Last checked November 2026 against 20 sources · Editorial policy
Estrogen patch brands, ranked
The US has five estradiol-only patch brands plus generics. Dotti, Minivelle and Vivelle-Dot are changed twice a week; Climara and Menostar once a week. All twice-weekly brands come in the same five doses. They differ in size, adhesive and price: 8 low-dose patches cost from $58.60 for Dotti to $158.08 for Vivelle-Dot. Menostar is only for bone loss.
Every US estradiol patch ranked by size, change schedule, adhesion data, cash price and FDA reports: Dotti, Minivelle, Climara, Vivelle-Dot, Menostar and generics.
Estrogen patch brands side by side
| 1. Dotti | 2. Minivelle | 3. Climara and weekly generics | 4. Vivelle-Dot | |
|---|---|---|---|---|
| Maker | Amneal. | Noven. | Bayer; generics from Mylan and Zydus. | Sandoz, made by Noven. |
| Change | Twice a week. | Twice a week. | Once a week. | Twice a week. |
| Doses, mg a day | 0.025 to 0.1, five steps. | 0.025 to 0.1, five steps. | 0.025 to 0.1, six steps incl. 0.06. | 0.025 to 0.1, five steps. |
| Size, lowest dose | 1.89 cm². | 1.65 cm². | 6.5 cm². | 2.5 cm². |
| Size, highest dose | 7.55 cm². | 6.6 cm². | 25 cm². | 10.0 cm². |
| Adhesion in the label | 85% fully stuck, 3% came off. | About 98% at least 90% stuck. | No figures; water and saunas may loosen it. | 85% fully stuck, 3% came off. |
| Cash price | From $58.60 for 8 (Drugs.com). | From $102.52 for 8 (Drugs.com); generic $47.83 (Cost Plus). | Generic $36.05, brand $53.30 a carton (Cost Plus). | From $158.08 for 8 (Drugs.com). |
| FDA reports, patch didn't stick | None of 169. | 463 of 3,297 (14.0%). | 636 of 4,259 (14.9%), Climara. | 338 of 3,593 (9.4%). |
| 1. Dotti | 2. Minivelle | 3. Climara and weekly generics | 4. Vivelle-Dot | |
|---|---|---|---|---|
| Maker | Amneal. | Noven. | Bayer; generics from Mylan and Zydus. | Sandoz, made by Noven. |
| Change | Twice a week. | Twice a week. | Once a week. | Twice a week. |
| Doses, mg a day | 0.025 to 0.1, five steps. | 0.025 to 0.1, five steps. | 0.025 to 0.1, six steps incl. 0.06. | 0.025 to 0.1, five steps. |
| Size, lowest dose | 1.89 cm². | 1.65 cm². | 6.5 cm². | 2.5 cm². |
| Size, highest dose | 7.55 cm². | 6.6 cm². | 25 cm². | 10.0 cm². |
| Adhesion in the label | 85% fully stuck, 3% came off. | About 98% at least 90% stuck. | No figures; water and saunas may loosen it. | 85% fully stuck, 3% came off. |
| Cash price | From $58.60 for 8 (Drugs.com). | From $102.52 for 8 (Drugs.com); generic $47.83 (Cost Plus). | Generic $36.05, brand $53.30 a carton (Cost Plus). | From $158.08 for 8 (Drugs.com). |
| FDA reports, patch didn't stick | None of 169. | 463 of 3,297 (14.0%). | 636 of 4,259 (14.9%), Climara. | 338 of 3,593 (9.4%). |
Estrogen patch brands: expectation vs reality
What people often expect
“Some estrogen patch brands are stronger, so switching brands changes your treatment”
What the evidence shows
Every estradiol patch delivers the same hormone, and the twice-weekly brands share the same five doses, 0.025 to 0.1 mg a day. What you'll notice between brands is the size of the patch, the adhesive, the change schedule and the price. A switch at the same dose keeps the same amount of estradiol, though a weekly and a twice-weekly patch need a new prescription.
How the estrogen patch brands differ
How we ranked the estrogen patch brands
We compared the estradiol-only patches for hot flashes on four things you can check: cash price for the lowest dose, patch size, adhesion data in the FDA label, and what people report to the FDA about patches that don't stick. Prices are from Drugs.com in November 2026 and Cost Plus Drugs in September 2026. No brand paid to be listed, and we don't earn from any of them.
