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Ask Dr. Norm S. Your Own Question
Dr. Norm S.
Dr. Norm S., Board Certified OB/GYN
Category: OB GYN
Satisfied Customers: 11221
Experience:  Over 30 years of experience in OB/GYN practice, including teaching students. Fellow of American Board of Obstetrics and Gynecology.
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I am on Vivelle Dot .05 mg patch and Prometrium which is

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I am on Vivelle Dot .05 mg patch and Prometrium which is 14 days every 3 months. Just came back from the eye doctor. My vision is deteriorating and it is not an eye issue. He said it was a systemic issue which could be from the St. JOhn's Wort i was taking or from my hormone replacement. I stopped St. JOhn'sWort last week and my vision improved somewhat.

I want to stop the hormone replacement right away to see if my vision improves. How do i wean off of these Vivelle Dot patches as I dont want to wait til my GYN appt in mid Dec.
There are a number of ways you could wean off the Vivelle Dot and Prometrium. Vivelle Dot comes in various dosage strengths, so you could ask you doctor to give you the .025 strength, which is half as much, or you could use the .05 and apply it just once weekly rather than twice. That won't be as smooth, since your levels will go from higher to lower each week as the patch loses strength. Depending on whether you're having much symptoms, you could then go to a patch every other week, and then every third week, and finally stop. It's a little easier to wean using pills, as you can take the pills every other day, then every third, then every fourth, etc. until you're off the estrogen. I would still use the Prometrium every 3 months or at the end of taking estrogen, as it will clean off the uterine lining so you won't be left with some buildup and spotting. You could also stop the Vivelle Dot abruptly, but you may have more menopausal symptoms that way. If you'd like to try the lower dose Vivelle Dot or the pills, just call your doctor, explain why you wish to stop, and your doctor can call in the prescription. Best wishes.
Customer: replied 6 years ago.
can i cut the patch in half to reduce the dose?
I believe it's not recommended, but will work fine. Be sure to store the unused part so it's not exposed to much air. The Vivelle Dot has the estrogen in a matrix, so it will still be released in a gradual fashion.
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