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Delestrogen
estradiol valerate
Black Box Warnings .
Endometrial Cancer with Unopposed Estrogen in Patients with Intact Uterus
unopposed estrogen use incr. risk of endometrial CA in patients with intact uterus; adding progestogen has been shown to decr. risk of endometrial hyperplasia, a possible precursor to endometrial CA; perform adequate diagnostic measures (including directed or random endometrial sampling) to rule out malignancy in menopausal patient with abnormal genital bleeding of unknown etiology
Adult Dosing .
Dosage forms: INJ: 10 mg per mL, 20 mg per mL, 40 mg per mL
vasomotor symptoms, moderate-severe menopausal
- [10-20 mg IM q4wk]
- Info: add progestogen x10-14 days/4wk cycle if intact uterus; use lowest effective estrogen dose, shortest effective tx duration
vulvovaginal atrophy, menopausal
- [10-20 mg IM q4wk]
- Info: add progestogen x10-14 days/4wk cycle if intact uterus; use lowest effective estrogen dose, shortest effective tx duration; not preferred if local symptoms only
hypoestrogenism
- [10-20 mg IM q4wk]
- Info: for hypogonadism, oopherectomy or primary ovarian failure; add progestogen x10-14 days/4wk cycle if intact uterus
advanced prostate CA, palliative tx
- [>30 mg IM q1-2wk]
transgender hormone therapy, feminizing (off-label)
- [5-30 mg IM q2wk]
- Info: adjust dose based on patient tx goals, clinical response, and estradiol levels; refer to WPATH or Endocrine Society guidelines
renal dosing
- [see below]
- renal disease: not defined, caution advised
- HD/PD: not defined, caution advised
hepatic dosing
- [see below]
- hepatic impairment: contraindicated
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.