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Menostar
estradiol transdermal
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: PATCH: 0.014 mg per day
osteoporosis prevention, postmenopausal
- [apply 1 patch qwk]
- Info: weigh estrogen tx risk/benefit; consider adding progestogen if intact uterus
renal dosing
- [see below]
- renal disease: not defined, caution advised
- HD/PD: not defined, caution advised
hepatic dosing
- [see below]
- hepatic impairment/disease: contraindicated
Peds Dosing .
- Dosage forms: PATCH: 0.014 mg per day
puberty induction, female (off-label)
- [associated with hypogonadism, 11 yo and older]
- Dose: apply 1-2 patches (0.1-0.2 mg) qwk; Start: cut patch to appropriate dose; start 3-7 mcg dose qwk x6-12mo, then incr. to 14 mcg dose qwk x6-12mo, then incr. to 25 mcg dose qwk x6-12mo, then incr. by 25 mcg per dose qwk x6-12mo; Info: 0.1 mg per day patch not available for this brand, see other estradiol transdermal products once higher dose required; add progesterone micronized or medroxyprogesterone after breakthrough bleeding occurs with at least 2y of estrogen tx if intact uterus; after puberty induction, titrate to lowest effective maintenance dose for hypoestrogenism until menopausal age
- [associated with constitutional causes, 13 yo and older]
- Dose: apply 1 patch qwk x3-6mo; Info: may incr. dose after 6mo if spontaneous puberty progression not achieved; see other estradiol transdermal products if higher dose required; reassess tx q3-6mo
renal dosing
- [not defined]
- renal impairment: consider adult renal dosing for guidance
- HD/PD: consider adult renal dosing for guidance
hepatic dosing
- [not defined]
- hepatic impairment: consider adult hepatic dosing for guidance