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Estradiol raises your risk of getting endometrial cancer (cancer of the lining of the uterus [womb]). The chance of developing endometrial cancer increases with the duration of estradiol use. You should be prescribed a progestin to consume along with topical estradiol if you have not undergone a hysterectomy, a procedure to remove the uterus. The risk of having endometrial cancer may be reduced, but your risk of acquiring certain other health issues, such as breast cancer, may increase. Inform your doctor if you have irregular or unexpected vaginal bleeding before starting to use topical estradiol if you have cancer or have ever had cancer. If you experience irregular or unusual vaginal bleeding while using topical estradiol, call your doctor right once. To assist ensure that you do not develop endometrial cancer during or after your treatment, your doctor will keep a careful eye on you.
Women who combined oral oestrogens (a class of drugs that includes estradiol) and progestins had an increased risk of heart attacks, strokes, blood clots in the lungs or legs, breast cancer, and dementia, according to a big study (loss of ability to think, learn, and understand). These disorders may also be more likely to affect women who take topical estradiol either alone or in combination with progestins. Inform your doctor if you smoke or use tobacco, if you’ve recently suffered a heart attack or stroke, if you currently have blood clots or breast cancer, or if anybody in your immediate family has a history of breast cancer. Moreover, let your physician know if you have or have had had high blood pressure, high cholesterol or fat levels, diabetes, heart disease, lupus (a condition in which the body attacks its own tissues, resulting in damage and swelling), breast lumps, or an abnormal mammogram (x-ray of the breast used to find breast cancer).
The major medical disorders mentioned above can present with any of the symptoms below. If you have any of the following signs while using topical estradiol, call your doctor right away: Speaking difficulties, dizziness, faintness, sudden complete or partial vision loss, double vision, weakness or numbness of an arm or a leg, excruciating chest pain or chest heaviness, coughing up blood, sudden shortness of breath, breast lumps or other breast changes, discharge from nipples, trouble concentrating, remembering, or picking up new information, as well as pain, tenderness, or redness in one leg.
You can take precautions to lessen your chance of experiencing a significant health issue when using topical estradiol. To prevent heart disease, heart attacks, or strokes, do not use topical estradiol by itself or in combination with a progestin. Take topical estradiol only as long as necessary and at the lowest dose necessary to control your symptoms. Every three to six months, discuss with your doctor whether you should reduce the dosage of your topical estradiol or stop using it altogether.
To help find breast cancer as early as possible, you should check your breasts monthly and get a mammography and breast exam conducted by a doctor once a year. If you have a personal or family history of illness, your doctor will advise you on how to properly inspect your breasts and whether you need to have them checked more frequently than once a year.
If you are undergoing surgery or will be put on bed rest, let your doctor know. In order to reduce your risk of developing blood clots, your doctor may advise you to cease using topical estradiol 4-6 weeks before to the procedure or place you on bed rest.
Regularly discuss the advantages and disadvantages of utilising topical estradiol with your doctor.
Why is this medication prescribed?
Women going through menopause can treat and prevent hot flushes (hot flashes; sudden, intense feelings of heat and sweating) using estradiol topical gel and emulsion (lotion-type mixture) (change of life; the end of monthly menstrual periods). In women going through menopause, estradiol topical gel is also used to treat vaginal dryness, itching, and burning. However, women who only experience burning, itching, or dryness in the vagina may find that a medicine given topically to the vagina is more effective. Estradiol belongs to the group of drugs known as oestrogen hormones. It functions by substituting the body’s natural production of oestrogen.
How should this medicine be used?
Gel, spray, and emulsion forms of topical estradiol are available for skin application. Typically, it is administered once daily. Applying estradiol emulsion ought to be done in the morning. Although estradiol gel can be administered at any time of day, it is best to apply it daily at roughly the same time. Ask your doctor or chemist to explain any instructions on your prescription label that you are unsure about following. As indicated, apply topical estradiol. Use it only as directed by your doctor, neither more nor less often.
Apply a small layer of estradiol gel to one arm, from the wrist to the shoulder, if you’re using it. Apply estradiol emulsion to your thighs and calves if you’re using it (lower legs). Applying estradiol gel or emulsion on your breasts is not advised. Make that the area of skin where topical estradiol will be applied is clear, fully dry, and free of any redness, irritation, or breaks.
