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EstroGel Pump (for use on skin)

Generic Name: estradiol topical (for use on skin) (ESS tra DYE ol TOP ik al)
Brand Name: Divigel 0.25 mg/packet, Divigel 0.5 mg/packet, Divigel 1 mg/packet, Elestrin Pump, EstroGel Pump, Evamist

Medically reviewed on September 14, 2018

What is EstroGel Pump?

Estradiol is a form of estrogen, a female sex hormone that regulates many processes in the body.

EstroGel Pump (for the skin) is used to treat certain symptoms of menopause such as hot flashes, and vaginal dryness, burning, and irritation.

EstroGel Pump may also be used for purposes not listed in this medication guide.

Important Information

You should not use EstroGel Pump if you have: undiagnosed vaginal bleeding, liver disease, a bleeding disorder, if you will have major surgery, or if you have ever had a heart attack, a stroke, a blood clot, or cancer of the breast, uterus/cervix, or vagina.

Do not use if you are pregnant.

Estradiol may increase your risk of developing a condition that may lead to uterine cancer. Report any unusual vaginal bleeding right away.

EstroGel Pump is absorbed through the skin and can cause side effects in a child who comes into contact with the skin where you have applied the medicine.

Using this medicine can increase your risk of blood clots, stroke, heart attack, or cancer of the breast, uterus, or ovaries. Estradiol should not be used to prevent heart disease, stroke, or dementia.

Before taking this medicine

You should not use estradiol if you are allergic to it, or if you have:

  • unusual vaginal bleeding that has not been checked by a doctor;

  • liver disease;

  • a history of heart attack, stroke, or blood clot;

  • an increased risk of having blood clots due to a heart problem or a hereditary blood disorder; or

  • a history of hormone-related cancer, or cancer of the breast, uterus/cervix, or vagina.

Do not use estradiol if you are pregnant. Tell your doctor right away if you become pregnant during treatment.

Using estradiol can increase your risk of blood clots, stroke, or heart attack. You are even more at risk if you have high blood pressure, diabetes, high cholesterol, if you are overweight, or if you smoke.

Estradiol should not be used to prevent heart disease, stroke, or dementia, because this medicine may actually increase your risk of developing these conditions.

Tell your doctor if you have ever had:

Using estradiol may increase your risk of cancer of the breast, uterus, or ovaries. Talk with your doctor about this risk.

Estradiol lowers the hormone needed to produce breast milk and can slow breast milk production. Tell your doctor if you are breast-feeding.

How should I use EstroGel Pump?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Use the medicine at the same time each day.

Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.

Wash your hands with soap and water after applying the medicine. Do not allow other people to get EstroGel Pump on their skin. If this happens, wash the area thoroughly with soap and water.

Do not allow a child to come into contact with the skin where you have applied EstroGel Pump. Topical estradiol is absorbed through the skin and can cause premature puberty in a child who comes into contact with this medicine. Cover treated areas with clothing to protect others from coming into contact with the skin where you apply this medicine.

If you need major surgery or will be on long-term bed rest, you may need to stop using this medicine for a short time. Any doctor or surgeon who treats you should know that you are using estradiol.

Estradiol may increase your risk of developing a condition that can lead to uterine cancer. To help lower this risk, your doctor may also want you to take a progestin. Report any unusual vaginal bleeding right away.

Your doctor should check your progress on a regular basis to determine whether you should continue this treatment. Self-examine your breasts for lumps on a monthly basis, and have regular mammograms while using EstroGel Pump.

Store at room temperature away from moisture and heat.

EstroGel Pump may be flammable. Do not use near high heat or open flame. Do not smoke until the medicine has completely dried on your skin.

What happens if I miss a dose?

Use the medicine as soon as you can, but skip the missed dose if your next dose is due in less than 12 hours. Do not use two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include nausea, vomiting, stomach pain, breast tenderness, drowsiness, and vaginal bleeding.

What should I avoid while using EstroGel Pump?

Do not apply sunscreen to your skin at the same time you apply EstroGel Pump.

Avoid getting EstroGel Pump in your eyes. If this does happen, rinse with water.

Avoid smoking. It can greatly increase your risk of blood clots, stroke, or heart attack while using estradiol.

Grapefruit may interact with estradiol and lead to unwanted side effects. Avoid the use of grapefruit products.

EstroGel Pump side effects

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

Call your doctor at once if you have:

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

  • 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--sudden vision loss, stabbing chest pain, feeling short of breath, coughing up blood, pain or warmth in one or both legs;

  • swelling or tenderness in your stomach;

  • jaundice (yellowing of the skin or eyes);

  • memory problems, confusion, unusual behavior;

  • unusual vaginal bleeding, pelvic pain;

  • a lump in your breast; or

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

Topical estradiol is absorbed through the skin of a child who comes into contact with this medicine. Call your doctor if a child in close contact with you develops swollen nipples or enlarged breasts.

Common side effects may include:

  • nausea, vomiting, stomach cramps;

  • bloating, swelling, weight gain;

  • breast pain or tenderness;

  • headache;

  • vaginal itching or discharge, changes in your menstrual periods, breakthrough bleeding;

  • thinning scalp hair; or

  • cold symptoms such as stuffy nose, sneezing, sore throat.

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)

What other drugs will affect EstroGel Pump?

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

Many drugs can affect estradiol. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any medicine you start or stop using.

Further information

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.

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

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