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Esterified Estrogens

    Brands

    DEA Class; Rx

    Common Brand Names; Estrogens, Esterified, Menest

    • Antineoplastics, Hormones; 
    • Estrogen Derivatives

    Mixture of sodium salts of the sulfate esters of estrogenic substances
    Primarily used to treat vasomotor and genitourinary symptoms associated with menopause
    Also used for osteoporosis prevention and for the treatment of conditions associated with estrogen deficiency

    Indicated for treatment of moderate to severe vasomotor symptoms (hot flashes) of menopause and/or related genitourinary symptoms including atrophic vaginitis, vulvar atrophy (kraurosis vulvae), whether menopause is natural or surgical (e.g., due to oophorectomy).

    For treatment of moderate to severe vasomotor symptoms (hot flashes) of menopause and/or related genitourinary symptoms including atrophic vaginitis, vulvar atrophy (kraurosis vulvae), whether menopause is natural or surgical (e.g., due to oophorectomy).
     
    For treatment of premenopausal females with estrogen deficiency due to hypogonadism or primary ovarian failure.
    For the palliative treatment of breast cancer that is inoperable and progressive in selected men and postmenopausal women.
    For the treatment of advancing inoperable prostate cancer.

    Documented hypersensitivity

    Active or history of breast cancer

    Arterial thromboembolic disease (stroke, MI), thrombophlebitis, DVT/PE, thrombogenic valvular disease

    Estrogen-dependent neoplasia, liver disease, liver tumors

    Uncontrolled hypertension

    Diabetes mellitus with vascular involvement

    Jaundice with prior oral contraceptive use

    Undiagnosed abnormal genital bleeding

    Common

    • Edema, peripheral edema

    • Headache

    • Melasma

    • Breast enlargement, breast tenderness

    • Bloating

    • Nausea

    • Vomiting

    Less common

    • Depression

    • Amenorrhea

    • Breakthrough bleeding

    • Spotting

    • Weight changes

    • Corneal curvation change

    Diabetes mellitus, endometriosis, hyperlipidemias, HTN, hypothyroidism, liver impairment, uterine leiomyomata, smoking, porphyria, patients with defects of lipoprotein metabolism, hypertriglyceridemia, hypothyroidism, ovarian cancer, exacerbation of endometriosis or other conditions

    Conditions exacerbated by fluid retention (asthma, epilepsy, migraine etc)

    Hypercalcemia may occur in patients with breast cancer and bone metastases

    Long-term postmenopausal estrogen treatment has been associated with an increased risk of breast cancer, MI, stroke, DVT, PE, and dementia

    Discontinue if the following develop jaundice, visual problems (may cause contact lens intolerance), any signs of VTE, migraine with unusual severity, significang blood pressure increase, severe depression, increased risk of thromboembolic complications after surgery

    Concomitant warfarin, oral anticoagulants: estrogens increase risk of thromboembolic disorders; may need to increase anticoagulant dose

    Pregnancy Category: X

    Lactation: Controversial; estrogens are excreted into breast milk in small quantities, use caution

    Adults

    Dependent on indication for therapy.

    Elderly

    Dependent on indication for therapy.

    Adolescents

    Dependent on indication for therapy.

    Children

    Not indicated in prepubescent females.

    Esterified estrogens

    tablet

    • 0.3mg
    • 0.625mg
    • 1.25mg
    • 2.5mg