Minivelle Vivelle Short Supply

Minivelle Vivelle Short Supply

Minivelle 17 beta estradiol system

Minivelle and Vivelle are severely backordered. We have not been able to determine the source of this short supply. It emanates from the manufacturer. This is not a local pharmacy problem it is not a distribution problem. For obscure reasons it is not being manufactured. We have not seen any recalls.

The 0.1 mg dose is in most demand and in short supply. Many of you have been dispensed a generic form of estradiol patches. Mylan is the leading generic house. Generic patches are not the same as the proprietary drug — Minivelle or Vivelle dot.

Estrogen patches are not about the drug which is bioidentical. It is 17-beta-estradiol. That is bioidentical.  Biologically identical to your own internally produced hormones.  The FDA prohibits the manufacturer labeling this as bioidentical.    That is a legal-political issue.  Not a medical issue.

Minivelle and Vivelle dotc


The Minivelle and Vivelle dots are a patented delivery system.  It is unique.   It assures a constant stream of low dose estradiol (E2 estrogen) day and night. Climara is old technology.  You cannot dose once weekly.   The manufacturer, per FDA approval, recommends twice weekly dosing. That will translate to a 3 day leg and a 4 day leg. It does not last more than 3 days.   If you dose twice weekly then one day of the week you get nothing.  I do not recommend twice weekly dosing.

Over the years I have strongly advised dosing Minivelle or Vivelle every 3 days. That assures a more constant delivery of sufficient estrogen day and night. The generic patches may not even last for 3 days.

Alternative Minivelle Vivelle Resolution:

You have a few alternatives until this supply problem is resolved.

  1. Apply 2 separate 0.05 mg patches changing every 3 days. Some women have noticed that 2 x 0.5 mg is more effective than 1 x 0.1 mg. Effect: increased cost.
  2. Reduce the dose to 0.075 mg from 0.1 mg.  The 0.075 mg is not currently in short supply. Effect: decreased effectiveness.
  3. If you are committed to the generic estradiol dot, consider changing every 2 days. Not every 3 days. Make sure this is the Mylan brand.  Effect: increased cost for more effectiveness.

Remember, estrogen is your friend.   Estrogen has 400 separate effects.   This story is to be continued.

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7 thoughts on “Minivelle Vivelle Short Supply

  1. Thank you for writing. Yes indeed, the patch does not last more than 3 days and in some women who are rapid metabolizers may need to change every two days. There is no question that changing the patch twice weekly as suggested yeilds a 3 day and 4 day leg. Unless you change day then night yeilding a 3.5 day cycle.

    Very few physicians will prescribe in this manner because it is not consistent with the manufacturers recommendation. And pharmacies are so resistant to “breaking open” partial packs. But it can be done — to your benefit.

  2. Hello
    You are the only doctor who discusses this! I am using the mylan patch .05 and do not notice any relief from my symptoms. I will try changing the patch every 3 days.
    Do you believe there is a difference in Mylan vs Miniville. I am hoping the doctor will change my prescription

  3. Thank you for your comments Martha. These patches do not last 4 days. Sometimes not even 3 days. So if you follow the current recommendations you will be receiving no hormones for one day (end of the 4 day leg). So first you change every 3 days. That will increase your levels. Your levels should be measured on day 1 and then on day 3 of this patch cycle to see the variability. Apply to the lower back. That increases absorption. Then you consider a higher dose if necessary. Twice weekly does not work! I never prescribe this way. There are some women who really do need a higher dose (0.15 to 0.2 mg) after you have considered all these modifications. The pharmacies and many prescribers may demur on all these recommendations.

  4. My estradiol levels are on the lower side 33.7. symptomatic . I am on 0.1 mg twice a week and have been for 2 years.
    Is it possible to increase since this is the highest dose ? Possibly by adding an additional lower dise patch to the one I am currently on?

  5. Hi Dr. Miller,

    I use the 0.075 mg Minivelle and this is also in short supply, I have gone to 4 different pharmacies and they can not get it. A couple of times they were able to get a 1 month supply from one of their other chains but that was it.

    If I switch to the 0.1 mg dose and apply the two 0.05 mg patches at a time as suggested above are these more readily available?

    Thank you for your time,
    Tamara Fliess

  6. Hi Brenda,

    An ongoing problem. Try calling 1-800-320-3789. They are supposed to direct you to local pharmacies that have Minivelle or Vivelle in stock.

    Dr. M.

  7. Dr Miller –
    Since I am using a 0.1 and also a 0.05 patch, how should
    I proceed with an alternative with my dose, that is also
    cost effective?

    Please let me know. I have enough to last maybe another
    2-weeks. Thanks!

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