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Brand Name
Estrace
Common Name
estradiol-17B (micronized)
How does this medication work? What will it do for me?

Estradiol-17ß (micronized) belongs to the class of medications known as estrogen replacement therapy. Estrogen is a female hormone produced by the ovaries. Once menopause is reached, the ovaries produce less estrogen and progesterone (another hormone), and symptoms of menopause can occur.

Estradiol-17ß (micronized) is an estrogen replacement hormone used to manage menopausal symptoms such as abnormal uterine bleeding, hot flashes, sweating, and chills. (See warnings about duration of use further in this article.)

It may also contribute to the prevention of osteoporosis in women when combined with diet, calcium, vitamin D, smoking cessation, and exercise. The decision to use this medication should be weighed against other options available for the treatment and prevention of osteoporosis.

Women who have not had a hysterectomy must also take a progestogen while they are taking this medication.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

How should I use this medication?

Typically, estrogen is taken for the first 21 to 25 days of each month. Women who have not had a hysterectomy (i.e., they still have a uterus) should take a progestogen (e.g., medroxyprogesterone) for the last 12 to 14 days of each estrogen cycle.

For treatment of menopausal symptoms, the usual dose is 1 mg daily for 21 to 25 days of each month. Attempts to discontinue the medication should be made every 3 to 6 months. If symptoms return, the medication should be continued.

For prevention of osteoporosis, the usual dose is 0.5 mg daily as soon as possible after the onset of menopause. The dose may be increased or decreased according to the level of estradiol in the blood.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

What form(s) does this medication come in?

0.5 mg
Each white, round, flat-faced, bevel-edged compressed tablet, with MJ logo and "021" on one side and scored on the reverse, contains estradiol-17ß (micronized) 0.5 mg. Nonmedicinal ingredients: acacia, dibasic calcium phosphate, cornstarch, lactose, magnesium stearate, silicon dioxide, and talc.

1 mg
Each lavender, round, flat-faced, bevel-edged compressed tablet, with MJ logo and "755" on one side and scored on the reverse, contains estradiol-17ß (micronized) 1 mg. Nonmedicinal ingredients: acacia, dibasic calcium phosphate, cornstarch, D&C Red No. 27 Aluminum Lake, FD&C Blue No. 1 Aluminum Lake, lactose, magnesium stearate, silicon dioxide, and talc.

2 mg
Each turquoise, round, flat-faced, bevel-edged compressed tablet, with MJ logo and "756" on one side and scored on the reverse, contains estradiol-17ß (micronized) 2 mg. Nonmedicinal ingredients: acacia, dibasic calcium phosphate, cornstarch, FD&C Blue No. 1 Aluminum Lake, FD&C Yellow No. 5 Aluminum Lake (tartrazine), lactose, magnesium stearate, silicon dioxide, and talc.

Who should NOT take this medication?

Estradiol-17ß (micronized) should not be taken by anyone who:

  • is allergic to any of the ingredients of the medication
  • is breast-feeding
  • is or may be pregnant
  • has a known or suspected estrogen-dependent tumour
  • has endometrial hyperplasia (thickening of the lining of the uterus)
  • has endometriosis or leiomyoma of the uterus
  • has had a blockage in an artery feeding the heart caused by a blood clot (coronary thrombosis)
  • has had a stroke
  • has had diseases of circulation or clotting
  • has had migraine headaches
  • has had partial or complete loss of vision or double-vision from eye disease related to circulation problems
  • has liver impairment or disease, especially of the obstructive type
  • has or has had breast cancer or endometrial cancer, except in special circumstances
  • has undiagnosed vaginal bleeding
What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • acne
  • bloating of stomach
  • breast pain or swelling
  • changes in cholesterol levels
  • cramps of lower stomach
  • depression or nervousness
  • dizziness
  • hair loss
  • headache (mild)
  • increased blood sugar levels
  • loss of appetite
  • nausea
  • vaginal bleeding or spotting
  • weight changes

Check with your doctor immediately if any of the following side effects occur:

  • crushing pain or chest heaviness
  • headache (sudden or severe)
  • loss of coordination (sudden)
  • loss of vision or change of vision (sudden)
  • pains in chest, groin, or leg, especially in the calf of leg
  • shortness of breath (sudden and unexplained)
  • slurring of speech (sudden)
  • stomach pains, nausea, and vomiting
  • weakness or numbness in arm or leg

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Important information about estrogen:

  • This medication should be used at the lowest dose that relieves your menopausal symptoms for the shortest time period possible.
  • You should not use estrogens with or without progestins to prevent heart disease, heart attacks, or strokes.

