Estrace

Common Name: estradiol-17ß (micronized)

How does Estrace work?

Estradiol-17ß (micronized) belongs to the class of medications known as estrogen replacement therapy. Estrogen is a female hormone produced by the ovaries. Once menopause is reached, the ovaries produce less estrogen and progesterone (another hormone) and symptoms of menopause can occur. Estradiol-17ß (micronized) is an estrogen replacement hormone used for the management of menopausal symptoms such as abnormal uterine bleeding, hot flashes, sweating, and chills. It may also contribute to the prevention of osteoporosis in women when combined with diet, calcium, and exercise. Women who have not had a hysterectomy must also take a progestogen while they are taking this medication. Your doctor may choose to use a medication for conditions other than the ones listed in these drug information articles. If you're unsure why you are taking this medication, contact your doctor.

How should I use Estrace?

Typically, estrogen is taken for the first 21 to 25 days of each month. Women who have not had a hysterectomy (i.e., they still have a uterus) should take a progestogen (e.g., medroxyprogesterone) for the last 12 to 14 days of each estrogen cycle. For treatment of menopausal symptoms, the usual dose is 1 mg daily for 21 to 25 days of each month. Attempts to discontinue the medication should be made every three to six months. If symptoms return, the medication should be continued. For prevention of osteoporosis, the usual dose is 0.5 mg daily as soon as possible after the onset of menopause. The dose may be increased or decreased according to the level of estradiol in the blood. Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor. It is very important that this medication be taken on a regular schedule as prescribed by the doctor. If you miss a dose of this medication take it as soon as you remember it. If it is almost time for your next dose, skip the missed dose and carry on with your regular schedule. Do not double-up on doses.

What form(s) does Estrace come in?

Estrace® is available in strengths of 0.5 mg, 1 mg, and 2 mg. 0.5 mg: Each white, scored tablet, with "MJ" and "021" on one side, contains estradiol-17ß micronized 0.5 mg. Nonmedicinal ingredients: acacia, dibasic calcium phosphate, cornstarch, lactose, magnesium stearate, silicon dioxide, and talc. 1 mg: Each lavender, scored tablet, with "MJ" and "755" on one side, contains estradiol-17ß micronized 1 mg. Nonmedicinal ingredients: acacia, dibasic calcium phosphate, cornstarch, D&C Red No. 27 Aluminum Lake, FD&C Blue No. 1 Aluminum Lake, lactose, magnesium stearate, silicon dioxide, and talc. 2 mg: Each turquoise, scored tablet, with "MJ" and "756" on one side, contains estradiol-17ß micronized 2 mg. Nonmedicinal ingredients: acacia, dibasic calcium phosphate, cornstarch, FD&C Blue No. 1 and Yellow No. 5 Aluminum Lake, lactose, magnesium stearate, silicon dioxide, and talc.

What should I NOT take with Estrace?

This medication should not be used by anyone who: has liver dysfunction or disease, especially of the obstructive type has or has had breast cancer or endometrial cancer, except in special circumstances has endometrial hyperplasia has a known or suspected estrogen-dependent tumour has undiagnosed vaginal bleeding has had a stroke has had coronary thrombosis has had migraine headaches has had diseases of circulation or clotting has had partial or complete loss of vision or double-vision from eye disease related to circulation problems has endometriosis or leiomyoma of the uterus is or may be pregnant is breast-feeding is allergic to any ingredient of the medication

Are there any other precautions or warnings for Estrace?

Endometrial cancer: There is evidence from several studies that estrogen replacement therapy increases the risk of cancer of the endometrium (uterus). Taking a progestogen appropriately along with the estrogen reduces this risk to the same level as that of a woman who does not take estrogen. For this reason, all women who have not had their uteruses removed should also take progestogen if they use estrogens. Breast cancer: Studies indicate an increased risk of breast cancer with long-term use of estrogen replacement therapy. Women who have breast nodules, fibrocystic disease, abnormal mammograms, or a strong family history of breast cancer should approach the use of estrogens with particular caution. Women who take estrogens should have regular breast examinations and should be instructed in breast self-examination. Blood problems: Estrogens should not be used by persons with active thrombophlebitis or thromboembolic disorders (diseases of blood clotting and abnormal circulation). They should also not be used (except in the treatment of cancer) by persons with a history of such disorders in association with estrogen use. Finally, they should be used with caution by people with cerebral vascular disease or coronary artery disease and only used if clearly needed. Some studies have suggested that, for healthy women, there is an increased relative risk of developing deep vein thrombosis or pulmonary embolism when on hormone replacement therapy. Women with severe varicose veins or severe obesity, and those needing to stay in bed for 3 weeks or more, are generally considered to be at increased risk of venous thromboembolism (blood clots in the bloodstream). Increased blood pressure is not uncommon for women using this medication. Blood pressure should be monitored with estrogen use, especially if high doses are used. Smoking can increase the risk of blood clots. Women taking estrogen are strongly advised not to smoke. Diabetes: Estrogens may affect blood sugar control. Anyone with diabetes should carefully monitor their blood glucose levels while taking any medication containing estrogen. Gallbladder disease: An increased risk of gallbladder disease has been reported in postmenopausal women who take estrogens. Fluid retention: Estrogen may cause sodium (salt) and fluid retention. Women with heart or kidney dysfunction, epilepsy, or asthma should be particularly careful when taking it. Cholesterol: Oral estrogens can increase triglycerides in the blood. Your physician may check your cholesterol while on estrogen. Fibroids: This medication may worsen fibroids, causing sudden enlargement, pain, or tenderness. If you notice these effects, contact your doctor. Pregnancy: Estrogen should not be used during pregnancy. If you become pregnant while taking this medication, contact your doctor. Breast-feeding: Estrogen is not safe for use during breast-feeding. A decision should be made whether to discontinue nursing or to discontinue the medication, taking into account the importance of the medication to the mother. Children: The safety and effectiveness of this medication have not been established for use by children.