Apply EstroGel after your bath or shower. If you go swimming, try to leave as much time as possible between using EstroGel and going swimming. Ocular side effects have included alterations in corneal curvature and contact lens discomfort. Retinal vascular thrombosis has been reported. Postmarketing side effects with Vivelle-Dot include intolerance to contact lenses. Emulsion is applied once daily in the morning, while in a comfortable seated position, to skin on both legs that is clean, dry, and not irritated. Instruct patient that product contains alcohol and to avoid fire, flame, or smoking until gel has dried.
If you notice a change in the results of your blood or urine sugar tests, check with your doctor. Inspect solution visually before administration. Do not administer if solution is cloudy, discolored, or contains particulate matter. Crystals may form if solution is stored at low temperature but will dissolve readily when solution is warmed. It's a discreet therapy, so no one knows you're treating your symptoms. Do not start using EstroGel if you have unusual vaginal bleeding, currently have or have had certain cancers, 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 EstroGel or any of its ingredients, or think you may be pregnant.
Other side effects have included reports of a possible increase in the risk of "fibrocystic breast disease" by as much as twofold. Postmarketing side effects with Vivelle-Dot include breast enlargement and pain, nipple discharge, fibrocystic breast changes and breast cancer. These vary in proportion from tissue to tissue. Product Information. Estrace estradiol.
Estrogens may be poorly metabolized in patients with impaired liver function. CE plus MPA compared with placebo. Estradiol benzoate d' PH: Ph. Eur. The dose of danazol will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of danazol. Advise patient that medication will be prepared and administered by health care provider in a medical setting on a scheduled basis.
Known or suspected pregnancy. Gently insert into vagina as far as it can comfortably go without force, using supplied applicator. Before you have any medical tests, tell the medical doctor in charge that you are taking danazol. The results of some tests may be affected by danazol. Do not use any EstroGel that came out while priming. Known, suspected, or history of cancer of the breast. Stampfer MJ, Colditz GA, Willett WC, et al. "Postmenopausal estrogen and cardiovascular disease. Ten-year follow-up from the Nurses' Health Study. Do not use estrogen-alone to prevent heart disease, heart attacks, strokes or dementia decline in brain function. Using estrogen-alone may increase your chance of getting cancer of the uterus womb. Report any unusual vaginal bleeding right away while you are using EstroGel. 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.
Jick H, Dinan B, Rothman KJ "Noncontraceptive estrogens and nonfatal myocardial infarction. Danazol may rarely cause your skin to be more sensitive to sunlight than it is normally. Exposure to sunlight, even for brief periods of time, may cause a skin rash, itching, redness, or other discoloration of the skin, or a severe sunburn. Check with your doctor if this occurs. After priming, the EstroGel pump is ready to use. The hormone in EstroGel can pass into your breast milk. Boschetti C, Cortellaro M, Nencioni T, Bertolli V, Della Volpe A, Zanussi C "Short- and long-term effects of hormone replacement therapy transdermal estradiol vs oral conjugated equine estrogens, combined with medroxyprogesterone acetate on blood coagulation factors in postmenopausal women. Estradiol-Hemihydrat PH: Ph. Eur. CYP3A4 may affect estrogen drug metabolism. Metabolic side effects have included reports of generally favorable alterations in plasma lipid profiles. Specifically, increased HDL and decreased cholesterol and LDL levels have occurred. Estrogen therapy may have led to increased serum triglyceride levels resulting in pancreatitis in patients with familial lipoprotein metabolic defects. Once dry, EstroGel is odorless. It may harm them. PO Start with 1 to 2 mg daily; adjust dose as needed to control symptoms. Administer cyclically eg, 3 wk on and 1 wk off.
Palmer JR, Rosenberg L, Clarke EA, Miller DR, Shapiro S "Breast cancer risk after estrogen replacement therapy: results from the Toronto Breast Cancer Study. Estradiolum hemihydricum PH: Ph. Eur. Abdominal distension, abdominal pain, flatulence 7%; nausea 6%; constipation, dyspepsia 5%; diarrhea 4%; gastritis, hemorrhoids, toothache, tooth disorder 1% to 3%. The risk of gallbladder disease requiring surgery in postmenopausal women receiving estrogen is increases 2- to 4-fold. Advise patient that if application of the emulsion in the morning is missed, to apply it as soon as remembered and to never apply the emulsion more than once each day. Instruct patient to allow gel of dry for up to 5 min before dressing. Grady D, Rubin SM, Petiti DB, et al. "Hormone therapy to prevent disease and prolong life in postmenopausal women. Tell your doctor if you are having surgery or will be on bedrest. Your doctor may tell you to stop using transdermal estradiol 4 to 6 weeks before the surgery or bedrest to decrease the risk that you will develop blood clots.
