
Ask a doctor about a prescription for ESTRADERM MATRIX 25 micrograms/24 hours TRANSDERMAL PATCHES
Package Leaflet:information for the user
ESTRADERM MATRIX 25 micrograms/24 hours transdermal patches
Estradiol
Read all of this leaflet carefully before you start using this medicine because it contains important information for you.
Contents of the pack and other information:
Estraderm Matrix is a Hormone Replacement Therapy (HRT) that contains the female hormone estradiol.
Estraderm Matrix is used in postmenopausal women.
Estraderm Matrix is used for:
During menopause, the amount of estrogens produced by the woman's body decreases. This can cause symptoms such as sudden hot flushes to the face, neck, and chest. Estraderm Matrix relieves these symptoms after menopause. You will only be prescribed Estraderm Matrix if your symptoms seriously disrupt your daily life.
After menopause, some women may develop fragile bones (osteoporosis). Consult your doctor about all available treatment options. If you have a high risk of suffering fractures due to osteoporosis and other medications are not suitable for you, you can use Estraderm Matrix to prevent osteoporosis after menopause.
Medical history and regular check-ups
The use of HRT involves risks that need to be considered when deciding whether to use it or to continue treatment.
Experience in treating women with premature menopause (due to ovarian failure or surgery) is limited. If you have premature menopause, the risks of using HRT may be different. Please consult your doctor.
Before starting (or resuming) HRT, your doctor will ask about your personal and family medical history. Your doctor may decide to perform a physical examination. This may include a breast examination and/or an internal examination, if necessary.
Once you start treatment with Estraderm Matrix, you should see your doctor for regular check-ups (at least once a year). During these check-ups, discuss the benefits and risks of continuing with Estraderm Matrix with your doctor.
Have regular breast examinations, as recommended by your doctor.
Do not use Estraderm Matrix
If any of the following conditions apply to you. If you are not sure about any of the points listed below, consult your doctorbefore using Estraderm Matrix.
Do not use Estraderm Matrix
If you experience any of the conditions mentioned above for the first time while using Estraderm Matrix, stop treatment immediately and consult your doctor immediately.
Warnings and precautions
Tell your doctor if you suffer or have suffered from any of the following conditions before starting treatment, as they may recur or worsen during treatment with Estraderm Matrix. In that case, you should see your doctor more frequently for regular check-ups:
Stop using Estraderm Matrix and see a doctor immediately.
If you experience any of the following while using HRT:
For signs of a blood clot, see "Stop using Estraderm Matrix and see a doctor immediately".
Note:Estraderm Matrix is not a contraceptive. If it has been less than 12 months since your last menstrual period or you are under 50 years old, you may still need additional contraceptive measures to prevent pregnancy. Talk to your doctor for advice.
HRT and cancer
Thickening of the lining of the uterus (endometrial hyperplasia) and cancer of the lining of the uterus (endometrial cancer)
Taking HRT with estrogen-only products will increase the risk of developing thickening of the lining of the uterus (endometrial hyperplasia) and cancer of the lining of the uterus (endometrial cancer).
The addition of a progestogen to estrogen treatment for at least 12 days of each 28-day cycle will protect you from this additional risk. Therefore, if you still have your uterus, your doctor will prescribe a progestogen for you to take alongside Estraderm Matrix for at least 12 days per cycle to reduce the risk of endometrial cancer. If you have had a hysterectomy (removal of the uterus), ask your doctor whether you can be treated safely with this medicine without the use of a progestogen.
In women between the ages of 50 and 65, who still have their uterus and are not taking HRT, about 5 in 1000 will be diagnosed with cancer of the lining of the uterus.
In women between the ages of 50 and 65, with a uterus, taking HRT with estrogen-only products, between 10 and 60 women in 1000 will be diagnosed with endometrial cancer (i.e., between 5 and 55 additional cases), depending on the dose and duration of therapy.
Unexpected bleeding
You will experience monthly bleeding (called withdrawal bleeding) while using Estraderm Matrix. However, if you experience unexpected bleeding or spotting that:
See your doctor as soon as possible.
Breast cancer
Existing data show that the use of hormone replacement therapy (HRT) with combined estrogen-progestogen or estrogen-only products increases the risk of breast cancer. The additional risk depends on how long you use HRT. The additional risk becomes apparent after 3 years of use. After stopping HRT, the additional risk will decrease over time but may persist for 10 years or more if you have used HRT for more than 5 years.
