Estring

— THERAPEUTIC CATEGORIES —
  • Menopause and HRT

Estring Generic Name & Formulations

General Description

Estradiol 7.5mcg/24hrs; vaginal ring.

Pharmacological Class

Estrogen.

How Supplied

Vaginal ring—1

Manufacturer

Estring Indications

Indications

Moderate-to-severe symptoms of vulvar and vaginal atrophy due to menopause.

Estring Dosage and Administration

Adult

Insert 1 ring high into vagina. Replace after 90 days.

Children

Not applicable.

Estring Contraindications

Contraindications

Undiagnosed abnormal genital bleeding. Breast or other estrogen-dependent neoplasms. Thromboembolic disorders (eg, DVT, PE, stroke, MI). Protein C, protein S, or antithrombin deficiency, or other thrombophilias. Hepatic impairment or disease. Pregnancy.

Estring Boxed Warnings

Boxed Warning

Endometrial cancer. Breast cancer. Cardiovascular disorders. Probable dementia.

Estring Warnings/Precautions

Warnings/Precautions

Increased risk of endometrial carcinoma or hyperplasia in women with intact uterus (adding progestin is essential). Not for prevention of cardiovascular disease or dementia. Increased risk of cardiovascular events (eg, MI, stroke, VTE); discontinue if occurs. Manage risk factors for cardiovascular disease and venous thromboembolism appropriately. Discontinue at least 4–6 weeks before surgery type associated with increased risk of thromboembolism or during prolonged immobilization. Increased risk of breast or ovarian cancer. Risk of probable dementia in women >65yrs of age. Gallbladder disease. Severe hypercalcemia in breast cancer or bone metastases. Visual abnormalities. History of hypertriglyceridemia. Discontinue if cholestatic jaundice, pancreatitis, hypercalcemia, or retinal vascular lesions occur. Monitor thyroid function. Conditions aggravated by fluid retention. Hypoparathyroidism. Endometriosis. Hereditary angioedema. Asthma. Diabetes. Epilepsy. Migraine. Porphyria. SLE. Hepatic hemangiomas. Narrow vagina, vaginal stenosis, prolapse, or vaginal infections increase risk of irritation or ulceration. Remove if vaginal infections occur; reinsert after resolved. Do initial complete physical and repeat yearly (include Pap smear, mammogram, BP). Reevaluate periodically. Nursing mothers: not recommended.

Estring Pharmacokinetics

See Literature

Estring Interactions

Interactions

Remove during treatment with other vaginally-administered preparations. Concomitant thyroid replacement; may need to increase thyroid dose. May interfere with lab tests (eg, thyroid, PT, coagulation factors, glucose tolerance, HDL/LDL, triglycerides, hormone concentrations, other binding or plasma proteins).

Estring Adverse Reactions

Adverse Reactions

Vaginal discomfort/pain, abdominal pain, nausea, back pain, arthritis, headache, insomnia, upper respiratory tract infection, leukorrhea, vaginitis; thromboembolism, neoplasms.

Estring Clinical Trials

See Literature

Estring Note

Not Applicable

Estring Patient Counseling

See Literature