ESTRONE

ESTRONE
(ess'trone)
Classifications: hormone; estrogen;
Therapeutic: estrogen; female hormone replacement therapy (hrt)

Prototype: Estradiol
Pregnancy Category: X

Availability

5 mg/mL injection

Action

Estrone is one-third less active at the cellular level than estradiol, the principal premenopausal estrogen. Due to increased risk of serious complications from extended use, estrogen HRT or estrogen-progestin HRT should be prescribed for the shortest duration possible consistent with the treatment goals of post menopausal symptoms.

Therapeutic Effect

Replaces estrogen in postmenopausal women, relieving symptoms of menopause.

Uses

Atrophic vaginitis, kraurosis vulvae, and abnormal bleeding (hormonal imbalance); also female hypogonadism, primary ovarian failure, vasomotor symptoms associated with menopause, and as palliative therapy of prostatic carcinoma.

Contraindications

Breast cancer; liver dysfunction; history of thromboembolic disease; known or suspected pregnancy (category X), lactation.

Cautious Use

Hypertension; gallbladder disease; diabetes mellitus; heart failure; kidney dysfunction; seizure disorders.

Route & Dosage

Menopause
Adult: IM 0.1–0.5 mg 2–3 times/wk

Female Hypogonadism, Primary Ovarian Failure
Adult: IM 0.1–1 mg/wk in single or divided doses

Inoperable Prostatic Cancer Palliation
Adult: IM 2–4 mg/d 2–3 times/wk

Administration

Intramuscular
  • Shake vial and syringe well to suspend medication before withdrawing and injecting medication.
  • Give deep into a large muscle.
  • Store at 15°–30° C (59°–86° F); protect from light and do not freeze.

Adverse Effects (≥1%)

CNS: Headache, dizziness, depression, libido changes. CV: Thromboembolic disorders, hypertension. GI: Nausea, vomiting, diarrhea, bloating, cholestatic jaundice. Urogenital: Mastodynia, spotting, changes in menstrual flow, dysmenorrhea, amenorrhea. Metabolic: Reduced carbohydrate tolerance, fluid retention. Other: Leg cramps, intolerance to contact lenses.

Interactions

Drug: Carbamazepine, phenytoin, rifampin decrease estrogen levels because they increase metabolism; may enhance steroid effects of corticosteroids; may decrease anticoagulant effects of oral anticoagulants.

Pharmacokinetics

Absorption: Occurs over several days. Metabolism: Converts to estradiol in GI mucosa. Half-Life: 4–18.5 h.

Nursing Implications

Assessment & Drug Effects

  • See nursing implications under estradiol.
  • Monitor for and report breakthrough vaginal bleeding.
  • Assess for relief of menopausal symptoms.
  • Lab tests: Monitor serum phosphatase levels with prostate cancer.
  • Monitor patients with conditions that may be influenced by fluid retention carefully (e.g., migraine, cardiac or kidney dysfunction, asthma, epilepsy, hypertension). Check BP on a regular basis.
  • Note: Spotting or breakthrough bleeding occurring when other drugs and estrone are taken concurrently indicates reduced availability of the estrogen.

Patient & Family Education

  • Review package insert to assure understanding of estrogen therapy.
  • Determine weight under standard conditions 1 or 2 times/wk and report sudden weight gain or other signs of fluid retention.
  • Notify physician of positive Homans' sign (calf pain upon flexing foot) and the following symptoms of thromboembolic disorders immediately: Tenderness, swelling, and redness in extremity; sudden, severe headache or chest pain; slurring of speech; change in vision; sudden shortness of breath.
  • Report symptoms of vaginal candidiasis (thick, white, curd-like secretions and inflamed, congested introitus) to permit appropriate treatment.
  • Notify physician of severe abdominal pain and tenderness or abdominal mass.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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© 2006-2017 medpill.info Last Updated On: 07/16/2017 (0.01)
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