Last checked November 2026 against 14 sources · Editorial policy
Dotti patch: doses, size, price and how it compares
Dotti is a twice-weekly estradiol patch made by Amneal and sold as a generic of Vivelle-Dot. It comes in five strengths, from 0.025 to 0.1 mg of estradiol a day, and is one of the smallest patches in the US: 1.89 cm² at the lowest dose. A box of 8 low-dose patches costs around $58.60 for cash payers.
Dotti estradiol patch: five doses, the smallest sizes, twice-weekly use, cash price from $58.60 for 8, adhesion data and FDA reports, checked November 2026.
Dotti vs Vivelle-Dot side by side
| Dotti (Amneal) | Vivelle-Dot (Sandoz) | |
|---|---|---|
| Doses | 0.025, 0.0375, 0.05, 0.075 or 0.1 mg a day. | 0.025, 0.0375, 0.05, 0.075 or 0.1 mg a day. |
| Patch size, lowest to highest dose | 1.89 to 7.55 cm². | 2.5 to 10.0 cm². |
| How often you change it | Twice a week. | Twice a week. |
| Where it goes | Lower abdomen or buttocks. | Lower abdomen or buttocks. |
| Adhesion in the label | 85% fully stuck, 3% came off, 471 observations. | 85% fully stuck, 3% came off, 471 observations. |
| Cash price, 8 patches of 0.025 mg | From $58.60 (Drugs.com, November 2026). | From $158.08 (Drugs.com, November 2026). |
| Cost Plus Drugs, box of 8 | $94.61, listed as the generic for Vivelle-Dot (September 2026). | Not listed. |
| FDA reports (FAERS) | 169 reports. | 3,593 reports. |
Doses
- Dotti (Amneal)
- 0.025, 0.0375, 0.05, 0.075 or 0.1 mg a day.
- Vivelle-Dot (Sandoz)
- 0.025, 0.0375, 0.05, 0.075 or 0.1 mg a day.
Patch size, lowest to highest dose
- Dotti (Amneal)
- 1.89 to 7.55 cm².
- Vivelle-Dot (Sandoz)
- 2.5 to 10.0 cm².
How often you change it
- Dotti (Amneal)
- Twice a week.
- Vivelle-Dot (Sandoz)
- Twice a week.
Where it goes
- Dotti (Amneal)
- Lower abdomen or buttocks.
- Vivelle-Dot (Sandoz)
- Lower abdomen or buttocks.
Adhesion in the label
- Dotti (Amneal)
- 85% fully stuck, 3% came off, 471 observations.
- Vivelle-Dot (Sandoz)
- 85% fully stuck, 3% came off, 471 observations.
Cash price, 8 patches of 0.025 mg
- Dotti (Amneal)
- From $58.60 (Drugs.com, November 2026).
- Vivelle-Dot (Sandoz)
- From $158.08 (Drugs.com, November 2026).
Cost Plus Drugs, box of 8
- Dotti (Amneal)
- $94.61, listed as the generic for Vivelle-Dot (September 2026).
- Vivelle-Dot (Sandoz)
- Not listed.
FDA reports (FAERS)
- Dotti (Amneal)
- 169 reports.
- Vivelle-Dot (Sandoz)
- 3,593 reports.
The Dotti patch: expectation vs reality
What people often expect
“A cheaper generic patch is a weaker or less sticky version of the brand”
What the evidence shows
Dotti delivers the same doses as Vivelle-Dot, from 0.025 to 0.1 mg a day, through a smaller patch. In the label's adhesion data from 3 short trials with 471 observations, 85% of patches stayed fully stuck for the whole wear time and 3% came off and were reapplied or replaced. And you'll pay around a third of Vivelle-Dot's cash price.
Dotti patch: what you need to know
What the Dotti patch is
Dotti is an estradiol transdermal system: a thin patch that releases estradiol through the skin for 3 to 4 days. Estradiol is the same estrogen the ovaries make. The label lists four uses: hot flashes and night sweats, vaginal dryness and atrophy, low estrogen after the ovaries are removed or fail, and preventing bone loss after menopause. Amneal makes it, and Cost Plus Drugs lists it as the generic for Vivelle-Dot.
