estradiol

If you miss a dose, use it as soon as you remember. If it is less than 12 hours before your next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Read the Patient Information Leaflet provided by your pharmacist before you start using this medication and each time you get a refill. If you have any questions, consult your doctor or pharmacist. Use this medication exactly as prescribed. Learn all usage instructions for your product. Follow the instructions for test sprays (priming) before first use of a new canister. Spray this medication on the inside of your forearm between the elbow and the wrist, usually once daily or as directed by your doctor. Allow the spray to dry for at least 2 minutes before dressing. Wash your hands with soap and water after each application. Your dosage (number of sprays) depends on your condition and response to treatment. Do not use more than 1 spray on the same area of skin. If your doctor directs you to use more than 1 spray each time you use the drug, use it on nearby skin on the forearm. Make sure the sprayed areas do not touch or overlap. Apply this drug to clean, dry, unbroken skin. Do not apply to irritated skin. Do not rub this medicine into the skin. If you shower or bathe before applying this medication, allow the skin to dry completely before use. Wait at least 30 minutes before getting the area wet or swimming. Do not apply anywhere but the forearm unless directed by your doctor. Do not apply this medication to breasts or in/around the vagina. Avoid getting this medication in the eyes. If this medication gets in the eyes, rinse them immediately with warm water. Tell your doctor if the eyes become irritated. To prevent this drug from getting on others (including children and pets), wait at least 30 minutes before allowing others to touch the skin where you applied the drug. If this drug accidentally gets on others, have them wash the area with soap and water as soon as possible. See Precautions section. Use this medication regularly to get the most benefit from it. To help you remember, use it at the same time each day. Keep track of the number of sprays you use. Discard the container after you have used the labeled number of sprays on the product package, even if there is medication left in the container. Tell your doctor if your condition does not improve or if it worsens.

Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first. This drug should not be used with the following medications because very serious interactions may occur: anastrozole, exemestane. If you are currently using either of these medications listed above, tell your doctor or pharmacist before starting estrogens. Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription products you may use, especially of: "blood thinners" (anticoagulants such as warfarin), corticosteroids (e.g., prednisone), raloxifene, tamoxifen, drugs affecting liver enzymes that remove estrogens from your body (such as St. John's wort, phenobarbital, phenytoin, carbamazepine, rifamycins including rifabutin, azole antifungals including itraconazole, macrolide antibiotics including erythromycin). This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

Do not share this medication with others. Keep all medical and laboratory appointments. You should have a complete physical examination that includes blood pressure measurements and breast/pelvic examinations at regular intervals (e.g., once a year) or as directed by your doctor. Follow your doctor's instructions on how to examine your own breasts, and report any lumps immediately. You should also be regularly screened for cervical cancer (e.g., Pap test) and have periodic mammograms as directed by your doctor. Consult your doctor for more details. Lifestyle changes that help promote healthy bones include increasing weight-bearing exercise, stopping smoking, limiting alcohol, and eating well-balanced meals that contain adequate calcium and vitamin D. Since you may also need to take calcium and vitamin D supplements and make lifestyle changes, consult your doctor for specific advice. Additional lifestyle changes (e.g., reducing stress, eating a low-fat/low-salt diet, losing weight if you are overweight) can help to control or prevent high blood pressure, high cholesterol, diabetes , heart disease, and strokes. To help prevent dementia, keep your mind active with mental exercises. Ask your doctor for more information about lifestyle changes that might benefit you. You can also manage hot flashes by keeping a cool body temperature (e.g., using a fan, drinking cool beverages, dressing lightly/in layers, avoiding hot/spicy foods). Limiting caffeine and alcohol, exercising regularly, and learning relaxation techniques may help reduce hot flashes. Vaginal lubricants can help lessen discomfort during intercourse.

This medication may be harmful if swallowed. If swallowing or overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US National Poison Hotline at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe nausea/vomiting, unusual vaginal bleeding.

