Consumer Information

Estrogel

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Treatment & Uses
Side Effects
Treating Overdose
Safety Information
Before Using

Generic Name: estradiol topical (for use on skin) (ess tra DYE ol TOP ik al)
Brand Names: Divigel, Elestrin, Estrasorb, Estrogel, Evamist

What is Estrogel?

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Estrogel is a clear, colorless gel medicine that contains an estrogen hormone called estradiol. Estrogens are female sex hormones made by a woman�s ovaries that regulates many processes in the body.

Estrogel is used to reduce moderate to severe hot flashes and to treat moderate to severe dryness, itching, and burning in and around the vagina

Estrogel may also be used for other purposes not listed here.

Important information about Estrogel

Do not use Estrogel if you have any of the following conditions: a history of stroke or blood clot, circulation problems, a bleeding disorder, a hormone-related cancer such as breast or uterine cancer, or abnormal vaginal bleeding. Estrogel can cause birth defects in an unborn baby. Do not use if you are pregnant. Use an effective form of birth control, and tell your doctor if you become pregnant during treatment. Estrogens will not prevent heart disease, heart attack, stroke, breast cancer, or dementia, and may actually increase your risk of developing these conditions. Estrogens may also increase your risk of uterine or ovarian cancer.

Talk with your doctor about your individual risks before using estradiol long-term. Your doctor should check your progress on a regular basis (every 3 to 6 months) to determine whether you should continue this treatment.

Have regular physical exams and self-examine your breasts for lumps on a monthly basis while using Estrogel.

What should I discuss with my health care provider before using Estrogel?

Estrogens will not prevent heart disease, heart attack, stroke, breast cancer, or dementia, and may actually increase your risk of developing these conditions. Estrogens may also increase your risk of uterine or ovarian cancer.

You should not use Estrogel if you have:

a bleeding or blood-clotting disorder;
liver or kidney disease;
a history of stroke or circulation problems;
abnormal vaginal bleeding that a doctor has not checked; or
any type of breast, uterine, or hormone-dependent cancer.

If you have certain conditions, you may need a dose adjustment or special tests to safely use Estrogel. Tell your doctor if you have:

high blood pressure, angina, or heart disease;
high cholesterol or triglycerides;
kidney disease;
asthma;
epilepsy or other seizure disorder;
migraines;
diabetes;
depression;
gallbladder disease; or
if you have had your uterus removed (hysterectomy).

FDA pregnancy category X. This medication can cause birth defects. Do not use Estrogel if you are pregnant. Tell your doctor right away if you become pregnant during treatment. Use an effective form of birth control while you are using this medication. Estradiol can pass into breast milk and may harm a nursing baby. This medication may also slow breast milk production. Do not use if you are breast-feeding a baby.

Estradiol increases your risk of developing endometrial hyperplasia, a condition that may lead to cancer of the uterus. Taking progestins while using estradiol may lower this risk. If your uterus has not been removed, your doctor may prescribe a progestin for you to take while you are using Estrogel.

How should I use Estrogel?

Use Estrogel exactly as it was prescribed for you. Do not use the medication in larger amounts, or use it for longer than recommended by your doctor. Follow the instructions on your prescription label.

Estrogel comes with patient instructions for safe and effective use, and directions for priming the spray or gel pump if needed. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

Apply Estrogel only to clean, dry, unbroken skin. Do not apply to skin that is red or irritated. Never apply Estrogel to the breasts.

Before using the pump for the first time, it must be primed. Remove the large pump cover, and fully depress the pump twice for the 93-gram pump or three times for the 50-gram pump and the 25-gram pump. Discard the unused gel by thoroughly rinsing down the sink or placing it in the household trash in a manner that avoids accidental exposure or ingestion by household members or pets. After priming, the pump is ready to use, and one complete pump depression will dispense the same amount of Estrogel each time.
Apply Estrogel at the same time each day. You should apply your daily dose of gel to clean, dry, unbroken skin. If you take a bath or shower or use a sauna, apply your Estrogel dose after your bath, shower, or sauna. If you go swimming, try to leave as much time as possible between applying your Estrogel dose and going swimming.
Be sure your skin is completely dry before applying Estrogel.
To apply the dose, collect the gel into the palm of your hand by pressing the pump firmly and fully with one fluid motion without hesitation.
Apply the gel to one arm using your hand. Spread the gel as thinly as possible over the entire area on the inside and outside of your arm from wrist to shoulder. Never apply Estrogel directly to the breast.
Always place the small protective cap back on the tip of the pump and the large pump cover over the top of the pump after each use.
Wash your hands with soap and water after applying the gel to reduce the chance that the medicine will spread from your hands to other people.
It is not necessary to massage or rub in Estrogel. Simply allow the gel to dry for up to 5 minutes before dressing.
Estrogel is flammable. Avoid smoking or being near an open flame until the medicine has dried completely.

Have regular physical exams and self-examine your breasts for lumps on a monthly basis while using Estrogel.

Store Estrogel at room temperature away from moisture and heat.

What happens if I miss a dose?

Use the medication as soon as you remember. If your next dose is less than 12 hours away, skip the missed dose and use the medicine at the next regularly scheduled time. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include nausea, vomiting, stomach pain, breast tenderness, drowsiness, and vaginal bleeding.

What should I avoid while using Estrogel?

Do not apply sunscreen to your skin at the same time you apply Estrogel. Avoid getting Estrogel in your eyes, and rinse thoroughly with water if this does happen.

Grapefruit and grapefruit juice may interact with estradiol and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor.

Estrogel side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:

chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;
sudden numbness or weakness, headache, confusion, or problems with vision, speech, or balance;
pain or swelling in your lower leg;
abnormal vaginal bleeding;
pain, swelling, or tenderness in your stomach;
jaundice (yellowing of the skin or eyes); or
a lump in your breast.

Less serious side effects may include:

nausea, vomiting, loss of appetite;
swollen breasts;
acne or skin color changes;
vaginal pain, dryness, or discomfort, decreased sex drive, impotence, or difficulty having an orgasm;
swelling, weight gain;
migraine headaches, dizziness, depression; or
break-through bleeding, vaginal itching or discharge.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Estrogel?

Tell your doctor about all other medications you use, especially:

St. John's wort;
a blood thinner such as warfarin (Coumadin);
ritonavir (Norvir);
carbamazepine (Carbatrol, Tegretol) or phenobarbital (Luminal, Solfoton);
an antibiotic such as clarithromycin (Biaxin), erythromycin (E-Mycin, E.E.S., Erythrocin, Ery-Tab), or rifampin (Rifadin, Rifater, Rifamate, Rimactane).
an antifungal medication such as ketoconazole (Nizoral) or itraconazole (Sporanox).

This list is not complete and there may be other drugs that can interact with Estrogel. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

Your pharmacist can provide more information about Estrogel.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Estrogel only for the indication prescribed.
Every effort has been made to ensure that the information provided is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects.