Estropipate

DEA Class; Rx

Common Brand Names; Ortho Est, Ogen 5, Ogen 2.5, Ogen 1.25, Ogen 0.625

Indicated for treatment of moderate to severe vasomotor symptoms (hot flashes) of menopause and/or related genitourinary symptoms including atrophic vaginitis, vulvar atrophy (kraurosis vulvae), whether menopause is natural or surgical (e.g., due to oophorectomy).

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

Undiagnosed abnormal vaginal bleeding

Uncontrolled hypertension

Diabetes mellitus with vascular involvement

Jaundice with prior oral contraceptive use

• Peripheral edema
• Depression
• Headache
• Melasma
• Bloating
• Nausea & vomiting
• Breast enlargement & tenderness
• Amenorrhea
• Breakthrough bleeding
• Spotting
• Weight changes
• Corneal curvation change

Diabetes mellitus, endometriosis, hyperlipidemias, HTN, 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 >35 years old, SLE, depression

Fluid retention may exacerbate asthma, epilepsy, migraines, & cardiac or renal dysfunction

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.

Hypercalcemia may occur in patients with breast cancer and bone metastases

Increased risk of endometrial and ovarian cancer in postmenopausal women

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

May increase risk of thromboembolic disorders, may need to increase anticoagulant dose when administering concomitantly with anticoagulants

Pregnancy Category: X

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