DRUGS AND SUPPLEMENTS

Esterified Estrogens, Estrone, Estropipate

March 21, 2017

Esterified Estrogens, Estrone, Estropipate injection

What are estrone injections?

ESTRONE injections (Estragyn 5®, Estrone®, Kestrone 5®) contain estrogen hormones. Estrogens are essential for maintaining normal female functions and are normally produced by the ovaries. After menopause, the ovaries decrease their production of these hormones. Estrogens can help relieve symptoms of the menopause (hot flashes, night sweats, mood changes, and vaginal dryness and irritation), and help to prevent the onset of osteoporosis (a loss of bone mass, so that bones become brittle and easily broken). Estrogens can also help improve female functions in women with hormonal imbalance or problems with their ovaries. Estrogens may also be given to certain men or women with inoperable breast cancers or prostate cancer. Occasionally these medications are used for other purposes. Generic estrone injections are available

What should my health care professional know before I receive estrone injections?

They need to know if you have any of these conditions:

  • asthma

  • blood vessel disease, blood clotting disorder, or suffered a stroke

  • breast, cervical, endometrial or uterine cancer

  • diabetes

  • fibroids in the womb, or endometriosis

  • heart, kidney or liver disease

  • high blood lipids or cholesterol

  • high blood pressure

  • high level of calcium in the blood

  • hysterectomy

  • mental depression

  • migraine

  • porphyria

  • tobacco smoker

  • vaginal bleeding

  • an unusual or allergic reaction to estrogens, other hormones, medicines, foods, dyes, or preservatives

  • pregnant or trying to get pregnant

  • breast-feeding

How should I use this medicine?

Estrone and estrogen injections are for injection into a muscle. The injection is given by a health-care professional

  • For all uses of this medicine:

Before starting this medication, read the paper on your prescription provided by your pharmacist or health care professional. This paper will tell you about the specific product you are taking. Make certain you understand the instructions

Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed

What if I miss a dose?

Try not to miss a dose. If you are unable to keep an appointment, call your prescriber or health care professional to reschedule

What drug(s) may interact with estrogen injections?

  • some antibiotics used to treat infections

  • barbiturates or benzodiazepines used for inducing sleep or treating seizures (convulsions)

  • bromocriptine

  • carbamazepine

  • cimetidine

  • cyclosporine

  • dantrolene

  • medications for diabetes

  • methotrexate

  • griseofulvin

  • hydrocortisone, cortisone, or prednisolone

  • isoniazid (INH)

  • methotrexate

  • phenytoin

  • raloxifene or tamoxifen

  • rifabutin, rifampin, or rifapentine

  • thyroid hormones

  • topiramate

  • tricyclic antidepressants

  • warfarin

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines

What should I watch for while taking estrogen injections?

Visit your prescriber or health care professional for regular checks on your progress. You should have a complete check-up every 6 months. You will also need a regular breast and pelvic exam and "Pap" smear while on estrogens therapy. You should also discuss the need for regular mammograms with your health care professional, and follow his or her guidelines for these tests. If you have any unusual bleeding contact your prescriber or health care professional for advice

Estrogens can make your body retain fluid, making your fingers, hands, or ankles swell. Your blood pressure can go up. Contact your prescriber or health care professional if you feel you are retaining fluid

If you have any reason to think you are pregnant; stop taking estrogens at once and contact your prescriber or health care professional

Tobacco smoking increases the risk of getting a blood clot or having a stroke while you are taking estrogens, especially if you are more than 35 years old. You are strongly advised not to smoke

If you wear contact lenses and notice visual changes, or if the lenses begin to feel uncomfortable, consult your eye care specialist or health care professional

In women who still have their uterus, estrogens increase the risk of developing a condition (endometrial hyperplasia) that may lead to cancer of the lining of the uterus. Taking progestins, another hormone drug, with estrogens lowers the risk of developing this condition. Therefore, if your uterus has not been removed (by a hysterectomy), your doctor may prescribe a progestin for you to take together with your estrogen. You should know, however, that taking estrogens with progestins may have additional health risks. You should discuss the use of estrogens and progestins with your health care professional to determine the benefits and risks for you

If you are going to have elective surgery, you may need to stop taking your estrogens one month beforehand. Consult your health care professional for advice prior to scheduling the surgery

What side effects may I notice from receiving estrogen injections?

