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About Evamist

What is Evamist®?

Evamist® (estradiol transdermal spray) is a prescription medicine spray that has been proven to reduce moderate-to-severe hot flashes caused by menopause. It has been shown to reduce both the severity and frequency of hot flashes.1

Evamist® (estradiol transdermal spray) contains 17β-estradiol, an estrogen hormone chemically synthesized from a plant source.2 Evamist is the only estrogen therapy spray approved by the FDA.

Download our patient brochure to learn more about Evamist® and how it’s applied.

How Evamist Works

Evamist® (estradiol transdermal spray) is a once-daily spray.

It delivers estrogen directly through the skin (transdermally) to your bloodstream.3,4 Your doctor can start you at the lowest dose (1 spray) and easily adjust your dose to 2 or 3 sprays to find the dose that works for you.5 Evamist is the only estrogen therapy with dosing flexibility that allows you to change the dose without requiring a new prescription.

Talk to your healthcare provider about what dosing would work best for you. You and your healthcare provider should talk regularly (every 3 to 6 months) about the dose you are taking and whether you need to adjust treatment.

How To Use Evamist®

Each Evamist® (estradiol transdermal spray) applicator contains enough medication to allow for initial priming of the pump with 3 sprays and application of 56 sprays, providing the precise amount of medicine each time the applicator is used.

The product will last approximately 56 days if you use 1 spray each day, 28 days if you use 2 sprays each day, and 18 days if you use 3 sprays each day. Do not use this applicator for more than 56 sprays even though the bottle may not be completely empty.

  1. Evamist® (estradiol transdermal spray) Prescribing Information, Perrigo, January 2015.
  2. Data on file, Perrigo.
  3. Evamist® (estradiol transdermal spray) Prescribing Information, Perrigo, January 2015.
  4. Nachtigall LE. Emerging delivery systems for estrogen replacement: aspects of transdermal and oral delivery. Am J Obstet Gynecol. 1995;173:993-997.
  5. Use of estrogen alone, or in combination with a progestin, should be with the lowest effective dose and the shortest duration consistent with treatment goals and risks for the individual woman.

Steps to applying Evamist.

Before using the Evamist® (estradiol transdermal spray) applicator for the first time, it must be primed. With the cover on and the applicator upright, fully depress the applicator 3 times with your thumb or index finger. After priming, the applicator is ready to use.


Do not apply Evamist® (estradiol transdermal spray) to other areas of the skin. Never apply Evamist directly to the breast or in or around the vagina.

Take steps to avoid unintended exposure to estrogen.

After you spray Evamist® (estradiol transdermal spray) on your skin, do not allow other people and pets to make contact with the area of skin where you applied the spray after application. Cover your skin with clothing where you sprayed Evamist if you think another person will come in contact with that area of skin. If you get Evamist spray on another area of your skin like your hands, wash that area of your skin with soap and water right away.

The estrogen in Evamist® (estradiol transdermal spray) can transfer from the area of skin where it was sprayed to other people. Do not allow others, especially children, to come into contact with the area of your skin where you sprayed Evamist. Young children who are accidentally exposed to estrogen through contact with women using Evamist may show signs of puberty that are not expected (for example, breast budding).

If another person accidentally touches the area of your skin where you sprayed Evamist® (estradiol transdermal spray), tell that person to wash the area of their skin with soap and water right away. The longer Evamist stays on the skin before it is washed off, the greater the chance the estrogen hormone may be absorbed.

If a child under your care unexpectedly starts to develop breasts or has other sexual changes:

  • Have the child checked right away by their healthcare provider
  • Stop using Evamist® (estradiol transdermal spray) and call your healthcare provider right away if you see any signs and symptoms in a child that may have occurred through accidental exposure to Evamist. In most cases the child’s breasts will go back to normal when they are no longer exposed to Evamist.
  • Talk to your healthcare provider about the correct use of Evamist when around children
  • Talk to your healthcare provider to discuss other treatments for your menopause symptoms if accidental exposure to Evamist cannot be avoided

Evamist® (estradiol transdermal spray) contains alcohol, and alcohol-based liquids are flammable. Avoid fire, flame, or smoking when using Evamist until the spray has dried. Do not apply Evamist while standing near a flame.

Evamist® (estradiol transdermal spray) can be stored in a clean, dry place at room temperature (15° to 30°C or 59° to 86°F) and does not need refrigeration. Do not freeze.

Evamist® (estradiol transdermal spray) should not be used after the expiration date.


Who Should Not Use Evamist?

