Estradiol is used as a hormone replacement therapy (HRT) in menopausal women. It is used to treat menopausal symptoms such as hot flushes, vaginal dryness and itch.
This medicine is also used to treat certain conditions caused by low levels of estrogen (primary sex hormone in women) and prevent osteoporosis (thinning and weakening of bones) in menopause women.
Estradiol may be used to treat other conditions as decided by your doctor.
Apply Estradiol on your skin exactly as directed by your doctor or according to the instructions on the label. Do not apply more or less than instructed by your doctor.
This medicine is available as a patch, gel, or spray.
If you have been given a patch, do not apply the patch on broken skin. Do not cut the patch. The release pattern of the medicine will be affected if you cut the patch. Do not use it for a longer period than instructed by your doctor.
To apply Estradiol transdermal patch:
- Remove the patch from the pouch with clean and dry hands.
- Remove the protective strip and apply the sticky side of the patch to a clean, dry and intact area of the skin. Apply either on your lower abdomen or upper buttocks. Alternate application area every time. Do not apply on or near your breasts. Avoid areas where the patch may be rubbed off by your clothes (e.g. waistline).
- Firmly press the patch onto the skin with your palm.
- Hold for about 10 seconds to ensure the patch sticks well to the skin.
- Contact with water while you are swimming or showering may cause the patch to fall off. If your patch falls off, reapply it. If you cannot reapply the patch, apply a new patch to a new area of skin and change the patch at the usual scheduled time.
- Throw away the used patch by folding the sticky sides together, put it back in the empty pouch, and place it in a rubbish bin. Do not throw it into the toilet bowl. Wash your hands after throwing the used patch.
If you are using transdermal gel, follow these steps:
- Wash and dry your hands.
- Squeeze the entire contents of the packet onto a clean, dry, and intact area of the skin of the upper thigh and gently spread the gel on a thin layer. Alternate application area every time. Do not apply on or near your breasts.
- Allow the gel to completely dry before dressing.
- Wash and dry your hands after each application.
If you are using transdermal spray, follow these steps:
- If it is your first time using the spray, prime the applicator first before using it. Hold the applicator in an upright position and with the cover still on, fully press down the pump button 3 times. After priming, the spray is now ready to use.
- Remove the cover on the spray. Rest the cone part of the spray flat against your skin.
- Spray the specified amount by pressing the pump firmly and fully. One complete spray will dispense the same amount of product each time.
- Spray to a clean, dry, and intact area of the skin. Apply on the inner part of your forearm. Alternate application area every time. Do not apply on or near your breasts or vagina.
- Allow to dry for at least 2 minutes before dressing.
Estradiol must be used regularly for it to be effective. Continue using it even when you feel better. Do not stop using it unless instructed by your doctor.
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on the type of your condition.
Apply the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
Do not double a dose to make up for the missed dose.
If you often forget to apply your medicine, let your doctor and pharmacist know.
Do not use Estradiol if you ever had an allergic reaction (e.g. rashes, breathlessness, swollen eyes) to this medicine or any of its ingredients.
Alert your doctor if you have the following conditions:
- history or current blood clot disorder e.g. deep vein thrombosis (blood clots in your leg veins), pulmonary embolism (blood clots in a lung artery)
- history or current liver disease
- recent heart attack or stroke
- history or current breast cancer or other cancer that is sensitive to hormones e.g. cancer of the lining of the uterus
- untreated endometrial hyperplasia (excessive thickening of the womb lining)
- unexplained or unusual vaginal bleeding
- porphyria (an inherited disorder that causes skin or nervous system abnormalities)
as Estradiol may not be suitable for you.
Do not use Estradiol if you are pregnant or planning to have a baby soon. If you become pregnant while being treated with this medicine, alert your doctor immediately. Estradiol may cause harm to your unborn child.
Do not breastfeed while you are being treated with this medicine.
Inform your doctor if you have the following conditions:
- epilepsy (fits or seizures)
- asthma
- migraine (severe throbbing pain or pulsating sensation usually affecting one side of the head that is often accompanied by nausea, vomiting, and sensitivity to light and sound) or severe headache
- kidney disease
- heart disease e.g. high blood pressure
- high levels of cholesterol or fats in the blood
- diabetes
- gallstones
- low level of parathyroid hormones
- low calcium level in the blood
- otosclerosis (hearing disorder due to abnormal bone growth in the ear)
- systemic lupus erythematosus (autoimmune disease that causes inflammation of certain organs in the body)
- hereditary or acquired angioedema (swelling of the deep layers of the skin usually around the face, throat, and lips)
- family or personal history of blood clot disorder
- family history of breast cancer in a first-degree relative
- history of excessive thickening of the womb lining
- history of chloasma (brown patches of skin usually on the face or neck during pregnancy)
- abnormal growth of tissues outside the womb
Inform your doctor if you are an active smoker.
If you have a tendency to develop chloasma, you should avoid exposure to the sun or UV rays while using Estradiol. Apply sunscreen and wear protective clothing and eyewear when going outdoors.
If you are going to have an operation, including minor surgery and dental work, inform your doctor or dentist that you are using this medicine.
If you are going for certain laboratory tests (e.g. tests for cholesterol, sugar, or clotting factors), inform your doctor that you are using this medicine.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Routine tests (e.g. blood cholesterol or sugar levels, thyroid function, bone exam, gynaecological exam) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
- Your blood pressure may rise to unsafe levels without you noticing it. Monitor your blood pressure regularly during treatment.
- Regular monitoring of signs and symptoms of blood clot formation and changes in brain function may also be needed.
Estradiol may cause any of the following side effects: headache, dizziness, nausea, vomiting, stomach pain, stomach wind, indigestion, hot flushes, muscle or joint pain, vaginal discharge, and breast pain or discomfort.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- rashes, breathlessness, swelling of the face, eyes or mouth
- weakness or numbness on one side of the body, trouble speaking, vision problems, changes in balance or coordination
- chest pain, tightness or pressure, pain that may spread to the arms, jaw, neck, shoulder or back, shortness of breath, lightheadedness
- new lump in the breast or armpit, swelling or thickening of the breast, changes in the nipple, dimpling of the breast skin
- abdominal swelling, weight loss, pelvic or back pain, changes in bowel habits, quickly feeling full when eating, frequent need to urinate
- abnormal vaginal bleeding, painful urination, pain during intercourse
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Inform your doctor and pharmacist if you are taking any of these medicines:
- rifampicin (medicine to treat TB [an infection known as tuberculosis])
- medicines for epilepsy (fits or seizures) e.g. phenobarbital, phenytoin, carbamazepine
- medicines for HIV infection e.g. ritonavir, nevirapine, efavirenz
- certain antibiotics e.g. clarithromycin
- certain medicines to treat fungal infection e.g. fluconazole, griseofulvin
- medicines for high blood pressure e.g. verapamil, diltiazem
- medicines used in organ transplants or certain immune disorders e.g. ciclosporin, tacrolimus
- fentanyl (strong pain killer)
- theophylline (asthma medicine)
- St. John’s wort (herbal medicine)
This list does not include all medicines that may interact with Estradiol.
Always notify your doctor or pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
Avoid alcohol.
Store in a cool, dry place away from the reach of children.
Do not freeze.
Medicines must not be used past the expiry date.
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