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Estradiol Dosage

Medically reviewed by Drugs.com. Last updated on Aug 17, 2023.

Applies to the following strengths: valerate 40 mg/mL; valerate 10 mg/mL; valerate 20 mg/mL; cypionate 5 mg/mL; 0.05 mg/24 hr; 0.1 mg/24 hr; 0.025 mg/24 hours twice weekly; 0.05 mg/24 hours twice weekly; 0.075 mg/24 hours twice weekly; 0.1 mg/24 hours twice weekly; 0.52 mg/0.87 g (0.06%); 0.75 mg/1.25 g (0.06%); 0.025 mg/24 hours weekly; 0.0375 mg/24 hours twice weekly; 0.5 mg; 1 mg; 2 mg; 0.25 mg/0.25 g (0.1%); 0.5 mg/0.5 g (0.1%); 1 mg/1 g (0.1%); 0.05 mg/24 hours weekly; 0.075 mg/24 hours weekly; 0.1 mg/24 hours weekly; 0.0375 mg/24 hours weekly; 0.06 mg/24 hours weekly; 1.5 mg; acetate 0.45 mg; acetate 0.9 mg; acetate 1.8 mg; 1.53 mg/spray; 0.75 mg/0.75 g (0.1%); 1.25 mg/1.25 g (0.1%); benzoate; valerate; 14 mcg/24 hours weekly; hemihydrate

Usual Adult Dose for Postmenopausal Symptoms

ORAL:
Initial dose: 0.5 to 2 mg orally once a day


TRANSDERMAL:
Extended-release (ER) Transdermal Film:
TWICE-weekly (Vivelle-dot, Minivelle, Alora, Dotti, Lyllana): Initial dose: 0.0375 to 0.05 mg/24 hours applied topically twice a week
Maintenance doses: 0.025 to 0.1 mg/24 hours applied topically twice a week
ONCE-weekly (Climara): Initial dose: 0.025 mg/24 hours applied topically once a week
Maintenance doses: 0.025 to 0.1 mg/24 hours applied topically once a week

Transdermal 0.1% Gel Packets (Divigel):
Initial dose: Apply 0.25 mg topically once a day to the skin of either the right or left upper thigh
Maximum dose: 1.25 mg/day

Transdermal Metered-Dose Pump
Initial dose (Elestrin): Apply 1 pump (0.52 mg) topically to upper arm once a day; dose adjustments can be made based on clinical response
Initial dose (Estrogel): Apply 1 pump (0.75 mg) topically once a day to arm; dose adjustments can be made based on clinical response

Transdermal Spray: (Evamist; 1 spray delivers 1.53 mg of estradiol):
Initial dose: 1 spray once a day in the morning to the forearm
Maintenance dose: 1 to 3 sprays once a day

VAGINAL:
Vaginal ring (Femring): 1 ring intravaginally once every 3 months

PARENTERAL:

Comments:

Uses: For the treatment of moderate to severe vasomotor symptoms associated with menopause.

Usual Adult Dose for Atrophic Urethritis

VAGINAL:
Vaginal cream (Estrace): Initial dose: 2 to 4 g intravaginally once a day for 1 or 2 weeks, then gradually reduce dose by half (goal to restore vaginal mucosa)


Vaginal inserts (Vagifem): 10 mcg intravaginally once a day for 2 weeks

Vaginal ring (Femring, Estring): 1 ring intravaginally once every 3 months

TRANSDERMAL:
Extended-release (ER) Transdermal Film:
TWICE-weekly (Vivelle-dot, Alora): Initial dose: 0.0375 mg/24 hours applied topically twice a week
Maintenance doses: 0.025 to 0.1 mg/24 hours applied topically twice a week

ONCE-weekly (Climara): Initial dose: 0.025 mg/24 hours applied topically once a week
Maintenance doses: 0.025 to 0.1 mg/24 hours applied topically once a week

Transdermal Metered-Dose Pump
Initial dose (Estrogel): Apply 1 pump (0.75 mg) topically once a day to arm; dose adjustments can be made based on clinical response

ORAL:
Initial dose: 0.5 to 2 mg orally once a day

PARENTERAL:

Comments:

Use: For the treatment of moderate to severe symptoms of vulvar and vaginal atrophy associated with menopause.

Usual Adult Dose for Atrophic Vaginitis

VAGINAL:
Vaginal cream (Estrace): Initial dose: 2 to 4 g intravaginally once a day for 1 or 2 weeks, then gradually reduce dose by half (goal to restore vaginal mucosa)


Vaginal inserts (Vagifem): 10 mcg intravaginally once a day for 2 weeks

Vaginal ring (Femring, Estring): 1 ring intravaginally once every 3 months

TRANSDERMAL:
Extended-release (ER) Transdermal Film:
TWICE-weekly (Vivelle-dot, Alora): Initial dose: 0.0375 mg/24 hours applied topically twice a week
Maintenance doses: 0.025 to 0.1 mg/24 hours applied topically twice a week

ONCE-weekly (Climara): Initial dose: 0.025 mg/24 hours applied topically once a week
Maintenance doses: 0.025 to 0.1 mg/24 hours applied topically once a week

Transdermal Metered-Dose Pump
Initial dose (Estrogel): Apply 1 pump (0.75 mg) topically once a day to arm; dose adjustments can be made based on clinical response

ORAL:
Initial dose: 0.5 to 2 mg orally once a day

PARENTERAL:

Comments:

Use: For the treatment of moderate to severe symptoms of vulvar and vaginal atrophy associated with menopause.

