ESTROGENS

Brand & Generic Names

C.E.S.	Estrone-A
CHLOROTRIANISENE	Estronol
CONJUGATED ESTROGENS	ESTROPIPATE
Deladiol-40	Estrovis
Delestrogen	ETHINYL ESTRADIOL
depGynogen	Etonol-LA
Depo Estradiol	Feminone
Depogen	Femogen Forte
DES	Femogex
DIETHYLSTILBESTROL	Foygen Aqueous
Dioval	Gynogen
Duragen	Honvol
Dura-Estrin	Hormogen
E-Cypionate	Kestrin Aqueous
ESTERIFIED ESTROGENS	LAE 20
Estinyl	Loestrin
Estrace	Lo-Ovral
Estra-D	Mannest
Estraderm	Menest
ESTRADIOL	Neo-Estrone
Estradiol LA	Norinyl
Estra-L	Ogen
Estratab	Piperazine
Estraval	Premarin
Estro-Cyp	Progens
Estrofem	QUINESTROL
ESTROGEN	Stilphostrol
Estroject-2	TACE
Estroject-L.A.	Unigen
ESTRONE	Valergen
Estrone 5	Wehgen
Estrone Sulfate

Basic Information

• Habit forming? No
• Prescription needed? Yes
• Available as generic? Yes
• Drug class: Female sex hormone (estrogen)

Uses

• Treatment for estrogen deficiency.
• Treatment for symptoms of menopause and menstrual-cycle irregularity.
• Treatment for estrogen-deficiency osteoporosis (bone softening from calcium loss).
• Treatment for vulvar squamous hyperplasia.
• Treatment for atrophic vaginitis.
• Treatment for prostate cancer.

Dosage & Usage Information

How to take:
Tablet or capsule--Swallow with liquid. If you can't swallow whole, crumble tablet or open capsule and take with liquid or food.
Vaginal cream or suppositories--Use as directed on label.
By injection under medical supervision.
Transdermal patches--Follow package instructions.

When to take:
At the same time each day.

If you forget a dose:
Take as soon as you remember up to 12 hours late. If more than 12 hours, wait for next scheduled dose (don't double this dose).

What drug does:
Restores normal estrogen level in tissues.
Combined with progestins for contraception.

Time lapse before drug works:
10 to 20 days.

Don't take with:
Any other medicine without consulting your doctor or pharmacist.

Overdose

SYMPTOMS:
Nausea, vomiting, fluid retention, breast enlargement and discomfort, abnormal vaginal bleeding.

WHAT TO DO:

Overdose unlikely to threaten life. If person takes much larger amount than prescribed, call doctor, poison-control center or hospital emergency room for instructions.

Possible Adverse Reactions or Side Effects

Life-threatening:

Profuse bleeding. Seek emergency treatment.

Common:

• Stomach cramps.
• Appetite loss.
• Nausea; diarrhea; swollen feet and ankles; tender, swollen breasts; acne; intolerance of contact lenses; change in menstruation.

Infrequent:

• Rash, stomach or side pain, joint or muscle pain, bloody skin blisters, breast lumps.
• Depression, dizziness, migraine headache, irritability, vomiting.
• Brown blotches, hair loss, vaginal discharge or bleeding, changes in sex drive.

Rare:

• Jaundice, hypercalcemia in breast cancer.
• Involuntary movements.

Warnings & Precautions

Don't take if:

• You are allergic to any estrogen-containing drugs.
• You have impaired liver function.
• You have had blood clots, stroke or heart attack.
• You have unexplained vaginal bleeding.

Before you start, consult your doctor:

• If you have had cancer of the breast or reproductive organs, fibrocystic breast disease, fibroid tumors of the uterus or endometriosis.
• If you have had migraine headaches, epilepsy or porphyria.
• If you have diabetes, high blood pressure, asthma, congestive heart failure, kidney disease or gallstones.
• If you plan to become pregnant within 3 months.

Over age 60:
Controversial. You and your doctor must decide if drug risks outweigh benefits.

Pregnancy:
Risk to unborn child outweighs drug benefits. Don't use.

Breast-feeding:
Drug filters into milk. May harm child. Avoid.

Infants & children:
Not recommended.

Prolonged use:

• Increased growth of fibroid tumors of uterus. Possible association with cancer of uterus.
• Talk to your doctor about the need for follow-up medical examinations or laboratory studies to check pap smear, liver function, mammogram.

Skin & sunlight:
May cause rash or intensify sunburn in areas exposed to sun or sunlamp.

Driving, piloting or hazardous work:
No problems expected.

Discontinuing:
You may need to discontinue estrogens periodically. Consult your doctor.

Others:

• In rare instances, may cause blood clot in lung, brain or leg. Symptoms are sudden severe headache, coordination loss, vision change, chest pain, breathing difficulty, slurred speech, pain in legs or groin. Seek emergency treatment immediately.
• Carefully read the paper called "Information for the Patient" that was given to you with your prescription. If you lose it, ask your pharmacist for a copy.

Possible Interaction with Other Drugs

GENERIC NAME	COMBINED EFFECT
------------------------	-----------------------
Anticoagulants*,	Decreased anti-
oral	coagulant effect.
Anticonvulsants,	Decreased estrogen
hydantoin*	effect.
Antidepressants,	Increased toxicity of
tricyclic (TCA)*	antidepressants.
Antidiabetics*,	Unpredictable
oral	increase or decrease in blood
	sugar.
Antifibrinolytic	Increased possibility
agents*	of blood clotting.
Carbamazepine	Decreased estrogen effect.
Clofibrate	Decreased clofibrate effect.
Dextrothyroxine	Decreased dextrothyroxine effect.
Didanosine	Increased risk of pancreatitis.
Guanfacine	May decrease antihypertensive
	effects of guanfacine.
Insulin	Possible decreased insulin effect.
	May require dosage adjustment.
Meprobamate	Increased estrogen effect.
Phenobarbital	Decreased estrogen effect.
Primidone	Decreased estrogen effect.
Rifampin	Decreased estrogen effect.
Tamoxifen	Decreased tamoxifen effect.
Terazosin	Decreases effectiveness of
	terazosin.
Thyroid hormones*	Decreased thyroid effect.
Ursodiol	Decreased effect of ursodiol.
Vitamin C	Possible increased estrogen effect.

Possible Interaction with Other Substances

INTERACTS WITH	COMBINED EFFECT
---------------	---------------
Alcohol:	None expected.
Beverages:	None expected.
Cocaine:	No proven problems.
Foods:	None expected.
Marijuana:	Possible menstrual irregularities
	and bleeding between periods.
Tobacco:	Increased risk of blood clots
	leading to stroke or heart attack.