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Estradiol spray

Pronunciation

Generic Name: estradiol (ES-tra-DYE-ol)
Brand Name: Evamist

Estradiol spray should not be used to prevent heart disease, heart attacks, strokes, or dementia. Estrogens may increase the risk of heart disease (including heart attack), stroke, dementia, serious blood clots (eg, in the lungs or legs), cancer of the uterus, and breast cancer in some women. Tell your doctor right away if you have unusual vaginal bleeding while you use estradiol spray. Talk with your doctor if you have questions about the benefits and risks of using estradiol spray.

Estradiol spray should be used for the shortest possible time at the lowest effective dose to minimize the risk of these side effects. Talk with your doctor regularly about your need to use estradiol spray.

Follow the directions for use very carefully. Do not allow others, especially CHILDREN, to come into contact with the area of your skin where estradiol spray has been applied. Young children who accidentally come into contact with estradiol spray may show unexpected signs of puberty (eg, breast budding in girls, breast enlargement in boys). If a child with whom you are in close contact unexpectedly starts to develop breasts or has other sexual changes, contact the child's doctor.


Estradiol spray is used for:

Treating certain moderate to severe symptoms of menopause (eg, hot flashes).

Estradiol spray is an estrogen hormone. It works by replacing estrogen in the body when it no longer produces enough on its own.

Do NOT use estradiol spray if:

  • you are allergic to any ingredient in estradiol spray
  • you have had a severe reaction (eg, swelling of the hands, face, lips, eyes, throat, or tongue; trouble swallowing or breathing; hoarseness) after taking estradiol spray
  • you are pregnant or suspect you may be pregnant
  • you have undiagnosed abnormal vaginal bleeding
  • you have blood clots (eg, in the lungs, legs, eyes), a history of blood clots, bleeding problems, or a condition that may increase your risk of blood clots
  • you have known or suspected breast cancer or another estrogen-dependent cancer, or you have a history of breast cancer
  • you have a history of liver problems or liver disease
  • you have had a heart attack or stroke

Contact your doctor or health care provider right away if any of these apply to you.

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Before using estradiol spray:

Some medical conditions may interact with estradiol spray. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have a history of endometriosis, growths in the uterus, abnormal mammogram, abnormal vaginal bleeding, a lump in the breast, or fibrocystic breast disease, or if a family member has had breast cancer
  • if you have dementia or other memory problems
  • if you have a history of asthma, cancer, high blood cholesterol or lipid levels, high or low blood calcium levels, diabetes, heart problems, high blood pressure, heart attack or stroke, kidney problems, liver tumor, mental or mood problems (eg, depression), underactive thyroid, migraine headaches, gallbladder or pancreas problems, seizures (eg, epilepsy), lupus, chorea, or the blood disease porphyria
  • if you have a problem called hereditary angioedema
  • if you smoke, use tobacco, are very overweight, or will be having surgery
  • if you have a history of yellowing of the eyes or skin during pregnancy or with past estrogen use
  • if a member of your family has a history of blood clots (eg, in the legs, lungs, eyes), diabetes, lupus, or obesity
  • if you have had your uterus removed (hysterectomy)

Some MEDICINES MAY INTERACT with estradiol spray. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Azole antifungals (eg, ketoconazole), HIV protease inhibitors (eg, ritonavir), or macrolide antibiotics (eg, erythromycin) because they may increase the risk of estradiol spray's side effects
  • Barbiturates (eg, phenobarbital), carbamazepine, hydantoins (eg, phenytoin), rifampin, or St. John's wort because they may decrease estradiol spray's effectiveness
  • Thyroid hormones (eg, levothyroxine) because their effectiveness may be decreased by estradiol spray

This may not be a complete list of all interactions that may occur. Ask your health care provider if estradiol spray may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use estradiol spray:

