Posology : מינונים

4.2   Posology and method of administration
Posology
The lowest effective dose should be used.
The generally accepted dosage is: application once a day in the morning or evening for 24-28 consecutive days every month or for three weeks out of every four. After the break, the treatment cycle should be repeated.
The dose should be adjusted during the second and/or third cycle according to the response.
Initiation of treatment:
Women who have never taken HRT and are post-menopausal or have very infrequent menstrual cycles: Treatment with Oestrogel can be started on any day.
Switching from a continuous oestrogen-progestogen combined HRT: treatment with Oestrogel can be started on any day of the cycle.
Switching from a cyclic or continuous sequential HRT treatment: finish the therapeutic sequence before beginning treatment with Oestrogel.

The correct dose of gel should be dispensed and applied to clean, dry, intact areas of skin e.g. on the arms and shoulders, or inner thighs. The area of application should be at least 750 cm2. Half the prescribed dose, should be applied to each arm/shoulder (or thigh). Oestrogel should NOT be applied on or near the breasts or on the vulval region. A frequent change in application sites is recommended.
Oestrogel should be allowed to dry for 5 minutes before covering the skin with clothing.
The gel should be applied by the patient herself, not by anyone else, and skin contact, particularly with a male partner, should be avoided for one hour after application. Wash hands with soap and water after applying the gel.
Washing the skin or contact with other skin products should be avoided until at least one hour after application of Oestrogel.
Patients should be informed that children should not come in contact with the area of the body where Oestrogel was applied on (see section 4.4).
For people not being treated with Oestrogel:
In the event of contact with an application area, which has not been washed or is not covered with clothing, wash the area of skin onto which Oestrogel may have been transferred as soon as possible, using soap and water.
If the patient forgets to apply a dose and it is more than 12 hours until the next dose, the missed dose should be applied and normal dosing resumed the next day. If the next dose is less than 12 hours away, it is best just to wait and apply the next dose normally. Patients should be advised not to apply two doses at the same time.
Forgetting a dose may increase the likelihood of break-through bleeding and spotting.