m2f taking estrogen, clear discharge from nipples
 

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Estrogen receptor antagonists


A drug may be classified by the chemical type of the active ingredient or by the way it is used to treat a particular condition. Each drug can be classified into one or more drug classes.

Estrogen receptor antagonists bind to estrogen receptors and inhibit the action of estrogen. Estrogen controls the growth of certain types of breast cancers called estrogen receptor positive cancers. So estrogen receptor antagonists are useful in treating patients with estrogen sensitive breast cancers.

See also

Medical conditions associated with estrogen receptor antagonists:

Breast CancerBreast Cancer, Metastatic Drug List:Faslodex
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Synthetic ovulation stimulants


A drug may be classified by the chemical type of the active ingredient or by the way it is used to treat a particular condition. Each drug can be classified into one or more drug classes.

Synthetic ovulation stimulants are drugs that stimulate ovulation or release of ovum from the ovaries.

The drug in this category has a similar structure to estrogen. It binds to the estrogen receptors so the brain thinks there is a low level of estrogen in the body. Therefore estrogen cannot provide accurate negative feedback to the hypothalamus and gonadotropin releasing hormone (GnRH) is released. GnRH activates the pituitary gland to release follicle stimulating hormone (FSH) and luteinizing hormone (LH). FSH and LH secretion stimulates growth of ovarian follicles and subsequent release of the egg.

Synthetic ovulation stimulants are used in treating infertility in anovulatory women.

See also

Medical conditions associated with synthetic ovulation stimulants:

Female Infertility Lactation Suppression Oligospermia Ovulation Induction Drug List: Clomid Serophene
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Vaginal Dryness Medications


There are currently no drugs listed for "Vaginal Dryness".

Definition of Vaginal Dryness: There are many causes of vaginal dryness. A very common cause of vaginal dryness is lack of the hormone estrogen in postmenopausal women. Other causes can include an infection, foreign body, or a tumor (a rare cause of vaginal dryness).

Learn more about Vaginal Dryness

Medical Encyclopedia:

Vaginal dryness
Drug List:
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Activella


Pronunciation: ES-tra-DYE-ol/nor-ETH-in-drone
Generic Name: Estradiol/Norethindrone
Brand Name: Activella

Activella should not be used to prevent heart disease, heart attacks, strokes, or dementia. Estrogens, with or without progestins, have been shown to increase the risk of heart disease (including heart attack), stroke, dementia, serious blood clots (eg, in the lungs or legs), cancer of the uterus, and breast cancer in some women. Tell your doctor right away if you have unusual vaginal bleeding while you use Activella. Talk with your doctor if you have questions about the benefits and risks of using Activella.

Activella should be used for the shortest possible time at the lowest effective dose to minimize the risk of these side effects. Talk with your doctor regularly about your need to use Activella.


Activella is used for:

Treating certain moderate to severe symptoms of menopause (eg, hot flashes; dryness, itching, or burning in or around the vagina). It is also used to prevent osteoporosis (weakened bones) in certain women after menopause. It may also be used for other conditions as determined by your doctor.

Activella is a combination of estrogen and progestin hormones. It works by replacing natural progestin and estrogen in women who can no longer produce enough of these hormones.

Do NOT use Activella if: you are allergic to any ingredient in Activella you are pregnant or think you may be pregnant you have liver problems, undiagnosed abnormal vaginal bleeding, or estrogen-dependent growths you have a history of blood clots (eg, in the lungs, legs, eyes) or breast cancer you have had recent (within the past year) bleeding in the brain, stroke, heart attack, or other serious blood vessel problems

Contact your doctor or health care provider right away if any of these apply to you.

Before using Activella:

Some medical conditions may interact with Activella. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

if you are pregnant, planning to become pregnant, or are breast-feeding if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement if you have allergies to medicines, foods (eg, corn), or other substances if you have had your uterus removed (hysterectomy), or you have a history of endometrial, cervical, or vaginal cancer; endometriosis; growths in the uterus; uterine fibroids; abnormal mammograms; or lumps in the breast if you have a history of asthma, kidney problems, heart problems (eg, heart failure), high blood pressure, blood vessel problems, heart attack, stroke, high cholesterol or lipid levels, diabetes, depression, dementia, gallbladder problems, or pancreas problems if you have high or low blood calcium levels or a history of cancer, growths in the liver, lupus, blood problems (eg, porphyria), migraine headaches, seizures, thyroid problems, or vision loss if you have a history of fluid retention (swelling) or tobacco use, or if you are very overweight if a member of your family has ever had a blood clot (eg, in the lung, leg) if you have a history of jaundice (yellowing of the eyes or skin) caused by pregnancy or estrogen use if you will be confined to a bed or chair for an extended period of time (eg, because of surgery or a long airplane ride)

Some MEDICINES MAY INTERACT with Activella. Tell your health care provider if you are taking any other medicines, especially any of the following:

Troleandomycin because the risk of jaundice (yellowing of the skin or eyes) and liver problems may be increased Macrolide antibiotics (eg, erythromycin) because they may increase the risk of Activella's side effects Azole antifungals (eg, ketoconazole) or HIV protease inhibitors (eg, ritonavir) because they may decrease Activella's effectiveness or increase the risk of Activella's side effects Acitretin, aprepitant, barbiturates (eg, phenobarbital), bosentan, carbamazepine, felbamate, griseofulvin, hydantoins (eg, phenytoin), modafinil, nevirapine, penicillins (eg, amoxicillin), rifampin, St. John's wort, tetracyclines (eg, doxycycline), or troglitazone because they may decrease Activella's effectiveness Beta-blockers (eg, propranolol), corticosteroids (eg, prednisone), or theophylline because the risk of their side effects may be increased by Activella Lamotrigine or thyroid hormones (eg, levothyroxine) because their effectiveness may be decreased by Activella

This may not be a complete list of all interactions that may occur. Ask your health care provider if Activella may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Activella:

Use Activella as directed by your doctor. Check the label on the medicine for exact dosing instructions.

An extra patient leaflet is available with Activella. Talk to your pharmacist if you have questions about this information. Take Activella by mouth with or without food. When you start a new dispenser of Activella, turn the inner disk so the current day of the week is lined up with the little plastic tab. To take the first tablet, pull the plastic tab up and break it off. Tip the tablet out of the dispenser. Every day after that, turn the outer transparent dial once space clockwise, as shown by the arrow. Tip the tablet for that day out of the dispenser. Grapefruit or grapefruit juice may increase the risk of Activella's side effects. Talk to your doctor before including grapefruit or grapefruit juice in your diet while taking Activella. Take Activella on a regular schedule to get the most benefit from it. Taking Activella at the same time each day will help you remember to take it. Continue to take Activella even if you feel well. Do not miss any doses. If you miss a dose of Activella, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Activella.

Important safety information: Activella may increase the risk of stroke, heart attack, blood clots, high blood pressure, or similar problems. The risk may be greater if you smoke. Tell your doctor or dentist that you take Activella before you receive any medical or dental care, emergency care, or surgery. Activella should be discontinued at least 4 to 6 weeks before surgery or any time you will be confined to a chair or bed for a long period of time (eg, a long plane flight). Talk to your doctor about the safe use of Activella if any of these conditions apply to you. Follow the diet and exercise program given to you by your health care provider. Talk to your doctor about whether you should take a calcium and vitamin D supplement while you use Activella. Activella may cause dark patches on your face (melasma). Exposure to the sun may make these patches darker. Ask your doctor whether you should use sunscreen or wear protective clothing when your skin is exposed to the sun, sunlamps, or tanning booths. If you wear contact lenses and you develop problems with them or with your vision, contact your doctor as soon as possible. Diabetes patients - Activella may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine. Activella may interfere with certain lab tests. Be sure your doctor and lab personnel know you are taking Activella. You should talk with your doctor regularly to determine whether or not you still need to take Activella. Lab tests, including mammograms, Pap smear, and blood pressure, may be performed while you use Activella. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments. You should perform monthly breast self-exams and receive yearly breast exams from your doctor while you are taking Activella. Talk with your doctor if you are unsure how to properly perform a breast self-exam. Report any lumps to your doctor right away. Activella should not be used in CHILDREN; safety and effectiveness in children have not been confirmed. PREGNANCY and BREAST-FEEDING: Do not take Activella if you are pregnant. If you think you may become pregnant, contact your doctor right away. Activella is found in breast milk. If you are or will be breast-feeding while you use Activella, check with your doctor. Discuss any possible risks to your baby. Possible side effects of Activella:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Back pain; breast tenderness or pain; headache; mild hair loss; nausea; stomach cramps, bloating, or pain; vaginal spotting or breakthrough bleeding; vomiting; weight changes.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness); calf or leg pain, swelling, or tenderness; chest pain; confusion; discharge from the nipples; fainting; irregular heartbeat; lumps in the breast; mental or mood changes (eg, depression, irritability, memory loss); numbness of an arm or leg; one-sided weakness; severe or persistent breast pain; severe or persistent dizziness, headache, or stomach pain; severe, persistent, or recurring abnormal vaginal bleeding; speech changes (eg, slurred speech); sudden severe nausea or vomiting; sudden shortness of breath; sudden unusual weight gain; swelling of hands or feet; unusual vaginal discharge, itching, or odor; vision changes (eg, double vision, sudden vision loss); yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

See also: Activella side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include severe or persistent nausea or vomiting; severe or unusual vaginal bleeding.

Proper storage of Activella:

Store Activella at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Activella out of the reach of children and away from pets.

General information: If you have any questions about Activella, please talk with your doctor, pharmacist, or other health care provider. Activella is to be used only by the patient for whom it is prescribed. Do not share it with other people. If your symptoms do not improve or if they become worse, check with your doctor. Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Activella. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012 Database Edition 12.1.1.002 Copyright © 2012 Wolters Kluwer Health, Inc. More Activella resources Activella Side Effects (in more detail)Activella DosageActivella Use in Pregnancy & BreastfeedingDrug ImagesActivella Drug InteractionsActivella Support Group3 Reviews for Activella - Add your own review/rating Activella Prescribing Information (FDA) Activella Advanced Consumer (Micromedex) - Includes Dosage Information Activella Concise Consumer Information (Cerner Multum) CombiPatch Prescribing Information (FDA) Combipatch topical patches Concise Consumer Information (Cerner Multum) Enablex Monograph (AHFS DI) Enalaprilat/Enalapril Maleate Monograph (AHFS DI) Mimvey Prescribing Information (FDA) Compare Activella with other medications Atrophic UrethritisAtrophic VaginitisHypoestrogenismPostmenopausal Symptoms
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Sex hormone combinations


A drug may be classified by the chemical type of the active ingredient or by the way it is used to treat a particular condition. Each drug can be classified into one or more drug classes.

Sex hormone combinations are products that contain more than one sex hormone, either estrogen and progestin or estrogen and androgen.

Estrogens are a group of hormones that are synthesized mainly by the ovaries and a small amount is synthesized by the testes in males and by the adrenal cortex in both sexes. The placenta produces a fairly large amount of estrogen as well. The three main endogenous estrogens are estradiol, estriol and estrone.

Progestins are a group of naturally occurring or synthetic steroid hormones. The naturally occurring progestin is progesterone, which is secreted by the corpus luteum of the ovary, the placenta and also (in small amounts) by the adrenal cortex and testes. It prepares the inner lining of the uterus for pregnancy, and if pregnancy occurs it maintains the uterus through the pregnancy and prevents ovulation by the ovaries during pregnancy.

Androgens are steroid hormones that stimulate development of male sex organs and sexual characteristics. Androgens are mainly released by the testes and small amounts are released by the adrenal cortex and ovaries.

The combinations, which have estrogen and progestin are used as birth control or to treat menopausal symptoms. Combinations with estrogen and androgen are used control menopausal symptoms.

See also

Medical conditions associated with sex hormone combinations:

Abnormal Uterine BleedingAcneAtrophic UrethritisAtrophic VaginitisBirth ControlEndometriosisGonadotropin InhibitionHot FlashesHypoestrogenismMenopausal DisordersMenstrual DisordersOophorectomyOsteoporosisPolycystic Ovary SyndromePostmenopausal SymptomsPrevention of OsteoporosisPrimary Ovarian Failure Drug List:/tags/estratest/
/tags/norinyl-1-35/
/tags/estratest-h-s/
/tags/angeliq/
/tags/ovcon-35/
/tags/ortho-novum-7-7-7/
/tags/aranelle/
/tags/modicon/
/tags/junel-1-20/
/tags/lo-loestrin-fe/
/tags/microgestin-fe-1-5-30/
/tags/climara_pro/
/tags/junel-fe-1-5-30/
/tags/microgestin-fe-1-20/
/tags/necon-7-7-7/
/tags/nortrel-7-7-7/
/tags/nortrel-1-35/
/tags/loestrin-21-1-20/
/tags/brevicon/
/tags/covaryx-hs/
/tags/cyclafem-7-7-7/
/tags/eemt-ds/
/tags/essian/
/tags/estrostep-fe/
/tags/genora-1-35/
/tags/jenest/
/tags/jinteli/
/tags/loestrin-21-1-5-30/
/tags/lunelle/
/tags/microgestin-1-5-30/
/tags/necon-0-5-35/
/tags/nelova-0-5-35/
/tags/nortrel-0-5-35/
/tags/ovcon-50/
/tags/premphase/
/tags/syntest-hs/
/tags/tri-legest/
/tags/zenchent/

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estrogen Vaginal


Commonly used brand name(s)

In the U.S.

Estrace Estring Femring Ortho Dienestrol Premarin Vagifem

In Canada

Estragyn Neo-Estrone Oestrilin

Available Dosage Forms:

Tablet Cream Insert, Extended Release Suppository Uses For estrogen

Estrogens are hormones produced by the body. Among other things, estrogens help develop and maintain female organs.

When your body is in short supply of this hormone, replacing it can ease the uncomfortable changes that occur in the vagina, vulva (female genitals), and urethra (part of the urinary system). Conditions that are treated with vaginal estrogens include a genital skin condition (vulvar atrophy), inflammation of the vagina (atrophic vaginitis), and inflammation of the urethra (atrophic urethritis).

Estrogens work partly by increasing a normal clear discharge from the vagina and making the vulva and urethra healthy. Using or applying an estrogen relieves or lessens:

Dryness and soreness in the vagina Itching, redness, or soreness of the vulva Feeling an urge to urinate more often then is needed or experiencing pain while urinating Pain during sexual intercourse

When used vaginally or on the skin, most estrogens are absorbed into the bloodstream and cause some, but not all, of the same effects as when they are taken by mouth. Estrogens used vaginally at very low doses for treating local problems of the genitals and urinary system will not protect against osteoporosis or stop the hot flushes caused by menopause.

Estrogens for vaginal use are available only with your doctor's prescription.

Before Using estrogen Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to medicines in this group or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Estrogen vaginal cream is not indicated in children. Studies have not been conducted.

Geriatric

Elderly women greater than 65 years of age may have an increased risk of certain side effects during treatment, especially stroke, invasive breast cancer, and memory problems.

Pregnancy

Estrogens should not be used during pregnancy, since an estrogen called diethylstilbestrol (DES) that is no longer taken for hormone replacement has caused serious birth defects in humans and animals.

Breast Feeding

Use of estrogen is not recommended in nursing mothers. Estrogens pass into the breast milk and may decrease the amount and quality of breast milk. Caution should be exercised in mothers who are using estrogen and breast-feeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of medicines in this class. Make sure you tell your doctor if you have any other medical problems, especially:

Asthma or Epilepsy or Heart problems or Kidney problems or Migraine headaches—Estrogens may worsen these conditions. Blood clotting problems—Although worsening of a blood clotting condition is unlikely, some doctors do not prescribe vaginal estrogens for patients with blood clotting problems or a history of these problems. Breast cancer (active, suspected, or past history)—Estrogens should not be used. Certain cancers, including cancers of the breast, bone, or uterus (active or suspected)—Estrogens may interfere with the treatment of breast or bone cancer or worsen cancer of the uterus when these conditions are present. Cholestatic jaundice (flow of bile from the liver is blocked), past history—Caution should be used when this condition is present. Diabetes mellitus (sugar diabetes)—Estrogens may alter your body's response to sugar in your diet. Endometriosis or Fibroid tumors of the uterus—Estrogens may worsen endometriosis or increase the size of fibroid tumors. Gallbladder problems (gallstones)—Estrogens may increase your chance of getting a gallbladder attack. Heart attack or Stroke (active or past history)—Estrogens should not be used. Hepatic hemangioma (noncancerous tumors of the liver)—Estrogens may worsen this medical problem. High blood pressure—Estrogens may worsen this medical problem. Hypercalcemia (too much calcium in your blood)—Estrogens may worsen this medical problem. Hypertriglyceridemia (too much triglycerides in your blood)—Estrogens may increase your chance of getting pancreatitis or other side effects. Hypocalcemia (too little calcium in your blood)—Your doctor should treat the low calcium in your blood before starting estrogen therapy. Irritation or infection of the vagina—Usually estrogens decrease infections or irritation of the vagina, but sometimes these conditions may become worse. Liver disease or Liver problems—Estrogens should not be used. Lupus erythematosus, systemic (SLE or lupus)—Estrogens may worsen this medical problem. Physical problems within the vagina, such as narrow vagina, vaginal stenosis, or vaginal prolapse—Estradiol vaginal insert or ring may be more likely to slip out of place or cause problems, such as irritation of the vagina. Porphyria—Estrogens may worsen this medical problem. Thyroid problems (underactive thyroid)—Estrogens may alter your body's response to your thyroid medication. Your doctor may alter the amount of thyroid replacement that you take while on estrogen therapy. Vision changes, sudden onset including Bulging eyes or Double vision or Migraine headache or Vision loss, partial or complete—Estrogens may cause these problems. Tell your doctor if you have had any of these problems. Unusual genital or vaginal bleeding of unknown causes—Use of estrogens may delay diagnosis or worsen the condition. The reason for the bleeding should be determined before estrogens are used. Proper Use of estrogen

Vaginal estrogen products usually come with patient directions. Read them carefully before using estrogen.

Wash your hands before and after using the medicine. Also, keep the medicine out of your eyes. If estrogen does get into your eyes, wash them out immediately, but carefully, with large amounts of tap water. If your eyes still burn or are painful, check with your doctor.

Use estrogen only as directed. Do not use more of it and do not use it for a longer time than your doctor ordered. It can take up to 4 months to see the full effect of the estrogens. Your doctor may reconsider continuing your estrogen treatment or may lower your dose several times within the first one or two months, and every 3 to 6 months after that. Sometimes a switch to oral estrogens may be required for added benefits or for higher doses. When using the estradiol vaginal insert or ring, you will need to replace it every 3 months or remove it after 3 months.

For vaginal creams or suppositories:

Vaginal creams and some vaginal suppositories are inserted with a plastic applicator. Directions for using the applicator are supplied with your medicine. If you do not see your dose marked on the applicator, ask your health care professional for more information. To fill the applicator for cream dosage forms: Screw the applicator onto the tube. Squeeze the medicine into the applicator slowly until it is measured properly. Remove the applicator from the tube. Replace the cap on the tube. To fill the applicator for suppository dosage form: Place the suppository into the applicator. To place the dose using the applicator for cream and suppository dosage forms: Relax while lying on your back with your knees bent or stand with one foot on a chair. Hold the full applicator in one hand. Slide the applicator slowly into the vagina. Stop before it becomes uncomfortable. Slowly press the plunger until it stops. Withdraw the applicator. The medicine will be left behind in the vagina. To care for the applicator for cream and suppository dosage forms: Clean the applicator after use by pulling the plunger out of the applicator and washing both parts completely in warm, soapy water. Do not use hot or boiling water. Rinse well. After drying the applicator, replace the plunger.