Twice-weekly estrogen patch brands: Dotti, Minivelle, Vivelle-Dot
Whichever you pick, it delivers 0.025, 0.0375, 0.05, 0.075 or 0.1 mg of estradiol a day, and you change it every 3 to 4 days. Minivelle is the smallest at every dose, 1.65 to 6.6 cm²; Dotti is close behind at 1.89 to 7.55 cm²; Vivelle-Dot is the largest, 2.5 to 10.0 cm². Minivelle and Vivelle-Dot both come from Noven. If the size of your patch bothers you, that's the first thing to change.
Learn more →Once-weekly estrogen patch brands: Climara and Menostar
If you'd rather change once a week, Climara comes in six doses, 0.025 to 0.1 mg a day, on patches of 6.5 to 25 cm², and has generics from Mylan and Zydus. In its trial, weekly hot flashes fell 67% on 0.05 mg against 18.1% on placebo. Menostar, also from Bayer, releases 14 mcg a day and is approved only to prevent bone loss after menopause, so it isn't ranked here.
Learn more →Estrogen patch prices compared
For 8 twice-weekly patches of 0.025 mg, Drugs.com lists Dotti from $58.60, Minivelle from $102.52 and Vivelle-Dot from $158.08. Cost Plus Drugs listed generic Minivelle at $47.83 for 8, Dotti at $94.61, the generic weekly patch at $36.05 and brand Climara at $53.30. That's almost three times more for Vivelle-Dot than for Dotti, for the same hormone at the same dose. Check your copay first, though: with insurance, a generic can cost you less than any of these.
Learn more →Which estrogen patch stays on best
You can't line these numbers up neatly, because each label measures adhesion its own way. Minivelle reports that about 98% of 208 observations had the patch at least 90% stuck over 84 hours. Dotti and Vivelle-Dot report 85% of 471 observations fully stuck and 3% coming off. Climara publishes no figure and warns that swimming, baths and saunas weren't studied. In FDA reports, a patch that didn't stick is the top term for Climara.
Estrogen patch brands during the 2026 shortage
On September 3, 2026 the FDA said demand for estradiol patches had grown, that it was working with all six manufacturers to raise supply, and that patches remain available though brands vary by pharmacy. Because twice-weekly brands share the same doses, you can ask the pharmacist for another brand at the same dose when yours is out. Your prescriber has to agree.
Learn more →Combination patches are a separate choice
If you still have a uterus, an estrogen-only patch needs a progestogen alongside it. Climara Pro and CombiPatch put both hormones in one patch; Climara Pro got its first generic, from Zydus, in October 2026. They're compared on their own page, because their doses and schedules don't match the estrogen-only brands.
Learn more →Estrogen patch brands by the numbers
5
1.65 cm²
$58.60 vs $158.08
$36.05
Adhesion figures come from each label's own studies and can't be compared head to head.
Estrogen patch brands ranked
1. Dotti: best value twice-weekly patch
Learn more →Good for
From $58.60 for 8 low-dose patches; same five doses as Vivelle-Dot; 1.89 cm² at the lowest dose; 85% fully stuck in label data.Watch
Only 169 FDA reports, so less real-world data; some pharmacies stock other generics instead.2. Minivelle: smallest patch, best adhesion data
Learn more →Good for
1.65 to 6.6 cm²; about 98% of observations at least 90% stuck over 84 hours; generic at $47.83 for 8 from Cost Plus.Watch
Brand from $102.52 for 8; no efficacy trials of its own, approved on bioequivalence to Vivelle.3. Climara and weekly generics: one change a week
Learn more →Good for
One patch day a week; six doses including 0.06 mg; generic $36.05 a carton at Cost Plus; 67% fewer hot flashes on 0.05 mg in its trial.Watch
Largest patches, 6.5 to 25 cm²; no adhesion figures; patch didn't stick in 14.9% of FDA reports.4. Vivelle-Dot: the original, most trial data
Learn more →Good for
Trials in 356 and 255 women behind its doses; 85% fully stuck in label data; widely covered by plans.Watch
Most expensive for cash payers, from $158.08 for 8; larger than Dotti and Minivelle.Not ranked: Menostar, for bones only
Learn more →Good for
14 mcg a day on a 3.25 cm² weekly patch; approved to prevent bone loss after menopause.Watch
Not approved for hot flashes; from $166.40 for 4 patches.
How to choose an estrogen patch
- Keep your dose when you change brands: twice-weekly brands share the same five strengths.
- Pick the schedule you'll remember: once a week (Climara) or twice a week (Dotti, Minivelle, Vivelle-Dot).
- If patches peel, go smaller before giving up on patches: Minivelle and Dotti are the smallest.
- Paying cash? Compare Drugs.com coupons with Cost Plus Drugs before you fill.
- If you have a uterus, make sure a progestogen is part of the plan.
