Before using transdermal estradiol, tell your doctor and pharmacist if you are allergic to any brand of transdermal estradiol, any other estrogen products, any other medications, or any adhesives. Ask your doctor or pharmacist if you are not sure if a medication you are allergic to contains estrogen.

Tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take.

Be sure to mention any of the following: amiodarone (Cordarone, Pacerone); antifungals such as itraconazole (Sporanox) and ketoconazole (Nizoral); aprepitant (Emend); carbamazepine (Carbatrol, Epitol, Tegretol); cimetidine (Tagamet); clarithromycin (Biaxin); cyclosporine (Neoral, Sandimmune); dexamethasone (Decadron, Dexpak); diltiazem (Cardizem, Dilacor, Tiazac, others); erythromycin (E.E.S, Erythrocin); fluoxetine (Prozac, Sarafem); fluvoxamine (Luvox); griseofulvin (Fulvicin, Grifulvin, Gris-PEG); lovastatin (Altocor, Mevacor); medications for human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) such as atazanavir (Reyataz), delaviridine (Rescriptor); efavirenz (Sustiva);indinavir (Crixivan), lopinavir (in Kaletra),nelfinavir (Viracept), nevirapine (Viramune); ritonavir (Norvir, in Kaletra), and saquinavir (Fortovase, Invirase); medications for thyroid disease; nefazodone; other medications that contain estrogen; phenobarbital; phenytoin (Dilantin, Phenytek); rifabutin (Mycobutin); rifampin (Rifadin, Rimactane, in Rifamate); sertraline (Zoloft);troleandomycin (TAO); verapamil (Calan, Covera, Isoptin, Verelan); and zafirlukast (Accolate).

Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

Tell your doctor what herbal products you are taking, especially St. John's wort.

Tell your doctor if you have or have ever had asthma; seizures; migraine headaches; endometriosis (a condition in which the type of tissue that lines the uterus [womb] grows in other areas of the body); uterine fibroids (growths in the uterus that are not cancer); yellowing of the skin or eyes, especially during pregnancy or while you were using an estrogen product; very high or very low levels of calcium in your blood; porphyria (condition in which abnormal substances build up in the blood and cause problems with the skin or nervous system)or gallbladder, thyroid, pancreas, liver or kidney disease.

Tell your doctor if you are pregnant or plan to become pregnant, or are breast-feeding. If you become pregnant while using transdermal estradiol, call your doctor.If you are using transdermal estradiol to prevent osteoporosis, talk to your doctor about additional ways to prevent the disease such as exercising and taking vitamin D and/or calcium supplements.What special dietary instructions should I follow?

Talk to your doctor about eating grapefruit and drinking grapefruit juice while using this medication.

Talk to your doctor about ways to increase the amount of calcium and vitamin D in your diet.

Transdermal estradiol may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• Headache
• Breast pain or tenderness
• Nausea
• Vomiting
• Constipation
• Gas
• Heartburn
• Weight gain or loss
• Hair loss
• Redness or irritation of the skin that was covered by the estradiol patch
• Swelling, redness, burning, irritation or itching of the vagina
• Vaginal discharge
• Painful menstrual periods
• Anxiety
• Depression
• Changes in mood
• Change in sexual desire
• Back, neck, or muscle pain
• Runny nose or congestion
• Cough
• Darkening of skin on face (may not go away even after you stop using transdermal estradiol
• Unwanted hair growth
• Difficulty wearing contact lenses

Some side effects can be serious. This is a partial list:

• Bulging eyes
• Yellowing of the skin or eyes
• Loss of appetite
• Fever
• Joint pain
• Stomach tenderness, pain, or swelling
• Movements that are difficult to control
• Itching
• Hives
• Rash, blisters on skin, or other skin changes
• Swelling, of the eyes, face, lips, tongue, throat, hands, feet, ankles, or lower legs
• Hoarseness
• Difficulty breathing or swallowing
• Transdermal estradiol may increase your risk of developing cancer of the ovaries and​ ​gallbladder disease that may need to be treated with surgery.

Talk to your doctor about the risks of using transdermal estradiol.

Transdermal estradiol may cause growth to slow or stop early in children who use large doses for a long time.

Your child's doctor will monitor her carefully during her treatment with transdermal estradiol.

Talk to your child's doctor about the risks of giving this medication to your child. Transdermal estradiol may cause other side effects.

Call your doctor if you have any unusual problems while using this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).