Estradiol (Absorbed through the skin)
Treats hot flashes and other symptoms of menopause or low amounts of estrogen.
There may be other brand names for this medicine.
EstroGel, Estrasorb, Divigel, Elestrin, Evamist
When This Medicine Should Not Be Used
You should not use this medicine if you have had an allergic reaction to estradiol. You should not use this medicine if you have liver disease, breast cancer, or certain other types of cancer. You should not use this medicine if you have a history of blood clotting problems, or if you have had a heart attack or stroke in the past 12 months. Do not use this medicine if you may be pregnant, or if you have unusual vaginal bleeding that has not been checked by your doctor. This medicine should not be used to prevent heart disease, heart attack, or stroke.
How to Use This Medicine
Liquid Mixture, Gel/Jelly, Spray
- Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to. This medicine is usually applied once a day, at the same time each day.
- This medicine is for use on the skin only. Do not get it in your eyes, nose, or mouth. Do not use it on skin areas that have cuts or scrapes. If it does get on these areas, rinse it off right away.
- This medicine comes with patient instructions. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.
- Wash your hands with soap and water before and after using this medicine.
- To use the emulsion:
- Apply the emulsion to your legs and it will be absorbed through your skin. The usual daily dose is two foil pouches, one for each leg.
- Cut or tear open the first pouch at the notches near the top. Squeeze out all of the medicine from the pouch onto the top of your left thigh. Rub the medicine thoroughly into your thigh and calf, for about three minutes. Repeat these steps to apply the medicine in the second pouch to the right thigh and calf.
- Allow the medicine to dry completely before dressing. Do not apply sunscreen at the same time to the area where you applied the emulsion. For each application, wait at least 25 minutes before you put on a sunscreen.
- To use the gel:
- The gel form of this medicine comes in a pump that delivers the correct dose of estradiol each time you press the pump. When using the pump for the first time, you may need to prime it by pumping two or three times. Follow the patient instructions for the container you use. After priming the pump, do not press the pump more than one time each time you use it or you may get too much.
- Apply the gel to clean, dry, and unbroken skin. Spread the gel as thinly as possible over the entire area on the inside and outside of one arm from the wrist up to the shoulder area. Do not apply the medicine directly to your breasts or in or around your vagina.
- Do not allow others to come in contact with the area of skin where you applied the gel for at least one hour after you use the medicine. Do not allow others to apply the gel for you. Allow the medicine to dry for at least five minutes before dressing.
- To use the spray:
- The spray form of this medicine comes in an applicator that delivers a measured amount of estradiol to the skin with each spray. When using a new spray applicator, prime the pump by holding the spray upright and pumping three times.
- Once the spray pump has been primed, apply the medicine to clean, dry, and unbroken skin on the inside of the forearm between the elbow and the wrist. Do not apply the medicine directly to your breasts or in or around the vagina.
- Allow the medicine to dry for at least two minutes before dressing, and at least thirty minutes before washing.
- Do not allow your child to touch the area of the arm where the medicine was sprayed. If you cannot avoid to come nearer with your child, wear clothes with long sleeves to cover the application site.
- If your child comes in direct contact with the arm where the medicine was sprayed, wash your child's skin right away with soap and water.
- Do not allow your pets to lick or touch the arm where the medicine was sprayed.
- The estradiol gel and spray are flammable. Avoid using these medicines near an open flame or while smoking.
If a dose is missed:
- If you miss a dose or forget to use your medicine, apply it as soon as you can. If it is almost time for your next dose, wait until then to apply the medicine and skip the missed dose. Do not apply extra medicine to make up for a missed dose.
How to Store and Dispose of This Medicine
- Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
- Ask your pharmacist, doctor, or health caregiver about the best way to dispose of the used medicine container and any leftover medicine after you have finished your treatment. You will also need to throw away old medicine after the expiration date has passed.
- Keep all medicine away from children and never share your medicine with anyone.
Drugs and Foods to Avoid
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.
