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|Estropipate Estropipate

Estropipate

Generic name: Estropipate
Brand names: Ogen, Ortho-Est

Why is Estropipate prescribed?

Estropipate and Ortho-Est are estrogen replacement drugs. The tablets are used to reduce symptoms of menopause, including feelings of warmth in face, neck, and chest, and the sudden intense episodes of heat and sweating known as "hot flashes." They also may be prescribed for teenagers who fail to mature at the usual rate.

In addition, either the tablets or Estropipate vaginal cream can be used for other conditions caused by lack of estrogen, such as dry, itchy external genitals and vaginal irritation.

Along with diet, calcium supplements, and exercise, Estropipate and Ortho-Est tablets are also prescribed to prevent osteoporosis, a condition in which the bones become brittle and easily broken.

Some doctors also prescribe these drugs to treat breast cancer and cancer of the prostate.

Most important fact about Estropipate

Because estrogens have been linked with increased risk of endometrial cancer (cancer in the lining of the uterus) in women who have had their menopause, it is essential to have regular check-ups and to report any unusual vaginal bleeding to your doctor immediately.

How should you take Estropipate?

Be careful to follow the cycle of administration your doctor establishes for you. Take the medication exactly as prescribed.

When using Estropipate Vaginal Cream, follow the instructions printed on the carton. It is for short-term use only. Remove the cap from the tube and make sure the plunger of the applicator is all the way into the barrel. Screw the nozzle of the applicator onto the tube and squeeze the cream into the applicator. The number on the plunger, which indicates the dose you should take, should be level with the top of the barrel. Unscrew the applicator and replace the cap on the tube. Insert the applicator into the vagina and push the plunger all the way down. Between uses, take the plunger out of the barrel and wash the applicator with warm, soapy water. Never use hot or boiling water.

--If you miss a dose...

Take the forgotten dose as soon as you remember. If it is almost time for the next dose, skip the one you missed and go back to your regular schedule. Never try to "catch up" by doubling the dose.

--Storage instructions...

Store at room temperature.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, notify your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking estrogen.

• More common side effects may include:
  Abdominal cramps, bloating, breakthrough bleeding, breast enlargement, breast tenderness and secretions, change in amount of cervical secretion, changes in sex drive, changes in vaginal bleeding patterns, chorea (irregular, rapid, jerky movements, usually affecting the face and limbs), depression, dizziness, enlargement of benign tumors (fibroids), excessive hairiness, fluid retention, hair loss, headache, inability to use contact lenses, menstrual changes, migraine, nausea, reduced ability to tolerate carbohydrates, spotting, spotty darkening of the skin, especially around the face, skin eruptions (especially on the legs and arms) with bleeding, skin irritation, skin redness and scaling, vaginal yeast infection, vision problems, vomiting, weight gain or loss, yellow eyes and skin

Why should Estropipate not be prescribed?

Estrogens should not be used if you know or suspect you have breast cancer or other cancers promoted by estrogen. Do not use estrogen if you are pregnant or think you may be pregnant. Also avoid estrogen if you have abnormal, undiagnosed genital bleeding, or if you have blood clots or a blood clotting disorder or a history of blood clotting disorders associated with previous estrogen use.

Estropipate Vaginal Cream should not be used if you are sensitive to or have ever had an allergic reaction to any of its components.

Special warnings about Estropipate

The risk of cancer of the uterus increases when estrogen is used for a long time or taken in large doses. There also may be increased risk of breast cancer in women who take estrogen for an extended period of time.

Women who take estrogen after menopause are more likely to develop gallbladder disease.

Estropipate also increases the risk of blood clots. These blood clots can cause stroke, heart attack, or other serious disorders.

Your doctor will check your blood pressure regularly. It could go up or down.

While taking estrogen, get in touch with your doctor right away if you notice any of the following:

Abdominal pain, tenderness, or swelling
Abnormal bleeding from the vagina
Breast lumps
Coughing up blood
Pain in your chest or calves
Severe headache, dizziness, or faintness
Speech changes
Sudden shortness of breath
Vision changes
Vomiting
Weakness or numbness in an arm or leg
Yellowing of the skin

Estropipate may cause fluid retention in some people. If you have asthma, epilepsy, migraine, or heart or kidney disease, use Estropipate with care.

Estrogen therapy may cause uterine bleeding or breast pain.

Possible food and drug interactions when taking Estropipate

If Estropipate is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Estropipate with the following:

Barbiturates such as phenobarbital
Blood thinners such as Coumadin
Epilepsy drugs (Tegretol, Dilantin, others)
Insulin
Tricyclic antidepressants (Elavil, Tofranil, others)
Rifampin (Rifadin)

Special information if you are pregnant or breastfeeding

Estrogens should not be used during pregnancy. If you are pregnant or plan to become pregnant, notify your doctor immediately. These drugs may appear in breast milk and could affect a nursing infant. If Estropipate is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment is finished.

Recommended dosage

HOT FLASHES AND NIGHT SWEATS

Estropipate Tablets:

The usual dose ranges from one .625 tablet to two 2.5 tablets per day. Tablets should be taken in cycles, according to your doctor"s instructions.

Ortho-Est Tablets:

The usual dose ranges from half a tablet to 4 tablets per day of Ortho-Est 1.25 or 1 to 8 tablets of Ortho-Est .625. Tablets should be taken in cycles, according to your doctor"s instructions.

VAGINAL INFLAMMATION AND DRYNESS

Estropipate Tablets:

The usual dose ranges from one .625 tablet to two 2.5 tablets per day. Tablets should be taken in cycles, according to your doctor"s instructions.

Ortho-Est Tablets:

The usual dose ranges from half a tablet to 4 tablets per day of Ortho-Est 1.25 or 1 to 8 tablets of Ortho-Est .625. Tablets should be taken in cycles, according to your doctor"s instructions.

Estropipate Vaginal Cream:

The usual dose is 2 to 4 grams daily. Cream should be used in cycles, and only for limited periods of time.

ESTROGEN HORMONE DEFICIENCY

Estropipate Tablets:

The usual dose ranges from one 1.25 tablet to three 2.5 tablets per day, taken for 3 weeks, followed by a rest period of 8 to 10 days.

Ortho-Est Tablets:

The usual dose ranges from 1 to 6 tablets per day of Ortho-Est 1.25 or 2 to 12 tablets of Ortho-Est .625, given for 3 weeks, followed by a rest period of 8 to 10 days.

OVARIAN FAILURE

Estropipate Tablets:

The usual dose ranges from one 1.25 tablet to three 2.5 tablets per day for 3 weeks, followed by a rest period of 8 to 10 days. Your doctor may increase or decrease your dosage according to your response.

Ortho-Est Tablets:

The usual dose ranges from 1 to 6 tablets per day of Ortho-Est 1.25 or 2 to 12 tablets of Ortho-Est .625 for 3 weeks, followed by a rest period of 8 to 10 days. Your doctor may increase or decrease your dosage according to your response.

PREVENTION OF OSTEOPOROSIS

Estropipate and Ortho-Est Tablets:

The usual dose is one .625 tablet per day for 25 days of a 31-day monthly cycle.

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose, seek emergency medical treatment immediately.

• Symptoms of Estropipate overdose may include:
  Nausea, vomiting, withdrawal bleeding