Comparison
In women between the ages of 50 and 54 who are not using HRT, about 13 to 17 in 1000 will be diagnosed with breast cancer over a 5-year period.
In women aged 50 who start HRT with estrogen-only products for 5 years, there will be between 16 and 17 cases per 1000 users (i.e., between 0 and 3 additional cases).
In women aged 50 who start HRT with combined estrogen-progestogen products for 5 years, there will be 21 cases per 1000 users (i.e., between 4 and 8 cases).
In women between the ages of 50 and 59 who are not taking HRT, an average of 27 cases of breast cancer will be diagnosed per 1000 women over a 10-year period.
In women aged 50 who start HRT with estrogen-only products for more than 10 years, there will be 34 cases per 1000 users (i.e., 7 additional cases).
In women aged 50 who start HRT with combined estrogen-progestogen products for 10 years, there will be 48 cases per 1000 users (i.e., 21 additional cases).
Examine your breasts regularly. See your doctor if you notice any change, such as:
In addition, it is recommended that you join breast cancer screening programs when they are offered to you. For breast cancer screening, it is important to inform the healthcare professional performing the X-ray that you are using HRT, as this medicine may increase the density of your breasts, which can affect the outcome of the mammogram. When breast density is increased, the mammogram may not detect all lumps.
Ovarian cancer
Ovarian cancer is less common than breast cancer. The use of HRT with estrogen-only or combined estrogen-progestogen products has been associated with a slightly increased risk of ovarian cancer.
The risk of ovarian cancer varies with age. For example, in women between the ages of 50 and 54 who are not taking HRT, about 2 cases of ovarian cancer are diagnosed per 2000 women over a 5-year period. In women taking HRT for 5 years, about 3 cases are diagnosed per 2000 users (i.e., about 1 additional case).
Effect of HRT on the heart and circulation
Blood clots in a vein (thrombosis)
The risk of blood clots in the veinsis about 1.3 to 3 times higher for HRT users than for non-users, especially during the first year of treatment.
Blood clots can be serious, and if one travels to the lungs, it can cause chest pain, difficulty breathing, fainting, or even death.
You are more likely to develop a blood clot in your veins with age and if you experience any of the following. Tell your doctor if you are in any of the following situations:
For signs of a blood clot, see "Stop using Estraderm Matrix and see a doctor immediately".
Comparison
In women in their 50s who are not taking HRT, about 4 to 7 in 1000 will have a blood clot in a vein over a 5-year period.
In women in their 50s who take combined HRT with estrogen-progestogen for 5 years, there will be 9 to 12 cases per 1000 users (i.e., 5 additional cases).
In women in their 50s who have had a hysterectomy and have been treated with HRT with estrogen-only products for 5 years, there will be 5 to 8 cases per 1000 users (i.e., 1 additional case).
Heart disease (heart attack)
There is no evidence that HRT will prevent a heart attack.
Women over 60 years old who use HRT with estrogen and progestogen are slightly more likely to develop heart disease than those who do not take HRT.
In women who have had a hysterectomy and are only taking estrogen therapy, there is no increased risk of heart disease.
Stroke
The risk of having a stroke is about 1.5 times higher in HRT users than in non-users. The number of additional stroke cases due to HRT use increases with age.
Comparison
In women in their 50s who do not take HRT, about 8 in 1000 will have a stroke over a 5-year period.
In women in their 50s who are treated with HRT, 11 in 1000 will have a stroke over a 5-year period (i.e., 3 additional cases).
Other conditions
HRT does not prevent memory loss. There is some evidence of an increased risk of memory loss in women who start HRT after the age of 65. Talk to your doctor for advice.
Children
Estraderm Matrix should not be used in children.
Other medicines and Estraderm Matrix
Some medicines may interfere with the effect of Estraderm Matrix. This may cause irregular bleeding. This occurs with the following medicines:
HRT may affect the way other medicines work:
Please inform your doctor or pharmacist if you are taking or have recently taken any other medicines, including those obtained without a prescription, herbal remedies, or other natural products. Your doctor will advise you.
Lab tests
If you need a blood test, tell your doctor or the laboratory staff that you are using Estraderm Matrix, as this medicine may affect the results of some tests. Some lab tests, such as glucose tolerance or thyroid function tests, may be affected by treatment with Estraderm Matrix.
