section name header

Pronunciation

es-tra-DYE-ole

Classifications

Therapeutic Classification: hormones

Pharmacologic Classification: estrogens

Indications

IM:

REMS


Action

  • Estrogens promote growth and development of female sex organs and the maintenance of secondary sex characteristics in women.
  • Metabolic effects include reduced blood cholesterol, protein synthesis, and sodium and water retention.
Therapeutic effects:
  • Restoration of hormonal balance in various deficiency states, including menopause.
  • Treatment of hormone-sensitive tumors.

Pharmacokinetics

Absorption: Well absorbed after oral administration. Readily absorbed through skin and mucous membranes.

Distribution: Widely distributed to tissues.

Metabolism/Excretion: Mostly metabolized by the liver and other tissues. Enterohepatic recirculation occurs, and more absorption may occur from the GI tract.

Half-Life: Gel: 36 hr.

Time/Action Profile

(estrogenic effects)

ROUTEONSETPEAKDURATION
POunknownunknownunknown
IMunknownunknownunknown
Transdermalunknownunknown3–4 days (Estraderm), 7 days (Climara)
Topicalunknownunknownunknown
Vaginal insertunknownunknown3–4 days
Vaginal ringunknownunknown90 days





Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

CV: edema, hypertension, MI, THROMBOEMBOLISM

Derm: oily skin, acne, pigmentation, urticaria

EENT: intolerance to contact lenses, worsening of myopia or astigmatism

Endo: gynecomastia (men), hyperglycemia

F and E: hypercalcemia, sodium and water retention

GI: nausea, weight changes, anorexia, jaundice, vomiting

GU:

women

amenorrhea, dysmenorrhea, breakthrough bleeding, cervical erosions, loss of libido, vaginal candidiasis;,

men

erectile dysfunction, testicular atrophy.

Metab: appetite

MS: leg cramps

Neuro: headache, dementia, dizziness, lethargy, STROKE

Misc: breast tenderness, MALIGNANCY (BREAST, ENDOMETRIAL, OVARIAN)

Interactions

Drug-drug:

Route/Dosage

Symptoms of Menopause, Atrophic Vaginitis, Moderate to Severe Dyspareunia, Female Hypogonadism, Ovarian Failure/Osteoporosis

Postmenopausal Breast Cancer

Prostate Cancer

Availability

(Generic available)

Estradiol

Estradiol Cypionate

Estradiol Transdermal Preparations

Estradiol Vaginal Preparations

Estradiol Valerate

Assessment

Lab Test Considerations:

Implementation

Patient/Family Teaching

Evaluation/Desired Outcomes

US Brand Names

estradiol cypionate: Depo-Estradiol,

estradiol tablets: Estrace,

estradiol transdermal gel: Divigel, Elestrin, EstroGel,

estradiol transdermal spray: EvaMist,

estradiol transdermal system : Alora, Climara, Dotti, Estraderm, Lyllana, Menostar, Minivelle, Vivelle-Dot,

estradiol vaginal cream: Estrace,

estradiol vaginal insert: Imvexxy,

estradiol vaginal ring: Estring, Femring,

estradiol vaginal tablet: Vagifem, Yuvafem,

estradiol valerate: Delestrogen

Canadian Brand Names

estradiol transdermal system : Estradot, Oesclim