When to call a doctor on an estrogen patch
Urgent: Chest pain, sudden shortness of breath, a painful swollen leg, sudden vision loss or stroke signs
Call 911. Blood clots and stroke are in the boxed warning of every estrogen patch.
Vaginal bleeding after menopause
See your doctor soon. Unexpected bleeding on estrogen needs checking.
Symptoms back after a brand switch
Check the dose on the new box, then tell your prescriber.
More →
Estrogen patch brands: questions women ask
What is the best estrogen patch?
If you're paying cash, we'd start with Dotti: the same doses as Vivelle-Dot on a smaller patch, from $58.60 for 8. If patches peel, Minivelle is the smallest and reports high adhesion in its own label. If two changes a week is hard, a weekly Climara generic is the cheapest at Cost Plus Drugs.
Are all estrogen patch brands the same?
In the way that matters, yes: you get estradiol from every one, and the twice-weekly brands share the same five doses. They differ in size, adhesive, schedule and price. If you switch brands at the same dose, you're getting the same amount of hormone.
Which estrogen patch is the smallest?
Minivelle. You'd wear 1.65 cm² at 0.025 mg and 6.6 cm² at 0.1 mg. Dotti is next, 1.89 to 7.55 cm². The largest is Climara at 0.1 mg, 25 cm².
Related →Which estrogen patch is the cheapest?
If you can use Cost Plus Drugs, it's the generic weekly patch at $36.05 a carton (September 2026). Among twice-weekly brands on Drugs.com, Dotti from $58.60 for 8 low-dose patches (November 2026). Check your insurance copay first.
Related →Is Dotti the same as Vivelle-Dot?
You'll get the same doses and schedule. Dotti is made by Amneal and sold by Cost Plus Drugs as the generic for Vivelle-Dot. Dotti's patches are smaller, 1.89 to 7.55 cm² against 2.5 to 10.0 cm².
Related →Can I switch estrogen patch brands during the shortage?
Usually, with your prescriber's agreement. The FDA said in September 2026 that patches remain available though brands vary by pharmacy. Twice-weekly brands swap at the same dose; moving to a weekly patch needs a new prescription.
Related →Is Menostar a regular estrogen patch?
No. Menostar releases 14 mcg of estradiol a day, a fraction of the 0.025 mg lowest dose of other patches, and is approved only to prevent bone loss after menopause, not to treat hot flashes.
Related →Sources
- Prescribing information: Dotti (estradiol transdermal system), 2024. DailyMed, US National Library of Medicine.
- Prescribing information: Minivelle (estradiol transdermal system). Noven Therapeutics, 2026. DailyMed, US National Library of Medicine.
- Prescribing information: Vivelle-Dot (estradiol transdermal system). Sandoz, 2023. DailyMed, US National Library of Medicine.
- Prescribing information: Climara (estradiol transdermal system). Bayer HealthCare, 2026. DailyMed, US National Library of Medicine.
- Prescribing information: Menostar (estradiol transdermal system). Bayer HealthCare, 2026. DailyMed, US National Library of Medicine.
- Drugs.com. Dotti prices, coupons, copay cards and patient assistance. Accessed November 2, 2026.
- Drugs.com. Vivelle-Dot prices, coupons, copay cards and patient assistance. Accessed November 2, 2026.
- Mark Cuban Cost Plus Drug Company. Hormone therapy medication prices (checked September 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.
- Drugs.com. Generic Climara availability: FDA-approved generics, manufacturers and approval dates. Accessed November 2, 2026.
- Drugs.com. Minivelle prices, coupons, copay cards and patient assistance. Accessed November 2, 2026.
- US Food and Drug Administration. FDA Adverse Event Reporting System (FAERS): reports naming Climara (estradiol transdermal system, once weekly; Climara Pro reports excluded), via openFDA. Data through July 30, 2026.
- US Food and Drug Administration. FDA update on estradiol transdermal patch availability. September 3, 2026.
- Prescribing information: Climara Pro (estradiol and levonorgestrel transdermal system). Bayer HealthCare, 2026. DailyMed, US National Library of Medicine.
- Prescribing information: CombiPatch (estradiol/norethindrone acetate transdermal system). Noven, 2024. DailyMed, US National Library of Medicine.
- US Food and Drug Administration. FDA approves once-weekly generic hormone therapy patch for women. News release, October 20, 2026.
- National 911 Program. 911.gov.
- Drugs.com. Menostar prices, coupons, copay cards and patient assistance. Accessed November 2, 2026.
- US Food and Drug Administration. FDA Adverse Event Reporting System (FAERS): reports naming Minivelle (estradiol transdermal system, twice weekly), via openFDA. Data through July 30, 2026.
- 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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