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Drug Notebook

FDA Alerts

  • 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.

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estradiol
(es tra DYE ole)

What is this medicine?
ESTRADIOL (es tra DYE ole) is an estrogen. It is mostly used as hormone replacement in menopausal women. It helps to treat hot flashes and prevent osteoporosis. It is also used to treat women with low estrogen levels or those who have had their ovaries removed.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

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What is the price of this medication and similar alternatives?

This pricing information is subject to change at the sole discretion of DS Pharmacy. This pricing information was updated 09/2009. For the most current and up-to-date pricing information, please visit www.drugstore.com. Actual costs to patients will vary depending on the use of specific retail or mail-order locations and health insurance copays.

Alora 0.05MG/24HR Patches WATSON LABS8/$58.41 or 24/$152.74
Alora 0.075MG/24HR Patches WATSON LABS8/$49.6 or 24/$141.73
Alora 0.1MG/24HR Patches WATSON LABS8/$60.65 or 24/$157.24
Climara 0.025MG/24HR Patches BAYER HEALTHCARE PHARMA4/$75.58 or 12/$179.95
Climara 0.0375MG/24HR Patches BAYER HEALTHCARE PHARMA4/$69.05 or 12/$187.81
Climara 0.05MG/24HR Patches BAYER HEALTHCARE PHARMA4/$75.58 or 12/$179.95
Climara 0.06MG/24HR Patches BAYER HEALTHCARE PHARMA4/$69.05 or 12/$176.75
Climara 0.075MG/24HR Patches BAYER HEALTHCARE PHARMA4/$69.05 or 12/$173.99
Climara 0.1MG/24HR Patches BAYER HEALTHCARE PHARMA4/$75.58 or 12/$179.95
CombiPatch 0.05-0.14MG/DAY Patches NOVARTIS8/$60.47 or 24/$161.41
CombiPatch 0.05-0.25MG/DAY Patches NOVARTIS8/$60.47 or 24/$161.97
Divigel 0.25MG/0.25GM Gel UPSHER-SMITH30/$77.36 or 90/$217.27
Divigel 0.5MG/0.5GM Gel UPSHER-SMITH1/$72.99 or 3/$199.97
Elestrin 0.52 MG/0.87 GM0.06%) Gel (AZUR PHARMA144/$155.71 or 432/$450.36
Estrace 0.1MG/GM Cream WARNER CHILCOTT PROF PROD DIV42/$126.77 or 127/$343.45
Estraderm 0.05MG/24HR Patches NOVARTIS8/$60.37 or 24/$160.58
Estraderm 0.1MG/24HR Patches NOVARTIS8/$65.94 or 24/$171.43
Estradiol 0.025MG/24HR Patches MYLAN4/$36.99 or 12/$86.97
Estradiol 0.0375MG/24HR Patches MYLAN4/$39.35 or 12/$115.69
Estradiol 0.05MG/24HR Patches MYLAN4/$36.99 or 12/$89.97
Estradiol 0.06MG/24HR Patches MYLAN4/$39.99 or 12/$115.97
Estradiol 0.075MG/24HR Patches MYLAN4/$35.99 or 12/$87.97
Estradiol 0.1MG/24HR Patches MYLAN4/$35.99 or 12/$86.97
Estrasorb 4.35MG/1.74GM Emulsion GRACEWAY PHARMACEUTICALS10/$16.95 or 17/$21.17
Estrogel 0.75 MG/1.25 GM0.06%) Gel (ASCEND THERAPEUTICS50/$75.15 or 150/$216.21
Menostar 14MCG/24HR Patches BAYER HEALTHCARE PHARMA4/$73.18 or 12/$199.15
Vivelle 0.05MG/24HR Patches NOVARTIS8/$49.99 or 24/$129.97
Vivelle-Dot 0.025MG/24HR Patches NOVARTIS8/$61.53 or 24/$164.81
Vivelle-Dot 0.0375MG/24HR Patches NOVARTIS8/$56.76 or 24/$150.95
Vivelle-Dot 0.05MG/24HR Patches NOVARTIS8/$57.99 or 24/$157
Vivelle-Dot 0.075MG/24HR Patches NOVARTIS8/$60.35 or 24/$153.35
Vivelle-Dot 0.1MG/24HR Patches NOVARTIS8/$65.93 or 24/$175.81

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

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

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How should I use this medicine?
Take this medicine by mouth. To reduce nausea, this medicine may be taken with food. Follow the directions on the prescription label. Take this medicine at the same time each day and in the order directed on the package. Do not take your medicine more often than directed.

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

A patient information sheet will be given with each prescription and refill. Read this sheet carefully each time. The sheet may change frequently.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.

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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. Do not take double or extra doses.

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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:

  • carbamazepine
  • certain antibiotics used to treat infections
  • certain barbiturates or benzodiazepines used for inducing sleep or treating seizures
  • grapefruit juice
  • medicines for fungus infections like itraconazole and ketoconazole
  • raloxifene or tamoxifen
  • rifabutin, rifampin, or rifapentine
  • ritonavir
  • St. John's Wort
  • warfarin

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

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Who should NOT use this medication?

  • Undiagnosed abnormal genital bleeding.
  • Known or suspected breast cancer or history of breast cancer (except when used for palliative treatment of metastatic disease in appropriately selected individuals).
  • Known or suspected estrogen-dependent neoplasia.
  • Active DVT or pulmonary embolism; history of DVT or pulmonary embolism.
  • Active or recent (within past year) arterial thromboembolic disease (e.g., stroke, MI).
  • Porphyria.
  • Liver disease or impairment.
  • Known or suspected pregnancy.
  • Known hypersensitivity to estrogens or any ingredient in the formulation.
  • Estradiol in fixed combination with drospirenone (Angeliq®) should not be used in women predisposed to hyperkalemia (i.e., those with renal impairment, hepatic impairment, or adrenal insufficiency).

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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.

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.

If you are going to have surgery, you may need to stop taking this medicine. Consult your health care professional for advice before you schedule the surgery.

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What should I tell my health care provider before I take this medicine?
They need to know if you have or ever had 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
  • 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

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Can I stop taking the medication if I feel better?
As a general rule, you should always take your medications exactly as prescribed and do not change the dosage or stop taking the medication without first discussing it with your healthcare provider.

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I am on so many medications; do I have to take them all?
This is called polypharmacy—many different medications being used at the same time by one person. Sometimes, being on multiple medications is acceptable and appropriate but at other times it may be problematic. If you are receiving your medications from multiple physicians you need to ensure that they all know what medications you are taking. The best way to do this is to make a list of all the medications you are currently using, including all nutritional supplements, homeopathic remedies, vitamins and over-the-counter drugs (if possible, also include all the diseases you have been diagnosed with). Give a copy to every doctor who takes care of you so they have it on file, this way they can avoid duplicating medications and perhaps even try to consolidate some. After every doctor's visit remember to update the list accordingly. Also, as much as you possibly can, try to use the same pharmacy to fill all your prescriptions, this way any potential drug interactions can be caught and averted.

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Where can I get more information?
More Information

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