Pregnancy and breastfeeding
Estraderm Matrix is a medicine for postmenopausal women only. If you become pregnant, stop treatment with Estraderm Matrix and contact your doctor.
Estraderm Matrix should not be used during breastfeeding.
Driving and using machines
Estraderm Matrix does not affect your ability to drive or use machines.
Follow your doctor's administration instructions for this medication exactly. If in doubt, consult your doctor again.
Remember to apply Estraderm Matrix.
Your doctor will try to prescribe the lowest dose to treat your symptom for the shortest possible time. Talk to your doctor if you think this dose is too strong or insufficient. Estraderm Matrix will be applied twice a week, i.e., the patch should be changed every 3 or 4 days.
Estraderm Matrix can be administered both continuously and cyclically:
Your doctor will indicate which treatment schedule is most suitable for you.
If you have not had your uterus removed (hysterectomy), your doctor will likely prescribe tablets containing another hormone, progesterone, for you to take regularly each month. Your doctor will explain how to take these tablets. After finishing the progesterone tablets each month, you may experience vaginal bleeding.
Follow your doctor's instructions on how to use the patches. If you think the effect of Estraderm Matrix is too strong or weak, inform your doctor or pharmacist.
You should wear the patch at all times. Change it every 3 or 4 days.
Each patch is sealed in a protective envelope and contains the active substance in an adhesive layer that is fixed directly to the skin. This adhesive layer is covered by a larger transparent film, divided into two parts by a notch. The transparent film (peel-off sheet) will be removed before applying the patch.
Open the envelope at the notch (do not use scissors to avoid damaging the patch) and remove the patch (Fig.1).
Make sure you do not have the previous patch on before applying the new patch.

Fig. 1
Remove the patch from the envelope, first remove the smaller part of the peel-off sheet, then the larger one, and discard them. Try not to touch the adhesive (Fig. 2,3) and remember that the patch should not be folded so that the adhesive faces do not come into contact. (Figures 2 and 3).

Figs. 2-3
Apply the patch immediately to an area below the waist (abdomen, buttocks, or lower back) and press for 10-20 seconds (Fig.4). Make sure it is well stuck, especially at the edges. Do not check the patch's adhesion by pulling on it once applied.
(Figure 4).

Fig. 4
Choose an area where few wrinkles are formed by movement and with little friction with clothing, otherwise, the patch will come off. The skin in the selected area should be dry and free of grease (since if not, the patch will not stick), therefore, do not use creams, lotions, or other cosmetics at the point where the patch is applied; also avoid areas with too much hair and where the skin has some alteration or irritation.
Experience indicates that skin irritation is less on the buttocks. Therefore, whenever possible, Estraderm Matrix should be applied to this area. Do not place Estraderm Matrix on the breasts.
As long as the patch is applied correctly, you can shower, bathe, swim, or exercise. If the patch comes off after bathing or showering, apply a new patch when the skin is cold and dry. Do not apply the patch to skin covered in sweat or after a very hot bath or shower.
The chosen area should be covered by clothing since it should not be exposed to direct sunlight or artificial sun.
You should change the patch every 3 or 4 days to ensure that your body receives the necessary dose of estradiol regularly. To do this, the simplest thing is to always change it on the same two days of the week, e.g., Monday and Thursday. Choose two days that you can easily remember for some reason. To memorize them, you will find a strip of labels on the box; stick the label with the selected days on the inner flap of the box. Discard the rest of the labels.
Do not place the patch in the same place twice in a row.After a week, you can apply a new patch to a previously used area. As long as you strictly follow these instructions, you will not have problems wearing the patches for 3-4 days.
If the patch comes off, you can place the same patch in a different area of the skin. Make sure it is clean, dry, and free of creams or lotions. If the patch does not stick properly to the skin, use a new one. Regardless of the day it happens, go back to changing the patch on the same days as you initially did.
Once you have used the patch, remove it, fold it with the adhesive side inward, and discard it, making sure it is out of the reach of children.
Your doctor will indicate the duration of your treatment with Estraderm Matrix. Do not stop treatment without consulting your doctor first.
Estraderm Matrix should be used for as long as necessary, usually for several months or longer. This will help control your symptoms and prevent bone loss that occurs after menopause.
