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

Dosing

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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15 thoughts on “Minivelle Vivelle Short Supply

  1. Hello,
    I was on Novartis 0.05 mg Vivelle-Dot for years and, at some point, my insurance would not cover it. I researched the generic made by Sandoz (subsidiary of Norvartis), and a company rep stated the generic is made in the US and is manufactured identically compared to Vivelle-Dot (packaging differences). I felt comfortable with that and have not had issues. Now I too can no longer get the Sandoz. Insurance will cover Mylan and Amneal Dotti. My issues with Mylan are: 1) manufactured in India, 2) once weekly, and 3) women comment on adherence problems. I’m not familiar with Dotti and its efficacy, etc. I think I will ask my doctor to switch to the much higher cost Vivelle-Dot (she has to make an appeal). Any help and input is appreciated! Thank you!

  2. Hi, I see this is old but you’ve responded to a late inquiries so very much hope you can respond to mine. I was on the Sandoval/Novartis generic 0.075 patch (bi-weekly) and did quite well on it, but was switched to the Minivelle patch and it did not have the same positive impact. (One of which is helping to maintain thinning hair, which is huge!) So my Dr suggested I go back to the Sandoval, essentially saying they aren’t all created equal. I was able to switch back but for only one script and now it can’t be found again so I’ve decided to pay out pocket for the brand name/Vivelle Dot. (My Dr had no issue specifying this for me.) Can you please tell me how the brand name is different from the generic, or more importantly, is it worth it, is it better, more consistent? My goal is consistency (and I’m willing to pay for it) and to get away from the generic switcheroo that is foisted upon me every few months. (Btw, I change the patch at 9am Monday and 9pm Thursday in an effort to get equal time out of each-not sure if it helps but it made sense to me.)

  3. Hello Dr. Miller,

    What is the difference between twice a week change and once a week change. I mean why does Climara patch suggests once a week change and the other twice if they re giving the same amount each day? Thank you.

  4. Please describe pharmacologic difference between Vivelle and generic. I have understood in first reading that Vivelle is bioidentical while generic is not. Just need it explained a little more in detail. Thanks!

  5. Hello,

    Just one worry left on my mind that l would like to share. I watched a naturopath sometime ago pointing out that the Yams that are used to make the body identical hormones are sprayed with pesticides? Although it sounded very absurd but also likely at the same time, l would love to hear your comments on this. Thank you.

  6. Hello,
    l am really glad to have found your blog. I am actually in Turkey at the moment and here there is only Climara available. I am 38 years old with POF, was put on Climara 50mcg and micronised progesterone 200mg x 14 a month. After reading your post, l will go ahead and change the patch every 3 days. My question is do you think 50mcg is too low for my age? In the prospectus it is not recommended to put two patches at the same time however you said that it is okay. I might as well put 2x 50mcg on one leg and alternate every 3 days. By the way if l put it on my lower back, where will be the next spot when l need to alternate? Sorry for too many questions l don t really have reliable sources here at the moment. Thank you.

  7. Thank you for writing. This is a story I hear everyday. First you decide the value of the Vivelle to your mother. Is the health benefit worth the cost? So many other medications on the market for chronic conditions are far more costly — but life changing. This is a cost/health-benefit decision. Never let insurance games limit your choice. Alternatively, some of my patients use Canadian Pharmacies. This works for some, but not a practice that I fully endorse. Women need estrogen.

  8. My mothers insurance stopped paying for vivelle dot so she had to use a discount coupon to get it, but, she had to settle for generic version becuase that’s how it paid… however the generic gives her head aches. What can she do?? Is there a way for her to get vivelle dot expensive? Is there anything you can suggest, ifso please do….Thank you

  9. 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.

  10. 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

  11. 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.

  12. 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?

  13. 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

  14. 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.

  15. 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!
    Brenda

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