m2f does estrogen use lead to permanent nipple sensitivity
 

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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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Lead Poisoning Medications


Topics under Lead Poisoning Lead Poisoning, Mild (1 drug) Lead Poisoning, Severe (2 drugs) Learn more about Lead Poisoning

Medical Encyclopedia:

Lead poisoning

Harvard Health Guide:

Symptoms and treatment for Lead Poisoning
Drug List:
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Multiple Chemical Sensitivity Medications


There are currently no drugs listed for "Multiple Chemical Sensitivity".

Definition of Multiple Chemical Sensitivity: Multiple chemical sensitivity (MCS) is described as a chronic condition characterized by adverse effects from exposure to low levels of chemicals or other substances in modern human environments.

Learn more about Multiple Chemical Sensitivity

Micromedex Care Notes:

Acute Rash Atopic Dermatitis Atopic Dermatitis In Children Contact Dermatitis Poison Ivy Sunburn
Drug List:
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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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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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Elleste Duet Conti Tablets


Elleste DuetTM Conti Tablets

(estradiol and norethisterone acetate)

Read all of this leaflet carefully before you start using this medicine. Keep this leaflet. You may need to read it again. If you have any 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 if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist. In this leaflet: 1. What Elleste Duet Conti Tablets are and what they are used for 2. Before you take Elleste Duet Conti Tablets 3. How to take Elleste Duet Conti Tablets 4. Possible side effects 5. How to store Elleste Duet Conti Tablets 6. Further information What Elleste Duet Conti Tablets Are And What They Are Used For

Elleste Duet Conti Tablets are a form of hormone replacement therapy (HRT).

They contain two hormones, estradiol hemihydrate and norethisterone acetate. Elleste Duet Conti Tablets are one of a group of medicines called combined estrogen-progestogen preparations. They are not an oral contraceptive.

Why has your doctor given you Elleste Duet Conti Tablets?

Elleste Duet Conti Tablets treat the symptoms of the menopause (change of life) in women who are at least one year past the menopause.

As you approach the menopause, your ovaries gradually produce fewer hormones. This may cause unpleasant symptoms such as hot flushes and sweating. Elleste Duet Conti Tablets replace hormones which you lose during the menopause and prevent or relieve any unpleasant symptoms. Your doctor will aim to give you the lowest dose required to treat your symptoms.

Other changes in your bones may also take place over a longer time. These changes can lead to an increased risk of your bones breaking or cracking. If you are at an increased risk of fractures due to osteoporosis (thinning of the bones) but are unable to take other treatments or if other therapies prove to be ineffective, Elleste Duet Conti Tablets may also be used for this purpose. Your doctor should discuss all the available options with you.

Before You Take Elleste Duet Conti Tablets

Elleste Duet Conti Tablets may not be suitable for all women. Read the list below.

DO NOT take Elleste Duet Conti Tablets, if you have, or have ever had:

a blood clot in a vein in your leg or anywhere else (a "deep vein thrombosis"); a blood clot that has travelled to your lung or another part of the body (an "embolus"); narrowed or blocked arteries possibly leading to angina and heart disease; breast or womb cancer; unexplained vaginal bleeding; liver problems, for example, jaundice (yellowing of the skin or eyes); porphyria (a rare inherited blood disease); untreated endometrial hyperplasia (an overgrowth of the lining of the womb).

Also do not take Elleste Duet Conti Tablets if you:

are pregnant or you think you could be pregnant; are breast-feeding; or have ever had an allergic reaction to any of the ingredients in Elleste Duet Conti Tablets (see Section 6).

Elleste Duet Conti Tablets contain lactose. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.

Safety of HRT

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.

Take special care with Elleste Duet Conti Tablets

Elleste Duet Conti Tablets might have an effect on various processes in your body. HRT should only be started for symptoms that reduce your quality of life.

Medical check-ups

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 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; 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. 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 estrogen 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.

Compare

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

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

Compare

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.

The following may be signs of a blood clot if you get:

painful swellling 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.

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.

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; as does having a later menopause. Your risk of breast cancer is higher if you:

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

The risk for a post-menopausal woman taking estrogen-only HRT for 5 years is about the same as for a woman of the same age who is 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 increases the longer you take it, but returns to normal within about 5 years after stopping.

Compare

Looking at women in their 50s 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 (ie an extra 1-2 cases).

If they take estrogen-only HRT for 10 years, the figure will be 37 in 1000 (ie 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 (ie an extra 6 cases).

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

If you notice any changes in your breasts 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 progestogen as well as the estrogen helps to lower the extra risk.

Elleste Duet Conti Tablets also contain progestogen.

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

Compare

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 50-65.

For women who take estrogen-only HRT, the figure will be between 10 and 60 in 1000 (ie an extra 5 to 55 cases), depending on the dose and how long you 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.

Make an appointment to see your doctor 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

It could be 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.

While you are taking Elleste Duet Conti Tablets

Certain diseases sometimes get worse when you are taking hormone replacement therapy. Your doctor may need to check you more closely if you suffer from any of the following.

Migraine or severe headache Asthma Gallstones Epilepsy High blood pressure A personal or family history of blood clots. Diabetes (see below) Liver problems Heart or kidney problems Endometrial hyperplasia (overgrowth of the lining of your womb) Fibroids in your womb (see below) Endometriosis (where tissue from your womb is found outside the womb). A history of breast cancer in your family Systemic lupus erythematosus (SLE; a chronic inflammatory disease affecting the skin and organs) Otosclerosis (an inherited form of deafness which sometimes gets worse during pregnancy). High levels of lipids in you blood (hypertriglyceridaemia)

Elleste Duet Conti Tablets may affect the results of certain laboratory tests, so tell the person taking the sample that you are taking Elleste Duet Conti Tablets.

If you have:

fibroids (lumps of fibrous and muscular tissue) in your womb, these may increase in size when you are taking Elleste Duet Conti Tablets. See your doctor if you have any pain or swelling in your abdomen. diabetes, you may need to change the amount of insulin you take. Check your blood glucose level more often until it is steady.

Do I need to use contraception while I am taking Elleste Duet Conti Tablets?

It is important to remember that Elleste Duet Conti Tablets are not an oral contraceptive (the pill).

If you are using the pill or another hormonal contraceptive, you will need to use another type of contraceptive. Please discuss this with your doctor.

Taking other medicines with Elleste Duet Conti Tablets

Please tell your doctor or pharmacist if you are using or have recently used any other medicines, including over-the-counter medicines.

In particular, tell your doctor if you are using any of the following because they may alter the effects of Elleste Duet Conti Tablets:

drugs that treat epilepsy, some anti-infectives (anti-virals or antibiotics) and sedatives. herbal medicines containing St. John's Wort: diabetic drugs, as this product may affect your blood glucose level. If you are being treated for diabetes please let your doctor or pharmacist know that you take Elleste Duet Conti.

If your doctor does not know that you are taking these other medicines, tell him or her before you start taking Elleste Duet Conti Tablets.

Pregnancy and breast-feeding

Elleste Duet Conti Tablets are for use in post-menopausal women. They should not be taken by pregnant or breast-feeding women.

Driving or using machines

No effects on driving or using machinery have been observed for Elleste Duet Conti Tablets.

Important information about some of the ingredients of Elleste Duet Conti Tablets

Elleste Duet Conti Tablets contain lactose. 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 Elleste Duet Conti Tablets If you are not taking any HRT

If you are not taking any HRT, you can start taking Elleste Duet Conti Tablets straightaway.

Take one tablet each day. You can take the tablets at a time of the day that suits you, but it is best to take them at about the same time each day. Swallow the tablets whole, with some water. All the tablets are the same. The days are marked on the strip to help you to remember to take one each day. Follow the direction of the arrows on the pack and take a tablet every day until the pack is empty. When you finish a foil strip, start a new strip the next day. Changing from another type of HRT

If you are changing from another type of HRT, and you usually have a monthly bleed, start taking Elleste Duet Conti Tablets on the first day of bleeding.

If you do not have a monthly bleed, start taking Elleste Duet Conti Tablets on any convenient day.

If your doctor gives you instructions on changing from another type of HRT you should follow these instructions. If you have any doubts you should contact your doctor.

Will I have periods?

You should not have monthly periods. In the first few months you may get some breakthrough bleeding or spotting. As you continue to take Elleste Duet Conti Tablets, some women will continue to have light spotting and some women will not bleed at all.

Tell your doctor if you:

still getting some bleeding after the first 3 to 4 months and this is a problem for you; don't bleed for a long time, but then start bleeding again. If you forget to take a tablet

Take the tablet as soon as you remember, and take the next one at the normal time.

If you have missed your tablet by more than 12 hours, dispose of this tablet safely and take the next one at the normal time. You may experience some breakthrough bleeding or spotting.

If you take more than you should

There should be no problems, but you may feel sick or actually be sick. If you are worried, contact your doctor. Take the usual tablet the following day.

Possible Side Effects

Like all medicines, Elleste Duet Conti Tablets can cause side effects, although not everybody gets them. 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.

