Generic Name

Conjugated Oestrogens

Precaution

Asthma, epilepsy, migraine; heart or kidney dysfunction; CV disease; cerebrovascular disorders; diabetes, hypercalcaemia; gall bladder disease; porphyria. Childn. Lactation. Lactation: Use controversial; estrogens are excreted into breast milk in small quantities; use with caution

Indication

Osteoporosis, Fungal infections, Itching, Burning, Hot flashes, Vaginal dryness, Vaginal atrophy, Menopausal symptoms, Female hypogonadism, Metastatic breast carcinoma, Ovarian failure, Prostate carcinoma, Primary ovarian failure, Hormone replacement therapy, Oral contraceptives

Contra Indication

Severe liver impairment; breast carcinoma; thromboembolic disorders; CV disease; undiagnosed vag bleeding; estrogen-dependent neoplasms; hypersensitivity; pregnancy.

Dose

N/A

Side Effect

>10% Abdominal pain (15-17%),Back pain (13-14%),Breast enlargement,Breast tenderness (7-12%),Headache (26-32%),Arthralgia (7-14%),Pharyngitis (10-12%),Sinusitis (6-11%),Diarrhea (6-7%) 1-10% Depression (5-8%),Dizziness (4-6%),Nervousness (2-5%),Flatulence (6-7%),Vaginitis (5-7%),Leukorrhea (4-7%),Leg cramps (3-7%),Increased cough (4-7%),Pruritus (4-5%) Frequency Not Defined Amenorrhea,Breakthrough bleeding,Corneal curvation change,Melasma,Spotting,Vaginal moniliasis,Weight changes Potentially Fatal: Unopposed replacement therapy in postmenopausal women associated with increased risk of endometrial and breast cancer. Potentially Fatal: Unopposed replacement therapy in postmenopausal women associated with increased risk of endometrial and breast cancer.

Pregnancy Category

Mode of Action

Estrogens modulate pituitary secretion of gonadotropins, leutinising hormones and follicle-stimulating hormones through -ve feedback mechanism, thus reducing elevated levels of hormones in postmenopausal women during oestrogen replacement therapy.

Interaction

Rifampicin, barbiturates increase rate of metabolism. Potentially Fatal: May reduce the efficacy of anticoagulants.

Pregnancy Category Note

N/A

Adult Dose

Menopausal Vasomotor Symptoms, Atrophic Vaginitis/Kraurosis Vulvae 0.3 mg PO once daily in either continuous daily regimen or cyclic regimen (25 days on, 5 days off); adjusted PRN; use lowest dose that control symptoms; may be given daily if medical assessment warrants it Female Hypogonadism 0.3-0.625 mg PO once daily in cyclic regimen (3 weeks on, 1 week off); may be titrated every 6-12 months; adjusted PRN; add progestin treatment should be added to maintain bone mineral density once skeletal maturity achieved Osteoporosis Prophylaxis 0.3 mg PO once daily in cyclic regimen (25 days on, 5 days off); adjusted PRN based on clinical response; may be given daily if medical assessment warrants it; administer lowest effective dose May also be used in combination with medroxyprogesterone acetate Prostate Cancer Palliation only 1.25-2.5 mg PO q8hr Female Castration/Primary Ovarian Failure 1.25 mg PO once daily in cyclic regimen (25 days on, 5 days off); adjusted PRN; administer lowest effective dose Breast Cancer Palliation Metastatic disease in selected patients (males and females):10 mg PO q8hr for >3 months Abnormal Uterine Bleeding 25 mg IV/IM; repeated in 6-12 hours PRN or 25 mg IV repeated q4hr for 24 hr; if no response after 2 doses, re-evaluate therapy Alternative regimen: 10-20 mg/day PO divided q4hr May administer low dose medroxyprogesterone acetate with therapy or following therapy Cyclic therapy: 25 days on, 5 days off; either 3 weeks on, 1 week off

Child Dose

N/A

Renal Dose

N/A

Administration

N/A