Side effects that you should report to your prescriber or health care professional as soon as possible:

  • breakthrough bleeding and spotting

  • breast enlargement, tenderness, unusual discharge or milk production

  • chest pain

  • leg, arm or groin pain

  • nausea, vomiting

  • severe headaches

  • stomach pain (severe)

  • sudden shortness of breath

  • swelling of the hands, feet or ankles, or rapid weight gain

  • vision or speech problems

  • yellowing of the eyes or skin

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):

  • change in sexual desire

  • mild stomach upset

  • mood changes, anxiety, depression, frustration, anger, or emotional outbursts

  • increased or decreased appetite

  • skin rash, acne, or brown spots on the face

  • tiredness

  • vaginal yeast infection (irritation and white discharge)

  • weight gain

Where can I keep my medicine?

Keep out of the reach of children

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F); do not freeze. Throw away any unused medicine after the expiration date

Esterified Estrogens, Estrone, Estropipate tablets

What are esterified estrogens and estropipate tablets?

ESTERIFIED ESTROGENS (Estratab®, Menest®); and ESTROPIPATE (Ogen®, Ortho-Est®) contain estrogen hormones. Estrogens are essential for maintaining normal female functions and are normally produced by the ovaries. After menopause, the ovaries decrease their production of these hormones. Estrogens can help relieve symptoms of the menopause (hot flashes, night sweats, mood changes, and vaginal dryness and irritation), and help to prevent the onset of osteoporosis (a loss of bone mass, so that bones become brittle and easily broken). Estrogens can also help improve female functions in women with hormonal imbalance or problems with their ovaries. Estrogens may also be given to certain men or women with inoperable breast cancers or prostate cancer. Occasionally these medications are used for other purposes. Generic esterified estrogen and estopipate tablets are available

What should my health care professional know before I take esterified estrogens or estropipate?

They need to know if you have any of these conditions:

  • asthma

  • blood vessel disease, blood clotting disorder, or suffered a stroke

  • breast, cervical, endometrial or uterine cancer

  • diabetes

  • fibroids in the womb, or endometriosis

  • heart, kidney or liver disease

  • high blood lipids or cholesterol

  • high blood pressure

  • high level of calcium in the blood

  • hysterectomy

  • mental depression

  • migraine

  • porphyria

  • tobacco smoker

  • vaginal bleeding

  • an unusual or allergic reaction to estrogens, other hormones, medicines, foods, dyes, or preservatives

  • pregnant or trying to get pregnant

  • breast-feeding

How should I take this medicine?

Take esterified estrogen or estropipate tablets by mouth. Follow the directions on the prescription label. Swallow the tablets with a drink of water. If the tablets upset your stomach, take them with food or milk. Take your doses at regular intervals; estrogens work best when taken at the same time each day. Do not take your medicine more often than directed

  • For all uses of this medicine:

Before starting this medication, read the paper on your prescription provided by your pharmacist or health care professional. This paper will tell you about the specific product you are taking. Make certain you understand the instructions

Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose and resume your normal schedule. Do not take double or extra doses

What drug(s) may interact with esterified estrogens or estropipate?

  • some antibiotics used to treat infections

  • barbiturates or benzodiazepines used for inducing sleep or treating seizures (convulsions)

  • bromocriptine

  • carbamazepine

  • cimetidine

  • cyclosporine

  • dantrolene

  • medications for diabetes

  • methotrexate

  • griseofulvin

  • hydrocortisone, cortisone, or prednisolone

  • isoniazid (INH)

  • methotrexate

  • mineral oil

  • phenytoin

  • raloxifene or tamoxifen

  • rifabutin, rifampin, or rifapentine

  • thyroid hormones

  • topiramate

  • tricyclic antidepressants

  • warfarin

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines

What should I watch for while taking esterified estrogens or estropipate?