Blood problems: Estrogens should not be used by persons with active thrombophlebitis or thromboembolic disorders (diseases of blood clotting and abnormal circulation). They should also not be used (except in the treatment of cancer) by persons with a history of such disorders in association with estrogen use. Finally, they should be used with caution by people with cerebral vascular disease or coronary artery disease, and only used if clearly needed.

Some studies have suggested that there is an increased relative risk for healthy women to develop deep vein thrombosis or pulmonary embolism when they put on hormone replacement therapy. Women with severe varicose veins or severe obesity, and those needing to stay in bed for 3 weeks or more, are generally considered to be at increased risk of venous thromboembolism (blood clots in the bloodstream).

Increased blood pressure is not uncommon for women using this medication. Blood pressure should be monitored with estrogen use, especially if high doses are used. Smoking can increase the risk of blood clots. Women taking estrogen are strongly advised not to smoke.

Breast cancer: Studies indicate an increased risk of breast cancer with long-term use of estrogen replacement therapy. Women who have breast nodules, fibrocystic disease, abnormal mammograms, or a strong family history of breast cancer should approach the use of estrogens with particular caution. Women who take estrogens should have regular breast examinations and should be instructed in breast self-examination.

Cholesterol: Oral estrogens can increase triglycerides in the blood. Your physician may check your cholesterol while you are on estrogen.

Diabetes: Estrogens may affect blood sugar control. Anyone with diabetes should carefully monitor their blood glucose levels while taking any medication containing estrogen.

Endometrial cancer: There is evidence from several studies that estrogen replacement therapy increases the risk of cancer of the endometrium (uterus). Taking a progestogen appropriately along with the estrogen reduces this risk to the same level as that of a woman who does not take estrogen. For this reason, all women who have not had their uterus removed should also take progestogen if they use estrogens.

Fibroids: This medication may worsen fibroids, causing sudden enlargement, pain, or tenderness. If you notice these effects, contact your doctor.

Fluid retention: Estrogen may cause sodium (salt) and fluid retention. Women with heart or kidney dysfunction, epilepsy, or asthma should be particularly careful when taking it.

Gallbladder disease: An increased risk of gallbladder disease has been reported in postmenopausal women who take estrogens.

Thyroid conditions: Individuals taking thyroid replacement therapy (for hypothyroidism) should have regular thyroid function tests while on this medication.

Pregnancy: Estrogen should not be used during pregnancy. If you become pregnant while taking this medication, contact your doctor.

Breast-feeding: Estrogen is not safe for use during breast-feeding. A decision should be made whether to discontinue breast-feeding or to discontinue the medication, taking into account the importance of the medication to the mother.

Children: The safety and effectiveness of this medication have not been established for children.

What other drugs could interact with this medication?

There may be an interaction between estradiol and any of the following:

  • antidiabetes medications (e.g., insulin, glyburide)
  • barbiturates (e.g., phenobarbital)
  • blood pressure-lowering medications (e.g., propranolol, enalapril, diltiazem)
  • carbamazepine
  • corticosteroids (e.g., hydrocortisone, prednisolone, prednisone)
  • grapefruit juice
  • meprobamate
  • phenylbutazone
  • phenytoin
  • protease inhibitors (e.g., ritonavir)
  • rifampin
  • St. John's wort
  • topiramate
  • warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.





The contents of this site are for informational purposes only. Always seek the advice of your physician or other qualified healthcare provider regarding any questions you may have about a medical condition.
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