- Make sure your doctor knows if you are also using a blood thinner such as warfarin (Coumadin®), carbamazepine (Tegretol®), clarithromycin (Biaxin®), erythromycin (E.E.S.®, Ery-tab®), itraconazole (Sporanox®), ketoconazole (Nizoral®), phenobarbital, rifampin (Rifadin®, Rifater®), ritonavir (Norvir®), St. John's wort, or thyroid medicine (levothyroxine, Synthroid®).
- Do not use cosmetics or other skin care products on the treated skin areas.
- Do not eat grapefruit or drink grapefruit juice while you are using this medicine.
Warnings While Using This Medicine
- It is unlikely that a postmenopausal woman may become pregnant. But, you should know that using this medicine while you are pregnant could harm your unborn baby. If you think you have become pregnant while using the medicine, tell your doctor right away.
- Make sure your doctor knows if you are breastfeeding, or if you have endometriosis or a history of cancer. Tell your doctor if you have asthma, diabetes, epilepsy, gallbladder disease, high or low calcium in the blood, kidney disease, lupus, migraine headaches, porphyria, or thyroid problems. Your doctor should know if you have heart disease, high blood pressure, high blood cholesterol, or a family history of high cholesterol. Tell your doctor if you have ever had liver problems caused by pregnancy or estrogen.
- Your doctor will need to check your progress at regular visits while you are using this medicine. Be sure to keep all appointments.
- This medicine should not be used to treat or prevent heart disease, stroke, or dementia. In fact, using large doses of this medicine over a long period of time may increase your risk of heart attack, stroke, blood clots, dementia, breast cancer, or uterine cancer. Talk with your doctor about this risk. If you still have your uterus (womb), ask your doctor if you should also use a progestin medicine.
- Your risk of heart disease or stroke from this medicine is higher if you smoke. Your risk is also increased if you have diabetes or high cholesterol, or if you are overweight. Talk with your doctor about ways to stop smoking. Keep your diabetes under control. Ask your doctor about diet and exercise to control your weight and blood cholesterol level.
- This medicine may also increase your risk of certain types of cancer. Talk to your doctor if you have concerns about this risk.
- Stop using this medicine and check with your doctor immediately if severe headache or sudden loss of vision or any other change in vision occurs while you are using this medicine. Your doctor may want you to have your eyes checked by an ophthalmologist (eye doctor).
- Check with your child's doctor right away if your child starts to have the following symptoms: nipple or breast swelling or tenderness in females, or enlargement of the breasts in males. Your child may have been exposed to Evamist® transdermal spray.
- Do not allow your pets to lick or touch the arm where Evamist® transdermal spray was applied. Small pets may be sensitive to this medicine. Call your pet's veterinarian if your pet starts to have the following symptoms: nipple or breast enlargement, swelling of the vulva, or any signs of illness.
- Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery or medical tests.
- Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain medical tests.
Possible Side Effects While Using This Medicine
Call your doctor right away if you notice any of these side effects:
- Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
- Chest pain, shortness of breath, or coughing up blood.
- Fever, chills, cough, sore throat, and body aches.
- Lumps in your breast.
- Numbness or weakness in your arm or leg, or on one side of your body.
- Pain in your lower leg (calf).
- Sudden or severe headache, problems with vision, speech, or walking.
- Sudden shortness of breath, coughing up blood.
- Swelling in your hands, ankles, or feet.
- Unusual vaginal bleeding, discharge, or itching.
- Yellowing of your skin or the whites of your eyes.
If you notice these less serious side effects, talk with your doctor:
- Back or joint pain.
- Changes in weight or hair growth.
- Mild skin rash or itching.
- Nausea, vomiting, diarrhea, or stomach cramps.
- Nervousness, anxiety.
- Runny or stuffy nose.
- Skin discoloration.
- Skin redness or itching where the medicine is applied.
- Swollen or tender breasts.
If you notice other side effects that you think are caused by this medicine, tell your doctor
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088
Review Date: 2011-02-04
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