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Estradiol Topical spray

It is mostly used as hormone replacement in menopausal women

Generic Name: estradiol topical  |  Brand Name: Estrogel

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) 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.

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

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 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.

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


Last Updated: March 21, 2012
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