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Estradiol Topical emulsion

It is used for symptoms of menopause like vaginal dryness, itching and increased or painful urinatio... more

Generic Name: estradiol topical  |  Brand Name: Divigel 0.25 mg/packet

Brand Names: Divigel 0.5 mg/packet, Estrogel, Divigel 0.25 mg/packet, Evamist, Elestrin, Divigel 1 mg/packet

There is an FDA Alert for this drug. Click here to view it.

  • Estrogens increase the risk of endometrial cancer in postmenopausal women. (See Endometrial Cancer under Cautions.)
  • Do not use estrogens with or without progestins for prevention of cardiovascular disease (see Cardiovascular Risk Reduction under Uses and Cardiovascular Disorders under Cautions) or dementia (see Alzheimer's Disease under Uses).
  • The Women’s Health Initiative (WHI) study of estrogen alone reported increased risks of stroke and DVT in postmenopausal women receiving approximately 7 years of therapy with conjugated estrogens 0.625 mg daily.
  • The WHI study of estrogen plus progestin reported increased risks of MI, stroke, invasive breast cancer, pulmonary embolism, and DVT in postmenopausal women receiving >5 years of therapy with conjugated estrogens 0.625 mg in conjunction with medroxyprogesterone acetate 2.5 mg daily.
  • The WHI Memory Study (WHIMS) reported increased risk of developing probable dementia in postmenopausal women ≥65 years of age receiving long-term therapy (4–5 years) with conjugated estrogens in conjunction with medroxyprogesterone acetate or conjugated estrogen alone. Not known whether this finding also applies to younger postmenopausal women.
  • Other dosages of conjugated estrogens with medroxyprogesterone and other combinations or dosage forms of estrogens with progestin not studied in WHI trials; in absence of comparable data, assume risks are similar.
  • Prescribe estrogens (with or without progestins) at the lowest effective dose and for the shortest duration consistent with treatment goals and risks for the individual woman.

What is this medicine?

ESTRADIOL (es tra DYE ole) contains the female hormone estrogen. It is used for symptoms of menopause like vaginal dryness, itching and increased or painful urination.

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, soy, other medicines, foods, dyes, or preservatives
  • pregnant or trying to get pregnant
  • breast-feeding

How should I use this medicine?

This medicine is for external use only. Follow the directions on the prescription label. Use exactly as directed. Two packets of estradiol topical emulsion contain enough medication for one day. Allow the emulsion to dry completely before covering with clothing. After you apply the emulsion to your legs wash both hands with soap and water to remove any residual emulsion. 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.

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

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. Do not use double or extra doses.

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
  • raloxifene or tamoxifen
  • warfarin

What should I watch for while using this medicine?

Visit your health care professional for regular checks on your progress. You will need a regular breast and pelvic exam. You should also discuss the need for regular mammograms with your health care professional, and follow his or her guidelines.

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 at once and contact your doctor or health care professional.

Tobacco smoking increases the risk of getting a blood clot or having a stroke, 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.

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


Last Updated: March 21, 2012
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