For vaginal insert or ring dosage form:

To place the vaginal insert: Relax while lying on your back with your knees bent or stand with one foot on a chair. Pinch or press the sides of the vaginal insert together, between your forefinger and middle finger. With one hand, part the folds of skin around your vagina. Slide the vaginal insert slowly into the upper third of your vagina. Stop before it becomes uncomfortable. The exact location is not too important but it should be comfortable. If it seems uncomfortable, then carefully push the vaginal insert higher into the vagina. To remove the vaginal insert: Stand with one foot on a chair. Slide one finger into the vagina and hook it around the closest part of the vaginal insert. Slowly pull the vaginal insert out. Dispose of the vaginal insert by wrapping it up and throwing it into the trash. Do not flush it down the toilet. Dosing

The dose medicines in this class will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of these medicines. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For conjugated estrogens For vaginal dosage form (cream): For treating inflammation of the vagina (atrophic vaginitis): Adults—At first, 0.5 gram (g) of conjugated estrogens inserted into the vagina once a day or as directed by your doctor to achieve the lowest dose possible. Usually your doctor will want you to use estrogen for only three weeks of each month (three weeks on and one week off). Your doctor may increase your dose as needed. However, the dose is usually not more than 2 grams per day. For treating a genital skin condition (vulvar atrophy): Adults—0.5 gram (g) of conjugated estrogens inserted into the vagina two times per week. Usually your doctor will want you to use estrogen for only three weeks of each month (three weeks on and one week off). For estradiol For vaginal dosage form (cream): For treating a genital skin condition (vulvar atrophy) and inflammation of the vagina (atrophic vaginitis): Adults—200 to 400 micrograms (mcg) of estradiol (two to four grams of cream) inserted into the vagina once a day for one to two weeks, decreasing the dose by one half over two and four weeks. After four weeks, your doctor will probably ask you to use the medicine less often, such as 100 mcg (one gram of cream) one to three times a week and for only three weeks of each month (three weeks on and one week off). For vaginal dosage form (insert or ring): For treating a genital skin condition (vulvar atrophy), inflammation of the vagina (atrophic vaginitis) in postmenopausal women, and inflammation of the urethra (urethritis) in postmenopausal women: Adults—One insert containing 2 to 24.8 milligrams (mg) of estradiol inserted into the vagina every three months. The insert will slowly release estradiol at a rate of 7.5 to 100 micrograms (mcg) every twenty-four hours with continuous use. For estrone For vaginal dosage form (cream): For treating a genital skin condition (vulvar atrophy) and inflammation of the vagina (atrophic vaginitis) in postmenopausal women: Adults—2 to 4 milligrams (mg) of estrone (two to four grams of cream) inserted into the vagina once a day or as directed by your doctor. For vaginal dosage form (suppository): For treating a genital skin condition (vulvar atrophy) and inflammation of the vagina (atrophic vaginitis) in postmenopausal women: Adults—250 to 500 micrograms (mcg) inserted into the vagina once a day or as directed by your doctor. Missed Dose

If you miss a dose of estrogen, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

When using the suppository or cream several times a week: If you miss a dose of estrogen and remember it within 1 or 2 days of the missed dose, use the missed dose as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

When using the cream or suppositories more than several times a week: If you miss a dose of estrogen, use it as soon as possible if remembered within 12 hours of the missed dose. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Keep out of the reach of children.

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using estrogen

It is very important that your doctor check your progress at regular visits to make sure estrogen does not cause unwanted effects. Plan on going to see your doctor every year, but some doctors require visits more often.

It is not yet known whether the use of vaginal estrogens increases the risk of breast cancer in women. It is very important that you check your breasts on a regular basis for any unusual lumps or discharge. Report any problems to your doctor. You should also have a mammogram (x-ray picture of the breasts) done if your doctor recommends it.

It is important that you have a regular pelvic exam (pap smear). Your doctor will tell you how often this exam should be done.

Talk to your doctor if you have high blood pressure, high cholesterol (fats in the blood), or diabetes, use tobacco, or are overweight. You may have a higher risk for getting heart disease.

Although the chance is low, use of estrogen may increase your chance of getting cancer of the ovary or uterus (womb). Regular visits to your health professional can help identify these serious side effects early.

If you think that you may be pregnant, stop using the medicine immediately and check with your doctor.

Tell the doctor in charge that you are using estrogen before having any laboratory test, because some test results may be affected.

For vaginal creams or suppositories:

Avoid using latex condoms, diaphragms, or cervical caps for up to 72 hours after using estrogen vaginal creams. Certain estrogen products may contain oils in the creams that can weaken latex (rubber) products and cause condoms to break or leak, or cervical caps or diaphragms to wear out sooner. Check with your health care professional to make sure the vaginal estrogen product you are using can be used with latex devices. estrogen is often used at bedtime to increase effectiveness through better absorption. Vaginal creams or suppositories will melt and leak out of the vagina. A minipad or sanitary napkin will protect your clothing. Do not use tampons (like those used for menstrual periods) since they may soak up the medicine and make the medicine less effective. Avoid exposing your male sexual partner to your vaginal estrogen cream or suppository by not having sexual intercourse right after using these medicines. Your male partner might absorb the medicine through his penis if it comes in contact with the medicine.

For estradiol vaginal inserts or rings:

Contact your doctor if you have problems removing your vaginal insert. It is not necessary to remove the vaginal insert for sexual intercourse unless you prefer to remove it. If you do take it out, or if it accidentally slips or comes out of the vagina, you can replace the vaginal insert in the vagina after washing it with lukewarm water. Never use hot or boiling water. If it slips down, gently push it upwards and back into place. Replace the vaginal insert every 3 months. Talk to your doctor on a regular basis about how long to use the vaginal insert. estrogen Side Effects

The risk of any serious adverse effect is unlikely for most women using low doses of estrogens vaginally. Even women with special risks have used vaginal estrogens without problems.

Check with your doctor immediately if any of the following side effects occur:

Less common Breast pain enlarged breasts itching of the vagina or genitals headache nausea stinging or redness of the genital area thick, white vaginal discharge without odor or with a mild odor Rare Feeling of vaginal pressure (with estradiol vaginal insert or ring) unusual or unexpected uterine bleeding or spotting vaginal burning or pain (with estradiol vaginal insert or ring) Incidence not known Diarrhea dizziness fast heartbeat feeling faint fever hives hoarseness itching joint pain, stiffness, or swelling muscle pain rash shortness of breath skin redness swelling of eyelids, face, lips, hands, or feet tightness in the chest trouble with breathing or swallowing vomiting wheezing

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common Abdominal or back pain clear vaginal discharge (usually means the medicine is working) Incidence not known Acne enlargement of penis or testes growth of pubic hair rapid increase in height swelling of the breasts or breast soreness in males

Also, many women who are using estrogens with a progestin (another female hormone) will start having monthly vaginal bleeding that is similar to menstrual periods. This effect will continue for as long as the medicine is taken. However, monthly bleeding will not occur in women who have had the uterus removed by surgery (hysterectomy).

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

The information contained in the Thomson Reuters Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

The use of the Thomson Reuters Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Reuters Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON REUTERS HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Reuters Healthcare does not assume any responsibility or risk for your use of the Thomson Reuters Healthcare products.


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Femring


Generic Name: estrogen (Vaginal route)

Commonly used brand name(s)

In the U.S.

Estrace Estring Femring Ortho Dienestrol Premarin Vagifem

In Canada

Estragyn Neo-Estrone Oestrilin

Available Dosage Forms:

Tablet Cream Insert, Extended Release Suppository Uses For Femring

Estrogens are hormones produced by the body. Among other things, estrogens help develop and maintain female organs.

When your body is in short supply of this hormone, replacing it can ease the uncomfortable changes that occur in the vagina, vulva (female genitals), and urethra (part of the urinary system). Conditions that are treated with vaginal estrogens include a genital skin condition (vulvar atrophy), inflammation of the vagina (atrophic vaginitis), and inflammation of the urethra (atrophic urethritis).

Estrogens work partly by increasing a normal clear discharge from the vagina and making the vulva and urethra healthy. Using or applying an estrogen relieves or lessens:

Dryness and soreness in the vagina Itching, redness, or soreness of the vulva Feeling an urge to urinate more often then is needed or experiencing pain while urinating Pain during sexual intercourse

When used vaginally or on the skin, most estrogens are absorbed into the bloodstream and cause some, but not all, of the same effects as when they are taken by mouth. Estrogens used vaginally at very low doses for treating local problems of the genitals and urinary system will not protect against osteoporosis or stop the hot flushes caused by menopause.

Estrogens for vaginal use are available only with your doctor's prescription.

Before Using Femring Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to medicines in this group or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Estrogen vaginal cream is not indicated in children. Studies have not been conducted.

Geriatric

Elderly women greater than 65 years of age may have an increased risk of certain side effects during treatment, especially stroke, invasive breast cancer, and memory problems.

Pregnancy

Estrogens should not be used during pregnancy, since an estrogen called diethylstilbestrol (DES) that is no longer taken for hormone replacement has caused serious birth defects in humans and animals.

Breast Feeding

Use of this medicine is not recommended in nursing mothers. Estrogens pass into the breast milk and may decrease the amount and quality of breast milk. Caution should be exercised in mothers who are using estrogen and breast-feeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of medicines in this class. Make sure you tell your doctor if you have any other medical problems, especially:

Asthma or Epilepsy or Heart problems or Kidney problems or Migraine headaches—Estrogens may worsen these conditions. Blood clotting problems—Although worsening of a blood clotting condition is unlikely, some doctors do not prescribe vaginal estrogens for patients with blood clotting problems or a history of these problems. Breast cancer (active, suspected, or past history)—Estrogens should not be used. Certain cancers, including cancers of the breast, bone, or uterus (active or suspected)—Estrogens may interfere with the treatment of breast or bone cancer or worsen cancer of the uterus when these conditions are present. Cholestatic jaundice (flow of bile from the liver is blocked), past history—Caution should be used when this condition is present. Diabetes mellitus (sugar diabetes)—Estrogens may alter your body's response to sugar in your diet. Endometriosis or Fibroid tumors of the uterus—Estrogens may worsen endometriosis or increase the size of fibroid tumors. Gallbladder problems (gallstones)—Estrogens may increase your chance of getting a gallbladder attack. Heart attack or Stroke (active or past history)—Estrogens should not be used. Hepatic hemangioma (noncancerous tumors of the liver)—Estrogens may worsen this medical problem. High blood pressure—Estrogens may worsen this medical problem. Hypercalcemia (too much calcium in your blood)—Estrogens may worsen this medical problem. Hypertriglyceridemia (too much triglycerides in your blood)—Estrogens may increase your chance of getting pancreatitis or other side effects. Hypocalcemia (too little calcium in your blood)—Your doctor should treat the low calcium in your blood before starting estrogen therapy. Irritation or infection of the vagina—Usually estrogens decrease infections or irritation of the vagina, but sometimes these conditions may become worse. Liver disease or Liver problems—Estrogens should not be used. Lupus erythematosus, systemic (SLE or lupus)—Estrogens may worsen this medical problem. Physical problems within the vagina, such as narrow vagina, vaginal stenosis, or vaginal prolapse—Estradiol vaginal insert or ring may be more likely to slip out of place or cause problems, such as irritation of the vagina. Porphyria—Estrogens may worsen this medical problem. Thyroid problems (underactive thyroid)—Estrogens may alter your body's response to your thyroid medication. Your doctor may alter the amount of thyroid replacement that you take while on estrogen therapy. Vision changes, sudden onset including Bulging eyes or Double vision or Migraine headache or Vision loss, partial or complete—Estrogens may cause these problems. Tell your doctor if you have had any of these problems. Unusual genital or vaginal bleeding of unknown causes—Use of estrogens may delay diagnosis or worsen the condition. The reason for the bleeding should be determined before estrogens are used. Proper Use of estrogen

This section provides information on the proper use of a number of products that contain estrogen. It may not be specific to Femring. Please read with care.

Vaginal estrogen products usually come with patient directions. Read them carefully before using this medicine.

Wash your hands before and after using the medicine. Also, keep the medicine out of your eyes. If this medicine does get into your eyes, wash them out immediately, but carefully, with large amounts of tap water. If your eyes still burn or are painful, check with your doctor.

Use this medicine only as directed. Do not use more of it and do not use it for a longer time than your doctor ordered. It can take up to 4 months to see the full effect of the estrogens. Your doctor may reconsider continuing your estrogen treatment or may lower your dose several times within the first one or two months, and every 3 to 6 months after that. Sometimes a switch to oral estrogens may be required for added benefits or for higher doses. When using the estradiol vaginal insert or ring, you will need to replace it every 3 months or remove it after 3 months.

For vaginal creams or suppositories:

Vaginal creams and some vaginal suppositories are inserted with a plastic applicator. Directions for using the applicator are supplied with your medicine. If you do not see your dose marked on the applicator, ask your health care professional for more information. To fill the applicator for cream dosage forms: Screw the applicator onto the tube. Squeeze the medicine into the applicator slowly until it is measured properly. Remove the applicator from the tube. Replace the cap on the tube. To fill the applicator for suppository dosage form: Place the suppository into the applicator. To place the dose using the applicator for cream and suppository dosage forms: Relax while lying on your back with your knees bent or stand with one foot on a chair. Hold the full applicator in one hand. Slide the applicator slowly into the vagina. Stop before it becomes uncomfortable. Slowly press the plunger until it stops. Withdraw the applicator. The medicine will be left behind in the vagina. To care for the applicator for cream and suppository dosage forms: Clean the applicator after use by pulling the plunger out of the applicator and washing both parts completely in warm, soapy water. Do not use hot or boiling water. Rinse well. After drying the applicator, replace the plunger.

For vaginal insert or ring dosage form:

To place the vaginal insert: Relax while lying on your back with your knees bent or stand with one foot on a chair. Pinch or press the sides of the vaginal insert together, between your forefinger and middle finger. With one hand, part the folds of skin around your vagina. Slide the vaginal insert slowly into the upper third of your vagina. Stop before it becomes uncomfortable. The exact location is not too important but it should be comfortable. If it seems uncomfortable, then carefully push the vaginal insert higher into the vagina. To remove the vaginal insert: Stand with one foot on a chair. Slide one finger into the vagina and hook it around the closest part of the vaginal insert. Slowly pull the vaginal insert out. Dispose of the vaginal insert by wrapping it up and throwing it into the trash. Do not flush it down the toilet. Dosing

The dose medicines in this class will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of these medicines. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For conjugated estrogens For vaginal dosage form (cream): For treating inflammation of the vagina (atrophic vaginitis): Adults—At first, 0.5 gram (g) of conjugated estrogens inserted into the vagina once a day or as directed by your doctor to achieve the lowest dose possible. Usually your doctor will want you to use this medicine for only three weeks of each month (three weeks on and one week off). Your doctor may increase your dose as needed. However, the dose is usually not more than 2 grams per day. For treating a genital skin condition (vulvar atrophy): Adults—0.5 gram (g) of conjugated estrogens inserted into the vagina two times per week. Usually your doctor will want you to use this medicine for only three weeks of each month (three weeks on and one week off). For estradiol For vaginal dosage form (cream): For treating a genital skin condition (vulvar atrophy) and inflammation of the vagina (atrophic vaginitis): Adults—200 to 400 micrograms (mcg) of estradiol (two to four grams of cream) inserted into the vagina once a day for one to two weeks, decreasing the dose by one half over two and four weeks. After four weeks, your doctor will probably ask you to use the medicine less often, such as 100 mcg (one gram of cream) one to three times a week and for only three weeks of each month (three weeks on and one week off). For vaginal dosage form (insert or ring): For treating a genital skin condition (vulvar atrophy), inflammation of the vagina (atrophic vaginitis) in postmenopausal women, and inflammation of the urethra (urethritis) in postmenopausal women: Adults—One insert containing 2 to 24.8 milligrams (mg) of estradiol inserted into the vagina every three months. The insert will slowly release estradiol at a rate of 7.5 to 100 micrograms (mcg) every twenty-four hours with continuous use. For estrone For vaginal dosage form (cream): For treating a genital skin condition (vulvar atrophy) and inflammation of the vagina (atrophic vaginitis) in postmenopausal women: Adults—2 to 4 milligrams (mg) of estrone (two to four grams of cream) inserted into the vagina once a day or as directed by your doctor. For vaginal dosage form (suppository): For treating a genital skin condition (vulvar atrophy) and inflammation of the vagina (atrophic vaginitis) in postmenopausal women: Adults—250 to 500 micrograms (mcg) inserted into the vagina once a day or as directed by your doctor. Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

When using the suppository or cream several times a week: If you miss a dose of this medicine and remember it within 1 or 2 days of the missed dose, use the missed dose as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

When using the cream or suppositories more than several times a week: If you miss a dose of this medicine, use it as soon as possible if remembered within 12 hours of the missed dose. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Keep out of the reach of children.

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using Femring

It is very important that your doctor check your progress at regular visits to make sure this medicine does not cause unwanted effects. Plan on going to see your doctor every year, but some doctors require visits more often.

It is not yet known whether the use of vaginal estrogens increases the risk of breast cancer in women. It is very important that you check your breasts on a regular basis for any unusual lumps or discharge. Report any problems to your doctor. You should also have a mammogram (x-ray picture of the breasts) done if your doctor recommends it.

It is important that you have a regular pelvic exam (pap smear). Your doctor will tell you how often this exam should be done.

Talk to your doctor if you have high blood pressure, high cholesterol (fats in the blood), or diabetes, use tobacco, or are overweight. You may have a higher risk for getting heart disease.

Although the chance is low, use of estrogen may increase your chance of getting cancer of the ovary or uterus (womb). Regular visits to your health professional can help identify these serious side effects early.

If you think that you may be pregnant, stop using the medicine immediately and check with your doctor.

Tell the doctor in charge that you are using this medicine before having any laboratory test, because some test results may be affected.

For vaginal creams or suppositories:

Avoid using latex condoms, diaphragms, or cervical caps for up to 72 hours after using estrogen vaginal creams. Certain estrogen products may contain oils in the creams that can weaken latex (rubber) products and cause condoms to break or leak, or cervical caps or diaphragms to wear out sooner. Check with your health care professional to make sure the vaginal estrogen product you are using can be used with latex devices. This medicine is often used at bedtime to increase effectiveness through better absorption. Vaginal creams or suppositories will melt and leak out of the vagina. A minipad or sanitary napkin will protect your clothing. Do not use tampons (like those used for menstrual periods) since they may soak up the medicine and make the medicine less effective. Avoid exposing your male sexual partner to your vaginal estrogen cream or suppository by not having sexual intercourse right after using these medicines. Your male partner might absorb the medicine through his penis if it comes in contact with the medicine.

For estradiol vaginal inserts or rings:

Contact your doctor if you have problems removing your vaginal insert. It is not necessary to remove the vaginal insert for sexual intercourse unless you prefer to remove it. If you do take it out, or if it accidentally slips or comes out of the vagina, you can replace the vaginal insert in the vagina after washing it with lukewarm water. Never use hot or boiling water. If it slips down, gently push it upwards and back into place. Replace the vaginal insert every 3 months. Talk to your doctor on a regular basis about how long to use the vaginal insert. Femring Side Effects

The risk of any serious adverse effect is unlikely for most women using low doses of estrogens vaginally. Even women with special risks have used vaginal estrogens without problems.

Check with your doctor immediately if any of the following side effects occur:

Less common Breast pain enlarged breasts itching of the vagina or genitals headache nausea stinging or redness of the genital area thick, white vaginal discharge without odor or with a mild odor Rare Feeling of vaginal pressure (with estradiol vaginal insert or ring) unusual or unexpected uterine bleeding or spotting vaginal burning or pain (with estradiol vaginal insert or ring) Incidence not known Diarrhea dizziness fast heartbeat feeling faint fever hives hoarseness itching joint pain, stiffness, or swelling muscle pain rash shortness of breath skin redness swelling of eyelids, face, lips, hands, or feet tightness in the chest trouble with breathing or swallowing vomiting wheezing

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common Abdominal or back pain clear vaginal discharge (usually means the medicine is working) Incidence not known Acne enlargement of penis or testes growth of pubic hair rapid increase in height swelling of the breasts or breast soreness in males

Also, many women who are using estrogens with a progestin (another female hormone) will start having monthly vaginal bleeding that is similar to menstrual periods. This effect will continue for as long as the medicine is taken. However, monthly bleeding will not occur in women who have had the uterus removed by surgery (hysterectomy).

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

The information contained in the Thomson Reuters Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

The use of the Thomson Reuters Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Reuters Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON REUTERS HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Reuters Healthcare does not assume any responsibility or risk for your use of the Thomson Reuters Healthcare products.


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Estrasorb Emulsion


Pronunciation: ES-tra-DYE-ol
Generic Name: Estradiol
Brand Name: Estrasorb

Estrasorb Emulsion should not be used to prevent heart disease, heart attacks, strokes, or dementia. Estrogens with or without progestins have been shown to increase the risk of heart disease (including heart attack), stroke, dementia, serious blood clots (eg, in the lungs or legs), cancer of the uterus, and breast cancer in some women. Tell your doctor right away if you have unusual vaginal bleeding while you use Estrasorb Emulsion. Talk with your doctor if you have questions about the benefits and risks of using Estrasorb Emulsion.

Estrasorb Emulsion should be used for the shortest possible time at the lowest effective dose to minimize the risk of these side effects. Talk with your doctor regularly about your need to use Estrasorb Emulsion.


Estrasorb Emulsion is used for:

Treating certain conditions caused by menopause (eg, hot flashes; vaginal itching, burning, or dryness).

Estrasorb Emulsion is an estrogen hormone used to provide the female hormone when the body no longer produces enough.

Do NOT use Estrasorb Emulsion if: you are allergic to any ingredient in Estrasorb Emulsion you are pregnant or suspect you may be pregnant you have abnormal vaginal bleeding of unknown cause you have known, suspected, or a history of breast cancer you have known or suspected cancers that are estrogen-dependent you have blood clots (eg, in the legs or lungs) or a history of blood clots you have had a recent (within the past year) heart attack or stroke you have liver problems

Contact your doctor or health care provider right away if any of these apply to you.

Before using Estrasorb Emulsion:

Some medical conditions may interact with Estrasorb Emulsion. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

if you are planning to become pregnant if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement if you have allergies to medicines, foods, or other substances if you have had yellowing of the eyes or skin during pregnancy or with past estrogen use if you have asthma, cancer, certain blood disorder (porphyria), depression, diabetes, epilepsy (seizures), eye or vision problems, fluid retention or swelling (edema), gallbladder disease, heart disease or other heart problems, high blood pressure, high cholesterol or triglyceride levels, high or low calcium levels in the blood, kidney problems, a certain type of liver growth (hemangioma), migraine headaches, pancreatitis, or thyroid problems if you have a history of an abnormal mammogram or breast lumps, endometriosis, ovarian cancer, or a family history of breast cancer if you or a family member have a history of blood clots (eg, in the legs or lungs) or lupus, or have been very overweight if you smoke or use tobacco products, you will be having surgery, or you will be on bedrest if you have had your uterus removed (hysterectomy)

Some MEDICINES MAY INTERACT with Estrasorb Emulsion. Tell your health care provider if you are taking any other medicines, especially any of the following:

Anticoagulants (eg, warfarin), corticosteroids (eg, prednisone), succinylcholine, or tacrine because their actions and the risk of their side effects may be increased by Estrasorb Emulsion Anticoagulants (eg, warfarin) or thyroid hormones (eg, levothyroxine) because their effectiveness may be decreased by Estrasorb Emulsion Barbiturates (eg, phenobarbital), hydantoins (eg, phenytoin), or rifampin because they may decrease Estrasorb Emulsion's effectiveness

This may not be a complete list of all interactions that may occur. Ask your health care provider if Estrasorb Emulsion may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Estrasorb Emulsion:

Use Estrasorb Emulsion as directed by your doctor. Check the label on the medicine for exact dosing instructions.

An extra patient leaflet is available with Estrasorb Emulsion. Talk to your pharmacist if you have questions about this information. If you are switching from oral estrogen to Estrasorb Emulsion, stop taking the oral estrogen and wait 1 week before using Estrasorb Emulsion. However, if symptoms return, you may start using Estrasorb Emulsion sooner. Wash your hands with soap and water both before and after using Estrasorb Emulsion. Sit in a comfortable sitting position and apply Estrasorb Emulsion to clean, dry skin of the leg. Cut or tear the pouch of medicine and empty the entire contents of the pouch onto the top of the thigh. Rub the medicine in well into the thigh and calf of the leg for 3 minutes until it is completely absorbed. Rub any medicine remaining on the hands onto the buttocks. If you are using two pouches of Estrasorb Emulsion, apply the second pouch of medicine to the opposite leg in the same way. Allow the medicine to dry completely before covering with clothing to avoid transfer to other people. Grapefruit and grapefruit juice may increase the risk of Estrasorb Emulsion's side effects. Talk to your doctor before including grapefruit or grapefruit juice in your diet while you are taking Estrasorb Emulsion. If you miss a dose of Estrasorb Emulsion, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use Estrasorb Emulsion.

Important safety information: Estrasorb Emulsion may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Estrasorb Emulsion with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it. Estrasorb Emulsion may cause dark skin patches on your face (melasma). Exposure to the sun may make these patches darker and you may need to avoid prolonged sun exposure and sunlamps. Consult your doctor regarding the use of sunscreens and protective clothing. Do NOT apply sunscreen to the application site for at least 25 minutes after applying Estrasorb Emulsion. Estrasorb Emulsion may increase the risk of blood clots. The risk may be greater if you smoke (especially in women older than 35 years). Contact your doctor if vaginal bleeding of unknown cause occurs. This could be a sign of a serious condition requiring immediate medical attention. Contact your doctor if vaginal discomfort occurs or if you suspect you have developed an infection while taking Estrasorb Emulsion. Follow your doctor's instructions for examining your breasts, and report any lumps immediately. If you wear contact lenses and you develop problems with them, contact your doctor. If you will be having surgery or will be confined to a chair or bed for a long period of time (eg, a long plane flight), notify your doctor beforehand. You may need to stop taking Estrasorb Emulsion at least 4 to 6 weeks beforehand as directed by your doctor. Nonprescription therapy to help prevent bone loss includes a weight-bearing exercise plan, as well as adequate daily calcium and vitamin D intake. Consult your doctor or pharmacist for more details. Estrasorb Emulsion may increase the risk of breast and endometrial cancer. Diabetes patients - Estrasorb Emulsion may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine. Estrasorb Emulsion may interfere with certain lab tests. Be sure your doctor and lab personnel know you are using Estrasorb Emulsion. Lab tests, including physical exams and blood pressure, may be performed while you use Estrasorb Emulsion. You should have breast and pelvic exams, and a Pap test at least once a year. You should also have periodic mammograms as determined by your doctor. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments. Use Estrasorb Emulsion with caution in the ELDERLY; they may be more sensitive to its effects. Estrasorb Emulsion should not be used in CHILDREN; safety and effectiveness in children have not been confirmed. PREGNANCY and BREAST-FEEDING: Do not use Estrasorb Emulsion if you are pregnant. Avoid becoming pregnant while you are taking it. If you think you may be pregnant, contact your doctor right away. Estrasorb Emulsion may be found in breast milk. If you are or will be breast-feeding while you use Estrasorb Emulsion, check with your doctor. Discuss any possible risks to your baby. Possible side effects of Estrasorb Emulsion:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Breast pain or tenderness; headache; hair loss; mild irritation or redness at the application site; mild nausea or vomiting; spotting or breakthrough bleeding; stomach cramps or bloating.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); back pain; breast discharge or lump in the breast; calf or leg pain or swelling; chest pain; confusion; coughing up blood; dark urine; depression; dizziness; fainting; fever; memory problems; mental or mood changes; migraine; muscle pain; one-sided weakness; nipple discharge; painful or difficult urination; persistent or severe breast pain or tenderness; persistent or severe headache, nausea, or vomiting; severe stomach pain or swelling; slurred speech; sudden shortness of breath; swelling of the hands, legs, or feet; unusual vaginal bleeding, discharge, itching, or odor; vision changes (eg, double vision, loss of vision); weakness or numbness of an arm or leg; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include excessive vaginal bleeding; severe nausea; vomiting.

Proper storage of Estrasorb Emulsion:

Store Estrasorb Emulsion at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store in original packaging until just before use. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Estrasorb Emulsion out of the reach of children and away from pets.

General information: If you have any questions about Estrasorb Emulsion, please talk with your doctor, pharmacist, or other health care provider. Estrasorb Emulsion is to be used only by the patient for whom it is prescribed. Do not share it with other people. If your symptoms do not improve or if they become worse, check with your doctor. Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Estrasorb Emulsion. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012 Database Edition 12.1.1.002 Copyright © 2012 Wolters Kluwer Health, Inc.
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Estradiol Emulsion


Pronunciation: ES-tra-DYE-ol
Generic Name: Estradiol
Brand Name: Estrasorb

Estradiol Emulsion should not be used to prevent heart disease, heart attacks, strokes, or dementia. Estrogens with or without progestins have been shown to increase the risk of heart disease (including heart attack), stroke, dementia, serious blood clots (eg, in the lungs or legs), cancer of the uterus, and breast cancer in some women. Tell your doctor right away if you have unusual vaginal bleeding while you use Estradiol Emulsion. Talk with your doctor if you have questions about the benefits and risks of using Estradiol Emulsion.

Estradiol Emulsion should be used for the shortest possible time at the lowest effective dose to minimize the risk of these side effects. Talk with your doctor regularly about your need to use Estradiol Emulsion.


Estradiol Emulsion is used for:

Treating certain conditions caused by menopause (eg, hot flashes; vaginal itching, burning, or dryness).

Estradiol Emulsion is an estrogen hormone used to provide the female hormone when the body no longer produces enough.

Do NOT use Estradiol Emulsion if: you are allergic to any ingredient in Estradiol Emulsion you are pregnant or suspect you may be pregnant you have abnormal vaginal bleeding of unknown cause you have known, suspected, or a history of breast cancer you have known or suspected cancers that are estrogen-dependent you have blood clots (eg, in the legs or lungs) or a history of blood clots you have had a recent (within the past year) heart attack or stroke you have liver problems

Contact your doctor or health care provider right away if any of these apply to you.

Before using Estradiol Emulsion:

Some medical conditions may interact with Estradiol Emulsion. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

if you are planning to become pregnant if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement if you have allergies to medicines, foods, or other substances if you have had yellowing of the eyes or skin during pregnancy or with past estrogen use if you have asthma, cancer, certain blood disorder (porphyria), depression, diabetes, epilepsy (seizures), eye or vision problems, fluid retention or swelling (edema), gallbladder disease, heart disease or other heart problems, high blood pressure, high cholesterol or triglyceride levels, high or low calcium levels in the blood, kidney problems, a certain type of liver growth (hemangioma), migraine headaches, pancreatitis, or thyroid problems if you have a history of an abnormal mammogram or breast lumps, endometriosis, ovarian cancer, or a family history of breast cancer if you or a family member have a history of blood clots (eg, in the legs or lungs) or lupus, or have been very overweight if you smoke or use tobacco products, you will be having surgery, or you will be on bedrest if you have had your uterus removed (hysterectomy)

Some MEDICINES MAY INTERACT with Estradiol Emulsion. Tell your health care provider if you are taking any other medicines, especially any of the following:

Anticoagulants (eg, warfarin), corticosteroids (eg, prednisone), succinylcholine, or tacrine because their actions and the risk of their side effects may be increased by Estradiol Emulsion Anticoagulants (eg, warfarin) or thyroid hormones (eg, levothyroxine) because their effectiveness may be decreased by Estradiol Emulsion Barbiturates (eg, phenobarbital), hydantoins (eg, phenytoin), or rifampin because they may decrease Estradiol Emulsion's effectiveness

This may not be a complete list of all interactions that may occur. Ask your health care provider if Estradiol Emulsion may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Estradiol Emulsion:

Use Estradiol Emulsion as directed by your doctor. Check the label on the medicine for exact dosing instructions.

An extra patient leaflet is available with Estradiol Emulsion. Talk to your pharmacist if you have questions about this information. If you are switching from oral estrogen to Estradiol Emulsion, stop taking the oral estrogen and wait 1 week before using Estradiol Emulsion. However, if symptoms return, you may start using Estradiol Emulsion sooner. Wash your hands with soap and water both before and after using Estradiol Emulsion. Sit in a comfortable sitting position and apply Estradiol Emulsion to clean, dry skin of the leg. Cut or tear the pouch of medicine and empty the entire contents of the pouch onto the top of the thigh. Rub the medicine in well into the thigh and calf of the leg for 3 minutes until it is completely absorbed. Rub any medicine remaining on the hands onto the buttocks. If you are using two pouches of Estradiol Emulsion, apply the second pouch of medicine to the opposite leg in the same way. Allow the medicine to dry completely before covering with clothing to avoid transfer to other people. Grapefruit and grapefruit juice may increase the risk of Estradiol Emulsion's side effects. Talk to your doctor before including grapefruit or grapefruit juice in your diet while you are taking Estradiol Emulsion. If you miss a dose of Estradiol Emulsion, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use Estradiol Emulsion.

Important safety information: Estradiol Emulsion may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Estradiol Emulsion with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it. Estradiol Emulsion may cause dark skin patches on your face (melasma). Exposure to the sun may make these patches darker and you may need to avoid prolonged sun exposure and sunlamps. Consult your doctor regarding the use of sunscreens and protective clothing. Do NOT apply sunscreen to the application site for at least 25 minutes after applying Estradiol Emulsion. Estradiol Emulsion may increase the risk of blood clots. The risk may be greater if you smoke (especially in women older than 35 years). Contact your doctor if vaginal bleeding of unknown cause occurs. This could be a sign of a serious condition requiring immediate medical attention. Contact your doctor if vaginal discomfort occurs or if you suspect you have developed an infection while taking Estradiol Emulsion. Follow your doctor's instructions for examining your breasts, and report any lumps immediately. If you wear contact lenses and you develop problems with them, contact your doctor. If you will be having surgery or will be confined to a chair or bed for a long period of time (eg, a long plane flight), notify your doctor beforehand. You may need to stop taking Estradiol Emulsion at least 4 to 6 weeks beforehand as directed by your doctor. Nonprescription therapy to help prevent bone loss includes a weight-bearing exercise plan, as well as adequate daily calcium and vitamin D intake. Consult your doctor or pharmacist for more details. Estradiol Emulsion may increase the risk of breast and endometrial cancer. Diabetes patients - Estradiol Emulsion may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine. Estradiol Emulsion may interfere with certain lab tests. Be sure your doctor and lab personnel know you are using Estradiol Emulsion. Lab tests, including physical exams and blood pressure, may be performed while you use Estradiol Emulsion. You should have breast and pelvic exams, and a Pap test at least once a year. You should also have periodic mammograms as determined by your doctor. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments. Use Estradiol Emulsion with caution in the ELDERLY; they may be more sensitive to its effects. Estradiol Emulsion should not be used in CHILDREN; safety and effectiveness in children have not been confirmed. PREGNANCY and BREAST-FEEDING: Do not use Estradiol Emulsion if you are pregnant. Avoid becoming pregnant while you are taking it. If you think you may be pregnant, contact your doctor right away. Estradiol Emulsion may be found in breast milk. If you are or will be breast-feeding while you use Estradiol Emulsion, check with your doctor. Discuss any possible risks to your baby. Possible side effects of Estradiol Emulsion:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Breast pain or tenderness; headache; hair loss; mild irritation or redness at the application site; mild nausea or vomiting; spotting or breakthrough bleeding; stomach cramps or bloating.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); back pain; breast discharge or lump in the breast; calf or leg pain or swelling; chest pain; confusion; coughing up blood; dark urine; depression; dizziness; fainting; fever; memory problems; mental or mood changes; migraine; muscle pain; one-sided weakness; nipple discharge; painful or difficult urination; persistent or severe breast pain or tenderness; persistent or severe headache, nausea, or vomiting; severe stomach pain or swelling; slurred speech; sudden shortness of breath; swelling of the hands, legs, or feet; unusual vaginal bleeding, discharge, itching, or odor; vision changes (eg, double vision, loss of vision); weakness or numbness of an arm or leg; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include excessive vaginal bleeding; severe nausea; vomiting.

Proper storage of Estradiol Emulsion:

Store Estradiol Emulsion at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store in original packaging until just before use. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Estradiol Emulsion out of the reach of children and away from pets.

General information: If you have any questions about Estradiol Emulsion, please talk with your doctor, pharmacist, or other health care provider. Estradiol Emulsion is to be used only by the patient for whom it is prescribed. Do not share it with other people. If your symptoms do not improve or if they become worse, check with your doctor. Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Estradiol Emulsion. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012 Database Edition 12.1.1.002 Copyright © 2012 Wolters Kluwer Health, Inc.
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Menest


Pronunciation: ess-TER-i-fide ESS-troe-jenz
Generic Name: Esterified Estrogens
Brand Name: Menest

Estrogens have been reported to increase the chance of womb (endometrial) cancer in women who have been through menopause, especially in women who receive estrogen-only hormone therapy. Contact your doctor immediately if you experience any unusual vaginal bleeding. Estrogens may also increase the risk of cancer of the ovary or breast. Estrogen-containing products should not be used to prevent heart disease. Estrogen given with another hormone (progestin) for replacement therapy can infrequently cause heart disease (eg, heart attacks), stroke, serious blood clots in the legs or lungs (pulmonary embolism/deep vein thrombosis), dementia, and cancer of the breast. These risks appear to depend on the length of time Menest is used and the amount of estrogen per dose. Therefore, Menest should be used for the shortest possible length of time at the lowest effective dose so that you obtain the benefits and minimize the chance of serious side effects from long-term treatment. Consult your doctor or pharmacist for details.


Menest is used for:

Treating certain symptoms of menopause (eg, hot flashes, vaginal itching, burning, or dryness). It is used to treat low levels of estrogen caused by certain conditions (eg, hypogonadism, castration, ovarian failure). It may be used to treat breast or prostate cancer in certain patients. It may also be used for other conditions as determined by your doctor.

Menest is a female estrogen hormone. It works by replacing natural estrogens in a woman who can no longer produce enough estrogen. It works for advanced prostate cancer by antagonizing male hormones.

Do NOT use Menest if: you are allergic to any ingredient in Menest you are pregnant or suspect you may be pregnant, or you have vaginal bleeding of abnormal or unknown cause you have a history of known or suspected breast cancer (unless your doctor tells you otherwise) you have any other estrogen-dependent cancer you have the blood disease porphyria, or a history of blood clots or liver problems you have had a recent (within the past year) stroke or heart attack

Contact your doctor or health care provider right away if any of these apply to you.

Before using Menest:

Some medical conditions may interact with Menest. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

if you are planning to become pregnant or are breast-feeding if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement if you have allergies to medicines, foods, or other substances if you have breast lumps or disease, an abnormal mammogram, or a family history of breast cancer or blood clots if you have yellowing of the skin or whites of the eyes during pregnancy or with past estrogen use, or high blood pressure during pregnancy (toxemia) if you have a vaginal infection or womb problems (eg, uterine fibroids/endometriosis, abnormal vaginal bleeding, other uterine problems) if you have abnormal calcium levels in the blood, asthma, cancer, cholesterol or lipid problems, depression, diabetes, epilepsy, excessive weight gain, gallbladder disease, heart disease or other heart problems, high blood pressure, kidney or liver disease, low thyroid hormone levels, lupus, migraine headaches, pancreas disease, seizures, or yellowing of the skin or eyes if you smoke, are overweight, or will be having surgery

Some MEDICINES MAY INTERACT with Menest. Tell your health care provider if you are taking any other medicines, especially any of the following:

Anticoagulants (eg, warfarin), corticosteroids (eg, prednisone), succinylcholine, or tacrine because their actions and the risk of their side effects may be increased by Menest Anticoagulants (eg, warfarin) because their effectiveness may be decreased by Menest Barbiturates (eg, phenobarbital), carbamazepine, rifampin, hydantoins (eg, phenytoin), or St. John's wort because they may decrease Menest's effectiveness Azole antifungals (eg, ketoconazole) or macrolide antibiotics (eg, erythromycin) because they may increase the risk of Menest's side effects

This may not be a complete list of all interactions that may occur. Ask your health care provider if Menest may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Menest:

Use Menest as directed by your doctor. Check the label on the medicine for exact dosing instructions. Check the label on the medicine for exact dosing instructions.

An extra patient leaflet is available with Menest. Talk to your pharmacist if you have questions about this information. Take Menest by mouth with or without food. Eating grapefruit or drinking grapefruit juice may increase the risk of side effects. Check with your doctor before including grapefruit or grapefruit juice in your diet. If you miss a dose of Menest, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Menest.

Important safety information: Menest may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Menest with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it. Limit alcoholic beverages. Menest may cause dark skin patches on your face (melasma). Exposure to the sun may make these patches darker and you may need to avoid prolonged sun exposure and sunlamps. Consult your doctor regarding the use of sunscreens and protective clothing. Smoking while using Menest may increase your risk of blood clots (especially in women older than 35 years of age). Contact your health care provider if vaginal bleeding of unknown cause occurs. This could be a sign of a serious condition requiring immediate medical attention. Contact your health care provider if vaginal discomfort occurs or if you suspect you have developed an infection while taking Menest. Follow your doctor's instructions for examining your breasts, and report any lumps immediately. If you wear contact lenses and you develop problems with them, contact your doctor. If you will be having surgery or will be confined to a chair or bed for a long period of time (eg, a long plane flight), notify your doctor beforehand. Special precautions may need to be taken in these circumstances while you are taking Menest. Diabetes patients - Menest may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine. Menest may interfere with certain lab tests. Be sure your doctor and lab personnel know you are using Menest. Discuss with your doctor every 3 to 6 months whether treatment with Menest is still appropriate. Lab tests will be required to monitor therapy. You should have a complete physical examination, including blood pressure measurements, breast and pelvic examinations, and a Pap test, at least once a year. You should also have periodic mammograms as determined by your doctor. Be sure to keep all doctor and lab appointments. Menest should not be used in CHILDREN; safety and effectiveness in children have not been confirmed. PREGNANCY and BREAST-FEEDING: Do not use Menest if you are pregnant. Avoid becoming pregnant while you are taking it. If you think you may be pregnant, contact your doctor right away. Menest is found in breast milk. If you are or will be breast-feeding while you use Menest, check with your doctor. Discuss any possible risks to your baby. Possible side effects of Menest:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Abnormal hair growth; breast tenderness; changes in sex drive; cramps; dizziness; flushing; hair loss; headache; lightheadedness; nausea; reduced tolerance to carbohydrates; stomach bloating and upset; swelling; vaginal infection; weight changes.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); abnormal vaginal bleeding; breast lumps; calf pain or tenderness; changes in vaginal bleeding (eg, spotting, breakthrough bleeding, prolonged bleeding); changes in vision or speech; chest pain; confusion; coughing of blood; mental/mood changes (eg, depression, memory loss); numbness of an arm or leg; one-sided weakness; pain, swelling, or tenderness in the stomach; problems with contact lenses (eg, changes in fit); severe headache, dizziness, fainting, or vomiting; sudden shortness of breath; swelling of hands or feet; unusual vaginal discharge, itching, or odor; weakness of an arm or leg; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

See also: Menest side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include excessive vaginal bleeding; severe nausea; vomiting.

Proper storage of Menest:

Store Menest at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Keep Menest out of the reach of children and away from pets.

General information: If you have any questions about Menest, please talk with your doctor, pharmacist, or other health care provider. Menest is to be used only by the patient for whom it is prescribed. Do not share it with other people. If your symptoms do not improve or if they become worse, check with your doctor. Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Menest. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012 Database Edition 12.1.1.002 Copyright © 2012 Wolters Kluwer Health, Inc. More Menest resources Menest Side Effects (in more detail) Menest Use in Pregnancy & Breastfeeding Drug Images Menest Drug Interactions Menest Support Group 2 Reviews for Menest - Add your own review/rating Menest Prescribing Information (FDA) Menest Concise Consumer Information (Cerner Multum) Menest Advanced Consumer (Micromedex) - Includes Dosage Information Compare Menest with other medications Atrophic Urethritis Atrophic Vaginitis Breast Cancer Breast Cancer, Palliative Hypoestrogenism Oophorectomy Osteoporosis Postmenopausal Symptoms Primary Ovarian Failure Prostate Cancer
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Premique 0.625mg / 5mg Coated Tablets


PREMIQUE 0.625mg/5mg Coated Tablets

Conjugated Estrogens and Medroxyprogesterone Acetate

Read all of this leaflet carefully before you start taking this medicine. Keep this leaflet. You may need to read it again. If you have further questions, please ask your doctor or pharmacist. This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours. If any of the side effects gets serious, or you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist. In this leaflet: 1. What Premique is and what it is used for 2. Before you take Premique 3. How to take Premique 4. Possible side effects 5. How to store Premique 6. Further information What Premique Is And What It Is Used For

Premique is one of a group of medicines known as Hormone Replacement Therapy (HRT). It is used to treat some of the symptoms and conditions associated with the menopause. Premique is a period-free HRT (an HRT product where you do not have a monthly bleed).

Your periods will stop once menopause is reached. This change is due to lowered levels of the hormones estrogen and progesterone. You may experience a number of unpleasant symptoms, including hot flushes, night sweats and vaginal dryness, around the time of menopause. Premique can relieve some of these symptoms by replacing some of the lost estrogen.

After the menopause some women may develop bone thinning (osteoporosis). If you are at an increased risk of fractures due to osteoporosis but are unable to take other treatments or if other therapies prove to be ineffective, Premique may also be used for this purpose. Your doctor should discuss all the available options with you.

Before You Take Premique 1 Do not take Premique if: you are allergic (hypersensitive) to conjugated estrogens or medroxyprogesterone acetate or any of the other ingredients of Premique; the ingredients are listed in Section 6 of this leaflet you have or have had breast cancer you have endometrial cancer (cancer of the lining of the womb) or have been told you have another type of estrogen-dependent cancer you have been told you have a blood circulation disorder or have had a blood clot you have a heart condition such as angina or have had a heart attack you have porphyria (a rare inherited metabolic disorder) you have recently had unexpected or very heavy vaginal bleeding you have been told that you have endometrial hyperplasia (abnormal growth of the lining of the womb) you have or have previously had liver disease you are pregnant, or you are breast-feeding.

Before you start taking HRT, your doctor should ask about your own and your family’s medical history. Your doctor may decide to examine your breasts and/or your abdomen, and may do an internal examination — but only if these examinations are necessary for you, or if you have any special concerns.

Once you’ve started on HRT, you should see your doctor for regular check-ups (at least once a year). At these check-ups, your doctor may discuss with you the benefits and risks of continuing to take HRT.

You are advised to:

go for regular breast screening and cervical smear tests regularly check your breasts for any changes such as dimpling of the skin, changes in the nipple, or any lumps you can see or feel.

Some diseases may be made worse by HRT. Therefore, if you have or have ever had any of the following remind your doctor as he or she may want to monitor you more closely:

uterine fibroids or endometriosis risk factors for blood clots (see section 2.2 - Blood Clots for more detail) a close relative who has had breast cancer or an estrogen dependent cancer, such as cancer of the womb or ovaries (see section 2.3Effects on your risk of developing cancer for more detail) high blood pressure heart disease (see section 2.2Heart Disease for more detail) liver disease (e.g. liver adenoma) kidney disease diabetes gallbladder disease or gallstones migraine systemic lupus erythematosus (SLE – a rare chronic inflammatory disease) epilepsy asthma otosclerosis (hearing loss due to a problem with the bones in your ear) low blood calcium levels (hypocalcaemia) high levels of fatty substances in the blood (hypertriglyceridaemia).

If there is a change in any of the above conditions whilst taking Premique tell your doctor.

As well as benefits, HRT has some risks which you need to consider when you’re deciding whether to take it, or whether to carry on taking it.

2 Effects on your heart or circulation:

Heart Disease

HRT is not recommended for women who have heart disease, or have had heart disease recently. If you have ever had heart disease, talk to your doctor to see if you should be taking HRT.

HRT will not help to prevent heart disease.

Studies with one type of HRT (containing conjugated estrogens plus the progestogen MPA) have shown that women may be slightly more likely to get heart disease during the first year of taking the medication. For other types of HRT, the risk is likely to be similar, although this is not yet certain.

If you get:

a pain in your chest that spreads to your arm or neck See a doctor as soon as possible and do not take any more HRT until your doctor says you can. This pain could be a sign of heart disease.

Stroke

Recent research suggests that HRT slightly increases the risk of having a stroke.

Other things that can increase the risk of stroke include:

getting older high blood pressure smoking drinking too much alcohol an irregular heartbeat.

If you are worried about any of these things, or if you have had a stroke in the past, talk to your doctor to see if you should take HRT.

Looking at women in their 50s who are not taking HRT — on average, over a 5-year period, 3 in 1000 would be expected to have a stroke.

For women in their 50s who are taking HRT, the figure would be 4 in 1000.

Looking at women in their 60s who are not taking HRT — on average, over a 5-year period, 11 in 1000 would be expected to have a stroke.

For women in their 60s who are taking HRT, the figure would be 15 in 1000.

If you get:

unexplained migraine-type headaches, with or without disturbed vision See a doctor as soon as possible and do not take any more HRT until your doctor says you can. These headaches may be an early warning sign of a stroke.

Blood Clots

HRT may increase the risk of blood clots in the veins (also called deep vein thrombosis, or DVT), especially during the first year of taking it.

These blood clots are not always serious, but if one travels to the lungs, it can cause chest pain, breathlessness, collapse or even death. This condition is called pulmonary embolism, or PE.

DVT and PE are examples of a condition called venous thromboembolism, or VTE.

You are more likely to get a blood clot:

if you are seriously overweight if you have had a blood clot before if any of your close family have had blood clots if you have had one or more miscarriages if you have any blood clotting problem that needs treatment with a medicine such as warfarin if you’re off your feet for a long time because of major surgery, injury or illness if you have a rare condition called SLE (systemic lupus erythematosus).

If any of these things apply to you, talk to your doctor to see if you should take HRT.

Looking at women in their 50s who are not taking HRT — on average, over a 5-year period, 3 in 1000 would be expected to get a blood clot.

For women in their 50s who are taking HRT, the figure would be 7 in 1000.

Looking at women in their 60s who are not taking HRT — on average, over a 5-year period, 8 in 1000 would be expected to get a blood clot.

For women in their 60s who are taking HRT, the figure would be 17 in 1000.

If you get:

painful swelling in your leg sudden chest pain difficulty breathing See a doctor as soon as possible and do not take any more HRT until your doctor says you can. These may be signs of a blood clot.

If you’re going to have surgery, make sure your doctor knows about it. You may need to stop taking HRT about 4 to 6 weeks before the operation, to reduce the risk of a blood clot. Your doctor will tell you when you can start taking HRT again.

3 Effects on your risk of developing cancer:

Breast Cancer

Women who have breast cancer, or have had breast cancer in the past, should not take HRT.

Taking HRT slightly increases the risk of breast cancer; so does having a later menopause. The risk for a post-menopausal woman taking estrogen-only HRT for 5 years is about the same as for a woman the same age who’s still having periods over that time and not taking HRT. The risk for a woman who is taking estrogen plus progestogen HRT is higher than for estrogen-only HRT (but estrogen plus progestogen HRT is beneficial for the endometrium, see Endometrial Cancer below).

For all kinds of HRT, the extra risk of breast cancer goes up the longer you take it, but returns to normal within about 5 years after stopping.

Your risk of breast cancer is also higher:

if you have a close relative (mother, sister or grandmother) who has had breast cancer if you are seriously overweight.

Looking at women aged 50 who are not taking HRT – on average, 32 in 1000 will be diagnosed with breast cancer by the time they reach the age of 65.

For women who start taking estrogen-only HRT at age 50 and take it for 5 years, the figure will be between 33 and 34 in 1000 (i.e. an extra 1-2 cases).

If they take estrogen-only HRT for 10 years, the figure will be 37 in 1000 (i.e. an extra 5 cases).

For women who start taking estrogen plus progestogen HRT at age 50 and take it for 5 years, the figure will be 38 in 1000 (i.e. an extra 6 cases).

If they take estrogen plus progestogen HRT for 10 years, the figure will be 51 in 1000 (i.e. an extra 19 cases).

If you notice any changes in your breast, such as:

dimpling of the skin changes in the nipple any lumps you can see or feel Make an appointment to see your doctor as soon as possible.

Endometrial Cancer (cancer of the lining of the womb)

Taking estrogen-only HRT for a long time can increase the risk of cancer of the lining of the womb (the endometrium). Taking a progestogen as well as the estrogen helps to lower the extra risk.

If you still have your womb, your doctor may prescribe a progestogen as well as estrogen. If so, these may be prescribed separately, or as a combined HRT product.

If you have had your womb removed (a hysterectomy), your doctor will discuss with you whether you can safely take estrogen without a progestogen.

If you’ve had your womb removed because of endometriosis, any endometrium left in your body may be at risk. So your doctor may prescribe HRT that includes a progestogen as well as an estrogen.

Your product, Premique, contains a progestogen.

Looking at women who still have a uterus and who are not taking HRT – on average 5 in 1000 will be diagnosed with endometrial cancer between the ages of 50 and 65.

For women who take estrogen-only HRT, the number will be 2 to 12 times higher, depending on the dose and how long they take it.

The addition of a progestogen to estrogen-only HRT substantially reduces the risk of endometrial cancer.

If you get breakthrough bleeding or spotting, it’s usually nothing to worry about, especially during the first few months of taking HRT.

But if the bleeding or spotting:

carries on for more than the first few months starts after you’ve been on HRT for a while carries on even after you’ve stopped taking HRT Make an appointment to see your doctor. It could be a sign that your endometrium has become thicker.

Ovarian Cancer

Ovarian cancer (cancer of the ovaries) is very rare, but it is serious. It can be difficult to diagnose, because there are often no obvious signs of the disease.

Some studies have indicated that taking estrogen-only HRT for more than 5 years may increase the risk of ovarian cancer. It is not yet known whether other kinds of HRT increase the risk in the same way.

4 Other Conditions

HRT will not help prevent memory loss. In one study of women who started using combined HRT after the age of 65, a small increase in the risk of dementia was observed.

Women with hypertriglyceridaemia (high levels of fatty substances in the blood) may experience large increases of their plasma triglycerides, which can lead to inflammation of the pancreas (pancreatitis). Symptoms of pancreatitis include sudden sharp abdominal pains, abdominal swelling, fever and feeling or being sick.

If you are taking thyroid hormone replacement therapy (e.g. thyroxine), your doctor may monitor your thyroid function more often when you start treatment.

HRT may affect some medical tests. If you visit a hospital or clinic for any medical tests, you should tell the doctor concerned that you are taking HRT.

5 Taking other medicines

Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.

In particular tell your doctor if you are taking:

an anticonvulsant (used to treat epilepsy e.g. phenobarbital, phenytoin, carbamazepine) an anti-infective (e.g. rifampicin, rifabutin, nevirapine, efavirenz, erythromycin, ketoconazole, ritonavir, nelfinavir) a herbal preparation such as St. John’s wort (Hypericum perforatum) metyrapone (most commonly used in the treatment of Cushing’s syndrome) aminoglutethimide (most commonly used in the treatment of breast cancer and Cushing’s syndrome).

The way that Premique works may be altered if other medicines are used at the same time.

6 Pregnancy and breast-feeding

You should stop taking Premique and tell your doctor immediately if you know or suspect you are pregnant, or if you are breast-feeding.

Premique is not a contraceptive. It is important that you use a reliable form of non-hormonal contraception (e.g. condom or diaphragm) if there is any possibility that you may still become pregnant. You should discuss this with your doctor.

7 Driving and using machines

There is no evidence to suggest that Premique will affect your ability to drive or to operate machinery.

8 Important information about some of the ingredients in Premique

Premique contains lactose and sucrose. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.

How To Take Premique 1 Instructions for proper use

Always take Premique exactly as your doctor has told you. You should check with your doctor or pharmacist if you are unsure.

The usual dose is one tablet every day.

Your doctor will aim to give you the lowest dose for the shortest time to treat your symptoms.

Take your tablet at the same time each day as this will help to remind you to take your medicine.

If you are not currently taking HRT or you are taking another period-free HRT, you may start your first pack of Premique at any convenient time.

If you are changing from an HRT product that gives you a monthly bleed, start Premique the day after you finish the course of the previous product, unless instructed otherwise by your doctor.

Begin your pack of Premique by taking the first tablet marked for that day of the week. Continue to take one tablet each day following the arrows until all 28 tablets have been taken.

While you are taking Premique you will have no tablet-free days. You should start your next pack the day after you finish the previous one.

Premique does not cause periods. However, you may experience some irregular bleeding or light bleeding (spotting) during your first few months of taking Premique. If the bleeding is troublesome, or continues beyond the first 3 months of treatment you should discuss this with your doctor (see section titled Endometrial Cancer above).

Do not try to take off the coating, divide or crush the tablets as this could affect the way Premique works.

2 If you take more Premique than you should

If you take too many tablets don’t worry. You may feel some nausea (sickness), breast tenderness, dizziness, abdominal pain, drowsiness, fatigue or experience a short period of vaginal bleeding, but it is unlikely that serious problems will result. If you are concerned talk to your doctor or pharmacist.

3 If you forget to take Premique

If you forget to take a tablet don’t worry. Take it as soon as you remember and then carry on taking the remaining tablets at the usual time.

If more than one tablet has been forgotten, do not take extra to try to make up for the missed tablets.

Missed tablets may cause a short period of light bleeding in women who have not had a hysterectomy.

If you have any further questions on the use of this product, ask your doctor or pharmacist.

Possible Side Effects

Like all medicines, Premique can cause side effects, although not everybody gets them.

1 Serious side effects

Stop taking Premique and tell your doctor immediately if you:

have an allergic reaction, signs of which include rash, itching, shortness of breath, difficulty breathing and a swollen face experience a migraine type headache (typically a throbbing headache and nausea preceded by visual disturbances) for the first time develop signs of jaundice (yellowing of the skin or the whites of the eyes) become pregnant experience a significant increase in your blood pressure develop a contraindication i.e. circumstances which make treatment inadvisable (see Section 2 - Before you take Premique).

Do not take any more tablets until your doctor says you can.

HRT can also increase the risk of heart disease, stroke, blood clots, breast cancer, endometrial cancer and ovarian cancer. Please see Section 2 - Before you take Premique.

2 Other side effects

Very common (affect more than 1 in 10 women)

breast pain

Common (affect less than 1 in 10 women)

breakthrough bleeding or spotting, vaginal inflammation, period pain breast tenderness, swollen breasts, nipple discharge depression muscle and joint aches, leg cramps weight change (increase or decrease) changes in your triglyceride levels (fatty substances in the blood)

Uncommon (affect less than 1 in 100 women)

changes in menstrual flow, vaginal discharge thrush nausea, bloating, abdominal pain headache, migraine blood clots in the veins dizziness changes in mood including anxiety changes in your interest in sex (increased or decreased libido) visible swelling of the face or ankles itchiness, acne difficulty wearing contact lenses gallbladder disease (e.g. gallstones) hair loss

Rare (affect less than 1 in 1000 women)

vomiting changes in breast tissue, milky secretion from the breasts irritability allergic reactions including swelling, rash or red patches on the skin increase in hair growth an intolerance to glucose a worsening of asthma increased size of fibroids ovarian cancer worsening of epilepsy heart attack, stroke inflammation of veins just under the skin inflammation of the pancreas irregular dark spots (usually on the face)

Very rare (affect less than 1 in 10000 women)

jaundice (e.g. yellowing of the skin) a worsening of chorea (an existing neurological disorder characterised by involuntary spasmodic movements of the body) a worsening of hypocalcaemia (low blood levels of calcium) blurred vision or loss of vision worsening of porphyria (a rare inherited metabolic disorder) growth of benign liver tumours

These side effects are usually temporary and should get better over time.

Other side effects that may occur while taking an estrogen-progesterone combined HRT are:

memory loss (dementia)

If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.

How To Store Premique

Keep out of the reach and sight of children.

Do not use this medicine after the expiry date stated on the carton and blister. The expiry date refers to the last day of the month.

Do not store above 25°C. Keep the blister in the outer carton to protect from light.

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.

Further Information 1 What Premique contains The active ingredients are an estrogen (conjugated estrogens) and a progestogen (medroxyprogesterone acetate).

Each blister pack contains 28 oval coated tablets, each tablet contains 0.625mg of conjugated estrogens and 5mg of medroxyprogesterone acetate (MPA). The tablets are light blue coloured and marked with “ 0.625/5”.

The other ingredients are calcium phosphate tribasic, calcium sulphate, microcrystalline cellulose, carnauba wax, glyceryl mono-oleates, lactose, magnesium stearate, methylcellulose, macrogol, pharmaceutical glaze, povidone, sucrose, titanium dioxide (E171), stearic acid and colour (E132, indigo carmine) and edible ink containing iron oxide black (E172), shellac, N-Butyl alcohol, propylene glycol and ethyl acetate. The inks and dyes used to coat your tablets are approved for use as food colourings. 2 What Premique looks like and contents of the pack

Your Premique carton contains either one or three blisters, each containing 28 tablets.

Not all pack sizes may be marketed.

The marketing authorisation holder is

John Wyeth & Brother Ltd trading as Wyeth Pharmaceuticals Huntercombe Lane South Taplow Maidenhead Berkshire SL6 0PH

The manufacturer is

Wyeth Medica Ireland Little Connell Newbridge County Kildare Republic of Ireland

This leaflet applies to Premique tablets only.

This leaflet was last approved in 04/2010

Doc ID 60103 (combined from doc id56233 and 51576)


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Clear Up Prep



Dosage Form: gel
Drug Facts ACTIVE INGREDIENT

Salicylic Acid 2% w/w.

INACTIVE INGREDIENTS

WATER • SORBITOL • ETHOXYDIGLYCOL • GLYCOLIC ACID • METHYL GLUCETH-20 • SODIUM CITRATE • GLYCERIN • LACTIC ACID • SODIUM HYDROXIDE • CELLULOSE GUM • XANTHAN GUM • ETHYLHEXYLGLYCERIN • PROPYLENE GLYCOL • PHENOXYETHANOL • CITRUS MEDICA LIMONUM (LEMON) FRUIT EXTRACT • HEDERA HELIX (IVY) EXTRACT • SAPONARIA OFFICINALIS EXTRACT •
ARCTIUM LAPPA ROOT EXTRACT • SALVIA OFFICINALIS (SAGE) LEAF EXTRACT •

DIRCETIONS

Cover the eyes with cotton pads soaked in Blue Water. With the fingertips, apply evenly to the face and neck Clear Up Prep Lotion, making sure to avoid the lips.

Application: 2-3 minutes | Pause: 7-8 minutes

WARNINGS

Enter section text here

image of carton label
image of tube 5ml label

Enter section text here

Keep out of reach of children.

Enter section text here


Clear Up Prep 
salicylic acid  gel Product Information Product Type HUMAN OTC DRUG NDC Product Code (Source) 62499-395 Route of Administration TOPICAL DEA Schedule      Active Ingredient/Active Moiety Ingredient Name Basis of Strength Strength SALICYLIC ACID (SALICYLIC ACID) SALICYLIC ACID 2 g  in 100 g Inactive Ingredients Ingredient Name Strength WATER   SORBITOL   DIETHYLENE GLYCOL MONOETHYL ETHER   GLYCOLIC ACID   METHYL GLUCETH-20   SODIUM CITRATE   GLYCERIN   LACTIC ACID   SODIUM HYDROXIDE   PROPYLENE GLYCOL   PHENOXYETHANOL   CARBOXYMETHYLCELLULOSE SODIUM   XANTHAN GUM   ETHYLHEXYLGLYCERIN   LEMON OIL   SAPONARIA OFFICINALIS ROOT   ARCTIUM LAPPA ROOT   SAGE OIL   Product Characteristics Color blue (dark bleu) Score      Shape Size Flavor Imprint Code Contains          Packaging # NDC Package Description Multilevel Packaging 1 62499-395-11 1 TUBE In 1 CARTON contains a TUBE (62499-395-10) 1 62499-395-10 5 g In 1 TUBE This package is contained within the CARTON (62499-395-11)
Marketing Information Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date OTC monograph final part358H 07/01/2010
Labeler - Laboratoire Dr. Renaud (202501565) Revised: 07/2010Laboratoire Dr. Renaud
More Clear Up Prep resources Clear Up Prep Side Effects (in more detail) Clear Up Prep Use in Pregnancy & Breastfeeding Clear Up Prep Drug Interactions Clear Up Prep Support Group 1 Review for Clear Up Prep - Add your own review/rating Compare Clear Up Prep with other medications Acne Dermatological Disorders Warts
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Vagifem


Pronunciation: ES-tra-DYE-ol
Generic Name: Estradiol
Brand Name: Vagifem

Vagifem should not be used to prevent heart disease, heart attacks, strokes, or dementia. Estrogens have been shown to increase the risk of heart disease (including heart attack), stroke, dementia, serious blood clots (eg, in the lungs or legs), cancer of the uterus, and breast cancer in some women. Tell your doctor right away if you have unusual vaginal bleeding while you use Vagifem. Talk with your doctor if you have questions about the benefits and risks of using Vagifem.

Vagifem should be used for the shortest possible time at the lowest effective dose to minimize the risk of these side effects. Talk with your doctor regularly about your need to use Vagifem.


Vagifem is used for:

Treating itching, burning, and dryness in or around the vaginal area in women past menopause.

Vagifem is a vaginal estrogen tablet. It works by increasing the amount of estrogen in the body in certain women who do not produce enough on their own.

Do NOT use Vagifem if: you are allergic to any ingredient in Vagifem you are pregnant or suspect you may be pregnant, have recently given birth or are breast-feeding you have unexplained, abnormal vaginal bleeding; known or suspected cancer of the breast or uterus; or estrogen-dependent tumors you have a history of breast cancer, blood clots (eg, deep vein thrombosis, pulmonary embolism), or liver problems you have had a heart attack or stroke within the last year

Contact your doctor or health care provider right away if any of these apply to you.

Before using Vagifem:

Some medical conditions may interact with Vagifem. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

if you are pregnant, planning to become pregnant, or are breast-feeding if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement if you have allergies to medicines, foods, or other substances if you or a family member has a history of lumps in the breast, an abnormal mammogram, or breast cancer if you have yellowing of the whites of the eyes or skin during pregnancy or with past estrogen use, or high blood pressure during pregnancy (toxemia) if you have uterine problems (eg, uterine fibroids/endometriosis) or vaginal conditions (eg, abnormal vaginal bleeding, recurring vaginal infections, prolapse, stenosis) if you have abnormal calcium levels in the blood, asthma, cancer, a certain blood disorder (porphyria), cholesterol or lipid problems, depression, diabetes, excessive weight gain, gallbladder disease, heart disease or other heart problems, high blood pressure, kidney or liver problems, low thyroid hormone levels, lupus, migraine headaches, pancreas disease, seizures (eg, epilepsy), vision problems, or yellowing of the skin or eyes if you smoke, will be having surgery, or will be on bed rest

Some MEDICINES MAY INTERACT with Vagifem. Tell your health care provider if you are taking any other medicines, especially any of the following:

Clarithromycin, erythromycin, itraconazole, ketoconazole, or ritonavir because they may increase the risk of Vagifem's side effects Barbiturates (eg, phenobarbital), carbamazepine, hydantoins (eg, phenytoin), rifampin, or St. John's wort because they may decrease Vagifem's effectiveness Blood thinners (eg, warfarin), corticosteroids (eg, prednisone), succinylcholine, or tacrine because their actions and the risk of their side effects may be increased by Vagifem

This may not be a complete list of all interactions that may occur. Ask your health care provider if Vagifem may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Vagifem:

Use Vagifem as directed by your doctor. Check the label on the medicine for exact dosing instructions.

An extra patient leaflet is available with Vagifem. Talk to your pharmacist if you have questions about this information. To use, tear off a single applicator, separate the plastic wrap, and remove the applicator from the plastic wrap. Select the position for vaginal insertion that is most comfortable for you (lying on the bed, squatting, or standing with one leg on a stool). Use the finger of one hand to press the applicator plunger. Use the other hand to gently and comfortably guide the applicator into the vagina. If the tablet falls out of the applicator before inserting the filled applicator, use a new applicator with a fresh tablet. Insert the tablet as far into the vagina as it can comfortably go without force. After inserting the filled applicator, gently press the plunger until you hear a click and the plunger is fully depressed. This will eject the tablet inside your vagina. The tablet will dissolve slowly over several hours. After depressing the plunger, gently remove the applicator and throw it away. Do not reuse the applicator. You may insert the tablet-filled applicator any time of day. You should use the applicator at the same time each day. Grapefruit and grapefruit juice may increase the risk of Vagifem's side effects. Talk to your doctor before including grapefruit or grapefruit juice in your diet while you are taking Vagifem. If you miss a dose of Vagifem, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use Vagifem.

Important safety information: Vagifem may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Vagifem with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it. Limit alcoholic beverages while you are using Vagifem. Vagifem may cause dark skin patches on your face (melasma). Exposure to the sun may make these patches darker and you may need to avoid prolonged sun exposure and sunlamps. Consult your doctor regarding the use of sunscreens and protective clothing. Vagifem may increase the risk of blood clots. The risk may be greater if you smoke (especially in women older than 35 years of age). Contact your doctor if vaginal bleeding of unknown cause occurs. This could be a sign of a serious condition requiring immediate medical attention. Contact your doctor if vaginal discomfort occurs or if you suspect you have developed an infection while taking Vagifem. Follow your doctor's instructions for examining your breasts, and report any lumps immediately. If you wear contact lenses and you develop problems with them, contact your doctor. If you will be having surgery or will be confined to a chair or bed for a long period of time (eg, a long plane flight), notify your doctor beforehand. Special precautions may need to be taken in these circumstances while you are taking Vagifem. Vagifem may increase the risk of breast and endometrial cancer. Your doctor may prescribe another hormone (progestin) to decrease this risk. Your doctor should reevaluate you every 3 to 6 months to determine whether you need to continue taking Vagifem. Diabetes patients - Vagifem may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine. Vagifem may interfere with certain lab tests. Be sure your doctor and lab personnel know you are using Vagifem. Lab tests, including hormone levels, physical exams, and blood pressure, may be performed while you use Vagifem. These tests may be used to monitor your condition or check for side effects. You should have breast and pelvic exams and a Pap test at least once a year. You should also have periodic mammograms as determined by your doctor. Be sure to keep all doctor and lab appointments. Use Vagifem with caution in the ELDERLY; they may be more sensitive to its effects, including an increased risk of heart problems, stroke, breast or uterine cancer, and certain mental problems (eg, dementia). Vagifem should not be used in CHILDREN; safety and effectiveness in children have not been confirmed. PREGNANCY and BREAST-FEEDING: Do not use Vagifem if you are pregnant. Avoid becoming pregnant while you are taking it. If you think you may be pregnant, contact your doctor right away. Vagifem is found in breast milk. Do not breast-feed while taking Vagifem. Possible side effects of Vagifem:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Breast pain or tenderness; diarrhea; hair loss; headache; mild nausea or vomiting; spotting or breakthrough bleeding; stomach cramps or bloating.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); back pain; breast discharge or lump in the breast; calf or leg pain or swelling; chest pain; coughing up blood; dark urine; dizziness; fainting; fever; memory problems; mental or mood changes (eg, depression); muscle pain; one-sided weakness; painful or difficult urination; persistent or severe breast pain or tenderness; persistent or severe headache, nausea, or vomiting; severe or persistent stomach pain or swelling; slurred speech; sudden shortness of breath; sunburn-like rash; swelling of the hands, legs, or feet; unusual vaginal bleeding, discharge, itching, or odor; unusual weight changes; vision changes; vomiting; weakness or numbness of an arm or leg; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include excessive vaginal bleeding; severe nausea; vomiting.

Proper storage of Vagifem:

Store Vagifem at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Vagifem out of the reach of children and away from pets.

General information: If you have any questions about Vagifem, please talk with your doctor, pharmacist, or other health care provider. Vagifem is to be used only by the patient for whom it is prescribed. Do not share it with other people. If your symptoms do not improve or if they become worse, check with your doctor. Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Vagifem. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012 Database Edition 12.1.1.002 Copyright © 2012 Wolters Kluwer Health, Inc.
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All Clear AR Drops


Pronunciation: na-FAZ-oh-leen
Generic Name: Naphazoline
Brand Name: Examples include All Clear and Clear Eyes
All Clear AR Drops are used for:

Temporarily relieving redness, burning, and irritation caused by dry eyes. It may also be used for other conditions as determined by your doctor.

All Clear AR Drops are an eye decongestant and lubricant. It works by constricting the blood vessels in the eye and coating the eye, which relieves redness, dryness, and irritation.

Do NOT use All Clear AR Drops if: you are allergic to any ingredient in All Clear AR Drops you have taken furazolidone or a monoamine oxidase (MAO) inhibitor (eg, phenelzine) within the past 14 days

Contact your doctor or health care provider right away if any of these apply to you.

Before using All Clear AR Drops:

Some medical conditions may interact with All Clear AR Drops. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

if you are pregnant, planning to become pregnant, or are breast-feeding if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement if you have allergies to medicines, foods, or other substances if you have glaucoma, high blood pressure, diabetes, heart problems, or thyroid problems, or you are taking medicine for high blood pressure

Some MEDICINES MAY INTERACT with All Clear AR Drops. Tell your health care provider if you are taking any other medicines, especially any of the following:

Tricyclic antidepressants (eg, amitriptyline) because they may decrease All Clear AR Drops's effectiveness Cocaine, furazolidone, MAO inhibitors (eg, phenelzine), or tricyclic antidepressants (eg, amitriptyline) because they may increase the risk of All Clear AR Drops's side effects, such as headache, fever, and high blood pressure Bromocriptine or cocaine because their actions and side effects may be increased by All Clear AR Drops

This may not be a complete list of all interactions that may occur. Ask your health care provider if All Clear AR Drops may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use All Clear AR Drops:

Use All Clear AR Drops as directed by your doctor. Check the label on the medicine for exact dosing instructions.

All Clear AR Drops are for use in the eye only. Avoid contact with the nose, mouth, or other mucous membranes. To use All Clear AR Drops, first, wash your hands. Tilt your head back. Using your index finger, pull the lower eyelid away from the eye to form a pouch. Drop the medicine into the pouch and gently close your eyes. Immediately use your finger to apply pressure to the inside corner of the eye for 1 to 2 minutes. Do not blink. Remove excess medicine around your eye with a clean tissue, being careful not to touch your eye. Wash your hands to remove any medicine that may be on them. To prevent germs from contaminating your medicine, do not touch the applicator tip to any surface, including your eye. Keep the container tightly closed. If you miss a dose of All Clear AR Drops and you are using it regularly, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule.

Ask your health care provider any questions you may have about how to use All Clear AR Drops.

Important safety information: Remove contact lenses before using All Clear AR Drops. Do not use All Clear AR Drops if it becomes cloudy or changes color. Contact your doctor if you experience changes in vision, eye pain, irritation, soreness, or continued redness, or if your condition does not improve after 3 days. Use All Clear AR Drops with caution in CHILDREN because they may be more sensitive to its effects. PREGNANCY and BREAST-FEEDING: If you become pregnant while taking All Clear AR Drops, discuss with your doctor the benefits and risks of using All Clear AR Drops during pregnancy. It is unknown if All Clear AR Drops are excreted in breast milk. If you are or will be breast-feeding while you are using All Clear AR Drops, check with your doctor or pharmacist to discuss the risks to your baby. Possible side effects of All Clear AR Drops:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Blurred vision; minor stinging when the medicine is dropped into the eye.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); changes in vision; eye pain; worsening or persistent eye irritation or redness.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

See also: All Clear AR side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. All Clear AR Drops may be harmful if swallowed, especially in children.

Proper storage of All Clear AR Drops:

Store All Clear AR Drops at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep All Clear AR Drops out of the reach of children and away from pets.

General information: If you have any questions about All Clear AR Drops, please talk with your doctor, pharmacist, or other health care provider. All Clear AR Drops are to be used only by the patient for whom it is prescribed. Do not share it with other people. If your symptoms do not improve or if they become worse, check with your doctor. Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about All Clear AR Drops. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012 Database Edition 12.1.1.002 Copyright © 2012 Wolters Kluwer Health, Inc. More All Clear AR resources All Clear AR Side Effects (in more detail) All Clear AR Use in Pregnancy & Breastfeeding All Clear AR Drug Interactions All Clear AR Support Group 0 Reviews for All Clear AR - Add your own review/rating Compare All Clear AR with other medications Eye Dryness/Redness Eye Redness/Itching
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Estrace


Pronunciation: ES-tra-DYE-ol
Generic Name: Estradiol
Brand Name: Examples include Estrace and Gynodiol

Estrace should not be used to prevent heart disease, heart attacks, strokes, or dementia. Estrogens have been shown to increase the risk of heart disease (including heart attack), stroke, dementia, serious blood clots (eg, in the lungs or legs), cancer of the uterus, and breast cancer in some women. Tell your doctor right away if you have unusual vaginal bleeding while you use Estrace. Talk with your doctor if you have questions about the benefits and risks of using Estrace.

Estrace should be used for the shortest possible time at the lowest effective dose to minimize the risk of these side effects. Talk with your doctor regularly about your need to use Estrace.


Estrace is used for:

Treating conditions due to menopause (eg, hot flashes; vaginal itching, burning, or dryness), treating vulval or vaginal atrophy, and preventing osteoporosis (brittle bones). It is also used for estrogen replacement therapy after failure of the ovaries and to relieve the symptoms of breast cancer.

Treating advanced prostate cancer. It is also used to relieve symptoms of breast cancer.

Estrace is a female estrogen hormone. It works by replacing natural estrogens in a woman who can no longer produce enough estrogen.It works for advanced prostate cancer by antagonizing male hormones.

Do NOT use Estrace if: you are allergic to any ingredient in Estrace you are pregnant or suspect you may be pregnant, have recently given birth or are breast-feeding, or have vaginal bleeding of abnormal or unknown cause you have known or suspected breast cancer (unless directed by your doctor) or you have cancers that are estrogen-dependent you have blood clots, vein inflammation, or liver disease you have had a recent stroke or heart attack

Contact your doctor or health care provider right away if any of these apply to you.

Before using Estrace:

Some medical conditions may interact with Estrace. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

if you are planning to become pregnant if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement if you have allergies to medicines, foods, or other substances if you have a family history of breast cancer, or you have breast lumps or disease, or an abnormal mammogram if you have yellowing of the whites of the eyes or skin during pregnancy or with past estrogen use, or high blood pressure during pregnancy (toxemia) if you have a vaginal infection or womb problems (eg, uterine fibroids/endometriosis, abnormal vaginal bleeding, other uterine problems) if you have abnormal calcium levels in the blood, asthma, cancer, certain blood disorder (porphyria), cholesterol or lipid problems, depression, diabetes, epilepsy, excessive weight gain, gallbladder disease, heart disease or other heart problems, high blood pressure, kidney or liver disease, low thyroid hormone levels, lupus, migraine headaches, pancreas disease, seizures, or yellowing of the skin or eyes if you smoke or will be having surgery

Some MEDICINES MAY INTERACT with Estrace. Tell your health care provider if you are taking any other medicines, especially any of the following:

Blood thinners (eg, warfarin), corticosteroids (eg, prednisone), succinylcholine, or tacrine because their actions and the risk of their side effects may be increased by Estrace Blood thinners (eg, warfarin) because their effectiveness may be decreased by Estrace Barbiturates (eg, phenobarbital), hydantoins (eg, phenytoin), or rifampin because they may decrease Estrace's effectiveness

This may not be a complete list of all interactions that may occur. Ask your health care provider if Estrace may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Estrace:

Use Estrace as directed by your doctor. Check the label on the medicine for exact dosing instructions.

An extra patient leaflet is available with Estrace. Talk to your pharmacist if you have questions about this information. Take Estrace by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation. Grapefruit and grapefruit juice may increase the risk of Estrace's side effects. Talk to your doctor before including grapefruit or grapefruit juice in your diet while you are taking Estrace. If you miss a dose of Estrace, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Estrace.

Important safety information: Estrace may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Estrace with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it. Limit alcoholic beverages while you are taking Estrace. Estrace may cause dark skin patches on your face (melasma). Exposure to the sun may make these patches darker and you may need to avoid prolonged sun exposure and sunlamps. Consult your doctor regarding the use of sunscreens and protective clothing. Estrace may increase the risk of blood clots. The risk may be greater if you smoke (especially in women older than 35 years of age). Contact your doctor if vaginal bleeding of unknown cause occurs. This could be a sign of a serious condition requiring immediate medical attention. Contact your doctor if vaginal discomfort occurs or if you suspect you have developed an infection while taking Estrace. Follow your doctor's instructions for examining your breasts and report any lumps immediately. Additional monitoring of your dose or condition may be necessary if you are presently taking an azole antifungal (eg, itraconazole), carbamazepine, a macrolide antibiotic (eg, erythromycin), ritonavir, cimetidine, or St. John's wort. If you wear contact lenses and you develop problems with them, contact your doctor. If you will be having surgery or will be confined to a chair or bed for a long period of time (eg, a long plane flight), notify your doctor beforehand. Special precautions may need to be taken in these circumstances while you are taking Estrace. Nonprescription therapy to help prevent bone loss includes a weight-bearing exercise plan, as well as adequate daily calcium and vitamin D intake. Consult your doctor or pharmacist for more details. Some of these products may contain the dye tartrazine (FD&C Yellow No. 5), which can cause allergic reactions in certain patients. Consult your doctor or pharmacist. If you previously had allergic reactions to the dye tartrazine, contact your doctor or pharmacist to determine if the product you are taking contains the dye tartrazine. Estrace may interfere with certain lab tests. Be sure your doctor and lab personnel know you are taking Estrace. Diabetes patients - Estrace may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine. Lab tests, including physical exams and blood pressure, may be performed while you use Estrace. You should have breast and pelvic exams, and a Pap test at least once a year. You should also have periodic mammograms as determined by your doctor. Be sure to keep all doctor and lab appointments. Estrace should not be used in CHILDREN; safety and effectiveness in children have not been confirmed. PREGNANCY and BREAST-FEEDING: Do not use Estrace if you are pregnant. Avoid becoming pregnant while you are taking it. If you think you may be pregnant, contact your doctor right away. Estrace may be found in breast milk. If you are or will be breast-feeding while you use Estrace, check with your doctor. Discuss any possible risks to your baby. Possible side effects of Estrace:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Breast pain or tenderness; headache; hair loss; mild nausea or vomiting; spotting or breakthrough bleeding; stomach cramps or bloating.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); back pain;breast discharge or lump in the breast; calf or leg pain or swelling; chest pain; coughing up blood; dark urine; depression; dizziness; fainting; fever; memory problems; mental or mood changes; muscle pain; one-sided weakness; painful or difficult urination; persistent or severe breast pain or tenderness; persistent or severe headache, nausea, or vomiting; severe stomach pain or swelling; slurred speech; sudden shortness of breath; sunburn-like rash; swelling of hands, legs, or feet; unusual vaginal bleeding, discharge, itching, or odor; vision changes; vomiting; weakness or numbness of an arm or leg; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

See also: Estrace side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include excessive vaginal bleeding; severe nausea; vomiting.

Proper storage of Estrace:

Store Estrace at room temperature, 59 to 86 degrees F (15 to 30 degrees C), in a tight, light-resistant container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Estrace out of the reach of children and away from pets.

General information: If you have any questions about Estrace, please talk with your doctor, pharmacist, or other health care provider. Estrace is to be used only by the patient for whom it is prescribed. Do not share it with other people. If your symptoms do not improve or if they become worse, check with your doctor. Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Estrace. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012 Database Edition 12.1.1.002 Copyright © 2012 Wolters Kluwer Health, Inc. More Estrace resources Estrace Side Effects (in more detail)Estrace Use in Pregnancy & BreastfeedingDrug ImagesEstrace Drug InteractionsEstrace Support Group3 Reviews for Estrace - Add your own review/rating Estrace Prescribing Information (FDA) Estrace Consumer Overview Estrace Advanced Consumer (Micromedex) - Includes Dosage Information estradiol Transdermal Advanced Consumer (Micromedex) - Includes Dosage Information Estradiol Monograph (AHFS DI) Estradiol Prescribing Information (FDA) Estradiol Professional Patient Advice (Wolters Kluwer) Alora Advanced Consumer (Micromedex) - Includes Dosage Information Alora Prescribing Information (FDA) Climara Consumer Overview Climara Prescribing Information (FDA) Delestrogen Prescribing Information (FDA) Depo-Estradiol Prescribing Information (FDA) Estraderm Prescribing Information (FDA) Estradiol Patch Prescribing Information (FDA) Estrasorb Prescribing Information (FDA) Estrasorb Consumer Overview Evamist Consumer Overview Evamist Prescribing Information (FDA) Femring Prescribing Information (FDA) Femtrace Consumer Overview Femtrace Prescribing Information (FDA) Femtrace Advanced Consumer (Micromedex) - Includes Dosage Information Menostar Prescribing Information (FDA) Menostar Consumer Overview Vivelle Prescribing Information (FDA) Vivelle-Dot Prescribing Information (FDA) Compare Estrace with other medications Atrophic UrethritisAtrophic VaginitisBreast Cancer, PalliativeHypoestrogenismOophorectomyPostmenopausal SymptomsPrimary Ovarian FailureProstate Cancer
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Estraderm Patch


Pronunciation: ESS-truh-DIE-ole
Generic Name: Estradiol
Brand Name: Examples include Estraderm and Vivelle

Estrogens have been reported to increase the chance of uterine (womb) cancer. Estrogen-containing products should not be used to prevent heart disease or dementia. Estrogen given alone or in combination with another hormone (progestin) for replacement therapy may increase your risk for heart disease (eg, heart attacks), stroke, serious blood clots in the legs (deep vein thrombosis) or lungs (pulmonary embolism), dementia, or breast cancer. These risks appear to depend on the length of time Estraderm Patch is used and the amount of estrogen per dose. Therefore, Estraderm Patch should be used exactly as prescribed by your doctor, for the shortest possible length of time at the lowest effective dose, so that you obtain the benefits and minimize the chance of serious side effects from long-term treatment. Consult your doctor or pharmacist for details.


Estraderm Patch is used for:

Treating conditions due to menopause (eg, hot flashes; vaginal itching, burning, or dryness), preventing osteoporosis (brittle bones) in certain women who have already gone through menopause, or replacing estrogen if the ovaries do not produce enough or are removed. It may also be used for other conditions as determined by your doctor.

Estraderm Patch is an estrogen hormone. It works by replacing natural estrogens in a woman who can no longer produce enough estrogen.

Do NOT use Estraderm Patch if: you are allergic to any ingredient in Estraderm Patch you are pregnant or suspect you may be pregnant you have undiagnosed, abnormal vaginal bleeding you have known or suspected abnormal estrogen-dependent growths, known or suspected breast cancer, or a history of breast cancer you have or have a history of blood clots in your legs, lungs, or other blood vessels you have had a heart attack or stroke within the past year or you have liver problems

Contact your doctor or health care provider right away if any of these apply to you.

Before using Estraderm Patch:

Some medical conditions may interact with Estraderm Patch. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

if you are pregnant, planning to become pregnant, or are breast-feeding if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement if you have allergies to medicines, foods, or other substances if you have breast lumps or disease, an abnormal mammogram, or a family history of breast cancer if you have yellowing of the whites of the eyes or skin during pregnancy or with past estrogen use, or if you have high blood pressure during pregnancy (toxemia) if you have a vaginal infection or womb problems (eg, uterine fibroids, endometriosis, abnormal vaginal bleeding, other uterine problems) if you have asthma, cancer (eg, breast cancer), certain blood problems (eg, porphyria), cholesterol or lipid problems, depression, diabetes, epilepsy, excessive weight gain, gallbladder disease, heart disease or other heart problems (eg, heart attack, congestive heart failure), high blood pressure, kidney or liver disease, underactive thyroid, lupus, migraine headaches, pancreas disease, seizures, yellowing of the skin or eyes (jaundice), or a history of abnormal calcium levels in the blood, or if you are very overweight if you smoke or will be having surgery

Some MEDICINES MAY INTERACT with Estraderm Patch. Tell your health care provider if you are taking any other medicines, especially any of the following:

Clarithromycin, erythromycin, azole antifungals (eg, itraconazole, ketoconazole), or ritonavir because they may increase the risk of Estraderm Patch's side effects Anticoagulants (eg, warfarin) because their actions and side effects may be increased by Estraderm Patch Carbamazepine, hydantoins (eg, phenytoin), barbiturates (eg, phenobarbital), rifampin, or St. John's wort because they may decrease Estraderm Patch's effectiveness

This may not be a complete list of all interactions that may occur. Ask your health care provider if Estraderm Patch may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Estraderm Patch:

Use Estraderm Patch as directed by your doctor. Check the label on the medicine for exact dosing instructions. Check the label on the medicine for exact dosing instructions.

An extra patient leaflet is available with Estraderm Patch. Talk to your pharmacist if you have questions about this information. If you are switching from oral estrogen to Estraderm Patch, stop taking the oral estrogen and wait 1 week before using Estraderm Patch. However, if your symptoms return, you may start using Estraderm Patch sooner. The patch is usually replaced twice a week (about every 3 to 4 days), or as directed by your doctor. Follow the dosing schedule carefully. Do not open the sealed pouch containing the patch until ready to use. Open the pouch and remove the patch from the protective liner. Apply the patch to a clean, dry, hairless area of the body, such as the lower abdomen or the upper part of the buttock, as described in the patient information leaflet or on the package. If you have any questions about where to apply the patch, contact your doctor or pharmacist for instructions. Press the patch firmly against the skin for about 10 seconds to be sure the patch stays on. If the system lifts off of your skin, press down to reapply. Wear only 1 system at any one time. Do not place the patch on the breast. Make sure the application site is not oily, damaged, or irritated. Avoid applying to the waistline because tight clothing may rub the patch off. Do not put the patch on an area where sitting may loosen it. Do not apply to a site that is exposed to sunlight. Contact with water while bathing, showering, or swimming will not affect the patch. When it is time to change the patch, remove it slowly. After removing the used patch, fold it in half with the sticky sides together. Discard the patch out of the reach of children and away from pets. Apply a new patch to a different area to prevent skin irritation. It is best to rotate the areas where the patch is applied, allowing at least 1 week in between applications to the same site. If the area around the patch becomes red, itchy, or irritated, try a new site. If the irritation continues or becomes worse, notify your doctor promptly. Grapefruit and grapefruit juice may increase the risk of Estraderm Patch's side effects. Talk to your doctor before including grapefruit or grapefruit juice in your diet while you are taking Estraderm Patch. If you miss a dose of Estraderm Patch, use it as soon as possible. If a patch falls off, reapply it or apply a new patch and wear it for the rest of the scheduled period, then resume your usual dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use Estraderm Patch.

Important safety information: Estraderm Patch may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Estraderm Patch with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it. Estraderm Patch may cause dark skin patches on your face (melasma). Exposure to the sun may make these patches darker, and you may need to avoid prolonged sun exposure and sunlamps. Consult your doctor regarding the use of sunscreens and protective clothing. Estraderm Patch may increase the risk of blood clots. The risk may be greater if you smoke (especially in women older than 35 years of age). Contact your health care provider if vaginal bleeding of unknown cause occurs. This could be a sign of a serious condition requiring immediate medical attention. Contact your health care provider if vaginal discomfort occurs or if you suspect you have developed an infection while taking Estraderm Patch. Follow your doctor's instructions for examining your breasts, and report any lumps immediately. If you wear contact lenses and you develop problems with them, contact your doctor. If you will be having surgery or will be confined to a chair or bed for a long period of time (eg, a long plane flight), notify your doctor beforehand. Special precautions may need to be taken while you are taking Estraderm Patch. Nondrug therapy to help prevent bone loss includes a weight-bearing exercise plan, as well as adequate daily calcium and vitamin D intake. Consult your doctor or pharmacist for more details. Estraderm Patch may interfere with certain lab tests. Be sure your doctor and lab personnel know you are using Estraderm Patch. Diabetes patients - Estraderm Patch may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine. Lab tests, including physical exams and blood pressure, may be performed while you use Estraderm Patch. You should have breast and pelvic exams, and a Pap test at least once a year. You should also have periodic mammograms as determined by your doctor. Be sure to keep all doctor and lab appointments. Use Estraderm Patch with caution in the ELDERLY; they may be more sensitive to its effects, especially dementia. Estraderm Patch should not be used in CHILDREN; safety and effectiveness in children have not been confirmed. PREGNANCY and BREAST-FEEDING: Do not use Estraderm Patch if you are pregnant. Avoid becoming pregnant while you are taking it. If you think you may be pregnant, contact your doctor right away. Estraderm Patch may be found in breast milk. If you are or will be breast-feeding while you use Estraderm Patch, check with your doctor. Discuss any possible risks to your baby. Possible side effects of Estraderm Patch:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Bone or limb pain; breakthrough bleeding; breast tenderness; dizziness or lightheadedness; neck or back pain; nausea; skin redness/irritation at the application site; upset stomach; weight change.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); abnormal vaginal bleeding; breast lumps; breast pain; changes in vaginal bleeding (eg, spotting, breakthrough bleeding, prolonged bleeding); changes in vision or speech (eg, change in contact lens fit, loss of vision); chest pain; coughing of blood; mental/mood changes (eg, severe depression, memory loss); one-sided weakness; pain or tenderness in calves or chest; pain, swelling, or tenderness in the stomach; severe headache or vomiting; sudden, severe headache, vomiting, dizziness, or fainting; sudden shortness of breath; swelling of hands or feet; unusual vaginal discharge, itching, or odor; weakness or numbness of an arm or leg; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

See also: Estraderm side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include excessive vaginal bleeding; severe nausea; vomiting.

Proper storage of Estraderm Patch:

Store Estraderm Patch at room temperature, 59 to 86 degrees F (15 to 30 degrees C). Store in original packaging until just before use. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Estraderm Patch out of the reach of children and away from pets.

General information: If you have any questions about Estraderm Patch, please talk with your doctor, pharmacist, or other health care provider. Estraderm Patch is to be used only by the patient for whom it is prescribed. Do not share it with other people. If your symptoms do not improve or if they become worse, check with your doctor. Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Estraderm Patch. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012 Database Edition 12.1.1.002 Copyright © 2012 Wolters Kluwer Health, Inc. More Estraderm resources Estraderm Side Effects (in more detail) Estraderm Use in Pregnancy & Breastfeeding Estraderm Drug Interactions Estraderm Support Group 1 Review for Estraderm - Add your own review/rating Compare Estraderm with other medications Atrophic Urethritis Atrophic Vaginitis Hypoestrogenism Oophorectomy Osteoporosis Postmenopausal Symptoms Primary Ovarian Failure
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Estradiol


Pronunciation: ES-tra-DYE-ol
Generic Name: Estradiol
Brand Name: Examples include Estrace and Gynodiol

Estradiol should not be used to prevent heart disease, heart attacks, strokes, or dementia. Estrogens have been shown to increase the risk of heart disease (including heart attack), stroke, dementia, serious blood clots (eg, in the lungs or legs), cancer of the uterus, and breast cancer in some women. Tell your doctor right away if you have unusual vaginal bleeding while you use Estradiol. Talk with your doctor if you have questions about the benefits and risks of using Estradiol.

Estradiol should be used for the shortest possible time at the lowest effective dose to minimize the risk of these side effects. Talk with your doctor regularly about your need to use Estradiol.


Estradiol is used for:

Treating conditions due to menopause (eg, hot flashes; vaginal itching, burning, or dryness), treating vulval or vaginal atrophy, and preventing osteoporosis (brittle bones). It is also used for estrogen replacement therapy after failure of the ovaries and to relieve the symptoms of breast cancer.

Treating advanced prostate cancer. It is also used to relieve symptoms of breast cancer.

Estradiol is a female estrogen hormone. It works by replacing natural estrogens in a woman who can no longer produce enough estrogen.It works for advanced prostate cancer by antagonizing male hormones.

Do NOT use Estradiol if: you are allergic to any ingredient in Estradiol you are pregnant or suspect you may be pregnant, have recently given birth or are breast-feeding, or have vaginal bleeding of abnormal or unknown cause you have known or suspected breast cancer (unless directed by your doctor) or you have cancers that are estrogen-dependent you have blood clots, vein inflammation, or liver disease you have had a recent stroke or heart attack

Contact your doctor or health care provider right away if any of these apply to you.

Before using Estradiol:

Some medical conditions may interact with Estradiol. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

if you are planning to become pregnant if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement if you have allergies to medicines, foods, or other substances if you have a family history of breast cancer, or you have breast lumps or disease, or an abnormal mammogram if you have yellowing of the whites of the eyes or skin during pregnancy or with past estrogen use, or high blood pressure during pregnancy (toxemia) if you have a vaginal infection or womb problems (eg, uterine fibroids/endometriosis, abnormal vaginal bleeding, other uterine problems) if you have abnormal calcium levels in the blood, asthma, cancer, certain blood disorder (porphyria), cholesterol or lipid problems, depression, diabetes, epilepsy, excessive weight gain, gallbladder disease, heart disease or other heart problems, high blood pressure, kidney or liver disease, low thyroid hormone levels, lupus, migraine headaches, pancreas disease, seizures, or yellowing of the skin or eyes if you smoke or will be having surgery

Some MEDICINES MAY INTERACT with Estradiol. Tell your health care provider if you are taking any other medicines, especially any of the following:

Blood thinners (eg, warfarin), corticosteroids (eg, prednisone), succinylcholine, or tacrine because their actions and the risk of their side effects may be increased by Estradiol Blood thinners (eg, warfarin) because their effectiveness may be decreased by Estradiol Barbiturates (eg, phenobarbital), hydantoins (eg, phenytoin), or rifampin because they may decrease Estradiol's effectiveness

This may not be a complete list of all interactions that may occur. Ask your health care provider if Estradiol may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Estradiol:

Use Estradiol as directed by your doctor. Check the label on the medicine for exact dosing instructions.

