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Estradiol


Patches
Chemical Name: ESTRADIOL (es-tra-DYE-ol)

Common uses
This medicine is an estrogen hormone used to provide female hormone when the body no longer produces enough. It is used to help reduce menopause symptoms (e.g., hot flashes, vaginal dryness), to prevent bone loss (osteoporosis) in people at high risk, and to treat other conditions as determined by your doctor. If you are only being treated for vaginal menopause symptoms, products applied locally such as vaginal creams, tablets, or rings should be considered before products taken by mouth or absorbed through the skin. There are several medicines (e.g., raloxifene or bisphosphonates) that are safe and effective to prevent or treat bone loss. These medicines should be considered for use before estrogen therapy. If you have other medical conditions as well and are prescribed estrogens for more than one condition, consult your doctor about your treatment plan and its options.

Before using
WARNING: Estrogens have been reported to increase the chance of womb cancer in women who have been through menopause, especially in women with a uterus who receive estrogen-only therapy. Estrogens may also increase the risk of cancer of the ovary or breast. Estrogen-containing medicines should not be used to prevent heart disease. Estrogen given in combination with another hormone called a progestin for replacement therapy can infrequently cause heart disease (including heart attacks), stroke, serious blood clots in the legs or lungs, dementia, and cancer of the breast. These risks appear to depend on the length of time this medicine is used and the amount of estrogen per dose. Therefore, this medicine should be used for the shortest possible length of time at the lowest effective dose so you obtain the benefits and minimize the chance of serious side effects from long-term treatment. Consult your doctor or pharmacist for details. If you use this medicine for an extended period of time, you should be evaluated at least once a year. This medicine must not be used during pregnancy because its use may result in birth defects or cancer later in the child's life. INFORM YOUR DOCTOR OR PHARMACIST of all prescription and over-the-counter medicine that you are taking. DO NOT START OR STOP any medicine without doctor or pharmacist approval. Inform your doctor of any other medical conditions including, a family medical history (especially breast lumps and cancer), asthma, diabetes, seizures, migraine headaches, heart disease (high blood pressure, heart attacks, congestive heart failure), kidney disease, low thyroid hormone, abnormal calcium level in the blood, depression, high blood pressure during pregnancy, yellowing of eyes or skin during pregnancy or with past estrogen use, womb problems (such as uterine fibroids or endometriosis), cholesterol or lipid problems, gallbladder disease, excessive weight gain, allergies, pregnancy, or breast-feeding. USE OF THIS MEDICINE IS NOT RECOMMENDED if you have a history of undiagnosed abnormal vaginal bleeding, certain cancers (such as breast or uterine cancer), blood clots, certain blood problems such as porphyria, liver disease, active/recent stroke, or heart attack. Contact your doctor or pharmacist if you have any questions or concerns about taking this medicine.

Directions
Follow the directions for using this medicine provided by your doctor. One patch is usually applied to the skin and worn for 1 week and then replaced. Be sure to follow your dosing schedule carefully. THIS MEDICINE COMES with a patient information leaflet. Read it carefully. Ask your doctor, nurse, or pharmacist any questions that you may have about this medicine. Do not open the sealed pouch containing the patch until you are ready to use it. Open the pouch and remove the patch. Peel off the liner. Apply to an area of clean, dry skin on the lower stomach or the top of the buttocks. DO NOT APPLY the patch to the breast. Do not apply at the waistline because tight clothing may rub the patch off. Do not put the patch on areas where sitting may loosen it. Press firmly in place for 10 seconds. After 1 week, remove the patch, fold the sticky side together and discard properly out of the reach of children or pets. If the area around the patch becomes red, itchy, or irritated, try a new site. If irritation continues or becomes worse, notify your doctor promptly. STORE THIS MEDICINE in the sealed pouch at room temperature below 86 degrees F (30 degrees C), away from heat, moisture, and light. IF YOUR PATCH ACCIDENTALLY FALLS OFF, dry your skin, reapply the patch, and wear for the rest of the 7-day period. IF YOU FORGET TO CHANGE THE PATCH AS SCHEDULED, change it as soon as possible and go back to your regular schedule. Do not double the dose to catch up.

