Drugplain

DOTTI .025 mg/d

Estradiol · PATCH, EXTENDED RELEASE · Bryant Ranch Prepack

No Recall HistoryCurrently in Shortage
Plain English

DOTTI is a patch, extended release containing estradiol at .025 mg/d, taken transdermal. Manufactured by Bryant Ranch Prepack.

Key Facts

Brand Name
DOTTI
Generic Name
Estradiol
NDC Code (Product)
72162-2032
Manufacturer
Bryant Ranch Prepack
Strength
.025 mg/d
Dosage Form
PATCH, EXTENDED RELEASE
Route
TRANSDERMAL
Marketing Status
Application #
ANDA211293
Drug Class
Estrogen [EPC]
Marketing Start
02/04/2019

Recall History

No Recall History

Side Effects Reported to FDA

FDA FAERS database · These are reported events, not confirmed side effects

drug ineffective3,544 reports
nausea2,676 reports
fatigue2,658 reports
headache2,632 reports
off label use2,244 reports
pain1,927 reports
diarrhoea1,825 reports
breast cancer female1,708 reports
dizziness1,586 reports
arthralgia1,511 reports

Full Prescribing Information

Source: FDA Drug Label (SPL)For healthcare professionals

Indications & Usage

1 INDICATIONS AND USAGE DOTTI is indicated for: DOTTI is an estrogen indicated for: Treatment of moderate to severe vasomotor symptoms due to menopause (1.1) Treatment of moderate to severe symptoms of vulvar and vaginal atrophy due to menopause (1.2) Limitations of Use When prescribing solely for the treatment of moderate to severe vaginal atrophy, first consider the use of topical vaginal products. Treatment of hypoestrogenism due to hypogonadism, castration, or primary ovarian failure (1.3) Prevention of postmenopausal osteoporosis (1.4) Limitations of Use When prescribing solely for the prevention of postmenopausal osteoporosis, first consider the use of non-estrogen medications. Consider estrogen therapy only for women at significant risk of osteoporosis. 1.1 Treatment of Moderate to Severe Vasomotor Symptoms Due to Menopause 1.2 Treatment of Moderate to Severe Symptoms of Vulvar and Vaginal Atrophy Due to Menopause Limitations of Use : When prescribing solely for the treatment of moderate to severe symptoms of vulvar and vaginal atrophy, first consider the use of topical vaginal products. 1.3 Treatment of Hypoestrogenism Due to Hypogonadism, Castration, or Primary Ovarian Fai

Dosage & Administration

2 DOSAGE AND ADMINISTRATION Generally, when estrogen is prescribed for a postmenopausal woman with a uterus, consider addition of a progestogen to reduce the risk of endometrial cancer. Generally, a woman without a uterus does not need to use a progestogen in addition to her estrogen therapy. In some cases, however, hysterectomized women who have a history of endometriosis may need a progestogen [see Warnings and Precautions (5.2 , 5.14) ] . Use estrogen-alone or in combination with a progestogen at the lowest effective dose and the shortest duration consistent with treatment goals and risks for the individual woman. Reevaluate postmenopausal women periodically as clinically appropriate to determine whether treatment is still necessary. Start therapy with DOTTI 0.0375 mg/day applied to the skin twice weekly for the treatment of moderate to severe vasomotor symptoms due to menopause or moderate to severe symptoms of vulvar and vaginal atrophy symptoms due to menopause. Dosage adjustment should be guided by the clinical response (2.1 , 2.2 , 2.3) Start therapy with DOTTI 0.025 mg/day for the prevention of postmenopausal osteoporosis (2.4) Place DOTTI on a clean, dry area of the lower

Contraindications

4 CONTRAINDICATIONS DOTTI is contraindicated in women with any of the following conditions: Undiagnosed abnormal genital bleeding [see Warnings and Precautions (5.2) ] . Breast cancer or a history of breast cancer [see Warnings and Precautions (5.2) ] . Estrogen-dependent neoplasia [see Warnings and Precautions (5.2) ] . Active DVT, PE, or a history of these conditions [see Warnings and Precautions (5.1) ] . Active arterial thromboembolic disease (for example, stroke and MI), or a history of these conditions [see Warnings and Precautions (5.1) ] . Known anaphylactic reaction, or angioedema, or hypersensitivity to DOTTI Hepatic impairment or disease Protein C, protein S, or antithrombin deficiency, or other known thrombophilic disorders Undiagnosed abnormal genital bleeding (4 , 5.2) Breast cancer or a history of breast cancer (4 , 5.2) Estrogen-dependent neoplasia (4 , 5.2) Active DVT, PE or a history of these conditions (4 , 5.1) Active arterial thromboembolic disease (for example, stroke and MI), or a history of these conditions (4 , 5.1) Known anaphylactic reaction, or angioedema, or hypersensitivity with DOTTI (4 , 5.15) Hepatic impairment or disease (4 , 5.10) Protein C, prote

Drug Interactions

7 DRUG INTERACTIONS In vitro and in vivo studies have shown that estrogens are metabolized partially by cytochrome P450 3A4 (CYP3A4). Therefore, inducers or inhibitors of CYP3A4 may affect estrogen drug metabolism. Inducers of CYP3A4 such as St. John’s wort ( Hypericum perforatum ) preparations, phenobarbital, carbamazepine and rifampin may reduce plasma concentrations of estrogens, possibly resulting in a decrease in therapeutic effects and/or changes in the uterine bleeding profile. Inhibitors of CYP3A4 such as erythromycin, clarithromycin, ketoconazole, itraconazole, ritonavir, and grapefruit juice may increase plasma concentrations of estrogens and may result in adverse reactions. Inducers and/or inhibitors of CYP3A4 may affect estrogen drug metabolism and decrease or increase the estrogen plasma concentration. ( 7 )

Adverse Reactions

6 ADVERSE REACTIONS The following serious adverse reactions are discussed elsewhere in labeling: Cardiovascular Disorders [see Boxed Warning , Warnings and Precautions (5.1) ] Malignant Neoplasms [see Boxed Warning , Warnings and Precautions (5.2) ] The most common adverse reactions (≥10%) with DOTTI are: headache, breast tenderness, nasopharyngitis, sinusitis, sinus headache, upper respiratory tract infection, back pain, depression, and irregular vaginal bleeding or spotting. ( 6.1 ) To report SUSPECTED ADVERSE REACTIONS, contact Amneal Pharmaceuticals at 1-877-835-5472 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. 6.1 Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. There were no clinical trials conducted with DOTTI. DOTTI is bioequivalent to the original formulation of estradiol transdermal system. The following adverse reactions have been reported with the original formulation of estradiol transdermal system therapy: Table 1. Summary of

Frequently Asked Questions

What is DOTTI used for?

DOTTI contains Estradiol. It is a patch, extended release taken transdermal. Consult your doctor for specific uses.

Is DOTTI a controlled substance?

DOTTI is not classified as a controlled substance by the DEA.

What is the generic name for DOTTI?

The generic name for DOTTI is Estradiol. There are 11 other brand versions of Estradiol.

What is the NDC code for DOTTI .025 mg/d?

The NDC (National Drug Code) for DOTTI .025 mg/d is 72162-2032, listed by Bryant Ranch Prepack.