What Is Combipatch?

Combipatch is a prescription transdermal patch that delivers two hormones through your skin: Estradiol (a form of estrogen) and Norethindrone Acetate (a progestin). It's classified as a combination hormone replacement therapy (HRT) and is specifically designed for women who have an intact uterus and need relief from menopause symptoms.

The patch is applied to the lower abdomen and replaced twice a week. It provides a steady, controlled dose of hormones directly into your bloodstream, bypassing the digestive system. This transdermal delivery method can reduce some side effects that are more common with oral HRT pills.

What Does Combipatch Treat?

Combipatch is FDA-approved for two primary uses:

1. Moderate to Severe Vasomotor Symptoms (Hot Flashes and Night Sweats)

Hot flashes and night sweats are among the most disruptive menopause symptoms. They're caused by declining estrogen levels, which affect your body's temperature regulation. Combipatch replaces estrogen to help reduce the frequency and severity of these episodes.

2. Prevention of Postmenopausal Osteoporosis

After menopause, declining estrogen accelerates bone loss, increasing the risk of osteoporosis and fractures. Combipatch helps maintain bone density. However, it's typically considered for osteoporosis prevention only when other treatments are not suitable, and the benefits and risks should be carefully weighed.

Why Does Combipatch Include a Progestin?

This is an important question. When estrogen is used alone in women who still have a uterus, it can cause the uterine lining (endometrium) to grow too thick — a condition called endometrial hyperplasia — which increases the risk of endometrial cancer.

The Norethindrone Acetate in Combipatch is a progestin that protects the uterine lining by preventing this overgrowth. If you've had a hysterectomy (uterus removed), you typically don't need the progestin component, and your doctor may prescribe an estrogen-only product instead.

For a deeper look at how these hormones work in your body, read our guide on how Combipatch works.

Combipatch Dosage Options

Combipatch comes in two strengths, both delivering hormones continuously over 3 to 4 days:

• 0.05 mg/0.14 mg per day — delivers 0.05 mg of Estradiol and 0.14 mg of Norethindrone Acetate daily
• 0.05 mg/0.25 mg per day — delivers 0.05 mg of Estradiol and 0.25 mg of Norethindrone Acetate daily

Your doctor will choose the appropriate strength based on your symptoms, medical history, and response to treatment. The general guideline is to use the lowest effective dose for the shortest time needed.

How to Use Combipatch

Applying Combipatch correctly ensures you get the right dose and minimizes skin irritation. Here's how:

1. Choose the right spot. Apply the patch to a clean, dry area on your lower abdomen. Do not apply it to your breasts.
2. Prepare the skin. The area should be free of lotions, oils, powders, or sunscreen. Don't apply to skin that is cut, irritated, or red.
3. Apply the patch. Peel off the protective liner and press the patch firmly against your skin for about 10 seconds. Make sure the edges stick well.
4. Replace twice weekly. Change the patch every 3 to 4 days (for example, every Monday and Thursday, or every Tuesday and Friday).
5. Rotate sites. Use a different spot on your lower abdomen each time. Wait at least one week before reusing the same area.
6. If a patch falls off, try to reapply it. If it won't stick, apply a new one and keep your regular schedule.

What If You Miss a Dose?

If you forget to change your patch on the scheduled day, apply a new one as soon as you remember. Then return to your regular twice-weekly schedule. Don't apply two patches at once to make up for a missed dose.

Common Side Effects

Like all HRT, Combipatch can cause side effects. The most common include:

• Skin irritation at the application site
• Headache
• Breast tenderness
• Nausea
• Bloating
• Breakthrough bleeding or spotting
• Mood changes

Most of these improve within the first few months. For a complete breakdown of side effects and when to seek help, see our detailed guide on Combipatch side effects.

Important Safety Information

Combipatch carries an FDA boxed warning — the strongest safety warning the FDA issues. Key points:

• Estrogen-progestin therapy should not be used to prevent heart disease or dementia.
• Studies (including the Women's Health Initiative) found increased risks of blood clots, stroke, heart attack, breast cancer, and probable dementia with combination HRT.
• Use the lowest dose that works for the shortest time needed.

Who Should Not Use Combipatch

Do not use Combipatch if you have:

• Known or suspected breast cancer or other estrogen-dependent cancers
• Undiagnosed abnormal vaginal bleeding
• Active or recent blood clots, stroke, or heart attack
• Liver disease
• Known or suspected pregnancy
• Allergy to any component of the patch
• Known protein C, protein S, or antithrombin deficiency

Drug Interactions

Several medications and supplements can affect how Combipatch works. Key interactions include:

• CYP3A4 inducers (Rifampin, Carbamazepine, Phenytoin, St. John's Wort) — may reduce Combipatch's effectiveness
• CYP3A4 inhibitors (Ketoconazole, Erythromycin, grapefruit juice) — may increase hormone levels and side effects
• Thyroid medications — estrogen can increase thyroid-binding globulin, potentially requiring a thyroid dose adjustment
• Blood thinners (Warfarin) — requires closer monitoring

For the full list, read our guide on Combipatch drug interactions.

Combipatch vs. Other HRT Options

Combipatch isn't the only combination HRT available. Here's how it compares:

• Climara Pro — another combination patch (Estradiol/Levonorgestrel), applied once weekly instead of twice
• Activella — an oral pill with the same active ingredients (Estradiol/Norethindrone Acetate)
• Prempro — an oral pill combining conjugated estrogens with Medroxyprogesterone Acetate
• Bijuva — an oral pill combining bio-identical Estradiol with Progesterone

If you can't find or tolerate Combipatch, explore alternatives to Combipatch.

Cost and Availability in 2026

Combipatch can be expensive. Brand-name Combipatch ranges from about $250 to $450 per month, while generics (Estradiol/Norethindrone Acetate patches) range from about $150 to $350 per month.

A generic version is available, and using discount tools like GoodRx or SingleCare can help lower costs. For a complete guide to reducing your out-of-pocket expenses, see how to save money on Combipatch.

Availability has been inconsistent due to ongoing supply chain challenges. If you're having trouble finding it, MedFinder can help you locate pharmacies with Combipatch in stock.

Bottom Line

Combipatch is a well-established combination HRT patch that effectively treats hot flashes and night sweats while protecting the uterine lining. It's applied twice weekly to the lower abdomen and comes in two strengths. Like all HRT, it carries important safety considerations — use it at the lowest effective dose for the shortest necessary time, and work closely with your doctor to monitor your health.

If you need help finding a prescriber, read our guide on how to find a doctor who can prescribe Combipatch.