Oestradiol patches 25 and 50 mcg: Supply issue

About the Estradot supply issue

The supplier of Estradot, Novartis, has advised PHARMAC they are experiencing stock issues for Estradot oestradiol patches 25 mcg per day and 50 mcg per day.

Novartis expects more stock will be available by December 2020. There is no shortage of the Estradot oestradiol patches 75 mcg per day and 100 mcg per day.  

Oestradiol patches

Estradiol TDP Mylan (25 mcg and 50 mcg) 

To ensure continuation of supply, we listed Estradiol TDP Mylan Patches (25 mcg per day and 50 mcg per day) as alternatives. These were funded from 1 November 2020. 

The supplier has advised that stock is available, as at 10 November 2020.

Estradiol TDP Mylan Patches are not approved by Medsafe. They need to be supplied in line with section 29 of the Medicines Act 1981. 

Climara 50 mcg patches

We previously listed Climara 50 mcg patches (which have a different dosage). We understand that there is limited stock of Climara, which is why we're now listing the Estradiol TDP Mylan patch.

Dosing regimen difference for Climara

Note that there is a difference in dosing regimen for Climara. It should be applied every 7 days (i.e. once weekly). The other oestradiol patches should be applied twice a week.

Quantity restriction: 1 patch per week

Due to the dosing difference, we've restricted Climara patches to no more than 1 patch per week in the Schedule from 1 July 2020

More information

Check the Medsafe data sheet for the approved brands.

Estradot data sheet on Medsafe's website(external link)

Climara data sheet on Medsafe's website(external link)

Alternative brand information for prescribers

Climara

Climara has been sourced as an alternate brand of oestradiol patches 50 mcg per day.

You can substitute Climara (50 mcg per day) for Estradot 50 (50 mcg per day).

Dosing regimen difference for Climara

Note that there is a difference in dosing regimen for Climara. It should be applied every 7 days (i.e. once weekly). The other oestradiol patches should be applied twice a week.

Climara data sheet on Medsafe's website(external link)

Quantity restriction: 1 patch per week

Due to the dosing difference, we've restricted Climara patches to no more than 1 patch per week in the Schedule from 1 July 2020 

Estradiol TDP Mylan 25 mcg and 50 mcg per day patches

Estradiol TDP Mylan has been sourced as an alternate brand of oestradiol patches 25 mcg per day and 50 mcg per day.

You can substitute:

• Estradiol TDP Mylan (25 mcg per day) for Estradot 25 (25 mcg per day) and
• Estradiol TDP Mylan (50 mcg per day) for Estradot 50 (50 mcg per day).

The dosing regimen is the same for Estradiol TDP Mylan and Estradot products. 

Estradiol TDP Mylan is an unapproved medicine in New Zealand. As such, it needs to be supplied in line with section 29 of the Medicines Act 1981. Prescribers need to be familiar with their obligations under section 29.

Only medical practitioners registered with the Medical Council of New Zealand can prescribe section 29 medicines. We appreciate that this limits the ability of non-medical prescribers to prescribe this medicine. We apologise for any inconvenience this causes. 

Learn more about supplying medicine under section 29 - Medsafe website(external link)

What section 29 means

Section 29 allows for medicines that are not Medsafe approved to be supplied to patients. The medicine must be prescribed by someone registered with the Medical Council of New Zealand – that is medical practitioners ie medical doctors.

Read information for your patients about what section 29 means - Health Navigator(external link)

Information for pharmacists

We know that stock issues can be disruptive for you and your patients. We thank you for your patience.

25 mcg patches

If you are unable to source the Estradot 25 mcg patches, Estradiol TDP Mylan 25 mcg per day patches (pharmacode 2601583) are listed on the Schedule from 1 November 2020.

• Stock of Estradiol TDP 25 mcg patches is likely to be available in early November 2020
• Estradot 25 mcg patches stock is likely to be available again in New Zealand by December 2020

50 mcg patches

If you are unable to source the Estradot 50 mcg patches, the following are listed:

• Climara 50 mcg per day (pharmacode 371114)
• (from 1 November 2020) Estradiol 50 mcg per day patches (pharmacode 2601591) are listed on the Schedule. 

Please note that Estradiol is an unapproved brand of oestradiol and needs to supplied in line with section 29 of the Medicines Act 1981. 

We ask that you advise your patients about the dosage differences for Climara. 

Dosing regimen difference for Climara

Note that there is a difference in dosing regimen for Climara. It should be applied every 7 days (i.e. once weekly). The other oestradiol patches should be applied twice a week.

Quantity restriction for Climara: 1 patch per week

Due to the dosing difference, we restricted Climara patches to no more than 1 patch per week in the Schedule from 1 July 2020

More information

There is no current supply issue with the oestradiol 75 mcg per day or 100 mcg per day patches.  

We anticipate the Estradot 50 mcg patches will be back in stock by December 2020. 

Who to contact

If you are a prescriber or pharmacist with questions about this supply issue:

• phone the supplier Novartis on 0800 354 335
• email enquiry@pharmac.govt.nz
• phone PHARMAC on 0800 660 050  

If you use the oestradiol 25 mcg or 50 mcg patches, contact your health professional. PHARMAC cannot give clinical advice about the best treatments for you.