Adult Dosing
Vasomotor symptoms; menopausal
- 0.75-6 mg PO daily; give in a cycle 21 days on, 7 days off
Vulvovaginal atrophy; menopausal
- 0.75-6 mg PO daily; give in a cycle 21 days on, 7 days off
Osteoporosis prevention; postmenopausal
- 0.75 mg PO daily; give in a cycle for 25 days of a 31-day per month
Hypoestrogenism
- 1.5-9 mg PO daily; give in a cycle 21 days on, 8-10 days off
Notes:
- In postmenopausal women with an intact uterus, add progestin for at least 12-14 days every 28 day cycle to reduce the risk of endometrial cancer
- Use lowest effective dose for shortest duration
- When solely prescribed for osteoporosis prevention; consider therapy only for women at significant risk of osteoporosis and for whom non-estrogenic medications are not considered appropriate
- When prescribing solely for vulvovaginal atrophy, topical vaginal products should be considered
Pediatric Dosing
- Not indicated in pediatric patients
[Outline]
- Estrogen and estrogen/progestin therapy increases the risk of cardiovascular events like myocardial infarction and stroke, discontinue the drug immediately if any of these event suspected [US Black Box warning]
- Risk factors for arterial vascular disease and/or venous thromboembolism should be managed appropriately and discontinue estrogen therapy at least 4 to 6 weeks before surgery associated with an increased risk of thromboembolism or during periods of prolonged immobilization
- Unopposed use of estrogens in women with an intact uterus increases the risk of endometrial cancer by 2-12 fold than in nonuser [US Black Box warning]
- Estrogens and progestins use in postmenopausal women increase the risk of breast cancer. Perform breast examination and mammogram yearly based on patient age, risk factors and prior mammogram results
- Estrogen and estrogen/progestin therapy increases the risk of dementia in postmenopausal women 65 years of age and older [US Black Box warning]
- Increases the risk of gallbladder diseases by 2- to 4-fold in postmenopausal women receiving estrogen therapy
- Estrogen therapy causes severe hypercalcemia in patients with breast cancer and bone metastases. Discontinue the therapy if hypercalcemia occurs, and provide appropriate measures
- Retinal vascular thrombosis occurs in patients receiving estrogens. Discontinue the drug if there is sudden partial or complete loss of vision, or a sudden onset of proptosis, diplopia or migraine. Permanently discontinue if papilledema or retinal vascular lesions are seen on examination
- Estrogen use causes increases in blood pressure, monitor BP at regular interval
- Estrogen therapy elevates the plasma triglycerides in patients with preexisting hypertriglyceridemia, leading to pancreatitis and other complications
- Use cautiously in patients with a history of cholestatic jaundice associated with past estrogen use or with pregnancy and in the case of recurrence discontinue the drug
- Estrogen administration causes increased thyroid-binding globulin (TBG) levels. Patients on thyroid hormone replacement therapy receiving estrogen require increased doses of their thyroid replacement therapy. Monitor thyroid function regularly to maintain free thyroid hormone levels in an acceptable range
- Use of progestin with estrogen in continuous regimen lowers the incidence of endometrial hyperplasia, than would be induced by estrogen treatment alone. However there is possible increased risk of breast cancer associated with the use of progestins with estrogens compared to estrogen-alone regimens
- Estrogen causes fluid retention, use cautiously in patients with conditions like asthma and cardiac or renal dysfunction
- Use of estrogen alone for 10 or more years increases the risk of ovarian cancer
- Estrogen therapy can cause exacerbation of asthma, diabetes mellitus, epilepsy, migraine or porphyria, systemic lupus erythematosus, and hepatic hemangiomas. Use cautiously in these patients
- Topical vaginal products should be considered when prescribing solely for the treatment of symptoms of vulvar and vaginal atrophy
Cautions: Use cautiously in
- Cardiovascular diseases
- Hypertension
- Hypertriglyceridemia
- History of Cholestatic Jaundice
- Hypothyroidism
- Asthma
- Diabetes mellitus
- Epilepsy
- Migraine
- Surgery or prolonged immobilization
- Porphyria
- Systemic lupus erythematosus
- Hepatic hemangiomas
- Endometriosis
- Severe hypocalcemia
- Gallbladder Disease
- Obesity
- Patients >65 yrs
- Tobacco use
Pregnancy Category:X
Breastfeeding: Decrease the quantity and quality of the milk when administration to nursing mothers. Detectable amounts of estrogens have been found in breast milk, use cautiously in nursing mother.
Pricing data from www.DrugStore.com in U.S.A.
- Estropipate 3 MG TABS [Bottle] (WATSON LABS)
30 mg = $24.99
90 mg = $74.97 - Estropipate 0.75 MG TABS [Bottle] (WATSON LABS)
30 mg = $20.99
60 mg = $31.97 - Estropipate 1.5 MG TABS [Bottle] (WATSON LABS)
30 mg = $20.99
60 mg = $35.97
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