Treatment of advanced androgen-dependent carcinoma of the prostate palliation only. The reported effects of estrogens on cardiovascular activity are variable. Alterations in lipid profiles in treated women are thought to be responsible for reducing cardiovascular risks. Data suggest estrogen use may increase blood pressure, particularly in patients receiving high doses, decrease blood pressure, or result in no change. In addition, noncontraceptive use of estrogens in young women particularly smokers may substantially increase the risk of nonfatal myocardial infarction. Other studies have concluded that no increased risk of myocardial infarction exists. Included as part of the PRECAUTIONS section. What are the possible side effects of EstroGel? Talk to your doctor or pharmacist or read the manufacturer's information that came with your medication to find out if you need to be careful when you swim, bathe, shower, or use a sauna while wearing an estradiol transdermal patch. Some brands of patches are not likely to be affected by these activities, but some brands of patches may loosen. Some types of patches may also be pulled and loosened by your clothes or towel when you change clothes or dry your body. You may need to check that your patch is still firmly attached after these activities. HDL and HDL 2 cholesterol subfraction concentrations; reduced LDL cholesterol concentrations; increased triglyceride levels; reduced response to metyrapone test. Instruct patient to allow application areas to dry thoroughly before covering with clothing to avoid transfer to other individuals. There are no pharmacodynamic data for EstroGel. The clinical significance of such hypercoagulability in postmenopausal women taking estrogens has not been determined.
EstroGel at the end of this Patient Information. This leaflet provides a summary of the most important information about EstroGel. Administer cyclically eg, 3 wk on and 1 wk off. Common side effects of estrogens include headache, breast pain, stomach or abdominal cramps, bloating, nausea and vomiting, hair loss, fluid retention, and vaginal yeast infection. Have reported that many women felt headaches, dizziness and slow heart rate. Because estrogens may cause fluid retention, carefully monitor patients with conditions influenced by fluid retention eg, cardiac dysfunction or renal function impairment. Crane MG, Harris JJ, Winsor W 3d "Hypertension, oral contraceptive agents, and conjugated estrogens. You may not get the correct dose. Instruct patient that prior to first application, the applicator must be primed by fully depressing the applicator 3 times. EstroGel works. EstroGel may also affect how your other medicines work. Auerbach R, Mittal K, Schwartz PE "Estrogen and progestin receptors in an ovarian ependymoma. Estradiol vaginal ring may not be suitable for women with narrow, short, or stenosed vaginas. Conditions that make the vagina more susceptible to vaginal ring irritation or ulceration include narrow vagina, vaginal stenosis, prolapse, and vaginal infections.
Estradiol benzoate PH: Ph. Eur. The use of estrogens is considered by manufacturers and some authorities to be contraindicated in patients with active thrombotic or thromboembolic disorders. In a large study, women who took estrogens a group of medications that includes estradiol by mouth with progestins had a higher risk of heart attacks, strokes, blood clots in the lungs or legs, breast cancer, and dementia loss of ability to think, learn, and understand. Women who use transdermal estradiol alone or with progestins may also have a higher risk of developing these conditions. Tell your doctor if you smoke or use tobacco, if you have had a heart attack or a stroke in the past year, and if you or anyone in your family has or has ever had blood clots or breast cancer. Also tell your doctor if you have or have ever had high blood pressure, high blood levels of cholesterol or fats, diabetes, heart disease, lupus a condition in which the body attacks its own tissues causing damage and swelling breast lumps, or an abnormal mammogram x-ray of the breast used to find breast cancer. Belchetz PE "Hormonal treatment of postmenopausal women. The longer you use estradiol, the greater the risk that you will develop endometrial cancer. If you have not had a hysterectomy surgery to remove the uterus you should be given another medication called a progestin to take with transdermal estradiol. This may decrease your risk of developing endometrial cancer but may increase your risk of developing certain other health problems, including breast cancer. Before you begin using transdermal estradiol, tell your doctor if you have or have ever had cancer and if you have unusual vaginal bleeding. Call your doctor immediately if you have abnormal or unusual vaginal bleeding during your treatment with transdermal estradiol. Your doctor will watch you closely to help ensure you do not develop endometrial cancer during or after your treatment. Excreted in the urine as conjugates. The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine. Instruct patient not to massage or rub the product into the skin but to allow the spray to dry for at least 2 min before dressing and at least 30 min before washing. Using danazol may cause irregular monthly periods or absence of menstrual period. If your regular monthly period does not begin within 60 to 90 days after you stop taking danazol, check with your doctor right away. Pharmaceutical companies are drug manufacturing companies that help in complete development of the drug from the background research to formation, clinical trials, release of the drug into the market and marketing of the drug. Steiger MJ, Quinn NP "Hormone replacement therapy induced chorea. You may need to stop taking estrogens. Please consult the medicine instruction manual on how to use and ensure it is not a controlled substance.
