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esterified estrogens

Generic Name: esterified estrogens (ess TER ih fied ESS troe jenz)
Brand Name: Menest

What are esterified estrogens?

Estrogen is a female sex hormone produced by the ovaries. Estrogen is necessary for many processes in the body.

Esterified estrogens are a man-made mixture of estrogens that are used to treat symptoms of menopause such as hot flashes, vaginal dryness, vaginal burning or irritation, or other hormonal changes in the vagina.

This medicine is also used to replace estrogen in women with ovarian failure or other conditions that cause a lack of natural estrogen in the body.

In some cases, esterified estrogens is used to treat symptoms of breast cancer in men and women. Esterified estrogens is also used in men to treat symptoms of advanced prostate cancer. Esterified estrogens treats only the symptoms of cancer but does not treat the cancer itself.

Esterified estrogens may also be used for purposes not listed in this medication guide.

What is the most important information I should know about esterified estrogens?

Do not use if you are pregnant.

You should not take esterified estrogens if you have any of the following conditions: unusual vaginal bleeding, a blood-clotting disorder, breast cancer (unless you are taking this medicine for breast cancer), or if you have ever had thyroid cancer or uterine cancer, or a blood clot caused by taking hormones.

Esterified estrogens may increase your risk of developing a condition that may lead to uterine cancer. Call your doctor at once if you have any unusual vaginal bleeding while using this medicine.

What should I discuss with my healthcare provider before taking esterified estrogens?

This medicine can harm an unborn baby or cause birth defects. Do not use if you are pregnant, and tell your doctor right away if you become pregnant.

You should not use esterified estrogens if you are allergic to it, if you are pregnant, or if you have:

  • unusual vaginal bleeding that a doctor has not checked;

  • a bleeding or blood-clotting disorder;

  • breast cancer (unless you are taking esterified estrogens to treat breast cancer symptoms);

  • a history of hormone-dependent cancer (such as breast, uterine, ovarian, or thyroid cancer); or

  • a history of blood clots caused by taking birth control pills or hormone replacement medicine.

Taking this medicine can increase your risk of blood clots, stroke, or heart attack, especially if you have certain other conditions.

To make sure esterified estrogens is safe for you, tell your doctor if you have:

  • heart disease (coronary artery disease, chest pain, history of heart attack, stroke, or blood clot);

  • gallbladder disease;

  • a history of depression;

  • liver disease;

  • a history of fibrocystic breast disease, lumps, nodules, or an abnormal mammogram;

  • a family history of breast cancer;

  • diabetes;

  • kidney disease;

  • epilepsy;

  • migraines;

  • a history of jaundice caused by pregnancy or birth control pills;

  • if you have had your uterus removed (hysterectomy);

  • if you are pregnant or plan to become pregnant;

  • if you have had a heart attack or stroke; or

  • if you have ever had a blood clot (especially in your lung or your lower body).

The hormones in esterified estrogens can pass into breast milk and may harm a nursing baby. This medicine may also slow breast milk production. Do not use if you are breast feeding a baby.

How should I take esterified estrogens?

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Esterified estrogens are sometimes taken daily and sometimes taken on a cycled schedule, depending on the condition being treated.

If you take this medicine on a cycled schedule, you will take it daily for several days or weeks and then have 7 to 10 days off the medicine, to mimic your body's natural monthly cycle.

If you are taking esterified estrogens to treat cancer, you may be taking the medicine more than once per day.

Follow your doctor's dosing instructions very carefully.

No matter what your dosing schedule, try to take the medicine at the same time each dosing day.

Call your doctor right away if you have any unusual vaginal bleeding.

To help lower your risk of uterine cancer, your doctor may also want you to take a progestin medication. Follow all dosing directions carefully.

If you need surgery or medical tests or if you will be on bed rest, you may need to stop taking your medicine for a short time. Any doctor or surgeon who treats you should know that you are taking esterified estrogens.

Store this medicine at room temperature away from moisture and heat.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

While taking esterified estrogens, you will need to visit your doctor regularly. Self-examine your breasts for lumps on a monthly basis and have regular mammograms.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

Call your doctor for instructions if you forget to start taking esterified estrogens again after the regular time off in your dosing cycle.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking esterified estrogens?

