Short answer: The Divigel Patient Information says not to double the dose the next day. If your next dose is less than 12 hours away, wait and apply your normal dose the next day. If it is more than 12 hours away, apply the missed dose and go back to normal the next day. Never apply it more than once a day.
| Situation | What the label says |
|---|---|
| Schedule | 0.25 to 1.25 g once daily on the right or left upper thigh, alternating days (2) |
| Next dose more than 12 hours away | Apply the missed dose; normal dosing the next day (Patient Information) |
| Next dose less than 12 hours away | Wait; apply the normal dose the next day (Patient Information) |
| Doubling up | Do not double the dose the next day (Patient Information) |
| Most per day | Not more than 1 time each day (Patient Information) |
| Spilled packet | Do not open a new packet that day (Patient Information) |
The Patient Information answers "What should I do if I miss a dose?" directly: do not double the dose on the next day to catch up. If your next dose is less than 12 hours away, it is best just to wait and apply your normal dose the next day. If it is more than 12 hours until the next dose, apply the dose you missed and resume your normal dosing the next day. Do not apply Divigel more than 1 time each day.
Example: you apply Divigel at 8 a.m. and remember at 2 p.m. The next dose is 18 hours away, so under the leaflet you would apply it then. If you remember at 10 p.m., the next dose is 10 hours away, so you would wait for the morning.
The Patient Information says that if you accidentally spill some of the contents of a packet, do not open a new packet to replace it that day.
Section 12.3 gives an apparent terminal half-life for estradiol of about 10 hours after Divigel is applied.
This page summarizes FDA labeling. It is not personalized medical advice; confirm what to do with your prescriber or pharmacist.