Estradiol topical spray

What is this medicine?

ESTRADIOL (es tra DYE ole) is an estrogen. It is mostly used as hormone replacement in menopausal women. This medicine helps relieve symptoms of menopause such as hot flashes, night sweats, and mood changes.

How should I use this medicine?

This medicine is for external use only. Follow the directions on the prescription label. Your health care provider will show you how to apply this medicine. Apply this medicine at the same time each day to clean, dry, unbroken skin on the inside of the forearm between the elbow and the wrist. If you take a bath or shower or use a sauna, apply this medicine after the bath, shower, or sauna, and once the skin is dry. Avoid fire, flame or smoking until the spray has dried. Do not apply to the breast. Do not use your medicine more often than directed.

A patient package insert for the product will be given with each prescription and refill. Read this sheet carefully each time. The sheet may change frequently.

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

What side effects may I notice from receiving this medicine?

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

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue

• breast tissue changes or discharge

• changes in vision

• chest pain

• confusion, trouble speaking or understanding

• dark urine

• general ill feeling or flu-like symptoms

• light-colored stools

• nausea, vomiting

• pain, swelling, warmth in the leg

• right upper belly pain

• severe headaches

• shortness of breath

• sudden numbness or weakness of the face, arm or leg

• trouble walking, dizziness, loss of balance or coordination

• unusual vaginal bleeding

• yellowing of the eyes or skin

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

• hair loss

• increased hunger or thirst

• increased urination

• irritation or mild redness at the application site

• symptoms of vaginal infection like itching, irritation or unusual discharge

What may interact with this medicine?

Do not take this medicine with any of the following medications:

• aromatase inhibitors like aminoglutethimide, anastrozole, exemestane, letrozole, testolactone

This medicine may also interact with the following medications:

• antibiotics used to treat tuberculosis like rifabutin, rifampin and rifapentine

• antiviral medicines for HIV or AIDS

• certain antibiotics like erythromycin and clarithromycin

• carbamazepine

• grapefruit juice

• medicines for fungal infections like ketoconazole and itraconazole

• phenobarbital

• raloxifene

• tamoxifen

• St. John's Wort

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, skip the missed dose and get back on your normal schedule. Do not use double or extra doses.

Where should 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). Throw away any unused medicine after the expiration date.

What should I tell my health care provider before I take this medicine?

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

• abnormal vaginal bleeding

• blood vessel disease or blood clots

• breast, cervical, endometrial, ovarian, liver, or uterine cancer

• dementia

• diabetes

• gallbladder disease

• heart disease or recent heart attack

• high blood pressure

• high cholesterol

• high level of calcium in the blood

• hysterectomy

• kidney disease

• liver disease

• migraine headaches

• protein C deficiency

• protein S deficiency

• stroke

• systemic lupus erythematosus (SLE)

• tobacco smoker

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

• pregnant or trying to get pregnant

• breast-feeding

What should I watch for while using this medicine?

Visit your doctor or health care professional for regular checks on your progress. You will need a regular breast and pelvic exam and Pap smear while on this medicine. You should also discuss the need for regular mammograms with your health care professional, and follow his or her guidelines for these tests.

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

If you have any reason to think you are pregnant, stop taking this medicine right away and contact your doctor or health care professional.

This medicine can transfer from your body to others. If a person or pet comes in contact with the area where this medicine was applied to your skin, they may have a serious risk of side effects. If you cannot avoid skin-to-skin contact with another person, make sure the site where this medicine was applied is covered with clothing. If accidental contact happens, the skin of the person or pet should be washed right away with soap and water.

Smoking increases the risk of getting a blood clot or having a stroke while you are taking this medicine, 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 doctor or health care professional.

This medicine can 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 this medicine 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.