There is a global shortage of estradiol patches, which is expected to continue for quite some time.

Pharmac have more information here: pharmac.govt.nz/medicine-funding-and-supply/medicine-notices/oestradiol

• Pharmac funds a maximum of 8 patches of each strength per month. Patients must pay for any patches dispensed over this limit.
• All brands of estradiol patches (Lyllana®, Estradot®, Climara®, Sandoz®, Mylan/Viatris® and Estraderm MX®) can be cut into halves, thirds, or quarters if necessary – see our previous communication:
  
  • medicinesinformation.co.nz/bulletins/can-transdermal-patches-be-halved/
• If the patient’s usual dose cannot be achieved by cutting patches:
  • Discuss with the patient and prescriber whether it may be suitable to increase or decrease the dose depending on patch strength availability.
    • In most cases, increasing the dose is likely to be safe and well-tolerated.
    • Some patients may be able to decrease their dose without re-emergence of menopausal symptoms.

Alternative funded patch options if patient’s usual strength is unavailable

• Discuss with the patient and prescriber about switching to an alternative estradiol formulation.
  • Estradiol tablets: Progynova® is fully funded and Estrofem® is partly funded.
  • Estradiol gel: Estrogel® and Sandrena® are available but not funded.
  • The Australasian Menopause Society has a guide to comparative dosing of different formulations: menopause.org.au/hp/information-sheets/ams-guide-to-mht-hrt-doses-nz

Health professionals are welcome to contact our service for specific advice on individual patients.