Generic Name: estradiol topical (for use on skin) (ess tra DYE ol TOP ik al)Brand Names: Divigel 0.25 mg/packet, Divigel 0.5 mg/packet, Divigel 1 mg/packet, Elestrin, Estrasorb, Estrogel, Evamist
Estradiol is a form of estrogen, a female sex hormone that regulates many processes in the body.
Estradiol topical is used to treat certain symptoms of menopause such as hot flashes, and vaginal dryness, burning, and irritation.
Estradiol topical may also be used for other purposes not listed in this medication guide.
Talk with your doctor about your individual risks before using estradiol long-term. Your doctor should check your progress on a regular basis (every 3 to 6 months) to determine whether you should continue this treatment.
Have regular physical exams and self-examine your breasts for lumps on a monthly basis while using estradiol topical.What should I discuss with my health care provider before using estradiol topical?Estrogens will not prevent heart disease, heart attack, stroke, breast cancer, or dementia, and may actually increase your risk of developing these conditions. Estrogens may also increase your risk of uterine or ovarian cancer.
Talk with your doctor about your individual risks before using estradiol long-term. Your doctor should check your progress on a regular basis (every 3 to 6 months) to determine whether you should continue this treatment.You should not use estradiol topical if you have:
a bleeding or blood-clotting disorder;
a history of stroke or circulation problems;
abnormal vaginal bleeding that a doctor has not checked; or
any type of breast, uterine, or hormone-dependent cancer.
If you have certain conditions, you may need a dose adjustment or special tests to safely use this medication. Tell your doctor if you have:
high blood pressure, angina, or heart disease;
high cholesterol or triglycerides;
epilepsy or other seizure disorder;
gallbladder disease; or
if you have had your uterus removed (hysterectomy).
Estradiol increases your risk of developing endometrial hyperplasia, a condition that may lead to cancer of the uterus. Taking progestins while using estradiol may lower this risk. If your uterus has not been removed, your doctor may prescribe a progestin for you to take while you are using estradiol topical.
Use this medication exactly as it was prescribed for you. Do not use the medication in larger amounts, or use it for longer than recommended by your doctor. Follow the instructions on your prescription label.
This medication comes with patient instructions for safe and effective use, and directions for priming the spray or gel pump if needed. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.Apply estradiol topical only to clean, dry, unbroken skin. Do not apply to skin that is red or irritated. Never apply this medicine to the breasts.
To use the topical gel (such as Estrogel):
Apply estradiol topical gel to the outside of your arm, from wrist to shoulder. Use the gel at the same time each day.
Do not rub the gel in, but allow it to dry on your skin for at least 5 minutes before you dress.
This medication is flammable. Avoid smoking or being near an open flame until the medicine has dried completely.
To use the topical emulsion (such as Estrasorb):
Apply this medicine while you are sitting down. You will use two foil pouches each time you apply this medication, unless your doctor has told you otherwise.
Cut or tear open the foil pouch and place the pouch on top of your left thigh, with the open end of the pouch pointing toward your knee.
Hold the pouch with one hand and use the fingers of your other hand to gently push all of the medicine out of the pouch and onto your thigh.
Spend at least 3 minutes rubbing the gel into your entire left thigh and calf. Rub any excess medicine onto your buttocks.
Cut or tear open the second pouch and apply the medicine to your right leg using the same method described above.
To use the topical spray (such as Evamist):
Apply the spray to the skin on the inside of your forearm, just below the elbow. Use the spray at the same time each day.
Place the cone of the spray applicator directly to your skin and hold the pump upright. Press the pump fully one spray. If your doctor has prescribed more than one spray, choose a different place on your inside forearm for the second spray. Use only the number of sprays your doctor has recommended.
Do not rub the spray in, but allow it to dry on your skin for at least 2 minutes before you dress. Do not wash your arm for at least 30 minutes after applying the spray.
Avoid allowing other people to get this medicine on their skin. If this happens, wash the area thoroughly with soap and water.
Have regular physical exams and self-examine your breasts for lumps on a monthly basis while using estradiol topical.Store this medication at room temperature away from moisture and heat.
Use the medication as soon as you remember. If your next dose is less than 12 hours away, skip the missed dose and use the medicine at the next regularly scheduled time. Do not use extra medicine to make up the missed dose.
Grapefruit and grapefruit juice may interact with estradiol and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor.
chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;
sudden numbness or weakness, headache, confusion, or problems with vision, speech, or balance;
pain or swelling in your lower leg;
abnormal vaginal bleeding;
pain, swelling, or tenderness in your stomach;
jaundice (yellowing of the skin or eyes); or
a lump in your breast.
Less serious side effects may include:
nausea, vomiting, loss of appetite;
acne or skin color changes;
vaginal pain, dryness, or discomfort, decreased sex drive, impotence, or difficulty having an orgasm;
swelling, weight gain;
migraine headaches, dizziness, depression; or
break-through bleeding, vaginal itching or discharge.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Tell your doctor about all other medications you use, especially:
St. John's wort;
a blood thinner such as warfarin (Coumadin);
carbamazepine (Carbatrol, Tegretol) or phenobarbital (Luminal, Solfoton);
an antibiotic such as clarithromycin (Biaxin), erythromycin (E-Mycin, E.E.S., Erythrocin, Ery-Tab), or rifampin (Rifadin, Rifater, Rifamate, Rimactane).
an antifungal medication such as ketoconazole (Nizoral) or itraconazole (Sporanox).
This list is not complete and there may be other drugs that can interact with estradiol topical. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.