Stop taking the tablets immediately and tell your doctor if: you become jaundiced (your skin or the whites of your eyes look yellow); you have itching all over your body; you have an unusual, severe or prolonged headache; your sight is affected in any way; you find it difficult to speak; any part of your body suddenly feels weak or numb; there is a chance that you could be or could become pregnant; or you develop any of the conditions listed under "Before you take Elleste Duet Conti Tablets".

During the first few months you may feel sick, have headaches, or your breasts may be painful or increase in size. These side effects should lessen as your body gets used to the medicine.

You may also get the following side effects:

Common: feeling sick, stomach cramps, headache, an increase in size of fibroids in the womb, breakthrough bleeding, changes in weight, oedema (swelling) of legs, breast tenderness and enlargement, mood changes, changes in sex drive.

Uncommon: indigestion, being sick, flatulence, gallstones and gallbladder disease, feeling dizzy, migraine, vaginal thrush, increase in blood pressure, leg cramps, breast cancer (please refer to the earlier section on breast cancer).

Rare: loss of hair from the scalp, increase in body and facial hair, itchiness, rashes, thromboembolic disease (please refer to the earlier section on the effects of HRT on the heart and circulation).

Very rare: heart disease (please refer to the earlier section on the effects of HRT on the heart and circulation), stroke, chloasma (brown patches on the skin), red swellings on the skin.

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 the risk of dementia was observed.

How To Store Elleste Duet Conti Tablets

Keep out of the reach and sight of children.

Do not store above 25°C. Store in the original package.

Do not take Elleste Duet Conti Tablets after the 'expiry date' shown on the box.

If your tablets are out of date, take them to your pharmacist who will dispose of them safely.

Further Information What Elleste Duet Conti Tablets contains Each tablet contains the active ingredients: 2 milligrams estradiol (as hemihydrate) and 1 milligram norethisterone acetate.
(The estradiol used to make Elleste Duet Conti Tablets does not come from animals). The tablets also contain: lactose monohydrate, maize starch, povidone, talc, magnesium stearate, macrogol 400, titanium dioxide (E171), black iron oxide (E172), and hypromellose (E464) (see also the warning at the end of section 2). What Elleste Duet Conti Tablets look like and contents of the pack

Elleste Duet Conti Tablets are grey film-coated tablets with an embossing.

They are supplied in three blister strips in each pack. Each strip contains 28 tablets.

Marketing Authorisation Holder Meda Pharmaceuticals Ltd Skyway House Parsonage Road Takeley Bishop's Stortford CM22 6PU UK Manufacturer Piramal Healthcare UK Ltd. Whalton Road Morpeth Northumberland NE61 3YA UK

This leaflet was last approved in October 2009.

If you have any comments on the way this leaflet is written, please write to

Meda Pharmaceuticals Ltd Skyway House Parsonage Road Takeley Bishop's Stortford CM22 6PU UK

20701188

5029/PIL8


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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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Lead Poisoning, Severe Medications


Drugs associated with Lead Poisoning, Severe

The following drugs and medications are in some way related to, or used in the treatment of Lead Poisoning, Severe. This service should be used as a supplement to, and NOT a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners.


Drug List: Calcium-Disodium-Versenate Chemet
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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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Travatan Z


Generic Name: travoprost ophthalmic (TRA voe prost off THAL mik)
Brand Names: Travatan, Travatan Z

What is travoprost ophthalmic?

Travoprost ophthalmic (for the eye) reduces pressure in the eye by increasing the amount of fluid that drains from the eye.

Travoprost ophthalmic is used to treat certain types of glaucoma and other causes of high pressure inside the eye.

Travoprost ophthalmic may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about travoprost ophthalmic?

Travoprost ophthalmic may cause a gradual change in the color of your eyes or eyelids and lashes, as well as increased growth or thickness of your eyelashes. These color changes, usually an increase in brown pigment, occur slowly and you may not notice them for months or years. Color changes may be permanent even after your treatment ends, and may occur only in the eye being treated. This could result in a cosmetic difference in eye or eyelash color from one eye to the other.

Do not allow the dropper to touch any surface, including the eyes or hands. If the dropper becomes contaminated it could cause an infection in your eye, which can lead to vision loss or serious damage to the eye.

After using this medication, wait at least 5 minutes before using any other eye drops that your doctor has prescribed.

What should I discuss with my health care provider before using travoprost ophthalmic? Do not use this medication if you are allergic to travoprost.

Before using travoprost, tell your doctor if you are allergic to any drugs, or if you have swelling or infection of your eye.

Travoprost ophthalmic may cause a gradual change in the color of your eyes or eyelids and lashes, as well as increased growth or thickness of your eyelashes. These color changes, usually an increase in brown pigment, occur slowly and you may not notice them for months or years. Color changes may be permanent even after your treatment ends, and may occur only in the eye being treated. This could result in a cosmetic difference in eye or eyelash color from one eye to the other.

FDA pregnancy category C. It is not known whether travoprost is harmful to an unborn baby. Before using this medication, tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether travoprost passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. How should I use travoprost ophthalmic?

Use this medication exactly as it was prescribed for you. Do not use the medication in larger amounts, or use it for longer than recommended by your doctor. Follow the instructions on your prescription label.

Wash your hands before using the eye drops.

To apply the eye drops:

Tilt your head back slightly and pull down on the lower eyelid to create a small pocket. Hold the dropper above the eye with the dropper tip down. Look up and away from the dropper. Squeeze out a drop and close your eye. Gently press your finger to the inside corner of the eye (near the nose) for about 1 minute to keep the liquid from draining into your tear duct.

If you use more than one drop in the same eye, wait about 5 minutes before putting in the next drop. Also wait at least 5 minutes before using any other eye drops that your doctor has prescribed.

Do not allow the dropper to touch any surface, including the eyes or hands. If the dropper becomes contaminated it could cause an infection in your eye, which can lead to vision loss or serious damage to the eye. At any time during your use of travoprost ophthalmic, tell your doctor at once if you have an eye injury, if you develop an eye infection, or if you plan to have eye surgery. Do not use the eye drops if the liquid changes colors or has particles in it. Store the drops at room temperature away from heat and moisture. Keep the bottle tightly closed when not in use. What happens if I miss a dose?

Use the medication as soon as you remember. If it is almost time for the next dose, skip the missed dose and use the medicine at the next regularly scheduled time. Do not use extra medicine to make up the missed dose.

What happens if I overdose? Seek emergency medical attention if you think you have used too much of this medicine.

An overdose of travoprost ophthalmic used in the eyes is not expected to produce life-threatening symptoms.

What should I avoid while using travoprost ophthalmic? Avoid using too much of this medication, which can actually make it less effective in lowering the pressure inside the eye.

Avoid using any eyedrop medicine that has not been prescribed by your doctor.

Travoprost ophthalmic side effects Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using travoprost ophthalmic and call your doctor at once if you have any of these serious side effects:

redness, swelling, itching, or pain in or around your eye;

oozing or discharge from your eye;

increased sensitivity to light;

vision changes; or

chest pain.

Less serious side effects may include:

mild eye discomfort;

headache;

feeling like something is in your eye;

blurred vision;

dry or watery eyes; or

stinging or burning of the eyes after using the drops.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect travoprost ophthalmic?

There may be other drugs that can affect travoprost ophthalmic. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

More Travatan Z resources Travatan Z Side Effects (in more detail) Travatan Z Use in Pregnancy & Breastfeeding Travatan Z Drug Interactions Travatan Z Support Group 1 Review for Travatan Z - Add your own review/rating Travatan Z Consumer Overview Travatan Z Drops MedFacts Consumer Leaflet (Wolters Kluwer) Travatan Prescribing Information (FDA) Travatan Monograph (AHFS DI) Travatan Advanced Consumer (Micromedex) - Includes Dosage Information Travatan Consumer Overview Travatan Drops MedFacts Consumer Leaflet (Wolters Kluwer) Compare Travatan Z with other medications Glaucoma, Open Angle Intraocular Hypertension Where can I get more information? Your pharmacist can provide more information about travoprost ophthalmic.

See also: Travatan Z side effects (in more detail)


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chlorotrianisene


Generic Name: chlorotrianisene (klor oh trye AN i seen)
Brand Names: Tace

What is chlorotrianisene?

Chlorotrianisene is a form of estrogen. Estrogen is a female sex hormone necessary for many processes in the body.

Chlorotrianisene is used to treat symptoms of menopause, deficiencies in ovary function (including underdevelopment of female sexual characteristics and some types of infertility), and prostate cancer.

Chlorotrianisene may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about chlorotrianisene?

Have yearly physical exams and examine your breasts for lumps on a monthly basis while taking chlorotrianisene.

Take chlorotrianisene with food or milk to lessen stomach upset. Do not take chlorotrianisene if you are pregnant. Who should not take chlorotrianisene? Do not take chlorotrianisene if you

have breast cancer. Tell your doctor if you have (or have ever had) breast cancer.

have vaginal bleeding that has not been diagnosed. It will be necessary to determine if any abnormal bleeding has a hormonal cause.

have a bleeding or blood-clotting disorder. Chlorotrianisene may increase the risk that a blood clot will form.