Visit your prescriber or health care professional for regular checks on your progress. You should have a complete check-up every 6 months. You will also need a regular breast and pelvic exam and "Pap" smear while on estrogens therapy. You should also discuss the need for regular mammograms with your health care professional, and follow his or her guidelines for these tests. If you have any unusual bleeding contact your prescriber or health care professional for advice

Estrogens can make your body retain fluid, making your fingers, hands, or ankles swell. Your blood pressure can go up. Contact your prescriber or health care professional if you feel you are retaining fluid

If you have any reason to think you are pregnant; stop taking estrogens at once and contact your prescriber or health care professional

Tobacco smoking increases the risk of getting a blood clot or having a stroke while you are taking estrogens, especially if you are more than 35 years old. You are strongly advised not to smoke

If you wear contact lenses and notice visual changes, or if the lenses begin to feel uncomfortable, consult your eye care specialist or health care professional

In women who still have their uterus, estrogens increase the risk of developing a condition (endometrial hyperplasia) that may lead to cancer of the lining of the uterus. Taking progestins, another hormone drug, with estrogens lowers the risk of developing this condition. Therefore, if your uterus has not been removed (by a hysterectomy), your doctor may prescribe a progestin for you to take together with your estrogen. You should know, however, that taking estrogens with progestins may have additional health risks. You should discuss the use of estrogens and progestins with your health care professional to determine the benefits and risks for you

If you are going to have elective surgery, you may need to stop taking your estrogens one month beforehand. Consult your health care professional for advice prior to scheduling the surgery

What side effects may I notice from taking esterified estrogens or estropipate?

Side effects that you should report to your prescriber or health care professional as soon as possible:

  • breakthrough bleeding and spotting

  • breast enlargement, tenderness, unusual discharge or milk production

  • chest pain

  • leg, arm or groin pain

  • nausea, vomiting

  • severe headaches

  • stomach pain (severe)

  • sudden shortness of breath

  • swelling of the hands, feet or ankles, or rapid weight gain

  • vision or speech problems

  • yellowing of the eyes or skin

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):

  • change in sexual desire

  • mild stomach upset

  • mood changes, anxiety, depression, frustration, anger, or emotional outbursts

  • increased or decreased appetite

  • skin rash, acne, or brown spots on the face

  • tiredness

  • vaginal yeast infection (irritation and white discharge)

  • weight gain

Where can I keep my medicine?

Keep out of the reach of children in a container that small children cannot open

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Throw away any unused medicine after the expiration date

Esterified Estrogens, Estrone, Estropipate vaginal cream

What is estropipate vaginal cream?

ESTROPIPATE (Ogen®) vaginal cream contains a natural estrogen female hormone. Estrogens are essential for maintaining normal female functions and are normally produced by the ovaries. After menopause, the ovaries decrease their production of estrogens. Estropipate vaginal cream can help relieve symptoms of vaginal irritation and dryness and urinary tract irritation that occurs in some women during menopause. Generic estropipate vaginal cream is not yet available. NOTE: This drug product is discontinued in the U.S

What should my health care professional know before I use estropipate vaginal cream?

They need to know if you have any of these conditions:

  • asthma

  • blood vessel disease, blood clotting disorder, or suffered a stroke

  • breast, cervical, endometrial or uterine cancer

  • diabetes

  • fibroids in the womb, or endometriosis

  • heart, kidney or liver disease

  • high blood lipids or cholesterol

  • high blood pressure

  • high level of calcium in the blood

  • hysterectomy

  • mental depression

  • migraine

  • porphyria

  • tobacco smoker

  • vaginal bleeding

  • an unusual or allergic reaction to estrogens, other hormones, medicines, foods, dyes, or preservatives

  • pregnant or trying to get pregnant

  • breast-feeding

How should I use this medicine?

