Short answer: The Elestrin Patient Information says not to double the dose the next day to catch up. If your next dose is less than 12 hours away, it is best to wait and apply your normal dose the next day. If it is more than 12 hours away, apply the missed dose and resume normal dosing the next day.
| Situation | What the label says |
|---|---|
| Schedule | Start with one pump (0.87 g gel, 0.52 mg estradiol) once daily on the upper arm (2.1) |
| Next dose more than 12 hours away | Apply the missed dose, then resume normal dosing the next day (Patient Information) |
| Next dose less than 12 hours away | Wait and apply the normal dose the next day (Patient Information) |
| Catching up | Do not double the dose the next day (Patient Information) |
| Timing | Apply at the same time each day (Instructions for Use) |
Patient Information, What should I do if I miss a dose?: "If you miss a dose, 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."
The prescribing information has no separate missed-dose section; the rule is in the Patient Information.
Example: you apply Elestrin at 8 a.m. and remember at 2 p.m. that you skipped it. The next dose is 18 hours away, more than 12, so under the label you would apply the missed dose then and go back to 8 a.m. the next day. If you remember at 10 p.m., the next dose is 10 hours away, less than 12, so the label says to wait for the next morning.
The Divigel Patient Information has the same 12-hour rule. The EstroGel label has no missed-dose rule. Each product has its own label, and the rule of one does not transfer to another.
This page summarizes FDA labeling. It is not personalized medical advice; confirm what to do with your prescriber or pharmacist.