Esterified Estrogens

DEA Class; Rx

Common Brand Names; Estrogens, Esterified, Menest

Documented hypersensitivity

Active or history of breast cancer

Arterial thromboembolic disease (stroke, MI), thrombophlebitis, DVT/PE, thrombogenic valvular disease

Estrogen-dependent neoplasia, liver disease, liver tumors

Uncontrolled hypertension

Diabetes mellitus with vascular involvement

Jaundice with prior oral contraceptive use

Undiagnosed abnormal genital bleeding

Common

• Edema, peripheral edema

• Headache

• Melasma

• Breast enlargement, breast tenderness

• Bloating

• Nausea

• Vomiting

Less common

• Depression

• Amenorrhea

• Breakthrough bleeding

• Spotting

• Weight changes

• Corneal curvation change

Diabetes mellitus, endometriosis, hyperlipidemias, HTN, hypothyroidism, liver impairment, uterine leiomyomata, smoking, porphyria, patients with defects of lipoprotein metabolism, hypertriglyceridemia, hypothyroidism, ovarian cancer, exacerbation of endometriosis or other conditions

Conditions exacerbated by fluid retention (asthma, epilepsy, migraine etc)

Hypercalcemia may occur in patients with breast cancer and bone metastases

Long-term postmenopausal estrogen treatment has been associated with an increased risk of breast cancer, MI, stroke, DVT, PE, and dementia

Discontinue if the following develop jaundice, visual problems (may cause contact lens intolerance), any signs of VTE, migraine with unusual severity, significang blood pressure increase, severe depression, increased risk of thromboembolic complications after surgery

Concomitant warfarin, oral anticoagulants: estrogens increase risk of thromboembolic disorders; may need to increase anticoagulant dose

Pregnancy Category: X

Lactation: Controversial; estrogens are excreted into breast milk in small quantities, use caution