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For the best possible benefit, it is important to receive each scheduled dose of this medication as directed. If you miss a dose, contact your doctor immediately to establish a new dosing schedule.

Read the Patient Information Leaflet if available from your pharmacist before you start using estradiol cypionate and each time you get a refill. If you have any questions, ask your doctor or pharmacist. This medication is injected into a muscle, usually every 3 to 4 weeks or as directed by your doctor. Dosage is based on your medical condition and response to treatment. If you are giving this medication to yourself at home, learn all preparation and usage instructions from your health care professional. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard medical supplies safely. This medication should be used regularly to get the most benefit from it. To help you remember, it may help to mark your calendar with a reminder. Tell your doctor if your condition persists or worsens.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval. Some products that may interact with this drug include: "blood thinners" (such as warfarin), corticosteroids (such as prednisone), thyroid replacement medication. Other medications can affect the removal of estradiol cypionate from your body, which may affect how estradiol cypionate works. Examples include azole antifungals (such as itraconazole), macrolide antibiotics (such as erythromycin), rifamycins (such as rifampin), St. John's wort, drugs used to treat seizures (such as carbamazepine, phenytoin), among others. This medication may interfere with certain laboratory tests (including blood clotting, thyroid function), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

Do not share this medication with others. Keep all medical and laboratory appointments. You should have regular physical exams (such as once a year, or as directed by your doctor) that include blood pressure, breast/pelvic exam, mammogram, and testing for cervical cancer (Pap test). Follow your doctor's instructions on how to examine your own breasts and report any lumps immediately. Consult your doctor for more details. Lifestyle changes (such as reducing stress, eating a low fat/low salt diet, losing weight if you are overweight) to control or prevent high blood pressure, high cholesterol, and diabetes help to prevent heart disease and strokes. Keep your mind active with mental exercises to help prevent dementia. Talk with your doctor about lifestyle changes that might benefit you. You can also manage hot flashes by keeping a cool body temperature (by 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. Using vaginal lubricants can help lessen discomfort during intercourse.

If overdose is suspected, contact a 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: nausea/vomiting, unusual/heavy vaginal bleeding in females.

Before using estradiol cypionate, 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. Before using this medication, tell your doctor or pharmacist your medical history, especially of: asthma, blood clots, cancer (including family history), high blood cholesterol/fat (triglyceride) levels, diabetes, gallbladder disease, heart disease (such as congestive heart failure, previous heart attack), high blood pressure, kidney disease, liver problems, lupus, migraines, mental/mood disorders (such as dementia, depression), mineral imbalance (low/high level of calcium in the blood), seizures, stroke, a certain blood disorder (porphyria), a certain hormone problem (hypoparathyroidism), underactive thyroid (hypothyroidism), uterus problems (such as uterine fibroids, endometriosis), vaginal symptoms (such as unusual bleeding), yellowing eyes/skin (cholestatic jaundice) during pregnancy or with past estrogen use. 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 are nearsighted or 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. 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. Tell your doctor if you will be having surgery or will be confined to a chair or bed for a long time (such as during a long plane flight). You may need to stop this medication for a time or take special precautions. Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). Children may be more sensitive to the side effects of this drug. It may affect their physical development and might stunt their growth. Discuss the possible effects of this medication with your child's doctor, and monitor your child's growth periodically. Older adults may be more sensitive to the side effects of this drug, especially mental/mood changes (including dementia). This medication must not be used during pregnancy. It may result in birth defects or, later in the child's life, cancer. If you become pregnant or think you may be pregnant, tell your doctor immediately. This medication does not prevent miscarriage and should not be used for this purpose. Small amounts of this medication pass into breast milk. This drug may reduce the quality and amount of breast milk produced. Consult your doctor before breast-feeding.

Consult the product instructions and your pharmacist for storage details. Keep all medications 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.

See also Warning section. Dizziness, lightheadedness, headache, stomach upset, bloating, nausea, vaginal bleeding/spotting, weight changes, increased/decreased interest in sex, or breast tenderness 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 right away if you have any serious side effects, including: breast lumps, mental/mood changes (such as depression, memory loss), abdominal pain/swelling/tenderness, swelling of hands/feet, unusual tiredness, unusual vaginal discharge/itching/odor. Get medical help right away if any of these rare but serious side effects occur: sudden severe headache, sudden vision changes (such as double vision, blindness or worsening vision, change in contact lens fit), symptoms of a heart attack (such as chest/jaw/left arm pain, shortness of breath, unusual sweating), symptoms of a stroke (such as weakness on one side of the body, slurred speech, confusion), unusual leg pain/redness/swelling/warmth. A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe 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.

Estrogens given alone and with another hormone (progestin) for replacement treatment after menopause have sometimes caused rare but very serious side effects. Discuss the risks and benefits of hormone treatment and your personal health history with your doctor. Estrogens have been reported to increase the chance 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. Estrogens may also increase your risk for cancer of the ovaries, stroke, dementia, and serious blood clots in the legs. Estrogen given in combination with progestin can infrequently cause heart disease (such as heart attacks), stroke, serious blood clots in the lungs/legs/pelvis, 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. To reduce your risk for serious side effects, use this medication for the shortest possible length of time at the lowest effective dose. Talk with your doctor about the details and check with him/her regularly (such as 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 use estrogen for a longer period. Products that contain estrogen should not be used to prevent heart disease or dementia. If you use this drug for an extended period, you should have regular physical exams and medical tests. See also Notes section.