Cautions
DO NOT USE THIS MEDICINE if you have had an allergic reaction to it or are allergic to any ingredient in this product. IT IS VERY IMPORTANT that you keep all doctor and laboratory appointments while you are using this medicine. Talk regularly with your doctor to determine if you still need to use this medicine. This medicine should be used for the shortest period of time at the lowest possible dose to reduce the risk for serious side effects. You should have a complete physical examination, including blood pressure measurements, breast and pelvic examinations, and a PAP test (for cervical cancer), at least once a year. You should also have periodic mammograms as determined by your doctor. Follow your doctor's instructions for examining your own breasts, and report any lumps immediately. If you will be having surgery or will be confined to a chair or bed for a long period of time (such as a long plane flight), notify your doctor beforehand. Special precautions may need to be taken in these circumstances. Some laboratory test results may be affected by this medicine. Make sure laboratory personnel and your doctors know you use this medicine. THIS MEDICINE MAY CAUSE DIZZINESS. DO NOT DRIVE, OPERATE MACHINERY, OR DO ANYTHING ELSE THAT COULD BE DANGEROUS until you know how you react to this medicine. Using this medicine alone, with other medicines, or with alcohol may lessen your ability to drive or to perform other potentially dangerous tasks. LIMIT ALCOHOL while using this medicine. THIS MEDICINE MAY CAUSE dark skin patches on your face (melasma). Exposure to the sun may make these patches darker. You may need to avoid prolonged sun exposure and sunlamps. Consult your doctor regarding the use of sunscreens and protective clothing. SMOKING WHILE USING THIS MEDICINE may increase your risk for blood clots (especially in women over 35 years old). IF THIS MEDICINE IS USED IN CHILDREN, their growth pattern should be monitored as this medicine may stunt their growth. CAUTION IS ADVISED WHEN USING THIS MEDICINE IN THE ELDERLY because they may be more sensitive to the effects of this medicine. DO NOT USE THIS MEDICINE if you are pregnant. IF YOU SUSPECT THAT YOU COULD BE PREGNANT, contact your doctor immediately. THIS MEDICINE IS EXCRETED in breast milk. IF YOU ARE OR WILL BE BREAST-FEEDING while using this medicine, check with your doctor or pharmacist to discuss the risks to your baby. IF YOU HAVE DIABETES, this medicine may affect your blood sugar. Check blood sugar levels closely and ask your doctor before adjusting the dose of your diabetes medicine.

Possible side effects
SIDE EFFECTS, that may occur while taking this medicine include dizziness, lightheadedness, headache, stomach upset, bloating, nausea, weight changes, increased or decreased interest in sex, breast tenderness, hair loss, or skin redness or irritation at the application site. CONTACT YOUR DOCTOR IMMEDIATELY if you experience mental or mood changes including depression or memory loss; calf pain or swelling; sudden severe headache; severe dizziness or fainting; chest pain; trouble breathing; one-sided weakness; slurred speech; vision changes including change in contact lens fit or loss of vision; breast lumps; swelling of hands or feet; changes in vaginal bleeding such as spotting, breakthrough bleeding, or prolonged bleeding; unusual vaginal discharge, itching, or odor; vomiting; or yellowing of eyes or skin. AN ALLERGIC REACTION TO THIS MEDICINE is unlikely, but seek immediate medical attention if it occurs. Symptoms of an allergic reaction include rash, itching, swelling, severe dizziness, or trouble breathing. If you notice other effects not listed above, contact your doctor, nurse, or pharmacist.

If you take too much
If overdose is suspected, remove the patch. Contact your local poison control center or emergency room immediately. Symptoms of overdose may include severe nausea or vomiting, and excessive vaginal bleeding. This medicine may be harmful if swallowed.

Additional information
A weight-bearing exercise plan and adequate daily intake of calcium and vitamin D are non-drug therapies that can help prevent bone loss. Talk with your doctor or pharmacist for more details. DO NOT SHARE THIS MEDICINE with others for whom it was not prescribed. DO NOT USE THIS MEDICINE for other health conditions. KEEP THIS MEDICINE out of the reach of children and pets. IF USING THIS MEDICINE FOR AN EXTENDED PERIOD OF TIME, obtain refills before your supply runs out.



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