Short answer: Both are estradiol skin patches. Minivelle is changed twice a week and starts at 0.0375 mg a day for hot flashes; it is approved for hot flashes and bone loss prevention.1 Climara is changed once a week, starts at 0.025 mg a day, and is also approved for vaginal atrophy and low estrogen.2 Both carry the estrogen boxed warning. Neither label compares the two.
| Minivelle | Climara | |
|---|---|---|
| Approved for | Hot flashes due to menopause; osteoporosis prevention1 | Hot flashes, vaginal atrophy, low estrogen from hypogonadism, castration or ovarian failure, and osteoporosis prevention2 |
| Schedule | Replaced twice weekly, every 3 to 4 days1 | Replaced once a week, every 7 days2 |
| Starting dose | 0.0375 mg a day for hot flashes; 0.025 mg a day for bone1 | 0.025 mg a day for every use2 |
| Strengths | Five, 0.025 to 0.1 mg a day1 | Six, 0.025 to 0.1 mg a day2 |
| Common side effects | Headache 31.1% on 0.05 mg vs 23.6% on placebo; breast tenderness 12.9% on 0.1 mg vs 01 | Breast pain 29% on 0.1 mg vs 4% on placebo; headache 18% on 0.05 mg vs 10%2 |
| If a patch falls off | Reapply it or put on a new one, keeping the original schedule1 | Reapply it elsewhere, or use a new one for the rest of the 7 days2 |
| Boxed warning | WARNING: ENDOMETRIAL CANCER, CARDIOVASCULAR DISORDERS, PROBABLE DEMENTIA, and BREAST CANCER1 | WARNING: ENDOMETRIAL CANCER, CARDIOVASCULAR DISORDERS, PROBABLE DEMENTIA and BREAST CANCER2 |
No efficacy trials were run with Minivelle itself; its label uses trials of Vivelle and its own skin studies. About 98% of 208 Minivelle wear checks showed the patch at least 90% stuck over 84 hours, and 2.2% of 136 people reported mild discomfort.1 Climara was tested against placebo: weekly hot flashes fell 67% on 0.05 mg and 72% on 0.1 mg vs 18.1% on placebo in an 11-week study.2 These numbers come from separate trials with different people, lengths and methods, so they are not a head-to-head comparison.
Both boxed warnings rest on Women's Health Initiative studies of oral conjugated estrogens; both labels say to use the lowest effective dose for the shortest time, and that women with a uterus generally add a progestogen.12
Which, if either, fits is for your prescriber. More detail: Minivelle side effects, Climara side effects, the Minivelle and Climara dosing schedules, the Minivelle and estradiol patch missed-dose pages, the estradiol guide, and Minivelle vs Vivelle-Dot: how do the two estradiol patches differ?.