Before taking this medication, tell your doctor if you

have any type of liver or gallbladder disease,

are diabetic,

suffer from migraines,

have epilepsy or seizures,

have heart disease, or

have kidney disease.

You may need a lower dose or special monitoring during treatment if you have any of the conditions listed above.

Chlorotrianisene is in the FDA pregnancy category X. This means that chlortrianisene will cause birth defects in an unborn baby. Do not take this medication if you are pregnant or are planning a pregnancy. Chlorotrianisene may decrease milk flow and have other effects on milk composition. Do not use this medication without first talking to your doctor if you are breast-feeding a baby. How should I take chlorotrianisene?

Take this medication exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with a full glass of water. Take chlorotrianisene with food or milk to lessen stomach upset.

Try to take each dose at the same time each day, preferably in the morning. You may be taking it every day, or you may be taking it every day for 3 weeks with 1 week off each month to mimic your body's natural cycle. Follow the directions on your prescription label.

If you are taking chlorotrianisene to treat cancer, you may be taking it several times a day in very large doses.

Store chlorotrianisene at room temperature away from moisture and heat. What happens if I miss a dose?

Take the missed dose as soon as you remember. Do not take a double dose of this medication unless otherwise directed by your doctor.

What happens if I overdose? An overdose of this medication is unlikely to threaten life. Consult an emergency room or poison control center for advice.

Symptoms of an estrogen overdose include nausea and vomiting.

What should I avoid while taking chlorotrianisene? Avoid prolonged exposure to sunlight. Chlorotrianisene may increase the sensitivity of your skin to sunlight. Use a sunscreen and wear protective clothing when exposure to the sun is unavoidable. Chlorotrianisene side effects If you experience any of the following serious side effects, stop taking chlorotrianisene and seek emergency medical attention:

an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);

a blood clot (pain, redness, and swelling in an arm or leg, shortness of breath, chest pain, headache, blurred vision, or confusion);

a lump in a breast; or

liver damage (yellowing of the skin or eyes, nausea, abdominal pain or discomfort, unusual bleeding or bruising, severe fatigue).

Other, less serious side effects may be more likely to occur. Continue to take chlorotrianisene and talk to your doctor if you experience

decreased appetite, nausea, or vomiting;

swollen breasts;

acn? or skin color changes;

decreased sex drive;

migraine headaches or dizziness;

water retention (swollen hands, feet, or ankles);

depression; or

changes in your menstrual cycle or breakthrough bleeding.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect chlorotrianisene?

Chlorotrianisene may decrease the effects of the following drugs:

anticoagulants (blood thinners) such as warfarin (Coumadin). This could lead to blood clots. Your doctor will want to monitor your anticoagulant therapy.

thyroid medications. A larger dose of thyroid medication may be needed.

insulin. Monitor your blood sugar levels and discuss any unusual changes with your doctor.

tamoxifen. Chlorotrianisene should not be taken during therapy with tamoxifen.

Chlorotrianisene may also increase the effects of some medications. The following drugs may have increased or dangerous side effects if taken with chlorotrianisene:

tricyclic antidepressants such as amitriptyline (Elavil) and doxepin (Sinequan); other commonly used tricyclic antidepressants, including amoxapine (Ascendin), clomipramine (Anafranil), desipramine (Norpramin), imipramine (Tofranil), nortriptyline (Pamelor), and protriptyline (Vivactil); and

didanosine (Videx).

Before taking this medication, tell your doctor if you are taking any of the medicines listed above.

Other drugs may also affect chlorotrianisene. The effects of chlorotrianisene are decreased by

phenytoin (Dilantin) and ethotoin (Peganone),

carbamazepine (Tegretol),

phenobarbital (Solfoton, Luminal),

primidone (Mysoline), and

rifampin (Rifadin).

You may need larger doses of chlorotrianisene if you are taking any of the medicines listed above.

Drugs other than those listed here may also interact with chlorotrianisene. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

More chlorotrianisene resources Chlorotrianisene Drug Interactions Chlorotrianisene Support Group 0 Reviews for Chlorotrianisene - Add your own review/rating Compare chlorotrianisene with other medications Menopausal Disorders Primary Ovarian Failure Prostate Cancer Where can I get more information? Your pharmacist has additional information about chlorotrianisene written for health professionals that you may read. What does my medication look like?

Chlorotrianisene is available with a prescription under the brand name Tace. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

Tace 12 mg--green, hard-gelatin capsules


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travoprost ophthalmic


Generic Name: travoprost ophthalmic (TRA voe prost off THAL mik)
Brand Names: Travatan, Travatan Z

What is travoprost ophthalmic?

Travoprost ophthalmic (for the eye) reduces pressure in the eye by increasing the amount of fluid that drains from the eye.

Travoprost ophthalmic is used to treat certain types of glaucoma and other causes of high pressure inside the eye.

Travoprost ophthalmic may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about travoprost ophthalmic?

Travoprost ophthalmic may cause a gradual change in the color of your eyes or eyelids and lashes, as well as increased growth or thickness of your eyelashes. These color changes, usually an increase in brown pigment, occur slowly and you may not notice them for months or years. Color changes may be permanent even after your treatment ends, and may occur only in the eye being treated. This could result in a cosmetic difference in eye or eyelash color from one eye to the other.

Do not allow the dropper to touch any surface, including the eyes or hands. If the dropper becomes contaminated it could cause an infection in your eye, which can lead to vision loss or serious damage to the eye.

After using this medication, wait at least 5 minutes before using any other eye drops that your doctor has prescribed.

What should I discuss with my health care provider before using travoprost ophthalmic? Do not use this medication if you are allergic to travoprost.

Before using travoprost, tell your doctor if you are allergic to any drugs, or if you have swelling or infection of your eye.

Travoprost ophthalmic may cause a gradual change in the color of your eyes or eyelids and lashes, as well as increased growth or thickness of your eyelashes. These color changes, usually an increase in brown pigment, occur slowly and you may not notice them for months or years. Color changes may be permanent even after your treatment ends, and may occur only in the eye being treated. This could result in a cosmetic difference in eye or eyelash color from one eye to the other.

FDA pregnancy category C. It is not known whether travoprost is harmful to an unborn baby. Before using this medication, tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether travoprost passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. How should I use travoprost ophthalmic?

Use this medication exactly as it was prescribed for you. Do not use the medication in larger amounts, or use it for longer than recommended by your doctor. Follow the instructions on your prescription label.

Wash your hands before using the eye drops.

To apply the eye drops:

Tilt your head back slightly and pull down on the lower eyelid to create a small pocket. Hold the dropper above the eye with the dropper tip down. Look up and away from the dropper. Squeeze out a drop and close your eye. Gently press your finger to the inside corner of the eye (near the nose) for about 1 minute to keep the liquid from draining into your tear duct.

If you use more than one drop in the same eye, wait about 5 minutes before putting in the next drop. Also wait at least 5 minutes before using any other eye drops that your doctor has prescribed.

Do not allow the dropper to touch any surface, including the eyes or hands. If the dropper becomes contaminated it could cause an infection in your eye, which can lead to vision loss or serious damage to the eye. At any time during your use of travoprost ophthalmic, tell your doctor at once if you have an eye injury, if you develop an eye infection, or if you plan to have eye surgery. Do not use the eye drops if the liquid changes colors or has particles in it. Store the drops at room temperature away from heat and moisture. Keep the bottle tightly closed when not in use. What happens if I miss a dose?

Use the medication as soon as you remember. If it is almost time for the next dose, skip the missed dose and use the medicine at the next regularly scheduled time. Do not use extra medicine to make up the missed dose.

What happens if I overdose? Seek emergency medical attention if you think you have used too much of this medicine.

An overdose of travoprost ophthalmic used in the eyes is not expected to produce life-threatening symptoms.

What should I avoid while using travoprost ophthalmic? Avoid using too much of this medication, which can actually make it less effective in lowering the pressure inside the eye.

Avoid using any eyedrop medicine that has not been prescribed by your doctor.

Travoprost ophthalmic side effects Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using travoprost ophthalmic and call your doctor at once if you have any of these serious side effects:

redness, swelling, itching, or pain in or around your eye;

oozing or discharge from your eye;

increased sensitivity to light;

vision changes; or

chest pain.

Less serious side effects may include:

mild eye discomfort;

headache;

feeling like something is in your eye;

blurred vision;

dry or watery eyes; or

stinging or burning of the eyes after using the drops.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Travoprost ophthalmic Dosing Information

Usual Adult Dose for Intraocular Hypertension:

Instill 1 drop in the affected eye(s) once daily in the evening.

Usual Adult Dose for Glaucoma (Open Angle):

Instill 1 drop in the affected eye(s) once daily in the evening.

Usual Pediatric Dose for Intraocular Hypertension:

16 years and older:
Instill 1 drop in the affected eye(s) once daily in the evening.

Usual Pediatric Dose for Glaucoma (Open Angle):

16 years and older:
Instill 1 drop in the affected eye(s) once daily in the evening.

What other drugs will affect travoprost ophthalmic?

There may be other drugs that can affect travoprost ophthalmic. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

More travoprost ophthalmic resources Travoprost ophthalmic Side Effects (in more detail)Travoprost ophthalmic DosageTravoprost ophthalmic Use in Pregnancy & BreastfeedingTravoprost ophthalmic Drug InteractionsTravoprost ophthalmic Support Group2 Reviews for Travoprost - Add your own review/rating Travatan Advanced Consumer (Micromedex) - Includes Dosage Information Travatan Consumer Overview Travatan Drops MedFacts Consumer Leaflet (Wolters Kluwer) Travatan Prescribing Information (FDA) Travatan Monograph (AHFS DI) Travatan Z Drops MedFacts Consumer Leaflet (Wolters Kluwer) Travatan Z Consumer Overview Compare travoprost ophthalmic with other medications Glaucoma, Open AngleIntraocular Hypertension Where can I get more information? Your pharmacist can provide more information about travoprost ophthalmic.

See also: travoprost side effects (in more detail)


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latanoprost ophthalmic


Generic Name: latanoprost ophthalmic (la TAN oh prost)
Brand Names: Xalatan, Xalatan Multi-Pack

What is latanoprost ophthalmic?

Latanoprost reduces pressure in the eye by increasing the amount of fluid that drains from the eye.

Latanoprost ophthalmic (for the eyes) is used to treat certain types of glaucoma and other causes of high pressure inside the eye.

Latanoprost ophthalmic may also be used for purposes not listed in this medication guide.

What is the most important information I should know about latanoprost ophthalmic? Do not use this medication while wearing contact lenses. Latanoprost ophthalmic may contain a preservative that can discolor soft contact lenses. Wait at least 15 minutes after using latanoprost ophthalmic before putting your contact lenses in.

Latanoprost ophthalmic may cause a gradual change in the color of your eyes or eyelids and lashes, as well as increased growth or thickness of your eyelashes. These color changes, usually an increase in brown pigment, occur slowly and you may not notice them for months or years. Color changes may be permanent even after your treatment ends, and may occur only in the eye being treated. This could result in a cosmetic difference in eye or eyelash color from one eye to the other.

Do not allow the tip of the dropper to touch any surface, including your eyes or hands. If the dropper becomes contaminated it could cause an infection in your eye, which can lead to vision loss or serious damage to the eye.

After using this medication, wait at least 5 minutes before using any other eye drops that your doctor has prescribed.

What should I discuss with my health care provider before using latanoprost ophthalmic? Do not use this medication if you are allergic to latanoprost.

To make sure you can safely use latanoprost ophthalmic, tell your doctor if you have swelling or infection of your eye.

Latanoprost ophthalmic may cause a gradual change in the color of your eyes or eyelids and lashes, as well as increased growth or thickness of your eyelashes. These color changes, usually an increase in brown pigment, occur slowly and you may not notice them for months or years. Color changes may be permanent even after your treatment ends, and may occur only in the eye being treated. This could result in a cosmetic difference in eye or eyelash color from one eye to the other.

FDA pregnancy category C. It is not known whether latanoprost ophthalmic will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. It is not known whether latanoprost passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. How should I use latanoprost ophthalmic? Do not use this medication while wearing contact lenses. Latanoprost ophthalmic may contain a preservative that can discolor soft contact lenses. Wait at least 15 minutes after using latanoprost ophthalmic before putting your contact lenses in.

Use exactly as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Wash your hands before using the eye drops.

To apply the eye drops:

Tilt your head back slightly and pull down your lower eyelid to create a small pocket. Hold the dropper above the eye with the tip down. Look up and away from the dropper as you squeeze out a drop, then close your eye.

Use only the number of drops your doctor has prescribed.

Gently press your finger to the inside corner of the eye (near your nose) for about 1 minute to keep the liquid from draining into your tear duct.

If you use more than one drop in the same eye, wait about 5 minutes before putting in the next drop.

Wait at least 10 minutes before using any other eye drops that your doctor has prescribed.

Do not allow the tip of the dropper to touch any surface, including your eyes or hands. If the dropper becomes contaminated it could cause an infection in your eye, which can lead to vision loss or serious damage to the eye. Tell your doctor right away if you have any eye injury or infection, or if you need to have any type of surgery, especially eye surgery. Do not use the eye drops if the liquid changes colors or has particles in it. Store an unopened bottle of latanoprost eye drops in a refrigerator. Once you have opened and begun using the drops, you may store them at room temperature, away from moisture, heat, and light. Keep the bottle tightly closed when not in use.

Do not use the eye drops if it has been longer than 6 weeks since you first opened the bottle. If you still need to use the medication, call your doctor for a new prescription.

What happens if I miss a dose?

If you forget to use the eye drops, skip the missed dose and use the medicine at the next regularly scheduled time. Do not use extra medicine to make up the missed dose.

What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. What should I avoid while using latanoprost ophthalmic? Avoid using too much of this medication, which can actually make it less effective in lowering the pressure inside the eye.

Do not use other eye medications unless your doctor tells you to.

Latanoprost ophthalmic side effects Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using latanoprost ophthalmic and call your doctor at once if you have any of these serious side effects:

redness, swelling, itching, or pain in or around your eye;

oozing or discharge from your eye;

increased sensitivity to light;

vision changes; or

chest pain.

Less serious side effects may include:

cold symptoms such as stuffy nose, sneezing, sore throat;

headache, dizziness;

mild eye discomfort;

blurred vision;

feeling like something is in your eye;

dry or watery eyes; or

stinging or burning of the eyes after using the drops.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Latanoprost ophthalmic Dosing Information

Usual Adult Dose for Intraocular Hypertension:

1 drop in the affected eye(s) once a day in the evening.

Usual Adult Dose for Glaucoma (Open Angle):

1 drop in the affected eye(s) once a day in the evening.

What other drugs will affect latanoprost ophthalmic?

There may be other drugs that can interact with latanoprost ophthalmic. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

More latanoprost ophthalmic resources Latanoprost ophthalmic Side Effects (in more detail) Latanoprost ophthalmic Dosage Latanoprost ophthalmic Use in Pregnancy & Breastfeeding Latanoprost ophthalmic Drug Interactions Latanoprost ophthalmic Support Group 5 Reviews for Latanoprost - Add your own review/rating Xalatan Prescribing Information (FDA) Xalatan Monograph (AHFS DI) Xalatan Advanced Consumer (Micromedex) - Includes Dosage Information Xalatan Drops MedFacts Consumer Leaflet (Wolters Kluwer) Xalatan Consumer Overview Compare latanoprost ophthalmic with other medications Glaucoma, Open Angle Intraocular Hypertension Where can I get more information? Your pharmacist can provide more information about latanoprost ophthalmic.

See also: latanoprost side effects (in more detail)


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Syntest H.S.


Generic Name: esterified estrogens and methyltestosterone (Oral route)

es-TER-i-fide ES-troe-jenz, meth-il-tes-TOS-ter-one

Oral route(Tablet)

Estrogens increase the risk of endometrial cancer; monitor for abnormal vaginal bleeding. Estrogens with or without progestins should not be used for the prevention of cardiovascular disease or dementia. Increased risks of myocardial infarction, stroke, invasive breast cancer, pulmonary emboli, and deep vein thrombosis in postmenopausal women (50 to 79 years of age) have been reported. An increased risk of developing probable dementia in postmenopausal women 65 years of age or older has also been reported. This product contains an estrogen and androgen, not a progestin. This combination should not be used during a known or suspected pregnancy.

Commonly used brand name(s)

In the U.S.

Covaryx Covaryx HS Essian Estratest Menogen Syntest D.S. Syntest H.S.

Available Dosage Forms:

Tablet

Therapeutic Class: Estrogen/Androgen Combination

Pharmacologic Class: Estrogen

Uses For Syntest H.S.

Esterified estrogens and methyltestosterone combination is used to treat the symptoms of menopause in patients who did not get relief after being treated with estrogens alone. These symptoms may include a feeling of heat, sweating, and warmth in the face, neck, or chest ("hot flashes"); and dryness, burning, and itching in the vagina.

Esterified estrogens are a man-made mixture of estrogens. Estrogen is a hormone that is produced by the body in greater amounts in females. It is necessary for normal sexual development of the female and for regulation of the menstrual cycle during the childbearing years. Methyltestosterone is a man-made form of testosterone, a hormone that is produced by the body in greater amounts in males and small amounts in females. Menopause symptoms occur when the hormone balance changes in the female body. This combination of hormones will relieve the symptoms of menopause by adding more hormones to the body.

This medicine is available only with your doctor's prescription.

Before Using Syntest H.S.

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine 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

The use of esterified estrogens and methyltestosterone combination is not recommended in children.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of esterified estrogens and methyltestosterone combination in the elderly. However, elderly patients are more likely to develop dementia and age-related kidney, liver, or heart problems, which may require caution and an adjustment in the dose for patients receiving this medicine.

Pregnancy Pregnancy Category Explanation All Trimesters X Studies in animals or pregnant women have demonstrated positive evidence of fetal abnormalities. This drug should not be used in women who are or may become pregnant because the risk clearly outweighs any possible benefit. Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

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. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Anisindione Bupropion Dicumarol Phenprocoumon

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Clarithromycin Ginseng Itraconazole Ketoconazole Levothyroxine Licorice Tipranavir Warfarin 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. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

Grapefruit Juice Other Medical Problems

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

Abnormal vaginal bleeding, undiagnosed or Blood clotting problems (e.g., deep vein thrombosis, pulmonary embolism), history of or Breast cancer, or history of or Heart attack, recent or history of or Liver disease, severe or Stroke, recent or history of—Should not be used in patients with these conditions. Asthma or Cancer (e.g., breast, cervix, liver, vagina) or Depression, history of or Diabetes or Edema (fluid retention) or Endometriosis (problem with the lining of the uterus) or Epilepsy or Eye or vision problems (e.g., retinal vascular thrombosis) or Gallbladder disease or Hepatitis (including cholestatic jaundice), history of or Hypercalcemia (high calcium in the blood) or Hypocalcemia (high calcium in the blood) or Hypothyroidism (underactive thyroid) or Migraine headaches, history of or Porphyria (enzyme problem) or Systemic lupus erythematosus—Use with caution. May make these conditions worse. Heart or blood vessel disease or Hypercholesterolemia (high cholesterol in the blood) or Hypertension (high blood pressure) or Hypertriglyceridemia (high triglycerides or fat in the blood) or Venous thromboembolism (clot in the veins), history of—May increase risk for more serious side effects. Proper Use of esterified estrogens and methyltestosterone

This section provides information on the proper use of a number of products that contain esterified estrogens and methyltestosterone. It may not be specific to Syntest H.S.. Please read with care.

Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

This medicine comes with a patient information insert. Read and follow the instructions in the insert carefully. Ask your doctor if you have any questions.

Dosing

The dose of this medicine 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 this medicine. 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 oral dosage form (tablets): For treatment of menopause symptoms: Adults—One to two tablets once a day. Children—Use is not recommended. 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.

Storage

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

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using Syntest H.S.

It is very important that your doctor check your progress at regular visits to make sure the medicine is working properly and to decide if you should continue to take it. These visits should be every 6 to 12 months or as otherwise directed by your doctor.

It is unlikely that a postmenopausal woman may become pregnant. But, you should know that using this medicine while you are pregnant could harm your unborn baby. If you think you have become pregnant while using the medicine, tell your doctor right away.

Very rarely, this medicine can cause serious side effects such as a heart attack or stroke. You are much more likely to have these side effects if you smoke cigarettes or are overweight, or if you have diabetes, high blood pressure, or a high blood cholesterol. Talk with your doctor if you think you might be at risk.

Using large doses of estrogen alone over a long period of time may increase the risk of some kinds of cancer (e.g., endometrial cancer). Talk with your doctor about this risk. If you have vaginal bleeding with this medicine, call your doctor right away.

This medicine may increase the risk of getting breast cancer. It is very important that you check your breasts on a regular basis for any unusual lumps or discharge, and that you have breast x-rays every year as directed by your doctor. These exams are very important if you have a family member with a history of breast cancer. Talk with your doctor about this risk.

This medicine may increase the risk of getting dementia in elderly women (above 65 years of age). Talk with your doctor if this concerns you.

Check with your doctor right away if blurred vision, difficulty with reading, or any other change in vision occurs during or after treatment. Your doctor may want you to have your eyes checked by an ophthalmologist (eye doctor).

Using large doses of methyltestosterone over a long period of time may increase the risk of serious liver problems (e.g., peliosis hepatis or liver cancer). Talk with your doctor about this risk.

Before you have any medical tests, tell the medical doctor in charge that you are taking this medicine. The results of some tests may be affected by this medicine. Also, you may need to stop using this medicine for a few weeks before and after having surgery, or if you are inactive for a long period of time.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Syntest H.S. Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

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

More common Absent, missed, or irregular menstrual periods acne or oily skin decreased breast size enlarging clitoris hoarseness or deepening of the voice menstrual changes stopping of menstrual bleeding unnatural hair growth or loss Rare Continuing nausea cough dark-colored urine difficulty with swallowing dizziness fast heartbeat fever hives itching light-colored stools loss of appetite puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue purple or red-colored spots on the body or inside the mouth or nose shortness of breath skin rash sore throat tightness in the chest unusual tiredness or weakness vomiting wheezing Incidence not known Abdominal or stomach bloating, cramps, or pain anxiety bleeding from gums or nose blistering, peeling, or loosening of the skin bloating bloody or cloudy urine burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings change in vaginal discharge changes in skin color, pain, or tenderness chest pain or discomfort chills clay-colored stools clear or bloody discharge from nipple confusion constipation convulsions darkening of urine decrease in amount of urine diarrhea difficult, burning, or painful urination difficulty with breathing difficulty with moving difficulty with speaking dimpling of the breast skin dizziness or lightheadedness double vision eye pain fainting fever fluid-filled skin blisters frequent urge to urinate headache heavy bleeding inability to move the arms, legs, or facial muscles inability to speak indigestion inverted nipple irregular heartbeats itching of the vagina or genital area joint or muscle pain large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs light-colored stools loss of appetite lump in the breast or under the arm mood or mental changes muscle cramps in the hands, arms, feet, legs, or face muscle pain or stiffness nausea noisy, rattling breathing numbness and tingling around the mouth, fingertips, or feet pain pain during sexual intercourse pain in the ankles or knees pain or discomfort in the arms, jaw, back, or neck pain or feeling of pressure in pelvis painful, red lumps under the skin, mostly on the legs pains in the stomach, side, or abdomen, possibly radiating to the back pelvic pain persistent crusting or scaling of the nipple pinpoint red or purple spots on the skin poor insight and judgment problems with memory or speech red, irritated eyes redness or swelling of the breast ringing in the ears sensitivity to the sun shortness of breath skin thinness slow speech sore on the skin of the breast that does not heal sore throat sores, ulcers, or white spots in the mouth or on the lips stomach pain sudden shortness of breath or troubled breathing sweating swelling swelling of the fingers, hands, feet, or lower legs tenderness of the breast thick, white curd-like vaginal discharge without odor or with mild odor tiredness tremor trouble recognizing objects trouble thinking and planning trouble walking troubled breathing at rest unexpected or excess milk flow from breasts unpleasant breath odor vaginal bleeding vision changes vomiting of blood weakness weight gain yellow eyes or skin

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:

Incidence not known Blemishes on the skin brown, blotchy spots on the exposed skin decreased interest in sexual intercourse depression headache, severe and throbbing inability to have or keep an erection increase or decrease in weight increased hair growth, especially on the face increased in sexual ability, desire, drive, or performance increased interest in sexual intercourse irritability leg cramps loss in sexual ability, desire, drive, or performance loss of hair mental depression pimples redness of the skin swelling or inflammation of the mouth twitching, uncontrolled movements of the tongue, lips, face, arms, or legs

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.

See also: Syntest H.S. side effects (in more detail)

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.

More Syntest H.S. resources Syntest H.S. Side Effects (in more detail) Syntest H.S. Use in Pregnancy & Breastfeeding Drug Images Syntest H.S. Drug Interactions Syntest H.S. Support Group 5 Reviews for Syntest H.S. - Add your own review/rating Compare Syntest H.S. with other medications Hot Flashes Menopausal Disorders Postmenopausal Symptoms
read more / Download


Syntest D.S.


Generic Name: esterified estrogens and methyltestosterone (Oral route)

es-TER-i-fide ES-troe-jenz, meth-il-tes-TOS-ter-one

Oral route(Tablet)

Estrogens increase the risk of endometrial cancer; monitor for abnormal vaginal bleeding. Estrogens with or without progestins should not be used for the prevention of cardiovascular disease or dementia. Increased risks of myocardial infarction, stroke, invasive breast cancer, pulmonary emboli, and deep vein thrombosis in postmenopausal women (50 to 79 years of age) have been reported. An increased risk of developing probable dementia in postmenopausal women 65 years of age or older has also been reported. This product contains an estrogen and androgen, not a progestin. This combination should not be used during a known or suspected pregnancy.

Commonly used brand name(s)

In the U.S.

Covaryx Covaryx HS Essian Estratest Menogen Syntest D.S. Syntest H.S.

Available Dosage Forms:

Tablet

Therapeutic Class: Estrogen/Androgen Combination

Pharmacologic Class: Estrogen

Uses For Syntest D.S.

Esterified estrogens and methyltestosterone combination is used to treat the symptoms of menopause in patients who did not get relief after being treated with estrogens alone. These symptoms may include a feeling of heat, sweating, and warmth in the face, neck, or chest ("hot flashes"); and dryness, burning, and itching in the vagina.

Esterified estrogens are a man-made mixture of estrogens. Estrogen is a hormone that is produced by the body in greater amounts in females. It is necessary for normal sexual development of the female and for regulation of the menstrual cycle during the childbearing years. Methyltestosterone is a man-made form of testosterone, a hormone that is produced by the body in greater amounts in males and small amounts in females. Menopause symptoms occur when the hormone balance changes in the female body. This combination of hormones will relieve the symptoms of menopause by adding more hormones to the body.

This medicine is available only with your doctor's prescription.

Before Using Syntest D.S.

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine 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

The use of esterified estrogens and methyltestosterone combination is not recommended in children.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of esterified estrogens and methyltestosterone combination in the elderly. However, elderly patients are more likely to develop dementia and age-related kidney, liver, or heart problems, which may require caution and an adjustment in the dose for patients receiving this medicine.

Pregnancy Pregnancy Category Explanation All Trimesters X Studies in animals or pregnant women have demonstrated positive evidence of fetal abnormalities. This drug should not be used in women who are or may become pregnant because the risk clearly outweighs any possible benefit. Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

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. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Anisindione Bupropion Dicumarol Phenprocoumon

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Clarithromycin Ginseng Itraconazole Ketoconazole Levothyroxine Licorice Tipranavir Warfarin 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. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

Grapefruit Juice Other Medical Problems

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

Abnormal vaginal bleeding, undiagnosed or Blood clotting problems (e.g., deep vein thrombosis, pulmonary embolism), history of or Breast cancer, or history of or Heart attack, recent or history of or Liver disease, severe or Stroke, recent or history of—Should not be used in patients with these conditions. Asthma or Cancer (e.g., breast, cervix, liver, vagina) or Depression, history of or Diabetes or Edema (fluid retention) or Endometriosis (problem with the lining of the uterus) or Epilepsy or Eye or vision problems (e.g., retinal vascular thrombosis) or Gallbladder disease or Hepatitis (including cholestatic jaundice), history of or Hypercalcemia (high calcium in the blood) or Hypocalcemia (high calcium in the blood) or Hypothyroidism (underactive thyroid) or Migraine headaches, history of or Porphyria (enzyme problem) or Systemic lupus erythematosus—Use with caution. May make these conditions worse. Heart or blood vessel disease or Hypercholesterolemia (high cholesterol in the blood) or Hypertension (high blood pressure) or Hypertriglyceridemia (high triglycerides or fat in the blood) or Venous thromboembolism (clot in the veins), history of—May increase risk for more serious side effects. Proper Use of esterified estrogens and methyltestosterone

This section provides information on the proper use of a number of products that contain esterified estrogens and methyltestosterone. It may not be specific to Syntest D.S.. Please read with care.

Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

This medicine comes with a patient information insert. Read and follow the instructions in the insert carefully. Ask your doctor if you have any questions.

Dosing

The dose of this medicine 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 this medicine. 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 oral dosage form (tablets): For treatment of menopause symptoms: Adults—One to two tablets once a day. Children—Use is not recommended. 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.

Storage

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

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using Syntest D.S.

It is very important that your doctor check your progress at regular visits to make sure the medicine is working properly and to decide if you should continue to take it. These visits should be every 6 to 12 months or as otherwise directed by your doctor.

It is unlikely that a postmenopausal woman may become pregnant. But, you should know that using this medicine while you are pregnant could harm your unborn baby. If you think you have become pregnant while using the medicine, tell your doctor right away.

Very rarely, this medicine can cause serious side effects such as a heart attack or stroke. You are much more likely to have these side effects if you smoke cigarettes or are overweight, or if you have diabetes, high blood pressure, or a high blood cholesterol. Talk with your doctor if you think you might be at risk.

Using large doses of estrogen alone over a long period of time may increase the risk of some kinds of cancer (e.g., endometrial cancer). Talk with your doctor about this risk. If you have vaginal bleeding with this medicine, call your doctor right away.

This medicine may increase the risk of getting breast cancer. It is very important that you check your breasts on a regular basis for any unusual lumps or discharge, and that you have breast x-rays every year as directed by your doctor. These exams are very important if you have a family member with a history of breast cancer. Talk with your doctor about this risk.

This medicine may increase the risk of getting dementia in elderly women (above 65 years of age). Talk with your doctor if this concerns you.

Check with your doctor right away if blurred vision, difficulty with reading, or any other change in vision occurs during or after treatment. Your doctor may want you to have your eyes checked by an ophthalmologist (eye doctor).

Using large doses of methyltestosterone over a long period of time may increase the risk of serious liver problems (e.g., peliosis hepatis or liver cancer). Talk with your doctor about this risk.

Before you have any medical tests, tell the medical doctor in charge that you are taking this medicine. The results of some tests may be affected by this medicine. Also, you may need to stop using this medicine for a few weeks before and after having surgery, or if you are inactive for a long period of time.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Syntest D.S. Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

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

More common Absent, missed, or irregular menstrual periods acne or oily skin decreased breast size enlarging clitoris hoarseness or deepening of the voice menstrual changes stopping of menstrual bleeding unnatural hair growth or loss Rare Continuing nausea cough dark-colored urine difficulty with swallowing dizziness fast heartbeat fever hives itching light-colored stools loss of appetite puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue purple or red-colored spots on the body or inside the mouth or nose shortness of breath skin rash sore throat tightness in the chest unusual tiredness or weakness vomiting wheezing Incidence not known Abdominal or stomach bloating, cramps, or pain anxiety bleeding from gums or nose blistering, peeling, or loosening of the skin bloating bloody or cloudy urine burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings change in vaginal discharge changes in skin color, pain, or tenderness chest pain or discomfort chills clay-colored stools clear or bloody discharge from nipple confusion constipation convulsions darkening of urine decrease in amount of urine diarrhea difficult, burning, or painful urination difficulty with breathing difficulty with moving difficulty with speaking dimpling of the breast skin dizziness or lightheadedness double vision eye pain fainting fever fluid-filled skin blisters frequent urge to urinate headache heavy bleeding inability to move the arms, legs, or facial muscles inability to speak indigestion inverted nipple irregular heartbeats itching of the vagina or genital area joint or muscle pain large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs light-colored stools loss of appetite lump in the breast or under the arm mood or mental changes muscle cramps in the hands, arms, feet, legs, or face muscle pain or stiffness nausea noisy, rattling breathing numbness and tingling around the mouth, fingertips, or feet pain pain during sexual intercourse pain in the ankles or knees pain or discomfort in the arms, jaw, back, or neck pain or feeling of pressure in pelvis painful, red lumps under the skin, mostly on the legs pains in the stomach, side, or abdomen, possibly radiating to the back pelvic pain persistent crusting or scaling of the nipple pinpoint red or purple spots on the skin poor insight and judgment problems with memory or speech red, irritated eyes redness or swelling of the breast ringing in the ears sensitivity to the sun shortness of breath skin thinness slow speech sore on the skin of the breast that does not heal sore throat sores, ulcers, or white spots in the mouth or on the lips stomach pain sudden shortness of breath or troubled breathing sweating swelling swelling of the fingers, hands, feet, or lower legs tenderness of the breast thick, white curd-like vaginal discharge without odor or with mild odor tiredness tremor trouble recognizing objects trouble thinking and planning trouble walking troubled breathing at rest unexpected or excess milk flow from breasts unpleasant breath odor vaginal bleeding vision changes vomiting of blood weakness weight gain yellow eyes or skin

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:

Incidence not known Blemishes on the skin brown, blotchy spots on the exposed skin decreased interest in sexual intercourse depression headache, severe and throbbing inability to have or keep an erection increase or decrease in weight increased hair growth, especially on the face increased in sexual ability, desire, drive, or performance increased interest in sexual intercourse irritability leg cramps loss in sexual ability, desire, drive, or performance loss of hair mental depression pimples redness of the skin swelling or inflammation of the mouth twitching, uncontrolled movements of the tongue, lips, face, arms, or legs

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.

See also: Syntest D.S. side effects (in more detail)

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.

More Syntest D.S. resources Syntest D.S. Side Effects (in more detail) Syntest D.S. Use in Pregnancy & Breastfeeding Drug Images Syntest D.S. Drug Interactions Syntest D.S. Support Group 5 Reviews for Syntest D.S. - Add your own review/rating Compare Syntest D.S. with other medications Hot Flashes Menopausal Disorders Postmenopausal Symptoms
read more / Download


Menogen


Generic Name: esterified estrogens and methyltestosterone (Oral route)

es-TER-i-fide ES-troe-jenz, meth-il-tes-TOS-ter-one

Oral route(Tablet)

Estrogens increase the risk of endometrial cancer; monitor for abnormal vaginal bleeding. Estrogens with or without progestins should not be used for the prevention of cardiovascular disease or dementia. Increased risks of myocardial infarction, stroke, invasive breast cancer, pulmonary emboli, and deep vein thrombosis in postmenopausal women (50 to 79 years of age) have been reported. An increased risk of developing probable dementia in postmenopausal women 65 years of age or older has also been reported. This product contains an estrogen and androgen, not a progestin. This combination should not be used during a known or suspected pregnancy.

Commonly used brand name(s)

In the U.S.

Covaryx Covaryx HS Essian Estratest Menogen Syntest D.S. Syntest H.S.

Available Dosage Forms:

Tablet

Therapeutic Class: Estrogen/Androgen Combination

Pharmacologic Class: Estrogen

Uses For Menogen

Esterified estrogens and methyltestosterone combination is used to treat the symptoms of menopause in patients who did not get relief after being treated with estrogens alone. These symptoms may include a feeling of heat, sweating, and warmth in the face, neck, or chest ("hot flashes"); and dryness, burning, and itching in the vagina.

Esterified estrogens are a man-made mixture of estrogens. Estrogen is a hormone that is produced by the body in greater amounts in females. It is necessary for normal sexual development of the female and for regulation of the menstrual cycle during the childbearing years. Methyltestosterone is a man-made form of testosterone, a hormone that is produced by the body in greater amounts in males and small amounts in females. Menopause symptoms occur when the hormone balance changes in the female body. This combination of hormones will relieve the symptoms of menopause by adding more hormones to the body.

This medicine is available only with your doctor's prescription.

Before Using Menogen

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine 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

The use of esterified estrogens and methyltestosterone combination is not recommended in children.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of esterified estrogens and methyltestosterone combination in the elderly. However, elderly patients are more likely to develop dementia and age-related kidney, liver, or heart problems, which may require caution and an adjustment in the dose for patients receiving this medicine.

Pregnancy Pregnancy Category Explanation All Trimesters X Studies in animals or pregnant women have demonstrated positive evidence of fetal abnormalities. This drug should not be used in women who are or may become pregnant because the risk clearly outweighs any possible benefit. Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

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. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Anisindione Bupropion Dicumarol Phenprocoumon

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Clarithromycin Ginseng Itraconazole Ketoconazole Levothyroxine Licorice Tipranavir Warfarin 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. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

Grapefruit Juice Other Medical Problems

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

Abnormal vaginal bleeding, undiagnosed or Blood clotting problems (e.g., deep vein thrombosis, pulmonary embolism), history of or Breast cancer, or history of or Heart attack, recent or history of or Liver disease, severe or Stroke, recent or history of—Should not be used in patients with these conditions. Asthma or Cancer (e.g., breast, cervix, liver, vagina) or Depression, history of or Diabetes or Edema (fluid retention) or Endometriosis (problem with the lining of the uterus) or Epilepsy or Eye or vision problems (e.g., retinal vascular thrombosis) or Gallbladder disease or Hepatitis (including cholestatic jaundice), history of or Hypercalcemia (high calcium in the blood) or Hypocalcemia (high calcium in the blood) or Hypothyroidism (underactive thyroid) or Migraine headaches, history of or Porphyria (enzyme problem) or Systemic lupus erythematosus—Use with caution. May make these conditions worse. Heart or blood vessel disease or Hypercholesterolemia (high cholesterol in the blood) or Hypertension (high blood pressure) or Hypertriglyceridemia (high triglycerides or fat in the blood) or Venous thromboembolism (clot in the veins), history of—May increase risk for more serious side effects. Proper Use of esterified estrogens and methyltestosterone

This section provides information on the proper use of a number of products that contain esterified estrogens and methyltestosterone. It may not be specific to Menogen. Please read with care.

Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

This medicine comes with a patient information insert. Read and follow the instructions in the insert carefully. Ask your doctor if you have any questions.

Dosing

The dose of this medicine 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 this medicine. 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 oral dosage form (tablets): For treatment of menopause symptoms: Adults—One to two tablets once a day. Children—Use is not recommended. 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.

Storage

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

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using Menogen

It is very important that your doctor check your progress at regular visits to make sure the medicine is working properly and to decide if you should continue to take it. These visits should be every 6 to 12 months or as otherwise directed by your doctor.

It is unlikely that a postmenopausal woman may become pregnant. But, you should know that using this medicine while you are pregnant could harm your unborn baby. If you think you have become pregnant while using the medicine, tell your doctor right away.

Very rarely, this medicine can cause serious side effects such as a heart attack or stroke. You are much more likely to have these side effects if you smoke cigarettes or are overweight, or if you have diabetes, high blood pressure, or a high blood cholesterol. Talk with your doctor if you think you might be at risk.

Using large doses of estrogen alone over a long period of time may increase the risk of some kinds of cancer (e.g., endometrial cancer). Talk with your doctor about this risk. If you have vaginal bleeding with this medicine, call your doctor right away.

This medicine may increase the risk of getting breast cancer. It is very important that you check your breasts on a regular basis for any unusual lumps or discharge, and that you have breast x-rays every year as directed by your doctor. These exams are very important if you have a family member with a history of breast cancer. Talk with your doctor about this risk.

This medicine may increase the risk of getting dementia in elderly women (above 65 years of age). Talk with your doctor if this concerns you.

Check with your doctor right away if blurred vision, difficulty with reading, or any other change in vision occurs during or after treatment. Your doctor may want you to have your eyes checked by an ophthalmologist (eye doctor).

Using large doses of methyltestosterone over a long period of time may increase the risk of serious liver problems (e.g., peliosis hepatis or liver cancer). Talk with your doctor about this risk.

Before you have any medical tests, tell the medical doctor in charge that you are taking this medicine. The results of some tests may be affected by this medicine. Also, you may need to stop using this medicine for a few weeks before and after having surgery, or if you are inactive for a long period of time.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Menogen Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

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

More common Absent, missed, or irregular menstrual periods acne or oily skin decreased breast size enlarging clitoris hoarseness or deepening of the voice menstrual changes stopping of menstrual bleeding unnatural hair growth or loss Rare Continuing nausea cough dark-colored urine difficulty with swallowing dizziness fast heartbeat fever hives itching light-colored stools loss of appetite puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue purple or red-colored spots on the body or inside the mouth or nose shortness of breath skin rash sore throat tightness in the chest unusual tiredness or weakness vomiting wheezing Incidence not known Abdominal or stomach bloating, cramps, or pain anxiety bleeding from gums or nose blistering, peeling, or loosening of the skin bloating bloody or cloudy urine burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings change in vaginal discharge changes in skin color, pain, or tenderness chest pain or discomfort chills clay-colored stools clear or bloody discharge from nipple confusion constipation convulsions darkening of urine decrease in amount of urine diarrhea difficult, burning, or painful urination difficulty with breathing difficulty with moving difficulty with speaking dimpling of the breast skin dizziness or lightheadedness double vision eye pain fainting fever fluid-filled skin blisters frequent urge to urinate headache heavy bleeding inability to move the arms, legs, or facial muscles inability to speak indigestion inverted nipple irregular heartbeats itching of the vagina or genital area joint or muscle pain large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs light-colored stools loss of appetite lump in the breast or under the arm mood or mental changes muscle cramps in the hands, arms, feet, legs, or face muscle pain or stiffness nausea noisy, rattling breathing numbness and tingling around the mouth, fingertips, or feet pain pain during sexual intercourse pain in the ankles or knees pain or discomfort in the arms, jaw, back, or neck pain or feeling of pressure in pelvis painful, red lumps under the skin, mostly on the legs pains in the stomach, side, or abdomen, possibly radiating to the back pelvic pain persistent crusting or scaling of the nipple pinpoint red or purple spots on the skin poor insight and judgment problems with memory or speech red, irritated eyes redness or swelling of the breast ringing in the ears sensitivity to the sun shortness of breath skin thinness slow speech sore on the skin of the breast that does not heal sore throat sores, ulcers, or white spots in the mouth or on the lips stomach pain sudden shortness of breath or troubled breathing sweating swelling swelling of the fingers, hands, feet, or lower legs tenderness of the breast thick, white curd-like vaginal discharge without odor or with mild odor tiredness tremor trouble recognizing objects trouble thinking and planning trouble walking troubled breathing at rest unexpected or excess milk flow from breasts unpleasant breath odor vaginal bleeding vision changes vomiting of blood weakness weight gain yellow eyes or skin

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:

Incidence not known Blemishes on the skin brown, blotchy spots on the exposed skin decreased interest in sexual intercourse depression headache, severe and throbbing inability to have or keep an erection increase or decrease in weight increased hair growth, especially on the face increased in sexual ability, desire, drive, or performance increased interest in sexual intercourse irritability leg cramps loss in sexual ability, desire, drive, or performance loss of hair mental depression pimples redness of the skin swelling or inflammation of the mouth twitching, uncontrolled movements of the tongue, lips, face, arms, or legs

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.

See also: Menogen side effects (in more detail)

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.

More Menogen resources Menogen Side Effects (in more detail) Menogen Use in Pregnancy & Breastfeeding Menogen Drug Interactions Menogen Support Group 0 Reviews for Menogen - Add your own review/rating Covaryx Concise Consumer Information (Cerner Multum) Estratest MedFacts Consumer Leaflet (Wolters Kluwer) Compare Menogen with other medications Hot Flashes Menopausal Disorders Postmenopausal Symptoms
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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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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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Invega Extended-Release Tablets


Pronunciation: PAL-ee-PER-i-done
Generic Name: Paliperidone
Brand Name: Invega

Invega Extended-Release Tablets are an atypical antipsychotic. It may increase the risk of death when used to treat mental problems caused by dementia in elderly patients. Most of the deaths were linked to heart problems or infection. Invega Extended-Release Tablets are not approved to treat mental problems caused by dementia.