An extra patient leaflet is available with Estradiol. Talk to your pharmacist if you have questions about this information. Take Estradiol by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation. Grapefruit and grapefruit juice may increase the risk of Estradiol's side effects. Talk to your doctor before including grapefruit or grapefruit juice in your diet while you are taking Estradiol. If you miss a dose of Estradiol, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Estradiol.

Important safety information: Estradiol may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Estradiol with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it. Limit alcoholic beverages while you are taking Estradiol. Estradiol may cause dark skin patches on your face (melasma). Exposure to the sun may make these patches darker and you may need to avoid prolonged sun exposure and sunlamps. Consult your doctor regarding the use of sunscreens and protective clothing. Estradiol may increase the risk of blood clots. The risk may be greater if you smoke (especially in women older than 35 years of age). Contact your doctor if vaginal bleeding of unknown cause occurs. This could be a sign of a serious condition requiring immediate medical attention. Contact your doctor if vaginal discomfort occurs or if you suspect you have developed an infection while taking Estradiol. Follow your doctor's instructions for examining your breasts and report any lumps immediately. Additional monitoring of your dose or condition may be necessary if you are presently taking an azole antifungal (eg, itraconazole), carbamazepine, a macrolide antibiotic (eg, erythromycin), ritonavir, cimetidine, or St. John's wort. If you wear contact lenses and you develop problems with them, contact your doctor. If you will be having surgery or will be confined to a chair or bed for a long period of time (eg, a long plane flight), notify your doctor beforehand. Special precautions may need to be taken in these circumstances while you are taking Estradiol. Nonprescription therapy to help prevent bone loss includes a weight-bearing exercise plan, as well as adequate daily calcium and vitamin D intake. Consult your doctor or pharmacist for more details. Some of these products may contain the dye tartrazine (FD&C Yellow No. 5), which can cause allergic reactions in certain patients. Consult your doctor or pharmacist. If you previously had allergic reactions to the dye tartrazine, contact your doctor or pharmacist to determine if the product you are taking contains the dye tartrazine. Estradiol may interfere with certain lab tests. Be sure your doctor and lab personnel know you are taking Estradiol. Diabetes patients - Estradiol may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine. Lab tests, including physical exams and blood pressure, may be performed while you use Estradiol. You should have breast and pelvic exams, and a Pap test at least once a year. You should also have periodic mammograms as determined by your doctor. Be sure to keep all doctor and lab appointments. Estradiol should not be used in CHILDREN; safety and effectiveness in children have not been confirmed. PREGNANCY and BREAST-FEEDING: Do not use Estradiol if you are pregnant. Avoid becoming pregnant while you are taking it. If you think you may be pregnant, contact your doctor right away. Estradiol may be found in breast milk. If you are or will be breast-feeding while you use Estradiol, check with your doctor. Discuss any possible risks to your baby. Possible side effects of Estradiol:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Breast pain or tenderness; headache; hair loss; mild nausea or vomiting; spotting or breakthrough bleeding; stomach cramps or bloating.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); back pain;breast discharge or lump in the breast; calf or leg pain or swelling; chest pain; coughing up blood; dark urine; depression; dizziness; fainting; fever; memory problems; mental or mood changes; muscle pain; one-sided weakness; painful or difficult urination; persistent or severe breast pain or tenderness; persistent or severe headache, nausea, or vomiting; severe stomach pain or swelling; slurred speech; sudden shortness of breath; sunburn-like rash; swelling of hands, legs, or feet; unusual vaginal bleeding, discharge, itching, or odor; vision changes; vomiting; weakness or numbness of an arm or leg; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include excessive vaginal bleeding; severe nausea; vomiting.

Proper storage of Estradiol:

Store Estradiol at room temperature, 59 to 86 degrees F (15 to 30 degrees C), in a tight, light-resistant container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Estradiol out of the reach of children and away from pets.

General information: If you have any questions about Estradiol, please talk with your doctor, pharmacist, or other health care provider. Estradiol is to be used only by the patient for whom it is prescribed. Do not share it with other people. If your symptoms do not improve or if they become worse, check with your doctor. Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Estradiol. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012 Database Edition 12.1.1.002 Copyright © 2012 Wolters Kluwer Health, Inc. More Estradiol resources Estradiol Use in Pregnancy & Breastfeeding Drug Images Estradiol Drug Interactions Estradiol Support Group 57 Reviews for Estradiol - Add your own review/rating Estradiol Monograph (AHFS DI) Estradiol Prescribing Information (FDA) Estradiol Professional Patient Advice (Wolters Kluwer) estradiol Transdermal Advanced Consumer (Micromedex) - Includes Dosage Information Alora Advanced Consumer (Micromedex) - Includes Dosage Information Alora Prescribing Information (FDA) Climara Consumer Overview Climara Prescribing Information (FDA) Delestrogen Prescribing Information (FDA) Depo-Estradiol Prescribing Information (FDA) Estrace Prescribing Information (FDA) Estrace Advanced Consumer (Micromedex) - Includes Dosage Information Estrace Consumer Overview Estraderm Prescribing Information (FDA) Estradiol Patch Prescribing Information (FDA) Estrasorb Consumer Overview Estrasorb Prescribing Information (FDA) Evamist Consumer Overview Evamist Prescribing Information (FDA) Femring Prescribing Information (FDA) Femtrace Advanced Consumer (Micromedex) - Includes Dosage Information Femtrace Consumer Overview Femtrace Prescribing Information (FDA) Menostar Consumer Overview Menostar Prescribing Information (FDA) Vivelle Prescribing Information (FDA) Vivelle-Dot Prescribing Information (FDA) Compare Estradiol with other medications Atrophic Urethritis Atrophic Vaginitis Breast Cancer, Palliative Hypoestrogenism Oophorectomy Osteoporosis Postmenopausal Symptoms Primary Ovarian Failure Prostate Cancer
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Clear Eyes Extra Relief Drops


Pronunciation: na-FAZ-oh-leen
Generic Name: Naphazoline
Brand Name: Examples include All Clear and Clear Eyes
Clear Eyes Extra Relief Drops are used for:

Temporarily relieving redness, burning, and irritation caused by dry eyes. It may also be used for other conditions as determined by your doctor.

Clear Eyes Extra Relief Drops are an eye decongestant and lubricant. It works by constricting the blood vessels in the eye and coating the eye, which relieves redness, dryness, and irritation.

Do NOT use Clear Eyes Extra Relief Drops if: you are allergic to any ingredient in Clear Eyes Extra Relief Drops you have taken furazolidone or a monoamine oxidase (MAO) inhibitor (eg, phenelzine) within the past 14 days

Contact your doctor or health care provider right away if any of these apply to you.

Before using Clear Eyes Extra Relief Drops:

Some medical conditions may interact with Clear Eyes Extra Relief Drops. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

if you are pregnant, planning to become pregnant, or are breast-feeding if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement if you have allergies to medicines, foods, or other substances if you have glaucoma, high blood pressure, diabetes, heart problems, or thyroid problems, or you are taking medicine for high blood pressure

Some MEDICINES MAY INTERACT with Clear Eyes Extra Relief Drops. Tell your health care provider if you are taking any other medicines, especially any of the following:

Tricyclic antidepressants (eg, amitriptyline) because they may decrease Clear Eyes Extra Relief Drops's effectiveness Cocaine, furazolidone, MAO inhibitors (eg, phenelzine), or tricyclic antidepressants (eg, amitriptyline) because they may increase the risk of Clear Eyes Extra Relief Drops's side effects, such as headache, fever, and high blood pressure Bromocriptine or cocaine because their actions and side effects may be increased by Clear Eyes Extra Relief Drops

This may not be a complete list of all interactions that may occur. Ask your health care provider if Clear Eyes Extra Relief Drops may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Clear Eyes Extra Relief Drops:

Use Clear Eyes Extra Relief Drops as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Clear Eyes Extra Relief Drops are for use in the eye only. Avoid contact with the nose, mouth, or other mucous membranes. To use Clear Eyes Extra Relief Drops, first, wash your hands. Tilt your head back. Using your index finger, pull the lower eyelid away from the eye to form a pouch. Drop the medicine into the pouch and gently close your eyes. Immediately use your finger to apply pressure to the inside corner of the eye for 1 to 2 minutes. Do not blink. Remove excess medicine around your eye with a clean tissue, being careful not to touch your eye. Wash your hands to remove any medicine that may be on them. To prevent germs from contaminating your medicine, do not touch the applicator tip to any surface, including your eye. Keep the container tightly closed. If you miss a dose of Clear Eyes Extra Relief Drops and you are using it regularly, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule.

Ask your health care provider any questions you may have about how to use Clear Eyes Extra Relief Drops.

Important safety information: Remove contact lenses before using Clear Eyes Extra Relief Drops. Do not use Clear Eyes Extra Relief Drops if it becomes cloudy or changes color. Contact your doctor if you experience changes in vision, eye pain, irritation, soreness, or continued redness, or if your condition does not improve after 3 days. Use Clear Eyes Extra Relief Drops with caution in CHILDREN because they may be more sensitive to its effects. PREGNANCY and BREAST-FEEDING: If you become pregnant while taking Clear Eyes Extra Relief Drops, discuss with your doctor the benefits and risks of using Clear Eyes Extra Relief Drops during pregnancy. It is unknown if Clear Eyes Extra Relief Drops are excreted in breast milk. If you are or will be breast-feeding while you are using Clear Eyes Extra Relief Drops, check with your doctor or pharmacist to discuss the risks to your baby. Possible side effects of Clear Eyes Extra Relief Drops:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Blurred vision; minor stinging when the medicine is dropped into the eye.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); changes in vision; eye pain; worsening or persistent eye irritation or redness.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

See also: Clear Eyes Extra Relief side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Clear Eyes Extra Relief Drops may be harmful if swallowed, especially in children.

Proper storage of Clear Eyes Extra Relief Drops:

Store Clear Eyes Extra Relief Drops at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Clear Eyes Extra Relief Drops out of the reach of children and away from pets.

General information: If you have any questions about Clear Eyes Extra Relief Drops, please talk with your doctor, pharmacist, or other health care provider. Clear Eyes Extra Relief Drops are to be used only by the patient for whom it is prescribed. Do not share it with other people. If your symptoms do not improve or if they become worse, check with your doctor. Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Clear Eyes Extra Relief Drops. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012 Database Edition 12.1.1.002 Copyright © 2012 Wolters Kluwer Health, Inc. More Clear Eyes Extra Relief resources Clear Eyes Extra Relief Side Effects (in more detail) Clear Eyes Extra Relief Use in Pregnancy & Breastfeeding Clear Eyes Extra Relief Drug Interactions Clear Eyes Extra Relief Support Group 0 Reviews for Clear Eyes Extra Relief - Add your own review/rating Compare Clear Eyes Extra Relief with other medications Eye Dryness/Redness Eye Redness/Itching
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Soltamox Solution


Generic Name: Tamoxifen (ta-MOX-i-fen)
Brand Name: Soltamox

Women taking Soltamox Solution to decrease the risk of developing breast cancer have developed cancer of the uterus, stroke, and blood clots in the lung. Some of these events have been fatal. Contact your doctor right away if you develop any of the following: unusual vaginal bleeding or discharge; abnormal menstrual period; groin pressure or pain; chest pain; shortness of breath; coughing up blood; confusion; one-sided weakness; vision or speech problems.

Women at high risk of breast cancer or with ductal carcinoma in situ (DCIS) should discuss the use of Soltamox Solution with their doctor. Decide if the possible benefits (reducing the risk of breast cancer) outweigh the risk of these events. The benefits of Soltamox Solution outweigh the risks in women who already have breast cancer.


Soltamox Solution is used for:

Treating breast cancer that has spread to other sites in the body.It is also used along with other medicines to treat other types of breast cancer. It is used in women who are at high risk for breast cancer and in women with DCIS (after surgery and radiation) to decrease the risk of developing breast cancer. It may also be used for other conditions as determined by your doctor.

Soltamox Solution is an antiestrogen. It works by blocking the effect of estrogen on certain tumors. This may prevent the growth of tumors that are activated by estrogen.

Do NOT use Soltamox Solution if: you are allergic to any ingredient in Soltamox Solution you are using Soltamox Solution to reduce your risk of breast cancer and you have a history of blood clots in the lung or leg you are using Soltamox Solution to reduce your risk of breast cancer and you also take certain anticoagulants (eg, warfarin) you are taking anastrozole

Contact your doctor or health care provider right away if any of these apply to you.

Before using Soltamox Solution:

Some medical conditions may interact with Soltamox Solution. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

if you are pregnant, planning to become pregnant, or are breast-feeding if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement if you have allergies to medicines, foods, or other substances if you have a history of blood clots in the legs or lungs if you have high levels of calcium in your blood, a weakened immune system, or low levels of white blood cells or platelets in your blood if you have high cholesterol or lipid levels if you have cataracts or other vision problems if you are using cytotoxic cancer medicines if you are confined to a bed or chair

Some MEDICINES MAY INTERACT with Soltamox Solution. Tell your health care provider if you are taking any other medicines, especially any of the following:

Anticoagulants (eg, warfarin) because the risk of bleeding may be increased Cytotoxic cancer medicines (eg, cisplatin) because the risk of developing blood clots may be increased Rifampin because it may decrease Soltamox Solution's effectiveness Fluorouracil or mitomycin C because they may increase the risk of Soltamox Solution's side effects Aromatase inhibitors (eg, anastrozole, letrozole) because their effectiveness may be decreased by Soltamox Solution

This may not be a complete list of all interactions that may occur. Ask your health care provider if Soltamox Solution may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Soltamox Solution:

Use Soltamox Solution as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Soltamox Solution comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Soltamox Solution refilled. Soltamox Solution may be taken by mouth with or without food. Use a measuring device marked for medicine dosing. Ask your pharmacist for help if you are unsure of how to measure your dose. Continue to take Soltamox Solution even if you feel well. Do not miss any doses. Taking Soltamox Solution at the same time each day will help you to remember to take it. If you miss a dose of Soltamox Solution, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Soltamox Solution.

Important safety information: Soltamox Solution may cause dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use Soltamox Solution with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it. Soltamox Solution may reduce the number of clot-forming cells (platelets) in your blood. Avoid activities that may cause bruising or injury. Tell your doctor if you have unusual bruising or bleeding. Tell your doctor if you have dark, tarry, or bloody stools. Soltamox Solution may lower the ability of your body to fight infection. Avoid contact with people who have colds or infections. Tell your doctor if you notice signs of infection like fever, sore throat, rash, or chills. New tumors have occurred in body sites other than the uterus in patients taking Soltamox Solution. It is unknown if Soltamox Solution may be the cause. Discuss any questions or concerns with your doctor. Women who take Soltamox Solution to reduce the risk of breast cancer should have a breast exam, mammogram, and gynecological exam before starting and during treatment with Soltamox Solution. Women who may become pregnant should begin taking Soltamox Solution during a menstrual period. Women who have irregular menstrual periods should have a pregnancy test immediately before starting Soltamox Solution. Talk to your doctor if you have any questions about how to begin taking Soltamox Solution. Women who may become pregnant must use effective nonhormonal birth control (eg, condoms, diaphragm) during sexual intercourse while they are taking Soltamox Solution and for 2 months after they stop taking it. Do not use hormonal birth control (eg, birth control pills); it may not work as well while you are taking Soltamox Solution. Discuss any questions about effective nonhormonal birth control with your doctor. Soltamox Solution will not prevent you from becoming pregnant. Lab tests, including breast exams, mammograms, gynecologic exams,complete blood counts, and liver function tests, may be performed while you use Soltamox Solution. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments. Soltamox Solution should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed. PREGNANCY and BREAST-FEEDING: Soltamox Solution may cause harm to the fetus. Do not become pregnant while you are using it and for 2 months after you stop using it. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Soltamox Solution while you are pregnant. It is not known if Soltamox Solution is found in breast milk. Do not breast-feed while taking Soltamox Solution. Possible side effects of Soltamox Solution:

All medicines may cause side effects, but many people have no, or minor side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Bone pain; constipation; coughing; hot flashes; muscle pain; nausea; tiredness; vaginal discharge; weight loss.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unexplained hoarseness); abnormal menstrual periods; abnormal vaginal bleeding or bloody discharge; chest pain; coughing up blood; dark urine; decreased sexual desire or ability; depression; fever, chills, or persistent sore throat; groin or pelvic pain or pressure; loss of appetite; loss of balance or coordination; missed menstrual period; new or increased breast tumor or pain; new or unusual lumps; one-sided weakness; pain or swelling in one or both legs; red, swollen, blistered, or peeling skin; severe or persistent tiredness or weakness; shortness of breath; skin changes; stomach pain; sudden severe headache; swelling of the arms or the legs; unusual bleeding or bruising; vision or speech problems; yellowing of the eyes or skin.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

See also: Soltamox side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include exaggerated reflexes; seizures; severe or persistent dizziness; tremor; trouble breathing; trouble walking.

Proper storage of Soltamox Solution:

Store Soltamox Solution at room temperature, below 77 degrees F (25 degrees C), in the original container. Do NOT refrigerate or freeze. Store away from moisture, heat, and light. Do not store in the bathroom. Throw away any unused medicine 3 months after the bottle is opened. Keep Soltamox Solution out of the reach of children and away from pets.

General information: If you have any questions about Soltamox Solution, please talk with your doctor, pharmacist, or other health care provider. Soltamox Solution is to be used only by the patient for whom it is prescribed. Do not share it with other people. If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Soltamox Solution. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012 Database Edition 12.1.1.002 Copyright © 2012 Wolters Kluwer Health, Inc. More Soltamox resources Soltamox Side Effects (in more detail) Soltamox Dosage Soltamox Use in Pregnancy & Breastfeeding Soltamox Drug Interactions Soltamox Support Group 0 Reviews for Soltamox - Add your own review/rating Compare Soltamox with other medications Breast Cancer Breast Cancer, Adjuvant Breast Cancer, Male Breast Cancer, Metastatic Breast Cancer, Palliative McCune-Albright Syndrome Precocious Puberty
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Estraderm MX


ESTRADERM MX 25, 50, 75 and 100

(estradiol)

These patches will usually be referred to as Estraderm MX in this leaflet

What you need to know about Estraderm MX

Your doctor has decided that you need this medicine to help treat your condition.

Please read this leaflet carefully before you start to use the patches. It contains important information. Keep the leaflet in a safe place because you may want to read it again.

If you have any other questions, or if there is something you don’t understand, please ask your doctor or pharmacist.

This medicine has been prescribed for you. Never give it to someone else. It may not be the right medicine for them even if their symptoms seem to be the same as yours.

If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.

In this leaflet: 1. What Estraderm MX patches are, and what they are used for 2. Things to consider before you start to use Estraderm MX patches 3. How to use Estraderm MX patches 4. Possible side effects 5. How to store the patches 6. Further information What Estraderm MX patches are and what they are used for

Estraderm MX is a patch which you stick on your skin. The patch contains a supply of estradiol which is released from the patch and absorbed through the skin into your blood stream. This is called a transdermal patch.

