$Unique_ID{BRK01949}
$Pretitle{}
$Title{ESTRADIOL (TOPICAL)}
$Subject{Estraderm (Ciba)}
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Copyright (C) 1991 Publications International, Ltd.


ESTRADIOL (TOPICAL)
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BRAND NAME (Manufacturer):
     Estraderm (Ciba)
TYPE OF DRUG:
     Estrogen
INGREDIENT:
     estradiol
DOSAGE FORM:
     Transdermal patch (delivers 0.05 mg or 0.1 mg per 24 hours)
STORAGE:
     Estradiol transdermal patches should be stored at room temperature in
their original packages.

USES

     Estradiol is a synthetic estrogen that is used to treat menopausal
symptoms or other conditions associated with estrogen deficiency.

TREATMENT

     Your prescription of estradiol will come with patient instructions.  It
is important that you follow the directions carefully.
     Wash and dry your hands before and after applying the patch.  Apply the
patch to a clean, dry, hairless area of the skin on the trunk of the body or
on the abdomen.  Do not apply to the breasts.  Avoid applying the patch over a
cut or to any area of the body where tight clothes might rub against the patch
and loosen it.  Apply the patch immediately after opening the packet and
removing the protective liner.  Press the patch firmly to the skin with the
palm of your hand for about ten seconds.  Make sure there is good contact of
the patch to the skin, especially around the edges.  Rotate the application
sites on the skin, waiting at least one week before applying to the same site.
     If the patch becomes loose or falls off, the same one can be reapplied.
If necessary, however, a new patch can be applied.  In either case, continue
with your original treatment schedule.
     If you miss an application of this medication, apply a new patch as soon
as possible unless it is almost time for the next application.  In that case,
return to your regular schedule.  Do not apply a double dose.

SIDE EFFECTS

     Minor.

     Acne, abdominal cramping, abnormal vaginal bleeding, bloating, breast
tenderness, change in sexual desire, darkening of the skin, diarrhea,
dizziness, fluid retention, frequent or painful urination, hair loss,
headache, nausea, nervousness, skin irritation at patch site, vomiting, or
weight gain.  These side effects should disappear as your body adjusts to the
drug.
     If you feel dizzy, sit or lie down for a while; get up slowly from a
sitting or reclining position, and be careful on stairs.
     Eating a full breakfast or having a midmorning snack may help to relieve
the nausea and vomiting.
     This medication can increase your sensitivity to sunlight.  You should,
therefore, try to avoid prolonged exposure to sunlight and sunlamps.  Wear
protective clothing and sunglasses, and use an effective sunscreen.

Major.

     Tell your doctor about any side effects that are persistent or
particularly bothersome.  IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about
blurred vision, chest pain, convulsions, depression, itching, loss of
coordination, pain or inflammation of the calves or thighs, shortness of
breath, skin rash, slurred speech, or yellowing of the eyes or skin.

INTERACTIONS

     Estradiol interacts with several other types of medications:
     1. It can decrease the effectiveness of oral anticoagulants (blood
thinners, such as warfarin).
     2. Carbamazepine, phenobarbital, phenytoin, primidone, and rifampin can
reduce the effectiveness of estradiol.
     3. Estradiol can increase the side effects and decrease the effectiveness
of tricyclic antidepressants.
     BE SURE TO TELL YOUR DOCTOR about any medications you are currently
taking, especially any listed above.

WARNINGS

     * Tell your doctor about unusual or allergic reactions you have had to
any medications, especially to estradiol, other estrogens, or oral
contraceptives.
     * Tell your doctor if you now have or if you have ever had asthma, blood
clot disorders, breast disease, depression, diabetes mellitus, epilepsy,
endometriosis, gallstones or gallbladder disease, heart disease, high blood
pressure, kidney disease, liver disease, migraine headaches, porphyria, or
uterine tumors.
     * Estrogens may cause a change in glucose tolerance in diabetic patients.
Be sure to tell your doctor if you notice any abnormalities in your urine or
blood glucose levels.
     * Estrogens can change your blood's clotting ability, so be especially
careful to avoid injuries.
     * Although it is not known if estrogens can increase the risk of breast
cancer, it is important that you examine your breasts regularly for lumps or
discharge.
     * If you notice tenderness, swelling, or bleeding of your gums, consult
your doctor or dentist.
     * Your doctor may schedule regular office visits to be sure your
medication is working properly.
     * Before having surgery or any other medical or dental treatment, be sure
to tell your doctor or dentist that you are taking this medication.
     * A package insert titled "Information for the Patient" should be
dispensed with your prescription.  It is important that you understand the
possible risks and benefits of this medication.  If you have any questions,
check with your doctor or pharmacist.
     * Cigarette smoking can greatly increase the risk of developing heart or
blood vessel disorders while taking this medication.  The risks increase with
the amount of smoking and the age of the smoker.
     * Be sure to tell your doctor if you are pregnant.  If you suspect you
are pregnant, discontinue use of the medication immediately.  Estrogens have
been shown to cause birth defects in the offspring of women who received these
medications during pregnancy.  Also, tell your doctor if you are
breast-feeding an infant.  Small amounts of estrogen pass into breast milk.
Estradiol can also decrease milk production.

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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