Use topical estradiol after bathing, showering, or using a sauna if you do any of these things, and after your skin has totally dried. Give yourself as much time as you can between applying the estradiol gel and swimming if you intend to go swimming. Avoid applying sunscreen right before, simultaneously with, or right after applying topical estradiol.
Gel form of estradiol could burn. Avoid smoking or going near an open flame after applying estradiol gel until it has dried.
Avoid getting the gel form of estradiol in your eyes. If you do accidentally get estradiol gel in your eyes, immediately rinse them thoroughly with warm water. If your eyes start to itch, contact a doctor.
Using estradiol gel yourself is advised. Never allow anyone else to apply the gel to your skin.
Use estradiol gel as directed by these steps:
- Remove the big pump cap and thoroughly depress the pump twice before applying your first dose of estradiol gel. To keep it out of the reach of kids and dogs, wash the gel that comes out down the sink or properly dispose of it. By doing this, the pump is primed to release the same quantity of medicine each time it is squeezed. After using the pump for the first time, do not repeat this process.
- One hand should be used to hold the pump while the other hand should be cupped beneath the nozzle. One dose of gel will be dispensed onto your palm by pressing the pump hard and thoroughly.
- Apply the gel as thinly as you can to your entire arm using your hand. Attempt to spread the gel from your wrist to your shoulder on both the inside and outside of your arm.
- Avoid massaging or rubbing the gel into your skin. To cover your arm with clothing, wait five minutes for the skin to dry.
- The tiny and large protective caps should be placed over the pump.
- Use soap and water to wash your hands.
These steps should be followed to use estradiol emulsion:
- Sit down comfortably and gather two pouches of estradiol emulsion.
- Cut or tear across the notches near the top of one pouch of estradiol emulsion to release it.
- With the open end of the bag towards your knee, place it flat on top of your left leg.
- The entire amount of emulsion in the pouch should be pushed onto your thigh using the fingertip of the hand holding the closed end of the bag.
- For three minutes, completely absorb the emulsion by massaging it into your thigh and calf with one or both hands.
- Your buttocks should receive whatever emulsion that is still on your hands.
- Use your right thigh and a fresh pouch of estradiol emulsion to perform steps 1-6 again, this time applying the second pouch’s contents to your right thigh and calf.
- Cover the area of skin where you applied the estradiol emulsion with garments after waiting until it is completely dry.
- Hands should be washed with soap and water.
For a copy of the manufacturer’s information for the patient, ask your chemist or doctor.
Other uses for this medicine
Ask your doctor or chemist for more details if you believe this drug should be used for something else.
What special precautions should I follow?
Before using topical estradiol,
- Inform your doctor and chemist if you have any allergies to estradiol gel or emulsion, other medicines containing oestrogen, other drugs, or any of the chemicals in these products. If you are unsure whether a drug you are allergic to contains oestrogen, ask your chemist for a list of the constituents in estradiol gel or emulsion.
- Inform your doctor and chemist about any prescription and over-the-counter drugs, vitamins, and dietary supplements you are currently taking or intend to take. Incorporate any of the following: pharmaceuticals for thyroid disease, lovastatin (Altocor, Mevacor), itraconazole (Sporanox) and ketoconazole (Nizoral), antifungal drugs such as itraconazole and ketoconazole, carbamazepine (Carbatrol, Epitol, Tegretol), erythromycin (E.E.S., Erythrocin), phenobarbital, rifampin (Rifa (Norvir, in Kaletra), Your physician might need to adjust the dosage of your drugs or keep a close eye on you for side effects.
- Please let your doctor know if you are taking any herbal supplements, especially St. John’s wort.
- Inform your doctor if you suffer from or have ever experienced the following conditions: asthma, seizures, migraine headaches, endometriosis (a condition in which the tissue that lines the uterus [womb] grows in other areas of the body), uterine fibroids (growths in the uterus that are not cancerous), yellowing of the skin or eyes, particularly during pregnancy or while you were using an oestrogen product; blood calcium levels that are abnormally high or low; porphyria, a condition in which aberrant blood material buildup results in issues with the skin or neurological system; or gallbladder, thyroid, liver, pancreas, or kidney disease.
- Inform your doctor if you are expecting, intend to get pregnant, or are nursing a baby. Call your doctor if you become pregnant while using topical estradiol.
- Have a plan to limit your time spent in the sun and to use sunscreen, sunglasses, and protective clothes. Ensure to wait a little before wearing sunscreen after administering topical estradiol. Your skin could become photosensitive if you use estradiol gel.
