on the estrogen dose and how long it’s used. Adding a progestin to an estrogen may lower the risk of endometrial cancer. But this combination may increase the risk of breast cancer. Tell your doctor if you have vaginal bleeding that is unusual or long lasting. This could be a sign of endometrial cancer. Due to this risk, your doctor will likely prescribe the lowest effective dose of CombiPatch for the shortest duration needed for your condition.

You can talk with your doctor to learn more about these risks.

* Sex and gender exist on spectrums. In this article, we use the term “female” to refer to a person’s sex assigned at birth.

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.