If you need surgery
If you are going to undergo surgery, tell your surgeon that you are using Estraderm Matrix. You may need to stop using Estraderm Matrix 4 to 6 weeks before the operation to reduce the risk of blood clot formation (see section 2, Blood clots in a vein). Ask your doctor when you can start treatment with Estraderm Matrix again.
If you use more Estraderm Matrix than you should
If you use more Estraderm Matrix than you should, contact your doctor or pharmacist immediately. Given the form of administration, it is unlikely that an overdose of this medication will occur.
In case of overdose or accidental ingestion, consult your doctor or pharmacist or call the Toxicology Information Service. Phone 915 620 420, indicating the medication and the amount used.
If you forget to use Estraderm Matrix
If you forget to change the patch, apply a new one as soon as you remember. Regardless of the day it happens, go back to changing the patch on the same days as you initially did.
If you have any other questions about using this product, ask your doctor or pharmacist.
Like all medicines, this medicine can cause side effects, although not everybody gets them. Tell your doctor if you suffer from any of the following side effects.
The following diseases are observed more frequently in women treated with HRT compared to women not treated with HRT:
For more information on these side effects, see section 2.
Some side effects can be serious:
If you experience any of these effects, stop using this medication and inform your doctor immediately.
Some side effects are very common:
(These side effects may affect at least 1 in 10 patients)
If you experience any of these effects severely, inform your doctor.
Some side effects are common:
(These side effects may affect between 1 and 10 in 100 patients)
If you experience any of these effects severely, inform your doctor.
Other side effects are uncommon.
(These side effects may affect between 1 and 10 in 1,000 patients)
If you experience any of these effects severely, inform your doctor.
Some side effects are rare:
(These side effects may affect between 1 and 10 in 10,000 patients)
If you experience any of these effects severely, inform your doctor.
Some side effects are very rare:
(They may affect less than 1 in 10,000 patients)
If you experience any of these effects severely, inform your doctor.
Some side effects have an unknown frequency:
(They cannot be estimated with the available data)
If you experience any of these effects severely, inform your doctor.
Other side effects that have been associated with HRT:
Reporting side effects
If you experience any type of side effect, consult your doctor, pharmacist, or nurse, even if it is a possible side effect not listed in this leaflet. You can also report them directly through the Spanish Medicines Monitoring System for Human Use: https://www.notificaram.es. By reporting side effects, you can help provide more information on the safety of this medication.
Breast cancer:The risk of breast cancer in women taking HRT is slightly increased and increases with the number of years of treatment. For more information, see the section "What you need to know before using Estraderm Matrix".
Endometrial cancer:The risk of endometrial cancer in women with a uterus who use products containing only estrogen (such as Estraderm Matrix) is increased and increases with the number of years of treatment. When estrogens are administered for long periods, the risk of developing tumors and endometrial abnormalities increases.
For more information, see the section "What you need to know before using Estraderm Matrix 25 micrograms transdermal patches".
If you think any of the side effects you are experiencing is serious or if you notice any side effect not mentioned in this leaflet, inform your doctor or pharmacist.
. If in doubt, ask your pharmacist how to dispose of the packaging and any unused medication. This will help protect the environment.Estraderm Matrix is presented in the form of a transdermal patch (release through the skin into the blood) and is available in packages of 8 patches.
Marketing authorization holder and manufacturer
Marketing authorization holder
Merus Labs Luxco II S.à.R.L.
208, Val des Bons Malades
L-2121 Luxembourg
Luxembourg
Manufacturer
LTS Lohmann Therapie-Systeme AG
Lohmannstr. 2
56626 Andernach, Rhineland-Palatinate
Germany
Norgine BV,
Antonio Vivaldistraat 150,
1083 HP Amsterdam,
Netherlands
You can request more information about this medication from the local representative of the marketing authorization holder
Norgine de España, S.L.U.
Paseo de la Castellana, 91, 2ª Planta
28046 Madrid
Spain
Date of the last revision of the leaflet: 07/2023
Other sources of information
Detailed information about this medication is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) http://www.aemps.gob.es
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Discuss dosage, side effects, interactions, contraindications, and prescription renewal for ESTRADERM MATRIX 25 micrograms/24 hours TRANSDERMAL PATCHES – subject to medical assessment and local rules.