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Estropipate

    Brands

    DEA Class; Rx

    Common Brand Names; Ortho Est, Ogen 5, Ogen 2.5, Ogen 1.25, Ogen 0.625

    • Estrogen Derivatives

    An oral synthetic estrogen that is piperazine-stabilized estrone sulfate (1.2 mg of estropipate is equivalent to 1 mg of sodium estrone sulfate)
    Used primarily for hormone replacement to treat vasomotor and genitourinary symptoms of menopause
    Also used for prevention of osteoporosis and for treating 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 postmenopausal osteoporosis prophylaxis.
    For treatment of premenopausal females with estrogen deficiency due to hypogonadism or primary ovarian failure.

    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

    Undiagnosed abnormal vaginal bleeding

    Uncontrolled hypertension

    Diabetes mellitus with vascular involvement

    Jaundice with prior oral contraceptive use

    • Peripheral edema
    • Depression
    • Headache
    • Melasma
    • Bloating
    • Nausea & vomiting
    • Breast enlargement & tenderness
    • Amenorrhea
    • Breakthrough bleeding
    • Spotting
    • Weight changes
    • Corneal curvation change

    Diabetes mellitus, endometriosis, hyperlipidemias, HTN, hypothyroidism, elderly, hepatic/renal impairment, uterine leiomyomata, porphyria, patients with defects of lipoprotein metabolism, hypertriglyceridemia, ovarian cancer, exacerbation of endometriosis or other conditions, smoking and >35 years old, SLE, depression

    Fluid retention may exacerbate asthma, epilepsy, migraines, & cardiac or renal dysfunction

    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.

    Hypercalcemia may occur in patients with breast cancer and bone metastases

    Increased risk of endometrial and ovarian cancer in postmenopausal women

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

    May increase risk of thromboembolic disorders, may need to increase anticoagulant dose when administering concomitantly with anticoagulants

    Pregnancy Category: X

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

    Adults

    9 mg/day PO.

    Geriatric

    6 mg/day PO for menopausal indications.

    Adolescents

    9 mg/day PO.

    Children

    Use not indicated in prepubescent females.

    Estropipate

    tablet

    • 0.75mg
    • 1.5mg
    • 3mg
    • 6mg