Estradiol vaginal cream is for use in the vagina only. Do not take by mouth. Follow the directions on the prescription label. Vaginal products work best if used at bedtime. Use at bedtime unless otherwise directed by your prescriber or health care professional. Read package directions carefully before using. Use the special applicator supplied with the cream. Wash hands before and after use. Fill the applicator with the cream and remove from the tube. Lie on your back, part and bend your knees. Insert the applicator into the vagina and push the plunger to expel the cream into the vagina. Wash the applicator with warm (not boiling) soapy water and rinse well. You also can apply a small amount of the cream to the labia (outer skin folds or "lips" of the vagina) to relieve dryness or irritation. Use exactly as directed for the complete length of time prescribed. Do not stop using except on your prescriber's advice

  • For all uses of this medicine:

Before starting this medication, read the paper on your prescription provided by your pharmacist or health care professional. This paper will tell you about the specific product you are taking. Make certain you understand the instructions

This vaginal medication is not prescribed for children

What if I miss a dose?

If you miss a dose, use it as soon as you can. If it is almost time for your next dose, use only that dose and resume your normal schedule. Do not use double or extra doses

What drug(s) may interact with estrogen?

Estropipate vaginal cream usually releases only a small amount of hormone into the body daily and is less likely to cause significant drug interactions with most medications. However, if you are on any of the following medications, you may want to ask your health care professional about any needed precautions. Do not use other vaginal medications without the advice of your health care professional

  • barbiturates or benzodiazepines used for inducing sleep or treating seizures (convulsions)

  • bromocriptine

  • carbamazepine

  • cimetidine

  • cyclosporine

  • dantrolene

  • medications for diabetes

  • methotrexate

  • griseofulvin

  • hydrocortisone, cortisone, or prednisolone

  • isoniazid (INH)

  • methotrexate

  • phenytoin

  • raloxifene or tamoxifen

  • rifabutin, rifampin, or rifapentine

  • thyroid hormones

  • topiramate

  • tricyclic antidepressants

  • warfarin

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines

What should I watch for while taking estropipate vaginal cream?

Visit your prescriber or health care professional for regular checks on your progress. You should have a complete check-up every 6 months. You will also need a regular breast and pelvic exam and "Pap" smear while on estrogens therapy. You should also discuss the need for regular mammograms with your health care professional, and follow his or her guidelines for these tests. If you have any unusual bleeding contact your prescriber or health care professional for advice

Estrogens can make your body retain fluid, making your fingers, hands, or ankles swell. Your blood pressure can go up. Contact your prescriber or health care professional if you feel you are retaining fluid

If you have any reason to think you are pregnant; stop taking estrogens at once and contact your prescriber or health care professional

Tobacco smoking increases the risk of getting a blood clot or having a stroke while you are taking estrogens, especially if you are more than 35 years old. You are strongly advised not to smoke

If you wear contact lenses and notice visual changes, or if the lenses begin to feel uncomfortable, consult your eye care specialist or health care professional

If you are going to have elective surgery, you may need to stop taking your estrogens one month beforehand. Consult your health care professional for advice prior to scheduling the surgery

What side effects may I notice from using estropipate vaginal cream?

Side effects that you should report to your prescriber or health care professional as soon as possible:

  • breakthrough bleeding and spotting

  • breast enlargement, tenderness, unusual discharge or milk production

  • chest pain

  • leg, arm or groin pain

  • nausea, vomiting

  • severe headaches

  • stomach pain (severe)

  • sudden shortness of breath

  • swelling of the hands, feet or ankles, or rapid weight gain

  • vision or speech problems

  • yellowing of the eyes or skin

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):

More Common:

  • mild irritation at the site(s) of cream application

Less Common:

  • change in sexual desire

  • mild stomach upset

  • mood changes, anxiety, depression, frustration, anger, or emotional outbursts

  • increased or decreased appetite

  • skin rash, acne, or brown spots on the face

  • tiredness

  • vaginal itching

  • vaginal yeast infection (irritation and itching with a white discharge)

  • weight gain

Where can I keep my medicine?

Keep out of the reach of children in a container that small children cannot open

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F); do not freeze. Throw away any unused medicine after the expiration date

Updated:  

March 21, 2017

Sources:  

U.S. FDA-approved Package Insert