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What you need to know about Estraderm TTS  
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Please read this carefully before you start to use your patches.  This leaflet does not contain the complete information about your patches.  If you have any questions or are not sure about anything ask your doctor or pharmacist.
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Estraderm TTS patches contain a substance called oestradiol. They come in three sizes:
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Estraderm TTS 25 containing 2mg <CB n=2> of oestradiol. Your body will absorb about 25 micrograms of oestradiol each day whilst you are wearing an Estraderm TTS 25 patch.
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Estraderm TTS 50 containing 4mg of oestradiol.  Your body will absorb about 50 micrograms of oestradiol each day whilst you are wearing an Estraderm TTS 50 patch.
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Estraderm TTS 100 containing 8mg of oestradiol.  Your body will absorb about 100 micrograms of oestradiol each day whilst you are wearing an Estraderm TTS 100 patch.
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Oestradiol is a form of oestrogen and belongs to a group of medicines known as Hormone Replacement Therapy (HRT) which are used to relieve symptoms of the menopause (change of life), such as hot flushes and night sweats.  Your <CB n=2> doctor may also prescribe this product (at a minimum dose of Estraderm TTS 50) for the prevention of osteoporosis (thinning of the bones).
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Things to remember about Estraderm TTS
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Make sure it is safe for you to use these patches (read the section inside this leaflet called 'Before using your patches').
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Instructions for using these patches are given in this leaflet.  Please follow them carefully.
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Estraderm TTS is NOT a contraceptive.  If you need advice about family planning talk to your doctor.
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These patches may cause unwanted effects in some people. You can find information about them in this leaflet. (Look in the <CB n=2> section called 'After using your patches').
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Keep your patches in a cool place, out of the reach of children.  When you take off a patch, fold it in half with the sticky side inwards and throw it away carefully.  Even used patches will contain some active medication so make sure that your patches are always kept well away from children.
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Before using your patches
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Are you being treated for a thrombosis (blood clot) of any kind?
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Do you have any liver, kidney or heart disease?
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Have you ever had treatment for a breast lump, or any serious disease of your womb?
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Have you had any bleeding between periods or since your last period, if your periods have stopped?
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Is there any chance that you may be pregnant?
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If the answer to any of these questions is YES, talk to your doctor or pharmacist before using your patches.
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Have you ever suffered from hearing loss during pregnancy or when taking oestrogens, for example, oral contraceptives?
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Do you suffer from epilepsy (fits) or migraine?
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If the answer to either of these questions is YES, tell your doctor or pharmacist.
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Most women using Estraderm will have had a hysterectomy (an <PB n=6> <CB n=1> operation to remove the womb).  If you have not had a hysterectomy you will need to take another hormone called progestogen for 12 days each month.  You will probably have a 'period' each month towards the end of the course of progestogen. This is quite normal.
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Using your patches
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Always use your patches as directed by your doctor.
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The patches should be changed twice each week, always on the same two days.  You may find it helpful to stick the 'day of the week' sticker beginning with your first day of treatment in the space on the inside cover of the carton.  This then shows the two days each week when you should change your patch.  
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Throw the other stickers away.
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  When you finish an Estraderm pack, start the next pack straightaway.  There is no need to have a break between packs.
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Putting on a patch
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Remove one sachet from the box and tear it open at the notch.  Use your fingers because cutting with scissors might damage the patch inside.  You must never cut or tear your patches in any way.
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Take out the transparent patch and loosen the backing by rubbing the edge of the patch between your thumb and forefinger.  The stiff protective liner will peel off the flexible, sticky patch.
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Stick the patch onto a hairless area of skin below the waist.  Most patients find that the buttock is the best place and that skin irritation is less likely to occur at this site.  You could also try the lower back, hip, abdomen or upper thigh.  Never put a patch on or near the breasts.
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Choose a clean, dry area of skin.  Avoid skin which is red or irritated.  Never powder or oil your skin before putting on a patch as it may not stick properly.
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Place the sticky patch on the area of skin you have chosen and press it firmly into position with the palm of your hand.  Pressing for 10 seconds or so will make it stick securely.
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Run your finger around the edge of the patch to make sure that the edges stick.  Provided that you have applied the patch correctly, you can bathe, shower or swim with little risk of the patch coming off.
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If the patch does come off in the bath or shower, just shake it to remove any water, dry the skin thoroughly and put it on again in the usual way.
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When the time comes to change your patch, take off the old one, fold it in half with the sticky side inwards, and throw it away carefully out of the reach of children.  Remember, it will still contain some medication.
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Always place your new patch on a fresh area of skin.
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If you forget to change the patch at the right time, you should <CB n=2> change it as soon as possible. Then continue to change your patches on the usual days as normal.
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After using your patches
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These patches sometimes cause unwanted effects in some people:
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Headaches, nausea or breast tenderness.
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Cramping pains in the calf.
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Feeling slightly bloated.
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Slight redness and itching of the skin where a patch has been.  This usually disappears within 3-4 days of taking off the patch.
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These effects are often mild and may wear off after a few weeks' treatment.
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If they are very troublesome and do not improve tell your doctor.
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Very rarely, a more severe skin reaction can occur.  If this happens, tell your doctor.
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If you have not had a hysterectomy and you have any irregular bleeding or spotting after the first month or so of treatment, tell your doctor.
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Other useful information
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Sunbathing - always make sure your patch is covered by clothing.
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Using a sunbed - either cover up your patch as above or take it off and put it back on after your shower when your skin is completely cool and dry.
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Swimming - you can wear your <CB n=2> patch beneath your swimming costume during swimming.
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Never stick on a patch straight after a hot bath or shower.  Wait a while for the skin to become completely cool and dry.
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If a patch comes off and will not stick back on, apply a new patch in the usual way.  Remember to apply your next patch at the normal time. If you have run out of <PB n=14> <CB n=1> patches, contact your doctor straightaway.
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Precautions
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Whilst you are receiving Estraderm TTS you should have regular check-ups with your doctor.  He or she will tell you how often this should he done.
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REMEMBER:
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 this medicine is for 
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YOU
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. Only a doctor can prescribe it for you. Never give it to someone else. It may harm them even if they have the same symptoms as you.
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This leaflet is produced in accordance with guidance issued by the Association of the British Pharmaceutical Industry.  The information in it applies only to Estraderm TTS.
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This leaflet has been prepared for patients as part of our 'Partners in Health Care' theme by:
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Ciba Laboratories Horsham, West Sussex,
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England.
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PL 0001/0112 PL 0001/0113 PL 0001/0114 Supplied by Ciba-Geigy, Switzerland for Ciba Laboratories,
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Horsham, West Sussex.
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Copyright Ciba-Geigy PLC MARCH 1993
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C  I  B  A
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