Estropipate

Estropipate is a prescription medication used to treat symptoms of menopause such as hot flashes, and vaginal dryness, burning, and irritation. Estropipate is also used for the treatment of hypoestrogenism due to hypogonadism, castration or primary ovarian failure and for prevention of postmenopausal osteoporosis.

• Estropipate is available under the following different brand names: Ortho Est, Ogen 5, Ogen 2.5, Ogen 1.25, Ogen 0.625

Common side effects of Estropipate include:

• stomach upset
• nausea
• vomiting
• loss of appetite
• bloating
• breast tenderness or swelling
• headache or migraine
• weight changes
• acne or skin color changes
• decreased sex drive
• impotence
• difficulty having an orgasm
• dizziness
• vaginal pain/dryness/discomfort
• swelling of your ankles or feet
• depression
• changes in the menstrual periods
• break-through bleeding

Serious side effects of Estropipate include:

• hives
• difficult breathing; swelling of the face, lips, tongue, or throat
• signs of an allergic reaction
• heart attack symptoms — chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating
• signs of a stroke — sudden numbness or weakness (especially on one side of the body), sudden severe headache, slurred speech, problems with vision or balance
• signs of a blood clot — sudden vision loss, stabbing chest pain, feeling short of breath, coughing up blood, pain, or warmth in one or both legs
• swelling or tenderness in the stomach
• jaundice (yellowing of the skin or eyes)
• memory problems, confusion, unusual behavior
• unusual vaginal bleeding and pelvic pain
• a lump in your breast
• high levels of calcium in your blood — nausea, vomiting, constipation, increased thirst or urination, muscle weakness, bone pain, lack of energy
• headache
• vaginal itching or discharge, changes in menstrual periods, breakthrough bleeding
• bloating, stomach cramps, nausea, vomiting
• breast pain
• thinning scalp hair
• fluid retention (swelling, rapid weight gain)

Rare side effects of Estropipate include:

• none

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, coordination loss, unsteady, very stiff muscles, high fever, profuse sweating, or tremors
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights
• Serious heart symptoms include fast, irregular, or pounding heartbeats; fluttering in the chest; shortness of breath; sudden dizziness, lightheadedness, or passing out

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Adult dosage

Tablet

• 0.75 mg
• 1.5 mg
• 3 mg
• 6 mg

Menopause

Adult dosage

• 0.75-6 mg orally once a day; taper at 3- to 6-month intervals
• Cream: 2-4 g intravaginal 3 weeks on and 1 week off

Ovarian Failure

Adult dosage

• 1.5-9 mg orally once a day for 3 weeks and then off for 8 days; repeat if necessary

Osteoporosis Prevention

Adult and geriatric dosage

• 0.75 mg orally once a day for 25 days and then off for 6 days; repeat

Dosage Considerations – Should be Given as Follows:

• See "Dosages"

If your medical doctor is using this medicine to treat your pain, 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, healthcare provider, or pharmacist first.

• Estropipate has severe interactions with the following drug:
  • ospemifene
• Estropipate has serious interactions with at least 32 other drugs
• Estropipate has moderate interactions with at least 161 other drugs
• Estropipate has minor interactions with at least 36 other drugs

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all the products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your healthcare professional or doctor for additional medical advice, health questions, or concerns.

Contraindications

• Documented hypersensitivity
• Active or history of breast cancer
• Arterial thromboembolic disease (stroke, myocardial infarction [MI]), thrombophlebitis, deep vein thrombosis (DVT)/pulmonary embolism (PE), thrombogenic valvular disease
• Estrogen-dependent neoplasia, liver disease, liver tumors
• Undiagnosed abnormal vaginal bleeding
• Uncontrolled hypertension
• Diabetes mellitus with vascular involvement
• Jaundice with prior oral contraceptive use

Effects of drug abuse

• None

Short-Term Effects

• See "What Are Side Effects Associated with Using Estropipate?"

Long-Term Effects

• See "What Are Side Effects Associated with Using Estropipate?"

Cautions

• Diabetes mellitus; endometriosis; hyperlipidemias; hypertension; hypothyroidism; elderly; hepatic/renal impairment; uterine leiomyomata; porphyria; patients with defects of lipoprotein metabolism, hypertriglyceridemia, ovarian cancer, exacerbation of endometriosis, or other conditions, smoking and older than 35 years; systemic lupus erythematosus; depression
• Fluid retention may exacerbate asthma, epilepsy, migraines, and cardiac or renal dysfunction
• Discontinue if the following develop — jaundice, visual problems (may cause contact lens intolerance), any signs of venous thromboembolism, migraine with unusual severity, significant blood pressure increase, severe depression, and increased risk for thromboembolic complications after surgery
• Hypercalcemia may occur in patients with breast cancer and bone metastases
• Increased risk for endometrial and ovarian cancer in postmenopausal women
• Long-term postmenopausal estrogen treatment has been associated with increased risk for breast cancer, MI, stroke, DVT, PE, and dementia
• May increase the risk for thromboembolic disorders; may need to increase the anticoagulant dose when administering concomitantly with anticoagulants

Pregnancy and Lactation

• Do not use during pregnancy
• Lactation
  • Controversial; estrogens are excreted into breast milk in small quantities, so use caution