Learn more →Dotti patch strengths and sizes
There are five strengths: 0.025, 0.0375, 0.05, 0.075 and 0.1 mg of estradiol a day. The patch grows with the dose, from 1.89 cm² at 0.025 mg to 7.55 cm² at 0.1 mg. The same doses of Vivelle-Dot measure 2.5 to 10.0 cm². For hot flashes the label starts at 0.0375 mg. When you switch brands, it's the strength that matters, not the name on the box.
Learn more →How to put on the Dotti patch
Put Dotti on clean, dry skin of the lower abdomen or buttocks, never on the breasts, and change it twice a week on the same two days, for example Sunday and Wednesday. Use a different spot each time. If it falls off, the label says to reapply the same patch or put a new one on another spot, then keep your usual change days. Fold the used patch sticky sides together before you throw it away.
Learn more →Does the Dotti patch stay on?
In the label's adhesion data, 85% of patches stayed completely stuck for the whole wear time and 3% came off and had to be reapplied or replaced, across 471 observations. That is the same figure as in the Vivelle-Dot label. If yours keeps lifting, look at your skin first: lotion and oil stop it sticking. Put it on bare skin, away from your waistband.
Dotti patch price with and without insurance
Drugs.com lists 8 Dotti patches of 0.025 mg from $58.60 for cash payers in November 2026, against $158.08 for Vivelle-Dot and $102.52 for Minivelle. Cost Plus Drugs listed a box of 8 at $94.61 in September 2026. That's a big gap for the same hormone. If you're insured, ask your pharmacy whether your plan prefers Dotti over the brand.
Learn more →Dotti patch and the 2026 patch shortage
On September 3, 2026 the FDA said women were having trouble finding their usual estradiol patch because demand had grown, and that it was working with all six manufacturers to raise supply. It also said patches remain available, though brands vary by pharmacy. If your pharmacy is out of Dotti, a pharmacist can often substitute another twice-weekly patch of the same dose with your prescriber's agreement.
Learn more →Dotti patch if you still have a uterus
Like every estrogen-only patch, Dotti carries a boxed warning: estrogen alone raises the risk of endometrial cancer in women with a uterus. A progestogen taken alongside it, such as micronized progesterone or a hormonal IUD, protects the lining. Women who've had a hysterectomy usually take estrogen alone. The label also says to use the lowest effective dose for as long as treatment is needed.
Learn more →The Dotti patch by the numbers
From the studies on this page
of patches stayed completely stuck in the label's adhesion data
85%
1.89 cm²
$58.60
169
Prices are cash prices for the lowest dose and change by pharmacy.
What people report to the FDA about Dotti
Dotti (estradiol transdermal system): 169 reports to the FDA, 68 serious · data through July 30, 2026
| Reaction | Reports | Share |
|---|---|---|
| Headache | 17 | 10.1% |
| Didn't work | 16 | 9.5% |
| Nausea | 14 | 8.3% |
| Diarrhea | 13 | 7.7% |
| Fatigue | 13 | 7.7% |
| Insomnia | 10 | 5.9% |
- No Dotti report used a term for a patch that didn't stick; skin reactions where the patch sits appeared in 7 of 169 reports (4.1%).
Dotti or another patch: who each one suits
Dotti if you want a twice-weekly patch at a lower price
Strong evidenceSame doses and schedule as Vivelle-Dot, a smaller patch, and a cash price around a third of the brand's. It suits most women starting a twice-weekly patch, and anyone paying cash. Ask your pharmacy to fill Dotti specifically if it's the one you want.
Related guide →Minivelle if you want the smallest patch
Strong evidenceMinivelle's lowest dose is 1.65 cm², a little smaller than Dotti's. In its label, about 98% of observations had an adhesion score of 0, meaning the patch stayed at least 90% stuck. It costs more than Dotti for cash payers.
Related guide →A once-weekly patch if two changes a week is hard to remember
Strong evidenceClimara and its generics are changed once a week. The patches are larger, from 6.5 cm², but there's only one change day to track. Cost Plus Drugs listed the generic weekly patch at $36.05 in September 2026.
Related guide →Gel or pills if patches irritate your skin
Some evidenceIf every patch leaves a rash, estradiol gel or spray keeps the through-the-skin route without adhesive. Pills are the cheapest option but pass through the liver first. Your prescriber can match the dose.
