Drugs and Therapeutics Shortage Update: Estradiol Transdermal Patch 

Prepared by Daniel Mak, MD; Edited by Neha Patel, DO 

On 3/12/26, the American Society of Health-System Pharmacists (ASHP) reported shortages of estradiol transdermal patches from multiple manufacturers, including Amneal, Noven, Sandoz, and Zydus.1 Although specific products were not listed, media reports note limited availability of major brands such as Vivelle-Dot® and Climara®. Estimated resupply dates range from mid-March (Zydus) to mid-April (Sandoz), while other manufacturers have not provided timelines.1  

The reason for the shortage has not been disclosed, but it is speculated to stem from increased demand following the FDA’s removal of menopause-related black box warnings on breast cancer, heart disease, and dementia risks.2,3   

An alternative to transdermal estrogen is oral micronized 17β-estradiol. For puberty induction in constitutional delay of growth and puberty, one approach is to start at 5 mcg/kg daily for 6-12 months, then increase to 10 mcg/kg daily.4 In individuals with Turner syndrome, 2007 guidelines recommend starting with 0.25 mg once daily and titrating to an adult dose of 2-4 mg/day over approximately 2 years.5 

References: 

  1. https://www.ashp.org/drug-shortages/current-shortages/drug-shortage-detail.aspx?id=1206&loginreturnUrl=SSOCheckOnly  
  1. https://www.cbsnews.com/baltimore/news/estrogen-patch-shortage-black-box-warning-removal-fda/  
  1. https://www.fda.gov/news-events/press-announcements/hhs-advances-womens-health-removes-misleading-fda-warnings-hormone-replacement-therapy 
  1. Palmert MR, Dunkel L. Clinical practice. Delayed puberty. N Engl J Med. 2012;366(5):443-453. doi:10.1056/NEJMcp1109290 
  1. Bondy CA; Turner Syndrome Study Group. Care of girls and women with Turner syndrome: a guideline of the Turner Syndrome Study Group. J Clin Endocrinol Metab. 2007;92(1):10-25. doi:10.1210/jc.2006-1374 
Posted in
Share this