Hormone Transdermal Patch

[Guest]

Rx and I did a few posts on this, but, just to close...

I found Climara, a transdermal hormone patch at the South East Pharmacy on Sukhumvit, near the corner of Soi 15.

4 patches, about 2 inches square each, deploy 50 micrograms/hr into the body. The total of 4 patches is 3.8mg of Estradiol. The cost is 380 baht for this package, with the expectation of putting on 1 patch per week.

The reason this is interesting is that all LBs use oral or injection for hormones. Oral use over a long period of time can cause internal problems, as the "first pass effect" (running through your stomach and liver before it gets into the blood) can have bad side effects. Also, the injection can be painful to some girls, as well as requiring a visit to the doctor every week.

Transdermal has a near 100% yield in terms of absorption into the body (no first pass effect). So basically it's more efficient and doesn't have the oral internal organ side effects.

The dosage is low and some doctors told me not enough, but I note most of the girls who have been taking hormones a long time are actually on very low dosages anyhow.

So the point of all this is that there is an alternative for any of you out there that try to help or take care of some LBs.

I've put 2 girls on this now and will let you know the results in a few months.

I'm not a doctor, so you have to do your own research! There is an infinite amount on the net - search for menopausal women sites!

[rxpharm]

Good information Ziggy, especially since it seems that Progynon will soon be unavailable in Thailand. Lbs will be looking for alternatives.

Oral estrogens can cause more side effects, so the patch is a good alternative to the injection. The only drawback is that the patch can often fall off in the hot humid climate of Thailand. There is an item called tincture of Benzoin (aka Friar's Balsam), that has been used to increase the reliablility of the patch adhesion.

If you are so inclined to help an lb with the patch contact me by PM and I will send you the details of how Friar's Balsam is used with the patch.

[Guest]

(ziggystardust @ Feb. 07 2007,09:31) 4 patches, about 2 inches square each, deploy 50 micrograms/hr into the body. The total of 4 patches is 3.8mg of Estradiol.

Sorry, have to correct you:

4 patches, about 2 inches square each, deploy 50 micrograms/day into the body. The total of 4 patches is 15.2mg of Estradiol (3.8mg per single patch)

[Guest]

Anyway the total Estradiol content (per patch) does not really matter, important is how much will go inside your body.

BTW: in order to save costs, you can keep the patch a little longer (10 days instead of 7 will already make a 25% saving ). Using a patch for 2 weeks will cut the costs in half, but you definitely will have problem with the adhesive.

Personally I dont like the idea of a patch, since the bioavailability of the active compound is subject to too many factors (hope you dont really think the 50mcg/day is accurate and constant during the 7 days).
Unfortunately there are not many alternatives in Thailand (if available, my preference would be an injection of Estradiol Laurate or Estradiol Merystate once a month)

[rxpharm]

Progynon depot, is estradiol valerate 10 mg depot injection. This has been a widely used estrogen of choice for many Thai lbs. Unfortunately the company is stopping shipment of this to Thailand, and perhaps shutting down production.

The transdermal estrogen patch is a reasonable alternative, and even though the absorption may not be always 50 mcg/day, it is generally pretty close.

Transdermal delivery systems have been in use a number of years, starting with nitroglycerin patches for angina, fentanyl patches for chronic, cancer pain control, scolopamine patches for motion sickness, nicotine patches for smoking cessation, etc.

As noted a common problem with the patch is adhesion for the specified length of time it is supposed to stay on. Tincture of Benzoin (Friar's Balsam) has been proven to help ensure the patch stays on.

Candyman - you definitely know your stuff!

[Guest]

Yes, sorry, I misread the 5 pt font on the package. You're right Candyman regarding the dosages.

Ok, so 10 days experience shows:

-No issue with the patch falling off; I think one misnomer of hot climates is that people sweat. Thais never sweat,
honestly, at least, I've seen LBs walking up the mountain in 38C without a single drop of sweat, literally.

-May's feedback is that it makes her feel happy, whereas Diane 35 made her "angry".

I am taking a wild guess here, but I am thinking that one whopping injection or oral tablets have a much higher initial intake whereas as the patch is very gradual, and perhaps that slower absorption helps reduce psychological side effects?