Usual Adult Dose for Hypoestrogenism

ORAL:
Initial dose: 1 to 2 mg orally once a day


TRANSDERMAL:
Extended-release (ER) Transdermal Film:
TWICE-weekly (Vivelle-dot, Minivelle, Alora): Initial dose: 0.0375 or 0.05 mg/24 hours applied topically twice a week
Maintenance doses: 0.025 to 0.1 mg/24 hours applied topically twice a week
ONCE-weekly (Climara): Initial dose: 0.025 mg/24 hours applied topically once a week
Maintenance doses: 0.025 to 0.1 mg/24 hours applied topically once a week

PARENTERAL:

Comments:

Uses: For the treatment of female hypoestrogenism due to hypogonadism, castration, or primary ovarian failure.

Usual Adult Dose for Oophorectomy

ORAL:
Initial dose: 1 to 2 mg orally once a day


PARENTERAL:

TRANSDERMAL:
Extended-release (ER) Transdermal Film:
TWICE-weekly (Vivelle-dot, Minivelle, Alora): Initial dose: 0.0375 or 0.05 mg/24 hours applied topically twice a week
Maintenance doses: 0.025 to 0.1 mg/24 hours applied topically twice a week
ONCE-weekly (Climara): Initial dose: 0.025 mg/24 hours applied topically once a week
Maintenance doses: 0.025 to 0.1 mg/24 hours applied topically once a week

Comments:

Use: For treatment of female hypoestrogenism due primary ovarian failure.

Usual Adult Dose for Primary Ovarian Failure

ORAL:
Initial dose: 1 to 2 mg orally once a day


PARENTERAL:

TRANSDERMAL:
Extended-release (ER) Transdermal Film:
TWICE-weekly (Vivelle-dot, Minivelle, Alora): Initial dose: 0.0375 or 0.05 mg/24 hours applied topically twice a week
Maintenance doses: 0.025 to 0.1 mg/24 hours applied topically twice a week
ONCE-weekly (Climara): Initial dose: 0.025 mg/24 hours applied topically once a week
Maintenance doses: 0.025 to 0.1 mg/24 hours applied topically once a week

Comments:

Use: For treatment of female hypoestrogenism due primary ovarian failure.

Usual Adult Dose for Breast Cancer-Palliative

10 mg orally 3 times a day for at least 3 months

Comments:


Use: For treatment of breast cancer (palliation only).

Usual Adult Dose for Osteoporosis

TRANSDERMAL:
Extended-release (ER) Transdermal Film:
TWICE-weekly (Vivelle-dot, Minivelle, Alora): Initial dose: 0.025 mg/24 hours applied topically twice a week

ONCE-weekly (Climara, Menostar): Initial dose: 0.14 or 0.025 mg/24 hours applied topically once a week

ORAL: 0.5 to 2 mg orally once a day

Comments:

Use: For the treatment of osteoporosis.

Usual Adult Dose for Prostate Cancer

ORAL: 1 to 2 mg orally 3 times a day

PARENTERAL:
estradiol valerate (Delestrogen): 30 mg or more IM every 1 to 2 weeks

Use: For the treatment (palliation only) of advanced androgen-dependent prostate carcinoma

Usual Adult Dose for Dyspareunia

Vaginal Insert:
Initial dose: 1 insert (4 mcg) intravaginally once a day for 2 weeks
Maintenance dose: 1 insert (4 or 10 mcg) intravaginally twice a week

Comments:


Use: For the treatment of moderate to severe dyspareunia, a symptoms of vulvar and vaginal atrophy due to menopause.

Renal Dose Adjustments

Use caution; estrogens may cause some degree of fluid retention

Liver Dose Adjustments

Contraindicated in patients with hepatic impairment or disease

Precautions

US BOXED WARNINGS: ENDOMETRIAL CANCER, CARDIOVASCULAR DISORDERS, PROBABLE DEMENTIA, and BREAST CANCER - Prescribe estrogens, with or without progestogens, at the lowest effective doses and for the shortest duration consistent with treatment goals and risks for the individual woman:


CONTRAINDICATIONS:

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Use caution; dose reduction may be advisable in women with ESRD receiving hemodialysis

Other Comments

Administration advice:


PARENTERAL: IM administration only

TRANSDERMAL: Apply to clean, dry, unbroken skin; wash hands after application; do not apply to breasts
Spray:

VAGINAL:
Vaginal Cream: Gently squeeze tube from bottom to expel the prescribed amount into the applicator; insert applicator deeply into vagina and press plunger downward
Vaginal Insert:
Vaginal Ring:

Storage requirements:

General:

Monitoring:

Patient advice:

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.