Use estradiol spray as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • An extra patient leaflet is available with estradiol spray. Talk to your pharmacist if you have questions about this information.
  • Estradiol spray is applied to the inside of the forearm, between the elbow and the wrist. Do not apply estradiol spray to any other area of the body besides the forearm. If you get estradiol spray on another area of your skin, wash that area of your skin with soap and water right away.
  • Apply estradiol spray to clean, intact skin only. Be sure the area is completely dry before applying estradiol spray.
  • Do not apply estradiol spray to skin that is irritated or broken. Do not apply it to your face, in or around the vagina, or to your breasts.
  • You will need to prime the pump before using it for the first time. To prime the pump, leave the cover on, hold the bottle in an upright position, and press the pump completely down 3 times. The pump is now ready for use.
  • Hold the applicator upright and rest the plastic cone flat against the skin of your forearm. Be sure there are no gaps between the cone and your skin. Press the pump firmly and fully 1 time. Do NOT massage or rub the medicine in.
  • If you are applying more than 1 spray, move the cone to an area of the skin next to but not touching the previous area. Then press the pump firmly and fully again.
  • Replace the protective cover over the pump after use.
  • Wash your hands with soap and water after using estradiol spray.
  • Allow the medicine to dry for at least 2 minutes before dressing.
  • Do not wash the application area for at least 1 hour after you apply estradiol spray.
  • Do not allow others to apply estradiol spray for you. Do not allow other people or pets to come into contact with the site where you applied estradiol spray. If someone else comes into contact with estradiol spray, have them wash the area with soap and water right away.
  • This pump contains enough medicine for 75 sprays (not counting the 3 sprays used to prime the pump). Throw away the pump after 75 sprays have been used, even if there is still medicine left in the pump. It may no longer give the correct amount of medicine with each dose.
  • Use estradiol spray at the same time each day.
  • If you miss a dose of estradiol spray, use it as soon as possible. If your next dose is less than 12 hours away, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use estradiol spray.

Important safety information:

  • Estradiol spray may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use estradiol spray with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Estradiol spray is for external use only. Do not get it in your eyes, nose, vagina, or mouth. If you get it in any of these areas, rinse right away with warm clean water.
  • Check with your doctor before you apply sunscreen to the application site while you are using estradiol spray.
  • Estradiol spray is flammable. Avoid fire, flame, or smoking until the medicine has dried on your skin.
  • Eating grapefruit or drinking grapefruit juice may increase the risk of estradiol spray's side effects. Talk to your doctor before including grapefruit or grapefruit juice in your diet while you are taking estradiol spray.
  • Tell your doctor or dentist that you take estradiol spray before you receive any medical or dental care, emergency care, or surgery. If possible, estradiol spray should be stopped at least 4 to 6 weeks before surgery or any time you might be confined to a bed or chair for a long period of time (such as a long plane flight, car ride, bedrest, or illness).
  • Estradiol spray may cause dark skin patches on your face. Exposure to the sun may make these patches darker. If patches develop, use a sunscreen or wear protective clothing when exposed to the sun, sunlamps, or tanning booths.
  • If you wear contact lenses and you develop problems with them, contact your doctor.
  • Diabetes patients - Estradiol spray may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
  • Estradiol spray may interfere with certain lab tests. Be sure your doctor and lab personnel know you are using estradiol spray.
  • Talk with your doctor regularly (eg, every 3 to 6 months) about whether you need to continue taking estradiol spray.
  • Lab tests and medical exams, including physicals and blood pressure, may be performed while you use estradiol spray. You should have breast and pelvic exams, and a Pap test at least once a year. You should also have periodic mammograms as determined by your doctor. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Examine your breasts monthly as directed by your doctor. Report any lumps right away.
  • Use estradiol spray with caution in the ELDERLY; they may be more sensitive to its effects.
  • Estradiol spray should not be used in CHILDREN; safety and effectiveness in children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: Do not use estradiol spray if you are pregnant. If you think you may be pregnant, contact your doctor right away. Estradiol spray is found in breast milk. Do not breast-feed while you are taking estradiol spray.

Possible side effects of estradiol spray:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Breast pain or tenderness; headache; mild fluid retention; mild hair loss; mild nausea or vomiting; spotting or breakthrough bleeding; stomach cramps or bloating.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness); blurred or double vision, vision loss, or other vision changes; breast lump or discharge; calf or leg pain or swelling; chest pain; confusion; coughing up blood; fainting; memory problems; mental or mood changes (eg, depression); migraine headache; numbness of an arm or leg; one-sided weakness; persistent or recurring abnormal vaginal bleeding; severe or persistent headache or dizziness; severe or persistent stomach pain, nausea, or vomiting; shortness of breath; slurred speech; swelling of the hands, legs, or feet; vaginal discharge, itching, or odor; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.

Proper storage of estradiol spray:

Store estradiol spray at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Do not freeze. Store away from heat, moisture, and light. Do not store in the bathroom or near an open flame. Do not use estradiol spray after the expiration date. Keep estradiol spray out of the reach of children and away from pets.

General information:

  • If you have any questions about estradiol spray, please talk with your doctor, pharmacist, or other health care provider.
  • Estradiol spray is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take estradiol spray or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about estradiol spray. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to estradiol spray. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your health care provider for complete information about the risks and benefits of using estradiol spray.

Issue Date: July 2, 2014
Database Edition 14.3.1.001
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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