Before using this product, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details. This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: vaginal bleeding of unknown cause, certain cancers (e.g., breast cancer, cancer of the uterus or ovaries), current/history of blood clots, history of stroke or heart attack, liver disease. Before using this medication, tell your doctor or pharmacist your medical history, especially of: family medical history (especially breast lumps and cancer), asthma, diabetes, seizures, migraine headaches, heart disease (e.g., high blood pressure, congestive heart failure), kidney disease, underactive thyroid (hypothyroidism), a certain hormone problem (hypoparathyroidism), mineral imbalance (low or high levels of calcium in the blood), mental/mood disorders (e.g., dementia, depression), high blood pressure during pregnancy (toxemia), yellowing eyes/skin (cholestatic jaundice) during pregnancy or with past estrogen use, uterus tissue problems (e.g., uterine fibroids, endometriosis), high levels of blood fats (cholesterol, triglycerides), gallbladder disease, obesity, certain blood disorder (porphyria), lupus. This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages. If you wear contact lenses, you may develop vision problems or trouble wearing your contact lenses. Contact your eye doctor if these problems occur. This drug may cause a patchy darkening of the skin on the face (melasma). Sunlight may worsen this darkening. Avoid prolonged sun exposure, tanning booths, and sunlamps. Use a sunscreen and wear protective clothing when outdoors. Wait 1 hour after applying this medication before applying sunscreen to the same area of skin. Do not smoke cigarettes or use tobacco. Estrogens combined with smoking further increase your risk for stroke, blood clots, high blood pressure, and heart attacks, especially in women older than 35. If you will be having surgery or will be staying in a chair or bed for a long time (e.g., a long plane flight), tell your doctor beforehand. Special precautions may need to be taken because of the increased risk for blood clots. This product is not meant for children. Children accidentally exposed to this medication by direct contact with someone using it may absorb this drug through their skin. If this occurs, the child may have unwanted side effects. Children should avoid contact with any unclothed area where the medication has been applied. Tell the doctor immediately if you notice unexpected signs of puberty in a child such as an increase in breast or nipple size. To decrease this risk, carefully follow all directions for the proper use of this drug. This medication must not be used during pregnancy. It may result in birth defects or cancer later in the child's life. If you become pregnant or think you may be pregnant, tell your doctor immediately. This medication may pass into breast milk. It may reduce the quality and amount of breast milk. Consult your doctor before breast-feeding.

Store at room temperature at 77 degrees F (25 degrees C) away from heat. Do not freeze. Because this product contains alcohol, avoid smoking during use and exposing the product to open flame. Brief storage between 59-86 degrees F (15-30 degrees C) is permitted. Keep all medicines away from children and pets. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

Dizziness, lightheadedness, headache, upset stomach, bloating, nausea, weight changes, increased/decreased interest in sex, breast tenderness, or skin redness/irritation at the application site may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. Tell your doctor immediately if any of these unlikely but serious side effects occur: mental/mood changes (e.g., severe depression, memory loss), breast lumps, swelling hands/feet, unusual vaginal bleeding (e.g., spotting, sudden bleeding, prolonged/returning bleeding), unusual vaginal discharge/itching/odor, yellowing eyes/skin, stomach/abdominal/pelvic pain, persistent nausea/vomiting, dark urine, worsening of seizures, signs of worsening diabetes control (e.g., increased thirst and urination). This medication may infrequently cause serious problems such as heart attacks, stroke, and blood clots. Seek immediate medical attention if you experience any of the following: chest/jaw/left arm pain, sudden severe headache, weakness on one side of the body, confusion, slurred speech, sudden vision changes (e.g., double vision, loss of vision), pain/redness/swelling of legs, trouble breathing, coughing up blood, sudden dizziness/fainting. A serious allergic reaction to this drug is rare. However, seek immediate medical attention you have any of the following symptoms of a serious allergic reaction: rash, itching/swelling (especially of the face/tongue/throat), dizziness, trouble breathing. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional. Certain estrogen products may also be used to prevent bone loss (osteoporosis) in people at high risk who cannot take other drugs. There are several other medications (e.g., raloxifene, bisphosphonates such as alendronate) that are safe and effective to prevent or treat bone loss. Your doctor should consider these medicines before estrogen treatment.

Estrogens given alone and with another hormone (progestin) for replacement therapy after menopause have rarely caused very serious side effects. Discuss the risks and benefits of hormone treatment and your personal health history with your doctor. Estrogens may increase the risk of cancer of the uterus (endometrial cancer). Taking a progestin with estrogen decreases this risk. Tell your doctor immediately if you have any unusual vaginal bleeding. It may be a sign of endometrial cancer. Estrogens may also increase your risk of cancer of the ovaries, stroke, loss of mental abilities (dementia), and serious blood clots in the legs. Estrogen used with progestin can infrequently cause heart disease (e.g., heart attacks), stroke, serious blood clots, dementia, and breast cancer. Some of these risks appear to depend on the length of time this drug is used and the amount of estrogen per dose. Therefore, use this medication for the shortest possible length of time at the lowest effective dose so that you can obtain the benefits while reducing the risk of serious side effects from long-term treatment. Discuss the details with your doctor and check with him/her regularly (e.g., every 3 to 6 months) to see if you still need to use this medication. Estrogen treatment alone does not appear to increase your risk of breast cancer when used for up to 7 years after menopause. However, talk to your doctor about the risks if you need to take estrogen for a longer period. Products that contain estrogen should not be used to prevent heart disease, stroke, or dementia. If you use this drug for a long time, you should have a complete physical exam at regular intervals (e.g., once a year) or as directed by your doctor. See also Notes section.