Related guide →
When to call a doctor on the Dotti patch
Urgent: Chest pain, sudden shortness of breath, a painful swollen leg, sudden vision loss or stroke signs
Call 911. These can be signs of a blood clot or stroke, risks listed in the boxed warning of every estrogen patch.
Vaginal bleeding after menopause
See your doctor soon. Unexpected bleeding on estrogen needs checking to rule out a problem with the uterine lining.
A new breast lump
Book an appointment to have it checked.
A rash that spreads, blisters or won't settle when you move the patch
Ask your prescriber about another brand or switching to gel or pills.
More →
Dotti patch: questions women ask
Is Dotti the same as Vivelle-Dot?
It contains the same hormone, estradiol, in the same five doses and is changed on the same twice-weekly schedule. Cost Plus Drugs lists it as the generic for Vivelle-Dot. The Dotti patch is smaller, 1.89 to 7.55 cm² against 2.5 to 10.0 cm², and is made by Amneal rather than Sandoz.
How much does the Dotti patch cost?
Drugs.com lists 8 patches of 0.025 mg from $58.60 for cash payers in November 2026; higher doses cost more. Cost Plus Drugs listed a box of 8 at $94.61 in September 2026. With insurance you pay your plan's generic copay.
Related →Where do you put a Dotti patch?
On clean, dry skin of the lower abdomen or the buttocks, away from the waistband. Never put it on the breasts. Use a new spot each time and let a site rest before you use it again.
Related →What if my Dotti patch falls off?
Reapply the same patch or put a new one on a different spot, then change it on your usual day. The label's adhesion data show 3% of patches came off during wear. Lotion, oil, a hot shower right before and a tight waistband make it more likely.
Can I swap my Dotti patch for another brand during a shortage?
Often yes, with your prescriber's agreement. The FDA said in September 2026 that patch supply varies by pharmacy but patches remain available, and a pharmacist can look for another FDA-approved estradiol patch of the same dose. Twice-weekly options include Vivelle-Dot and Minivelle.
Related →What is the lowest dose of the Dotti patch?
0.025 mg of estradiol a day, the patch the label lists for preventing bone loss after menopause. For hot flashes, the label's usual starting dose is 0.0375 mg a day, adjusted to the lowest dose that controls symptoms.
Related →Do I need progesterone with the Dotti patch?
If you still have a uterus, yes. Estrogen alone raises the risk of endometrial cancer, and a progestogen such as micronized progesterone protects the lining. After a hysterectomy, estrogen alone is usually enough.
Related →Sources
- Prescribing information: Dotti (estradiol transdermal system), 2024. DailyMed, US National Library of Medicine.
- Drugs.com. Dotti prices, coupons, copay cards and patient assistance. Accessed November 2, 2026.
- Mark Cuban Cost Plus Drug Company. Hormone therapy medication prices (checked September 2026).
- Drugs.com. Vivelle-Dot prices, coupons, copay cards and patient assistance. Accessed November 2, 2026.
- Prescribing information: Vivelle-Dot (estradiol transdermal system). Sandoz, 2023. DailyMed, US National Library of Medicine.
- Drugs.com. Minivelle prices, coupons, copay cards and patient assistance. Accessed November 2, 2026.
- US Food and Drug Administration. FDA update on estradiol transdermal patch availability. September 3, 2026.
- US Food and Drug Administration. FDA Adverse Event Reporting System (FAERS): reports naming Dotti (estradiol transdermal system, twice weekly), via openFDA. Data through July 30, 2026.
- Prescribing information: Minivelle (estradiol transdermal system). Noven Therapeutics, 2026. DailyMed, US National Library of Medicine.
- Prescribing information: Climara (estradiol transdermal system). Bayer HealthCare, 2026. DailyMed, US National Library of Medicine.
- British Menopause Society. Tool for clinicians: HRT preparations and equivalent alternatives. 2024.
- Prescribing information: EstroGel (estradiol gel 0.06%). Ascend Therapeutics, 2026. DailyMed, US National Library of Medicine.
- National 911 Program. 911.gov.
- US Food and Drug Administration. FDA Adverse Event Reporting System (FAERS): reports naming Vivelle-Dot (estradiol transdermal system, twice weekly), via openFDA. Data through July 30, 2026.
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