Do not start using Evamist® (estradiol transdermal spray) if you:

  • Have unusual vaginal bleeding
    • Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb). Your healthcare provider should check any unusual vaginal bleeding to find out the cause.
  • Currently have or have had certain cancers
    • Estrogens may increase the chance of getting certain types of cancers, including cancer of the breast or uterus. If you have or have had cancer, talk with your healthcare provider about whether you should use Evamist® (estradiol transdermal spray).
  • Had a stroke or heart attack
  • Currently have or have had blood clots
  • Currently have or have had liver problems
  • Have been diagnosed with a bleeding disorder
  • Are allergic to Evamist or any of its ingredients
  • Think you may be pregnant
    • Evamist® (estradiol transdermal spray) is not for pregnant women. If you think you may be pregnant, you should have a pregnancy test and know the results. Do not use Evamist if the test is positive and talk to your healthcare provider.

Before you use Evamist® (estradiol transdermal spray), tell your healthcare provider if you:

  • Have any unusual vaginal bleeding
    • Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb). Your healthcare provider should check any vaginal bleeding to find out the cause.
  • Have any other medical conditions
    • Your healthcare provider may need to check you more carefully if you have certain conditions, such as asthma (wheezing), epilepsy (seizures), diabetes, migraine, endometriosis, lupus, angioedema (swelling of face and tongue), or problems with your heart, liver, thyroid, kidneys, or have high calcium levels in your blood.
  • Are going to have surgery or will be on bed rest
    • Your healthcare provider will let you know if you need to stop using Evamist® (estradiol transdermal spray).
  • Are breast feeding
    • The hormone in Evamist® (estradiol transdermal spray) can pass into your breast milk.

Tell your healthcare provider about all the medicine you take including prescription and nonprescription medicines, vitamins, and herbal supplements. Some medicines may affect how Evamist® (estradiol transdermal spray) works. Evamist may also affect how your other medicines work. Keep a list of your medicines and show it to your healthcare provider and pharmacist when you get a new medicine.

What Should I Avoid While Using Evamist?

  • Do not allow others to make contact with the area of skin where you applied Evamist® (estradiol transdermal spray)
  • Because Evamist contains alcohol, which is flammable, avoid fire, flame, or smoking until the area of your skin where you have applied Evamist has dried

What Are The Possible Side Effects Of Evamist?

Side effects are grouped by how serious they are and how often they happen when you are treated.

Serious, but less common side effects include:

  • heart attack
  • stroke
  • blood clots
  • dementia
  • breast cancer
  • cancer of the lining of the uterus (womb)
  • cancer of the ovary
  • high blood pressure
  • high blood sugar
  • gallbladder disease
  • liver problems
  • changes in your thyroid hormone levels
  • enlargement of benign tumors of the uterus (“fibroids”)

Call your healthcare provider right away if you get any of the following warning signs or any other unusual symptoms that concern you:

  • new breast lumps
  • unusual vaginal bleeding
  • changes in vision or speech
  • sudden new severe headaches
  • severe pains in your chest or legs with or without shortness of breath, weakness, and fatigue

Less serious, but common side effects include:

  • headache
  • breast pain
  • irregular vaginal bleeding or spotting
  • stomach or abdominal cramps, bloating
  • nausea and vomiting
  • hair loss
  • fluid retention
  • vaginal yeast infection

These are not all the possible side effects of Evamist® (estradiol transdermal spray). For more information, ask your healthcare provider or pharmacist. Tell your healthcare provider if you have any side effect that bothers you or does not go away. You may report side effects to Perrigo at 1-866-634-9120 or to FDA at 1-800-FDA-1088.

What Can I Do To Lower My Chances Of A Serious Side Effect With Evamist?

Talk with your healthcare provider regularly about whether you should continue using Evamist® (estradiol transdermal spray).

  • If you have a uterus, talk with your healthcare provider about whether the addition of a progestin is right for you.
  • The addition of a progestin is generally recommended for women with a uterus to reduce the chance of getting cancer of the uterus.
  • See your healthcare provider right away if you get vaginal bleeding while using Evamist® (estradiol transdermal spray).
  • Have a pelvic exam, breast exam, and mammogram (breast X-ray) every year unless your healthcare provider tells you something else.
  • If members of your family have had breast cancer or if you have ever had breast lumps or an abnormal mammogram, you may need to have breast exams more often.
  • If you have high blood pressure, high cholesterol (fat in the blood), diabetes, are overweight, or if you use tobacco, you may have a higher chance of getting heart disease.
  • Ask your healthcare provider for ways to lower your chances of getting heart disease.

How Should I Store Evamist?

Store Evamist® (estradiol transdermal spray) at room temperature of 68°F to 77°F (20°C to 25°C). Do not freeze. Safely throw away medicine that is out of date or no longer needed.

Keep Evamist And All Medicines Out of the reach of children

Do not use Evamist® (estradiol transdermal spray) for conditions for which it was not prescribed. Do not give Evamist to other people, even if they have the same symptoms you have. It may harm them.

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