Candyman, you are forgetting convenience. Imagine having to run to a doctor every week and cut a shot in your bum. It is basically a pain in the ass, figuratively and sometimes literally, as told to me by LBs.

There are no other patches available yet. Vivelle Dot seems to get good press on the web, but I couldn't find it here.

[Guest]

(ziggystardust @ Feb. 12 2007,23:20) I am taking a wild guess here, but I am thinking that one whopping injection or oral tablets have a much higher initial intake whereas as the patch is very gradual, and perhaps that slower absorption helps reduce psychological side effects?

You are right about the tablets, they will cause a more rapid increase of blood's Estradiol level. Also: the amount present in your system will be less constant than with patches.

For injections... well that all depends from the amount you inject and especially from the king of Estradiol Ester you are using. If you inject small amounts of an extremely long Ester (example: Estradiol Hexadecanoate or Estradiol Octadecanoate) you will have a graduate increase and later constant blood levels of Estradiol.
Another factor concerning injections, is the type of carrier used (what the solution that contains the Estradiol is made of).
By using Low-Carbon-Tryglycrides as carrier instead of Sesame Oil (like Caproic/Capric/Caprylic Triglycerides) you would have a very prolonged absorption and time of action of Estradiol. One injection every 8 weeks would probably be enough! *

All sounds perfect... but of course there is a problem about the availability of such pharmaceuticals. Unless you know a private laboratory, you'll probably have only Estradiol Valerate available to you (Progynon Depot for example). Meaning you'll have to inject more frequently. Concerning the dose however, you can choose it yourself... NOBODY forces you to inject a full ampoule (inject less if you want the corresponding amount of Climara Patches).




*) Technical Note:
For most chemists/doctors this may seem a paradox, but this is what happens when you combine High-Carbon-Esterified-Hormones with Low-Carbon-Carriers (it's very difficult to explain and has to do with the different absorption way of C4-C5-C6-C8 compounds compared to C16-C18 compounds).

[Guest]

(ziggystardust @ Feb. 12 2007,23:20) -No issue with the patch falling off; I think one misnomer of hot climates is that people sweat. Thais never sweat,
honestly, at least, I've seen LBs walking up the mountain in 38C without a single drop of sweat, literally.

Since you don't have access to other pharmaceuticals, guess you are pretty much stuck with the Patches.

Good is that you don't sweat (no problems with the adhesives)

You could in that case use the patch for 2 weeks, cutting the costs by half. The Acrylate Matrix will deliver similar amounts of Estradiol for 2-3 weeks.

[rxpharm]

(Candyman @ Feb. 13 2007,03:35) Since you don't have access to other pharmaceuticals, guess you are pretty much stuck with the Patches.

Good is that you don't sweat (no problems with the adhesives)

You could in that case use the patch for 2 weeks, cutting the costs by half. The Acrylate Matrix will deliver similar amounts of Estradiol for 2-3 weeks.

Candyman, you are a scientist and a humorist! I have recommended using the patches for longer than specified as the matrix is filled to more than 3.8 mg of estradiol per patch. Do you know just how much extra there may be? This is necessary to create the concentration gradient that drives the hormone absorption from the acylic matrix into the subcutaneous layer under the skin.

I did recommend to some lb friends who were trying Estraderm patches (not available in Thailand yet) they could leave it on for a week instead of 3-4 days (change twice a week as recommended by the company).

This will become a bigger concern for Thai lbs as the supplies of Progynon Depot disappear.

[Snick]

One of the characters on the TV show Ugly Betty is using the patch....so it must be good.



( for those who don't know what I am talking about, its a USA TV Show with a M2F ( played by a GG though) )

[Guest]

(rxpharm @ Feb. 13 2007,03:45) ...This will become a bigger concern for Thai lbs as the supplies of Progynon Depot disappear.

I'm pretty sure there will be a bunch of imported products after Progynon Depot has disappeared. It's a big market and you see what already happened with other pharmaceuticals coming from India, Pakistan, China,...


wait a minute... Why don't I register a new formula at Thai FDA myself. And unlike Schering, make it a "1-every-8-weeks-injection"

Only thing stopping me... the Thai FDA is the worse I ever dealt with worldwide +