ESTERIFIED ESTROGENS

(ess TER ih fied ESS troe jenz) Brand: Estratab, Menest

What is the most significant information I must know about esterified estrogens?

• Esterified estrogens magnify the risk of developing a condition (endometrial hyperplasia) that may lead to cancer of the lining of the uterus. Taking progestins, other hormone drug, with esterified estrogens lowers the risk of developing this condition. Therefore, if your uterus has not been removed, your doctor may prescribe a progestin for you to take together with the estrogen. Visit your doctor regularly and message any unusual vaginal bleeding right away.

• Have yearly physical exams and examine your breasts for lumps on a monthly basis while taking esterified estrogens.

• Do not take esterified estrogens if you are pregnant.

What are esterified estrogens?

• Estrogen is a female sex hormone necessary for much processes in the body.

• Esterified estrogens are naturally occurring female sex hormones that are used to treat symptoms of menopause; deficiency in ovary function (including underdevelopment of female sexual characteristics and some types of infertility); some types of breast cancer in men and in postmenopausal women; degeneration of the vagina; and urethra and prostate cancer. In addition, esterified estrogens are used to prevent osteoporosis.

• Esterified estrogens may also be used for purposes another than those listed in this medicine guide.

Who must not take esterified estrogens?

• Do not take esterified estrogens without first talking to your doctor if you have

· a circulation, bleeding, or blood-clotting disorder;

· undiagnosed, emergency vaginal bleeding; or

· any type of breast, uterine, or hormone-dependent cancer.

• Taking esterified estrogens may be dangerous in some cases if you have any of the conditions listed above.

• Till taking esterified estrogens, speak your doctor if you have

· tall blood pressure, angina, or heart disease;

· tall levels of cholesterol or triglycerides in your blood;

· liver disease;

· kidney disease;

· asthma;

· epilepsy;

· migraines;

· diabetes;

· depression;

· gallbladder disease;

· uterine fibroids; or

· had a hysterectomy (uterus removed).

• You may not be able to take esterified estrogens, or you may require a dosage adjustment or particular monitoring during treatment if you have any of the conditions listed above.

• Esterified estrogens are in the FDA pregnancy category X. This means that esterified estrogens will reason birth defects in an unborn child. Do not take this medicine if you are pregnant or are planning a pregnancy.

• Esterified estrogens may decrease milk flow and have another effects on milk composition. Do not use this medicine without first talking to your doctor if you are breast-feeding a baby.

How must I take esterified estrogens?

• Take this medicine exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

• Take every doze with a full glass of water.

• Take esterified estrogens with food or milk to lessen stomach upset.

• Try to take each doze at the same time every day. You may be taking it each day, or you may be taking it each day for 3 weeks with 1 week off every month to mimic your body's natural cycle. Follow the directions on your prescription label.

• If you are taking esterified estrogens to treat cancer, you may be taking it different times a day in very big doses.

• Have yearly physical exams and examine your breasts for lumps on a monthly basis while taking esterified estrogens.

• Store esterified estrogens at room temperature away from moisture and heat.

What happens if I miss a dose?

• Take the missed doze as soon as you remember. Do not take a double doze of this medicine unless otherwise directed by your doctor.

What happens if I overdose?

• An overdose of this medicine is unlikely to threaten life. Consult an abnormal room or poison control center for advice.

• Symptoms of an overdose of esterified estrogens include nausea, vomiting, and breakthrough bleeding in females.

What must I avoid while taking esterified estrogens?

• There are no restrictions on food, beverages, or activity while taking esterified estrogens unless your doctor directs otherwise.

What are the possible side effects of esterified estrogens?

• If you experience any of the next serious side effects, stop taking esterified estrogens and search abnormal medical attention:

· an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or person; or hives);

· a blood clot (pain, redness, and swelling in an hand or leg, shortness of breath, chest pain, headache, blurred vision, or confusion);

· a lump in a breast; or

· liver hurt (yellowing of the skin or eyes, nausea, abdominal pain or discomfort, unusual bleeding or bruising, severe fatigue).

• Another, smaller serious side effects may be more likely to occur. Continue to take esterified estrogens and conversation to your doctor if you experience

· decreased appetite, nausea, or vomiting;

· swollen or tender breasts;

· acne or skin color changes;

· decreased sex drive;

· migraine headaches or dizziness;

· water retention (swollen hands, foots, or ankles);

· problems with wearing contact lenses;

· depression; or

· changes in your menstrual cycle or breakthrough bleeding.

• It is unclear to what extent estrogen treatments may affect the risk of breast cancer.

• Side effects another than those listed here may also occur. Conversation to your doctor about any side effect that seems unusual or that is especially bothersome. You may message side effects to FDA at 1-800-FDA-1088.

What another drugs will affect esterified estrogens?

• Till taking esterified estrogens, speak your doctor if you are taking any of the next medicines:

· an anticoagulant (blood thinner) such as warfarin (Coumadin);

· a thyroid medicine such as Synthroid, Levoxyl, Levothroid, and others;

· insulin or an oral diabetes medication such as glipizide (Glucotrol) or glyburide (Diabeta, Micronase);

· tamoxifen (Nolvadex);

· didanosine (Videx);

· phenytoin (Dilantin) or ethotoin (Peganone);

· carbamazepine (Tegretol);

· phenobarbital (Solfoton, Luminal);

· primidone (Mysoline); or

· rifampin (Rifadin).

• A dosage adjustment or particular monitoring may be required during treatment if you are taking any of the medicines listed above.

• Drugs another than those listed here may also interact with esterified estrogens. Conversation to your doctor and pharmacist till taking any prescription or over-the-counter medicines.

Where can I get more information?

• Your pharmacist has additional information about esterified estrogens written for health professionals that you may read.

Remember, hold this and all another medicines out of the reach of children, never share your medicines with others, and use this medicine only for the indication prescribed.

Disclaim: Each effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses external of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way must be construed to indicate that the drug or drug combination is safety, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the help of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

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