Comprehensive medication guide to {drug} including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Divigel is a prescription topical estradiol gel used to treat moderate to severe hot flashes (vasomotor symptoms) caused by menopause. It belongs to the estrogen hormone replacement therapy class. The gel is applied once daily to the skin of the upper thigh and delivers estradiol — the primary form of estrogen — directly through the skin into the bloodstream.
Divigel is manufactured by Vertical Pharmaceuticals, LLC and is also available as generic estradiol gel 0.1%. It may also be used off-label for vaginal dryness, bone loss prevention in postmenopausal women, and as part of gender-affirming hormone therapy.
Divigel delivers estradiol transdermally — meaning it passes through the skin into the bloodstream. Once absorbed, estradiol binds to estrogen receptors in target tissues throughout the body. By restoring estrogen levels that naturally decline during menopause, Divigel acts on the hypothalamic thermoregulatory center in the brain to reduce hot flashes and night sweats.
Unlike oral estrogen, transdermal delivery bypasses the liver's first-pass metabolism, which may result in a lower risk of certain side effects like blood clots compared to oral formulations.
Divigel comes in single-dose foil packets in the following strengths:
Your doctor will typically start you at the lowest effective dose and adjust as needed.
Divigel earns a findability score of 55 out of 100, meaning it can be moderately difficult to locate. While Divigel itself is not on the FDA drug shortage list, the broader estradiol market — especially patches — has experienced supply disruptions since 2023, driving more patients toward gel formulations like Divigel. This increased demand can make it harder to find at your local pharmacy. Generic estradiol gel is generally easier to locate than brand-name Divigel.
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Several types of healthcare providers can prescribe Divigel:
Divigel is also available through telehealth providers, making it accessible for patients who prefer virtual consultations.
No, Divigel is not a controlled substance. It is not scheduled by the DEA. Divigel does require a prescription but does not carry the additional restrictions associated with controlled medications. You can get refills without the special requirements that apply to controlled substances.
The most frequently reported side effects of Divigel include:
Serious but rare side effects can include stroke, deep vein thrombosis, pulmonary embolism, and heart attack. Women with a uterus should use a progestogen alongside Divigel to reduce the risk of endometrial cancer. Contact your healthcare provider immediately if you experience chest pain, sudden severe headache, vision changes, or leg swelling.
If you're unable to find Divigel or it's not the right fit, several alternatives are available:
Divigel can interact with several medications and substances:
Always inform your doctor about all medications, supplements, and herbal products you are taking before starting Divigel.
Divigel is an effective transdermal estradiol gel for managing menopausal hot flashes, with five dose strengths allowing flexible treatment. While the brand can be expensive at $650–$900 per month, generic estradiol gel is available for as low as $32–$50 with discount coupons. With a findability score of 55, it may take some effort to locate — particularly as demand for estradiol products has increased due to ongoing patch shortages in the broader HRT market. If your pharmacy is out of stock, ask about generic estradiol gel or use Medfinder to locate it at a pharmacy near you.
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