Colditz GA, Hankinson SE, Hunter DJ, et al. "The use of estrogens and progestins and the risk of breast cancer in postmenopausal women. Remove the patch from the pouch. Estrogen plus progestin has been reported to increase the risk of cancer. Estrogens alone do not appear to increase the risk of when used for up to 7 years. Estreva, and the result of the survey is set out below. It is noteworthy that the product of the survey is based on the perception and impressions of the visitors of the website as well as the views of Estreva consumers. We, as a result of this, advice that you do not base your therapeutic or medical decisions on this result, but rather consult your certified medical experts for their recommendations. Consumers can purchase this brand online or from retail stores that carry the brand. See Table 2 for results. These are not all the possible side effects of EstroGel. The recommended area of application is the arm. Talk with your healthcare provider regularly about whether you should continue using EstroGel. FSH through a negative feedback mechanism.
How should this medicine be used? Psychiatric side effects have included case reports of rapid mood cycling in patients with severe depression. Postmarketing side effects with Vivelle-Dot include nervousness, affect liability and irritability. Wash it down the sink to avoid accidental exposure to others. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist. Advise patient to apply daily dose at the same time each day. If bathing, showering, or using the sauna, apply after bath, shower, or use of sauna. If swimming, leave as much time as possible between product application and swimming. Postmarketing reports concerning a transdermal product Climara have included a few cases in which there were a combination of the symptoms of generalized hives or rash with swelling of the throat or eyelid edema. What should I do if I miss a dose? Teach patient proper method of breast self-examination.
You can take steps to decrease the risk that you will develop a serious health problem while you are using transdermal estradiol. Do not use transdermal estradiol alone or with a progestin to prevent heart disease, heart attacks, strokes, or dementia. Use the lowest dose of transdermal estradiol that controls your symptoms and only use transdermal estradiol as long as needed. Talk to your doctor every 3 to 6 months to decide if you should use a lower dose of transdermal estradiol or should stop using the medication. How is EstroGel supplied? Free hormone concentrations may be decreased. Herndon, VA 20170, By DPT Laboratories, San Antonio, TX 78215. Undiagnosed abnormal genital bleeding; known, suspected, or history of breast cancer; known or suspected estrogen-dependent neoplasia; active deep vein thrombosis, pulmonary embolism, or history of theses conditions; active or recent within past year arterial thromboembolic disease eg, stoke, MI; liver dysfunction or disease; known or suspected pregnancy; hypersensitivity to any component of the product. Instruct patient to apply dose by collecting the gel into the palm of the hand and applying the gel to one arm. Spread the gel as thinly as possible over the entire area on the inside and outside of the arm, from wrist to shoulder.
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Musculoskeletal side effects have included arthralgias. Postmarketing side effects with Vivelle-Dot include leg cramps. It is very important that your doctor check your progress at regular visits to make sure that danazol does not cause unwanted effects. Blood tests may be needed to check for unwanted effects. Orally administered estradiol undergoes first-pass effect. Metabolic conversion occurs primarily in the liver but also at local target tissue sites. Also undergoes enterohepatic recirculation.
In some countries, this medicine may only be approved for veterinary use. Since asthma, diabetes mellitus, epilepsy, migraine, porphyria, systemic lupus erythematosus, and hepatic hemangiomas may be exacerbated by estrogens, use with caution. IM 1 to 5 mg injected every 3 to 4 weeks.
Retinal vascular thrombosis may occur, leading to loss of vision, sudden onset of proptosis, diplopia, or migraine. In order for danazol to help you, it must be taken regularly for the full time of treatment as ordered by your doctor. The increased risk is apparent after 4 yr of treatment.
PRECAUTIONS, and Geriatric Use. Conter RL, Longmire WP Jr "Recurrent hepatic hemangiomas. Possible association with estrogen therapy. Press firmly with palm of hand for approximately 10 sec. Be sure good contact is made, especially at edges. If patch falls off, attempt to reapply. Apply new patch to different site if necessary.