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

Esterified estrogens side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using esterified estrogens and call your doctor at once if you have:

  • signs of a stroke--sudden numbness or weakness (especially on one side of the body), sudden severe headache, slurred speech, problems with vision or balance;

  • signs of a blood clot in the lung--chest pain, sudden cough, wheezing, rapid breathing, coughing up blood;

  • signs of a blood clot in your leg--pain, swelling, warmth, or redness in one or both legs;

  • heart attack symptoms--chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating;

  • liver problems--severe stomach pain, fever, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

  • high levels of calcium in your blood--nausea, vomiting, constipation, increased thirst or urination, muscle weakness, bone pain, confusion, lack of energy, or tired feeling;

  • a change in the pattern or severity of migraine headaches;

  • swelling in your hands, ankles, or feet;

  • a breast lump; or

  • severe skin reaction--fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common side effects may include:

  • light vaginal bleeding or spotting;

  • breast pain or tenderness;

  • nausea, vomiting, bloating;

  • skin color changes, increased facial hair, thinning scalp hair;

  • headache, dizziness, mood changes, decreased sex drive;

  • vaginal itching or discharge, very light menstrual periods; or

  • problems with contact lenses.

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.

See also: Side effects (in more detail)

Esterified estrogens dosing information

Usual Adult Dose for Osteoporosis:

0.3 mg orally once a day.

In addition to hormonal therapy, adequate calcium intake is important for postmenopausal women who require treatment or prevention of osteoporosis. The average diet of older American women contains 400 to 600 mg of calcium per day. A suggested optimal intake is 1500 mg per day. If dietary intake is insufficient to achieve 1500 mg per day, supplementation may be useful in women who have no contraindication to calcium supplementation.

Long-term therapy (for more than 5 years) is generally necessary in order to obtain substantive benefits in reducing the risk of bone fracture. Maximal benefits are obtained if estrogen therapy is initiated as soon after menopause as possible. The optimal duration of therapy has not been definitively determined.

Usual Adult Dose for Postmenopausal Symptoms:

1.25 mg orally once a day.

In general, the duration of hormone therapy for the treatment of postmenopausal symptoms should be limited. Treatment for one to five years is generally sufficient. However, long-term therapy (for the treatment/prophylaxis of osteoporosis and for risk reduction of cardiovascular disease) may be considered during the time in which the patient is being treated for postmenopausal symptoms.

Usual Adult Dose for Atrophic Urethritis:

0.3 mg to 1.25 mg orally once a day.

In general, the duration of hormone therapy for the treatment of postmenopausal symptoms like atrophic vaginitis, kraurosis vulvae, or atrophic urethritis should be limited. Treatment for one to five years is generally sufficient.

Usual Adult Dose for Atrophic Vaginitis:

0.3 mg to 1.25 mg orally once a day.

In general, the duration of hormone therapy for the treatment of postmenopausal symptoms like atrophic vaginitis, kraurosis vulvae, or atrophic urethritis should be limited. Treatment for one to five years is generally sufficient.

Usual Adult Dose for Hypoestrogenism:

2.5 mg to 7.5 mg orally once a day in divided doses for 21 days followed by a 10 day rest period. This schedule is repeated as necessary to product bleeding.

Usual Adult Dose for Oophorectomy:

1.25 mg orally once a day.

Usual Adult Dose for Primary Ovarian Failure:

1.25 mg orally once a day.

Usual Adult Dose for Breast Cancer:

10 mg orally three times a day for at least three months.

Estrogen therapy for breast cancer should be considered only for palliation in the treatment of metastatic disease in postmenopausal women and select male patients.

Usual Adult Dose for Prostate Cancer:

1.25 mg to 2.5 mg orally three times a day.

Estrogen therapy for prostate cancer should be considered only for palliation in the treatment of metastatic disease in select patients.

What other drugs will affect esterified estrogens?

Other drugs may interact with esterified estrogens, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Where can I get more information?

  • Your pharmacist can provide more information about esterified estrogens.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. 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. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 4.01. Revision Date: 2016-03-14, 6:52:36 PM.

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