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Esterified Estrogens Dosage

Medically reviewed on April 12, 2018.

Applies to the following strengths: 0.3 mg; 0.625 mg; 1.25 mg; 2.5 mg

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.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Hepatic metabolism of estrogens may be impaired in patients with liver disease and caution is recommended.

Precautions

US BOXED WARNINGS:
-CARDIOVASCULAR DISORDERS AND PROBABLE DEMENTIA: Estrogen with or without progestins should not be used for prevention of cardiovascular disease. The Women's Health Initiative (WHI) study reported an increased risk of deep vein thrombosis (DVT), pulmonary embolism (PE), stroke, invasive breast cancer, and myocardial infarction (MI) in postmenopausal women (50 to 79 years of age) during 5 years of treatment with oral conjugated estrogens (CE) (0.625 mg) combined with medroxyprogesterone acetate (MPA) (2.5 mg), relative to placebo. The WHI Memory Study (WHIMS) study reported an increased risk of developing probable dementia in postmenopausal women 65 years of age or older during 4 years of treatment with oral CE plus MPA relative to placebo. It is unknown whether this finding applies to younger postmenopausal women or women taking estrogen alone therapy.
-ENDOMETRIAL CANCER: Estrogens increase the risk of endometrial cancer. Close clinical surveillance of all women taking estrogens is important. Adequate diagnostic measures, including endometrial sampling when indicated, should be undertaken to rule out malignancy in all cases of undiagnosed persistent or recurring abnormal vaginal bleeding. There is no evidence that the use of "natural" estrogens results in a different endometrial risk profile than synthetic estrogens at equivalent doses.
-Other doses of CE with MPA, and other combinations and dosage forms of estrogens and progestins were not studied in the WHI clinical trials and, in the absence of comparable data, these risks should be assumed to be similar. Due to these risks, estrogens with or without progestins should be prescribed at the lowest effective doses and for the shortest duration consistent with treatment goals and risks for the individual woman.

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

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Further information

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

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