The active ingredient in the patches is estradiol. This is one of a group of hormones called estrogens which are the natural female sex hormone produced in large amounts by the ovaries before the menopause. After the menopause the ovaries produce less estrogen.

Estraderm MX is used as hormone replacement therapy (HRT) to relieve the symptoms of the menopause. The menopause can occur naturally or as the result of surgery.

Estraderm MX 50 and 75 patches can also be used to prevent osteoporosis (thinning of the bones), when you have a high risk of future fractures, and if you are unable to take other medicines for this purpose.

To relieve the symptoms of the menopause:

Estraderm MX is used to help relieve the uncomfortable symptoms which you sometimes get during and after the menopause (the time when menstrual periods stop). Menopause occurs naturally in all women, usually between the ages of 45 and 55. It also occurs in younger women who have had their ovaries removed by surgery. The reduced levels of estrogen can cause unpleasant symptoms such as hot face, neck and chest, hot flushes (sudden waves of heat and sweating all over), sleep problems, irritability and depression.

Some women also have problems with urine control, or with a dry vagina which may cause discomfort during or after sexual intercourse. Taking estrogens can reduce or eliminate these symptoms.

To prevent osteoporosis:

After the age of 40, and especially after the menopause, some women are at risk of developing osteoporosis. This is when the bones become thinner and weaker and more likely to break, especially the bones of the spine, hip and wrist. Lack of estrogens increases the risk of osteoporosis. Taking estrogens after the menopause slows down bone loss and can help to prevent it. The protective effects on the bone cease once treatment is stopped. You should discuss the benefits and risks of Estraderm MX and other therapies with your doctor.

Things to consider before you start to use Estraderm MX

Read this section carefully because, there are some conditions your doctor should know about before you start your treatment.

Medical check-ups

Before you start using HRT, your doctor should ask you about your own, and your family’s, medical history. Your doctor may decide to examine your breasts and/or your abdomen and may do an internal examination - but only if these examinations are necessary for you, or you have any special concerns. Once you have started HRT, you should see your doctor for regular check-ups (at least once a year). At these check-ups your doctor may discuss with you the benefits and risks of continuing with HRT.

While you are using HRT make sure that you:

Go for regular breast screening and cervical smear tests. Regularly check your breasts for any changes such as dimpling of the skin, changes in the nipple, a discharge from the nipple, or any lumps you can see or feel.

Some people MUST NOT use Estraderm MX. Talk to your doctor if:

you have ever had any unusual or allergic reaction to estrogens or to any other components of the patch, (These are listed at the end of the leaflet.) you have, or have ever had, breast cancer, (See the section below on breast cancer.) you have, or have ever had, cancer of the endometrium (lining of the womb) or any other cancer which is sensitive to estrogens, (See the sections below on endometrial and ovarian cancer.) you have a blood disease called porphyria, you have, or have ever had, a blood clot in a vein in your leg or anywhere else (a deep vein thrombosis) or a clot that has travelled to your lung or another part of your body (an embolus), (See the section below on blood clots.) you have ever had a heart attack, stroke or angina, (See the sections below on heart disease and stroke.) you have had any unexpected bleeding or very heavy bleeding from the vagina, you have a history of liver disease, you have a condition called endometrial hyperplasia (thickening of the lining of the womb), you are pregnant or breastfeeding.
Estraderm MX should not be used in children.

You should also ask yourself these questions before using the patch. If the answer to any of these questions is YES, tell your doctor or pharmacist because Estraderm MX might not be the right medicine for you.

Has anyone in your immediate family had breast cancer? Do you have fibroids or any other growths in your womb? Have you had a hysterectomy? Do you have endometriosis (a condition which causes painful periods)? Do you have high blood pressure? Do you have any problems with your liver? Do you have diabetes, epilepsy or asthma? Do you get migraine or other bad headaches? Do you have a condition called lupus (SLE)? Do you have problems with your hearing? Do you have any of the conditions which put you at increased risk of blood clots (see below)? Do you have a high level of cholesterol or other fats in your blood? Do you have heart or kidney problems? Have you ever had problems with your gall bladder, such as gallstones? Are you over 65? Are you taking other medicines?

Some medicines can interfere with your treatment. Tell your doctor or pharmacist if you are taking any of the following:

medicines to treat epilepsy such as phenobarbital, phenytoin and carbamazepine, antibiotics and other medicines to treat infections (e.g. rifampicin, rifabutin, nevirapine, efavirenz, ritonavir, nelfinavir), the herbal medicine St John’s Wort (also known as Hypericum perforatum).

Always tell your doctor or pharmacist about all the medicines you are taking. This means medicines you have bought yourself as well as medicines on prescription from your doctor.

Before you have a blood test remind your doctor that you are using Estraderm MX as it may affect the result.

Will there be any problems with driving or using machinery?

No problems have been reported.

Using contraception whilst taking Estraderm MX

Estraderm MX is not a contraceptive, nor a fertility treatment.

If you are using an oral or other hormone contraceptive, e.g. the pill or depot injection, you must change to a non-hormone contraceptive, for example, a diaphragm or condom, BEFORE starting Estraderm MX.

If you have been told that you don’t need to use a contraceptive any longer, you won’t need one while you are using Estraderm MX even if you have a monthly bleed.

Other special warnings

HRT will not help to prevent heart disease.

As well as benefits, HRT has some risks which you need to consider when you are deciding whether to use it, or whether to carry on using it. These are:

Effects on your heart or circulation

i. Heart disease

HRT is not recommended for women who have heart disease, or have had heart disease recently. If you have ever had heart disease, talk to your doctor to see if you should be using HRT.

Studies with one type of HRT (containing conjugated estrogen plus a progestogen) have shown that women may be slightly more likely to get heart disease during the first year of taking the medication. For other types of HRT, the risk is likely to be similar, although this is not yet certain.

If you get:

A pain in your chest that spreads to your arm or neck,

See a doctor as soon as possible and do not use any more HRT until your doctor says you can. This pain could be a sign of heart disease.

ii. Stroke

Recent research suggests that HRT slightly increases the risk of having a stroke. Other things that can increase the risk of stroke include:

Getting older High blood pressure Smoking Drinking too much alcohol An irregular heartbeat

If you are worried about any of these things, or if you have had a stroke in the past, talk to your doctor to see if you ought to be using HRT.

If you get:

Unexplained migraine-type headaches, with or without disturbed vision,

See a doctor as soon as possible and do not use any more HRT until your doctor says you can. These headaches may be an early warning sign of a stroke.

iii. Blood clots

Using HRT may increase the risk of blood clots in the veins (also called deep vein thrombosis, or DVT), especially during the first year. These blood clots are not always serious, but if one travels to the lungs, it can cause chest pain, breathlessness, collapse or even death. This condition is called pulmonary embolism, or PE.

DVT and PE are examples of a condition called venous thromboembolism, or VTE.

You are more likely to get a blood clot if:

You are seriously overweight You have had a blood clot before Any of your close family have had blood clots You have had one or more miscarriages You have any blood clotting problem that needs treatment with a medicine such as warfarin You’re off your feet for a long time because of major surgery, injury or illness You are going on a long journey and will be immobile for some time You have a rare condition called systemic lupus erythematosus (SLE – a connective tissue disease).

If any of these things apply to you, talk to your doctor to see if you should be using HRT.

If you get:

Painful swelling in your leg Sudden chest pain Difficulty breathing

See a doctor as soon as possible and do not use any more HRT until your doctor says you can. These may be signs of a blood clot.

If you’re going to have surgery, make sure your doctor knows about it. You may need to stop using HRT about 4 to 6 weeks before the operation, to reduce the risk of a blood clot. Your doctor will tell you when you can start using HRT again.

A comparison – the approximate risk of stroke or blood clots in women not using, or using, HRT over a 5 year period

Women in their 50s
Stroke has been reported in 3 in 1,000 women not using HRT, compared to 4 in 1,000 women using HRT.
Blood clots have been reported in 3 in 1,000 women not using HRT, compared to 7 in 1,000 women using HRT.

Women in their 60s
Stroke has been reported in 11 in 1,000 women not using HRT, compared to 15 in 1,000 women using HRT.
Blood clots have been reported in 8 in 1,000 women not using HRT, compared to 17 in 1,000 women using HRT.

Effects on your risk of developing cancer

i. Breast cancer

Women who have breast cancer, or have had breast cancer in the past, should not use HRT.

Using HRT slightly increases the risk of breast cancer; so does having a late menopause.

The risk for a post-menopausal woman using estrogen-only HRT for 5 years is about the same as for a woman of the same age who’s still having periods over that time and not using HRT. The risk for a woman who is using combined HRT (estrogen plus progestogen) is higher than for estrogen-only HRT (but combined HRT is beneficial for the endometrium, see Endometrial cancer, below).

For all kinds of HRT, the extra risk of breast cancer goes up the longer you use it, but returns to normal within about 5 years of stopping HRT.

Your risk of breast cancer is also higher if:

You have a close relative (mother, sister or grandmother) who has had breast cancer You are seriously overweight.

If you notice any changes in your breast, such as:

Dimpling of the skin Changes in the nipple or a discharge from the nipple Any lumps you can see or feel

Make an appointment to see your doctor as soon as possible.

A comparison – the risk of developing breast cancer: the number of women aged 50 who will get breast cancer by the time they are 65.

32 in 1,000 of these women who are not using HRT, will get breast cancer.
33.5 in 1,000 of these women who have used estrogen-only HRT for 5 years, will get breast cancer.
37 in 1,000 of these women who have used estrogen-only HRT for 10 years, will get breast cancer.
38 in 1,000 of these women who have used combined HRT for 5 years, will get breast cancer.
51 in 1,000 of these women who have used combined HRT for 10 years, will get breast cancer.

ii. Endometrial cancer (cancer of the lining of the womb)

Estraderm MX is an estrogen-only product.

Using estrogen-only HRT for a long time can increase the risk of cancer of the lining of the womb. Taking a progestogen as well as the estrogen helps to lower the extra risk.

If you still have your womb, your doctor may prescribe a progestogen as well as estrogen.

They can be prescribed separately, or as a combined HRT product.

If you have had your womb removed (a hysterectomy), your doctor will discuss with you whether you can safely take estrogen without a progestogen.

If you’ve had your womb removed because of endometriosis, any endometrium left in your body may be at risk. So your doctor may prescribe HRT that includes a progestogen as well as an estrogen.

A comparison – the risk of developing endometrial cancer

Women who still have their uterus and who do not use HRT

About 5 in 1,000 women aged 50 will get endometrial cancer by the time they are 65.

Women who have used estrogen-only HRT

The number will be 2-12 times higher depending on the dose and length of use.

Women who have used estrogen plus progestogen HRT

The risk of endometrial cancer is substantially reduced.

If you get breakthrough bleeding or spotting, it’s usually nothing to worry about, especially during the first few months of taking HRT.

But if the bleeding or spotting:

Carries on for more than the first few months Starts after you’ve been on HRT for a while Carries on even after you’ve stopped using HRT

Make an appointment to see your doctor. It could be a sign that your endometrium has become thicker.

iii. Ovarian cancer (cancer of the ovaries)

Cancer of the ovaries is very rare, but it is serious. It can be difficult to diagnose, because there are often no obvious signs of the disease.

Some studies have indicated that using estrogen-only HRT for more than 5 years may increase the risk of ovarian cancer. It is not yet known whether other kinds of HRT increase the risk in the same way.

Effects on your risk of developing dementia

HRT will not prevent memory loss. In one study of women who started using combined HRT after the age of 65, a small increase in risk of dementia was observed.

How to use Estraderm MX patches

The doctor will tell you how to use Estraderm MX and what dose you need. Always follow his/her instructions carefully. The information will be on the pharmacist’s label.

Check the label carefully. If you are not sure, ask your doctor or pharmacist. Do not change the dose or stop the treatment without talking to your doctor.

If you have not had a hysterectomy, your doctor will give you tablets containing another hormone called progestogen to offset the effects of estrogens on the lining of the womb. (See the section above on endometrial cancer.) Your doctor will explain to you how to take these tablets. Withdrawal bleeding may occur at the end of the progestogen treatment period. Tell your doctor if you get irregular and/or heavy bleeding (see endometrial cancer).

Starting to use the patches

Estraderm MX patches are applied to the skin. You wear them all the time. You should apply a new patch twice a week i.e. every 3 or 4 days.

If you are not currently using any form of HRT (patch or tablets), if you have had a hysterectomy or if you have been using a continuous combined HRT product (where estrogen and the progestogen are given every day without interruption), you can start to use Estraderm MX on any convenient day. If you are changing from a cyclic or sequential HRT treatment where the progestogen is added for 12-14 days of the cycle, start to use Estraderm MX the day after you complete the cycle. If you are still having periods you should start to use Estraderm MX within 5 days of starting your period, irrespective of how long you bleed. About the patch

Where to apply the patch

Stick the patch on to a hairless area of skin below the waist. Most patients find that the buttock is the best place. Choose an area of the buttock where the skin is not inflamed, broken, or irritated. You could also try the lower back, hip or abdomen.

Never put a patch on or near the breasts.

Choose a clean, dry area of skin. To help the patch stick, the skin should be clean, dry, and free of creams, lotions, oil, or powder. You should use a different area of skin each time. Wait a week before using the same area again. Avoid skin which is red or irritated.

Do not expose the patch to direct sunlight.

Opening the sachets

Each Estraderm MX patch is sealed in an airtight sachet. Tear open one of the sachets at the notch (do not use scissors) and take out the patch. Don’t take the patch out of the sachet until immediately before you intend to use it.

Removing the lining

A stiff, transparent protective lining covers the sticky side of the patch, i.e. the side that will be placed against your skin. First remove the smaller piece of the transparent liner. Then peel off the larger piece. Try to avoid touching the adhesive and remember not to allow the patch to become folded so that the sticky surfaces come in contact with each other. Now apply the patch.

Applying the patch

With the palm of your hand press the sticky side of the patch firmly onto the spot you have chosen. Hold it there for about 10-20 seconds. Make sure that it sticks well, especially around the edges, but once the patch is in place do not pull at it to test that it is sticking properly.

When and how to remove the patch

The patches should be changed twice a week on the same two days of the week, e.g. Mondays and Thursdays. Choose two days which you are likely to remember.

Note the day of the week on which you are starting the treatment.

When the time comes to change the patch, peel it off and fold it in half with the sticky side inside. Dispose of the patch carefully (see Section 5), making sure that it is kept out of the reach of children because it will still contain some medication. Stick a new patch onto a different area of skin.

What to do if a patch comes off

If a patch falls off it will not stick to your skin again. Use another patch on a different area of your skin (see Where to apply the patch). Make sure you choose a clean, dry, lotion-free area of the skin. No matter what day this happens, go back to changing the patch on the same days as usual.

Other useful information Bathing, swimming, showering or exercising should not affect the patch if it has been correctly applied. You may wear the patch under your swimming costume. Never apply a patch on a sweaty area or after a hot bath or shower. Wait until the skin is completely cool and dry. Do not remove the patch and try to put it somewhere else, it will not stick to your skin again. Instead apply a new patch in the usual way. Remember to apply your next patch at the normal time. If you have run out of patches, please contact your doctor straight away. (See also advice on What to do if a patch comes off.) Sunbathing: always make sure your patch is covered by clothing. Using a sunbed: cover up the patch The drug in your patch is contained in the adhesive and not in a special reservoir. The drug in your patch is a gel which is colourless. This does not mean that the patch does not contain any medication. How long to use Estraderm MX

Estraderm MX should be used only as long as needed, possibly for several months or more. This will help to control your symptoms.

While you are using Estraderm MX you should go to the doctor regularly to discuss the possible risks and benefits associated with HRT, and whether you still need the treatment.

Your doctor will aim to give you the lowest possible dose for the shortest possible length of time to treat your symptoms.

If you forget to use Estraderm MX

If you forget to apply a patch, apply a new patch as soon as you remember. No matter what day that happens, go back to changing this patch on the same day as you usually do.

There is an increased chance of breakthrough bleeding or spotting if there is a break in treatment.

Estraderm MX Side Effects

Estraderm MX is suitable for most people, but, like all medicines, there are sometimes side effects.

Stop using Estraderm MX immediately and tell your doctor if you develop any of the following: Signs of an allergic reaction (difficulty in breathing, tight chest, itching all over, generalised swelling or itching). Migraine or unusually severe headaches, or signs of stroke You become pregnant Signs of jaundice (yellowing of your skin or eyes). The side effects listed below have also been reported:

Up to 1 in 10 people have experienced:

Headache Feeling sick or bloated, stomach ache Redness and itching where the patch has been applied Tender or painful breasts Breakthrough bleeding.

Up to 1 in 100 people have experienced:

Breast cancer.

Up to 1 in 1,000 people have experienced:

Dizziness Blood clots, bruising, worsening varicose veins, raised blood pressure Abnormal liver function test results, jaundice Rash and itching over large areas of the skin. This sensitivity reaction may become severe if you carry on using the patches without talking to your doctor. Changes in the pigmentation in your skin (lightening or darkening of your skin colour) Unusual weight changes, fluid retention (swelling or accumulation of fluid in the lower legs or ankles), leg pain. Other side effects include: Estrogen-dependent conditions such as cancer of the endometrium, heart attack, stroke, dementia (these are discussed in Section 2) and gall bladder disease.

Tell your doctor or pharmacist as soon as possible if you do not feel well while you are using Estraderm MX. Ask your doctor or pharmacist to answer any questions you may have.

How to store the patches

Keep Estraderm MX out of the reach and sight of children both before and after use.

Store below 25°C, away from direct sunlight.

Do not use Estraderm MX after the expiry date shown on the pack.

Do not use a new Estraderm MX pack that is damaged or shows signs of tampering.

If your doctor tells you to stop using Estraderm MX, please take any patches left back to your pharmacist to be destroyed. Only keep them if the doctor tells you to. Do not throw them away with your normal household water or waste. This will help to protect the environment.

Further information

The active substance in Estraderm MX is estradiol. The estradiol is derived from plants and is produced synthetically.

The other ingredients in Estraderm MX are isopropyl palmitate, acrylic adhesive (in solution in ethylacetate/hexane) and ethyl acetate. The backing film consists of ethylene vinyl acetate/polyester film laminate. The protective liner, which is removed before the patch is used, is a siliconized polyester film. The estradiol is released gradually while you are wearing the patch.

Estraderm MX 25 contains 0.75 mg estradiol releasing about 25 micrograms of estradiol a day.

Estraderm MX 50 contains 1.5 mg estradiol releasing about 50 micrograms of estradiol a day.

Estraderm MX 75 contains 2.25 mg estradiol releasing about 75 micrograms of estradiol a day.

Estraderm MX 100 contains 3.0 mg estradiol releasing about 100 micrograms of estradiol a day.

A one month pack contains 8 patches; a 3-month pack contains 24 patches of one size.

The product licence holder is Novartis Pharmaceuticals UK Limited Frimley Business Park Frimley Camberley Surrey GU16 7SR England Estraderm MX patches are made by Lohmann LTS Lohmannstr. 2 P.O. Box 1525 56605 Andernach Germany

This leaflet was revised in December 2008.

Fill this in to remind you when to change your patch. Please tick the box for the days of the week when you should change your patch.

Monday + Thursday Tuesday + Friday Wednesday + Saturday Thursday + Sunday Friday + Monday Saturday + Tuesday Sunday + Wednesday

If you would like any more information, or would like the leaflet in a different format, please contact Medical Information at Novartis Pharmaceuticals UK Ltd, telephone number 01276 698370.

ESTRADERM MX is a registered trade mark

Copyright Novartis Pharmaceuticals UK Limited


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