Select a medication above to begin.
Menest
estrogens, esterified
Black Box Warnings .
Endometrial Cancer Risk
estrogens incr. risk in postmenopausal pts; rule out malignancy w/ endometrial sampling or other tests if undiagnosed persistent or recurrent abnormal vaginal bleeding; no evidence that 'natural' estrogens are more or less hazardous than 'synthetic' estrogens at equi-estrogenic doses
Cardiovascular and Other Risks
estrogens +/- progestins should not be used for cardiovascular dz or dementia prevention; incr. risk of MI, stroke, PE/DVT, and invasive breast CA in postmenopausal pts 50-79 yo (WHI estrogen/progestin study regimen = conjugated estrogens 0.625 mg/day w/ medroxyprogesterone 2.5 mg/day x5y); incr. risk of probable dementia in postmenopausal pts 65 yo and older (WHIMS estrogen/progestin substudy regimen = conjugated estrogens 0.625 mg/day w/ medroxyprogesterone 2.5 mg/day x4y); risk unknown in younger postmenopausal pts; other doses or estrogen/progestin combos not studied, but assume similar risk; use lowest effective estrogen dose, shortest duration based on individual tx goals and risks
Adult Dosing .
Dosage forms: TAB: 0.3 mg, 0.625 mg, 1.25 mg
vasomotor sx, mod-severe menopausal
- [1.25 mg PO qd]
- Info: cycle 21 days on, 7 days off; use lowest effective estrogen dose, shortest effective tx duration; add progestin if intact uterus
vulvovaginal atrophy, menopausal
- [0.3-1.25 mg PO qd]
- Info: not preferred if local sx only; cycle 21 days on, 7 days off; use lowest effective estrogen dose, shortest effective tx duration; add progestin if intact uterus
hypoestrogenism
- [assoc. w/ hypogonadism]
- Dose: 2.5-7.5 mg/day PO divided qd-tid; Info: cycle 20 days on, 10 days off; titrate to lowest effective maint. dose; add progestin on days 15-20 of cycle if no withdrawal bleeding
- [assoc. w/ oopherectomy or primary ovarian failure]
- Dose: 1.25 mg PO qd; Info: cycle 20 days on, 10 days off; titrate to lowest effective maint. dose; add progestin if intact uterus
metastatic breast CA, palliative tx
- [10 mg PO tid for at least 3mo]
advanced prostate CA, palliative tx
- [1.25-2.5 mg PO tid]
osteoporosis prevention, postmenopausal (off-label)
- [0.3 mg PO qd]
- Info: cycle 21 days on, 7 days off; add progestin x10-14 days/28 day cycle if intact uterus; weigh estrogen tx risk/benefit
renal dosing
- [see below]
- renal dz: not defined, caution advised
- HD/PD: not defined, caution advised
hepatic dosing
- [see below]
- hepatic impairment/dz: contraindicated
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.