- You should be aware that topical estradiol can be dangerous if someone touches it while it is on your skin or in the bottle. Men and kids are the groups most at risk. After applying topical estradiol, wait an hour before allowing anyone else to touch the affected area of skin. Immediately after touching topical estradiol, a person should wash their skin with soap and water.
What special dietary instructions should I follow?
If you plan to consume grapefruits or grapefruit juice while taking this medication, consult your doctor.
What should I do if I forget a dose?
Use the missed dose of estradiol gel right away if you forget to use it but remember more than 12 hours before you are supposed to use your next dose. Skip the missed dose and carry on with your regular dosing plan the following day if you recollect less than 12 hours before you are supposed to administer your next dose. Applying more gel won’t make up for a forgotten dose.
Apply estradiol emulsion as soon as you recall if you neglect to do it in the morning. Applying more emulsion to make up for missed doses is not advised, and applying estradiol emulsion more than once per day is also not advised.
What side effects can this medication cause?
Side effects from topical estradiol are possible. If any of these symptoms are severe or do not go away, let your doctor know right once:
- Breast pain or tenderness
- Weight gain or loss
- Mood changes
- Difficulty falling asleep or staying asleep
- Changes in sexual desire
- Back pain
- Runny nose
- Flu-like symptoms
- Hair loss
- Unwanted hair growth
- Darkening of the skin on the face
- Difficulty wearing contact lenses
- Irritation or redness of the skin where you applied topical estradiol
- Swelling, redness, burning, irritation, or itching of the vagina
- Vaginal discharge
Some adverse effects may be severe. Call your doctor right away if you have any of the following symptoms or any of the ones detailed in the IMPORTANT CAUTION section:
- Enlarged eyes
- Eyes or skin that have a yellow tint
- Reduced appetite
- Joints hurt
- Stomach ache, agony, or tenderness
- Moves that are challenging to manage
- Blisters or rashes on the skin
- Edoema of the lower legs, hands, feet, ankles, tongue, throat, eyes, face, lips, and/or throat
- Breathing or swallowing challenges
Topical estradiol may raise your risk of getting gallbladder illness and ovarian cancer, both of which may require surgery to address. Discuss the dangers of using this drug with your doctor.
Further negative consequences from topical estradiol are possible. If you experience any strange issues while taking this medicine, contact your doctor right away.
You or your doctor can submit a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting programme online or by phone if you have a serious side event (1-800-332-1088).
What should I know about storage and disposal of this medication?
Keep this medication tightly closed in the original container and out of the reach of children. Keep it away from excessive heat and moisture at room temperature (not in the bathroom). Keep topical estradiol from freezing. Avoid using estradiol gel near flames. Even if it is not entirely empty, dispose of your estradiol gel pump after you have consumed 64 doses.
Unused prescriptions must be disposed of carefully to prevent pets, kids, and other people from ingesting them. You should not, however, dispose of this medication in the toilet. Instead, utilising a medicine take-back programme is the easiest approach to get rid of your medication. To find out about take-back programmes in your area, speak with your chemist or the garbage/recycling agency in your city. If you do not have access to a take-back programme, see the FDA’s Safe Disposal of Medications website at http://goo.gl/c4Rm4p for additional information.
Although many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Always lock safety caps and promptly stash medication up and away from young children where it is out of their sight and reach to prevent poisoning. http://www.upandaway.org
In case of emergency/overdose
Call the poison control hotline at 1-800-222-1222 in the event of an overdose. Moreover, information can be found online at https://www.poisonhelp.org/help. Call 911 right once if the person has collapsed, experienced a seizure, is having difficulty breathing, or cannot be roused.
Overdose symptoms could include:
- Uterine bleeding
What other information should I know?
Keep all of your appointments with your physician and the lab. To determine how your body is responding to topical estradiol, your doctor may request specific lab tests.
Inform the lab staff and your doctor that you are using topical estradiol prior to any laboratory test.
Do not share your medication with anybody else. Any queries you may have regarding prescription refills should be directed to your chemist.
You should keep a written record of every medication you take, including any over-the-counter (OTC) items, prescription drugs, and dietary supplements like vitamins and minerals. This list should be brought with you whenever you see a doctor or are admitted to the hospital. You should always have this information with you in case of emergencies.