What are the potential side effects of taking 2 Dotti (transdermal medication) patches every other day?

Side Effects of Dotti Patches Used Every Other Day

Using 2 Dotti patches every other day can lead to increased risk of adverse effects including skin irritation, hormonal side effects, and potentially serious systemic complications due to excessive medication absorption.

Understanding Dotti Patches

Dotti patches are transdermal medication delivery systems, typically containing estrogen for hormone replacement therapy. When used correctly, they deliver a controlled amount of medication through the skin. However, using multiple patches simultaneously can significantly increase the medication dose beyond recommended levels.

Local Skin Reactions

• Skin irritation - The most common side effect includes erythema, peeling, dryness, and burning at the application site 1
• Contact dermatitis - Both irritant and allergic contact dermatitis can develop, especially with repeated applications to the same area 2
• Hyperpigmentation - Changes in skin color at the application site may occur with prolonged use 1

Systemic Side Effects

Using multiple patches simultaneously can lead to excessive hormone absorption and increased risk of:

Hormonal Effects

• Menstrual irregularities - Including breakthrough bleeding, spotting, or amenorrhea 1
• Breast tenderness or enlargement
• Mood changes - Irritability, depression, or mood swings 1
• Headaches and dizziness - More common with higher doses 1

Gastrointestinal Effects

• Nausea and vomiting - Can be severe with overdosing 1, 3
• Changes in appetite 1

Cardiovascular Effects

• Increased risk of thromboembolic complications - Including deep vein thrombosis and pulmonary embolism 1
• Elevated blood pressure
• Fluid retention and edema

Serious Risks of Overdosing

Using multiple patches simultaneously constitutes an overdose and can lead to:

• Severe nausea and vomiting - Leading to dehydration and electrolyte imbalances 3
• Renal failure - As documented in a case report of multiple patch application 3
• Metabolic disturbances - Including alterations in lipids and liver function 1

Proper Usage Guidelines

1. Only one patch should be applied at a time - Using multiple patches simultaneously significantly increases the risk of side effects
2. Follow the prescribed schedule - Typically one patch every 3-4 days, not multiple patches every other day
3. Rotate application sites - To reduce skin irritation
4. Remove old patches before applying new ones - To prevent accidental overdosing

Warning Signs Requiring Medical Attention

• Severe or persistent skin reactions that don't improve
• Signs of excessive estrogen: severe headaches, chest pain, shortness of breath, leg pain/swelling
• Visual disturbances
• Severe abdominal pain
• Jaundice (yellowing of skin/eyes)

Conclusion

The practice of using 2 Dotti patches every other day is not recommended due to the increased risk of both local and systemic adverse effects. A case report documented fatal outcomes from multiple patch application due to severe vomiting leading to dehydration and renal failure 3. Patients should strictly adhere to prescribed dosing schedules and never apply multiple patches unless specifically instructed by their healthcare provider.