Invega Extended-Release Tablets are used for:

Treating schizophrenia or schizoaffective disorder. It may also be used for other conditions as determined by your doctor.

Invega Extended-Release Tablets are an atypical antipsychotic. Exactly how it works is not known. It is thought to work by affecting certain substances in the brain.

Do NOT use Invega Extended-Release Tablets if: you are allergic to any ingredient in Invega Extended-Release Tablets or to risperidone you cannot swallow the tablet whole you have severe kidney problems you have a history of certain heart problems (eg, irregular heartbeat, long QT syndrome) you are taking medicines that may cause a certain type of irregular heartbeat (prolonged QT interval) (eg, antiarrhythmics, such as amiodarone, procainamide, quinidine, or sotalol; a phenothiazine, such as chlorpromazine or thioridazine; or quinolone antibiotics, such as gatifloxacin or moxifloxacin)

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

Before using Invega Extended-Release Tablets:

Some medical conditions may interact with Invega Extended-Release Tablets. 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 seizures, heart problems (eg, heart failure; fast, slow, or irregular heartbeat), an abnormal electrocardiogram (ECG), a heart attack, a stroke, blood vessel problems, low blood volume, low white blood cell levels, high blood cholesterol or triglyceride levels, or high or low blood pressure if you have a history of kidney problems, severe liver problems, stomach or bowel problems (eg, narrowing, inflammation, blockage), cystic fibrosis, neuroleptic malignant syndrome (NMS), suicidal thoughts or attempts, or alcohol abuse or dependence if you have diabetes or are very overweight, or if a family member has had diabetes if you have low blood potassium or magnesium levels, Alzheimer disease, dementia, Parkinson disease, diarrhea, or esophagus problems (eg, trouble swallowing) if you have had high blood prolactin levels or a history of certain types of cancer (eg, breast, pancreas, pituitary), or if you are at risk for breast cancer if you are dehydrated, drink alcohol, or will be exposed to high temperatures

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

Alpha-blockers (eg, doxazosin) or medicine for high blood pressure because the risk of low blood pressure and fainting may be increased Antiarrhythmics, (eg, amiodarone, flecainide, procainamide, quinidine, sotalol), arsenic, cisapride, dofetilide, domperidone, H1 antagonists (eg, astemizole, terfenadine), macrolides (eg, erythromycin), methadone, phenothiazines, (eg, chlorpromazine, thioridazine), quinolone antibiotics (eg, gatifloxacin, levofloxacin, moxifloxacin), streptogramins (eg, quinupristin/dalfopristin), or tyrosine kinase inhibitors (eg, nilotinib, sunitinib) because the risk of irregular heartbeat may be increased. Ask your doctor if you are unsure if any of your medicines might increase the risk of irregular heartbeat Anticholinergics (eg, scopolamine) because the risk of overheating may be increased Divalproex sodium, risperidone, or valproic acid because they may increase the risk of Invega Extended-Release Tablets's side effects Carbamazepine because it may decrease Invega Extended-Release Tablets's effectiveness Dopamine receptor agonists (eg, pramipexole) or levodopa because their effectiveness may be decreased by Invega Extended-Release Tablets

This may not be a complete list of all interactions that may occur. Ask your health care provider if Invega Extended-Release Tablets 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 Invega Extended-Release Tablets:

Use Invega Extended-Release Tablets as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Take Invega Extended-Release Tablets by mouth with or without food. Take in the morning unless your doctor tells you otherwise. Swallow Invega Extended-Release Tablets whole. Do not break, crush, or chew before swallowing. Take Invega Extended-Release Tablets with a full glass of water (8 oz/240 mL). Drinking extra fluids while you are taking Invega Extended-Release Tablets are recommended. Check with your doctor for instructions. Taking Invega Extended-Release Tablets at the same time each day will help you remember to take it. Continue to take Invega Extended-Release Tablets even if you feel well. Do not miss any doses. If you miss a dose of Invega Extended-Release Tablets, 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 Invega Extended-Release Tablets.

Important safety information: Invega Extended-Release Tablets may cause drowsiness, dizziness, light-headedness, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use Invega Extended-Release Tablets with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it. Do not drink alcohol while you are taking Invega Extended-Release Tablets. Do not use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are taking Invega Extended-Release Tablets without checking with your doctor; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness. Invega Extended-Release Tablets may cause dizziness, light-headedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects. Do not become overheated in hot weather or while you are being active; heatstroke may occur. You may notice the tablet shell in your stool. This is normal and not a cause for concern. Invega Extended-Release Tablets may raise your blood sugar. High blood sugar may make you feel confused, drowsy, or thirsty. It can also make you flush, breathe faster, or have a fruit-like breath odor. If these symptoms occur, tell your doctor right away. Diabetes patients - Invega Extended-Release Tablets may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine. NMS is a possibly fatal syndrome that can be caused by Invega Extended-Release Tablets. Symptoms may include fever; stiff muscles; confusion; abnormal thinking; fast or irregular heartbeat; and sweating. Contact your doctor at once if you have any of these symptoms. Some patients who take Invega Extended-Release Tablets may develop muscle movements that they cannot control. This is more likely to happen in elderly patients, especially women. The chance that this will happen or that it will become permanent is greater in those who take Invega Extended-Release Tablets in higher doses or for a long time. Muscle problems may also occur after short-term treatment with low doses. Tell your doctor at once if you have muscle problems with your arms; legs; or your tongue, face, mouth, or jaw (eg, tongue sticking out, puffing of cheeks, mouth puckering, chewing movements) while taking Invega Extended-Release Tablets. Invega Extended-Release Tablets 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. Invega Extended-Release Tablets may increase the amount of a certain hormone (prolactin) in your blood. Symptoms may include enlarged breasts, missed menstrual period, decreased sexual ability, or nipple discharge. Contact your doctor right away if you experience any of these symptoms. Invega Extended-Release Tablets may rarely cause a prolonged, painful erection. This could happen even when you are not having sex. If this is not treated right away, it could lead to permanent sexual problems, such as impotence. Contact your doctor right away if this happens. Lab tests, including fasting blood sugar levels, complete blood cell counts, and blood cholesterol or lipid levels, may be performed while you take Invega Extended-Release Tablets. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments. Invega Extended-Release Tablets may cause weight gain. Your weight may need to be monitored while you take Invega Extended-Release Tablets. Use Invega Extended-Release Tablets with caution in the ELDERLY; they may be more sensitive to its effects, especially uncontrolled muscles movements. Invega Extended-Release Tablets should be used with extreme caution in CHILDREN younger than 12 years old when used for schizophrenia and in children younger than 18 years old when used for schizoaffective disorder; safety and effectiveness in these children have not been confirmed. PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of taking Invega Extended-Release Tablets while you are pregnant. Taking Invega Extended-Release Tablets during the third trimester may result in uncontrolled muscle movements or withdrawal symptoms in the newborn. Discuss any questions or concerns with your doctor. Invega Extended-Release Tablets are found in breast milk. If you are or will be breast-feeding while you take Invega Extended-Release Tablets, check with your doctor. Discuss any possible risks to your baby. Possible side effects of Invega Extended-Release Tablets:

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:

Constipation; dizziness; drowsiness; dry mouth; headache; indigestion; light-headedness; restlessness; sore throat; weight gain.

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); abnormal thoughts; behavior changes; chest pain; confusion; decreased sexual ability; decreased urination; enlarged breasts; fainting; fast or irregular heartbeat; fever, chills, or persistent sore throat; increased saliva production or drooling; increased sweating; mental or mood changes; missed menstrual period; muscle pain, weakness, or stiffness; nipple discharge; prolonged, painful erection; seizures; severe or prolonged dizziness or headache; shortness of breath; suicidal thoughts or attempts; symptoms of high blood sugar (eg, increased thirst, hunger, or urination; unusual weakness); tremor; trouble concentrating, speaking, or swallowing; trouble sitting still; trouble walking or standing; uncontrolled muscle movements (eg, arm or leg movements, twitching of the face or tongue, jerking or twisting); unusual eye movements.

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: Invega 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 fainting; fast or irregular heartbeat; loss of consciousness; seizures; severe drowsiness or dizziness; stiffness of the face, limbs, or neck; trouble walking; unusual muscle movement.

Proper storage of Invega Extended-Release Tablets:

Store Invega Extended-Release Tablets 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 Invega Extended-Release Tablets out of the reach of children and away from pets.

General information: If you have any questions about Invega Extended-Release Tablets, please talk with your doctor, pharmacist, or other health care provider. Invega Extended-Release Tablets 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 Invega Extended-Release Tablets. 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 Invega resources Invega Side Effects (in more detail) Invega Use in Pregnancy & Breastfeeding Drug Images Invega Drug Interactions Invega Support Group 15 Reviews for Invega - Add your own review/rating Compare Invega with other medications Bipolar Disorder Depression Schizoaffective Disorder Schizophrenia
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