Estrace

Estrace tablets contain estradiol, a form of estrogen. Estradiol is a female sex hormone that regulates many processes in the body.

Estrace is used to treat menopause symptoms such as hot flashes and vaginal changes, and to prevent osteoporosis (bone loss) in menopausal women, and to replace estrogen in women with ovarian failure or other conditions that cause a lack of natural estrogen in the body.

Estrace is sometimes used as part of cancer treatment in women and men.

Brand-name Estrace tablets have been discontinued in the United States. All three strengths (0.5 mg, 1 mg, and 2 mg) are listed as discontinued in the FDA's Drugs@FDA database. The tablets were not withdrawn from sale for reasons of safety or effectiveness.

Generic estradiol tablets are still available in the same 0.5 mg, 1 mg, and 2 mg strengths, so if you were prescribed Estrace tablets your pharmacist can supply a generic estradiol tablet instead. Talk to your pharmacist or doctor if you are not sure which product you have been given.

Two different medicines are sold under the Estrace name. They contain the same active ingredient, estradiol, but they are not interchangeable.

• Estrace tablets are swallowed. They deliver estradiol throughout the body and are used for hot flashes and other menopause symptoms, low estrogen levels, prevention of osteoporosis, and, in some cases, as part of cancer treatment. The brand tablets have been discontinued, but generic estradiol tablets are available.
• Estrace Cream (estradiol vaginal cream USP 0.01%) is applied inside the vagina using a calibrated applicator. It is approved only for the treatment of moderate to severe symptoms of vulvar and vaginal atrophy due to menopause. Estrace Cream is still marketed.

Because Estrace Cream is applied locally, it uses a much smaller amount of estradiol than the tablets. Estradiol from the cream can still be absorbed into the bloodstream, however, so the same warnings that apply to estrogen taken by mouth also need to be considered when using the cream.

If you have been prescribed the cream, see Estrace Vaginal Cream for information specific to that product. The information on this page is about the tablets.

Take Estrace exactly as it was prescribed for you. Follow all directions on your prescription label. Do not take this medicine in larger amounts or for longer than recommended.

Estradiol may increase your risk of developing a condition that may lead to uterine cancer. Call your doctor at once if you have any unusual vaginal bleeding while using this medicine.

Your doctor should check your progress on a regular basis (every 3 to 6 months) to determine whether you should continue this treatment. Self-examine your breasts for lumps on a monthly basis and have a mammogram every year while using Estrace.

If you need major surgery or will be on long-term bed rest, you may need to stop using this medicine for a short time. Any doctor or surgeon who treats you should know that you are using Estrace.

Store at room temperature away from moisture, heat, and light. Keep the bottle tightly closed when not in use.

You should not use Estrace if you have: undiagnosed vaginal bleeding, liver disease, a bleeding disorder, if you will be having major surgery, or if you have ever had a heart attack, a stroke, a blood clot, or cancer of the breast, uterus/cervix, or vagina.

Do not use Estrace if you are pregnant.

Estradiol may increase your risk of developing a condition that may lead to uterine cancer. Report any unusual vaginal bleeding right away.

Using estradiol can increase your risk of blood clots, stroke, or heart attack, or cancer of the breast, uterus, or ovaries. Estradiol should not be used to prevent heart disease, stroke, or dementia.

Have regular physical exams and mammograms, and self-examine your breasts for lumps on a monthly basis while using Estrace.

You should not use Estrace if you are allergic to estradiol, or if you have:

• unusual vaginal bleeding that has not been checked by a doctor;
• liver disease;
• a history of heart attack, stroke, or blood clot;
• an increased risk of having blood clots due to a heart problem or a hereditary blood disorder; or
• a history of hormone-related cancer, or cancer of the breast, uterus/cervix, or vagina.

Do not use Estrace if you are pregnant. Tell your doctor right away if you become pregnant during treatment.

Using this medicine can increase your risk of blood clots, stroke, or heart attack. You are even more at risk if you have high blood pressure, diabetes, high cholesterol, if you are overweight, or if you smoke.

Estrace should not be used to prevent heart disease, stroke, or dementia, because this medicine may actually increase your risk of developing these conditions.

To make sure this medicine is safe for you, tell your doctor if you have ever had:

• heart disease;
• liver problems, or jaundice caused by pregnancy or taking hormones;
• kidney disease;
• gallbladder disease;
• asthma;
• epilepsy or other seizure disorder;
• migraines;
• lupus;
• endometriosis or uterine fibroid tumors;
• hereditary angioedema;
• porphyria (a genetic enzyme disorder that causes symptoms affecting the skin or nervous system);
• a thyroid disorder; or
• high levels of calcium in your blood.

Using estradiol may increase your risk of cancer of the breast, uterus, or ovaries. Talk with your doctor about this risk.

Estrace lowers the hormone needed to produce breast milk and can slow breast milk production. Tell your doctor if you are breastfeeding.

Get emergency medical help if you have signs of an allergic reaction to Estrace: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• heart attack symptoms, such as chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating;
• signs of a stroke, such as 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, such as 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 your stomach;
• jaundice (yellowing of the skin or eyes);
• memory problems, confusion, unusual behavior;
• unusual vaginal bleeding, pelvic pain;
• a lump in your breast; or
• high levels of calcium in your blood, such as nausea, vomiting, constipation, increased thirst or urination, muscle weakness, bone pain, lack of energy.

Common Estrace side effects may include:

• nausea, vomiting, diarrhea, stomach cramps;
• mood changes, sleep problems (insomnia);
• cold symptoms such as stuffy nose, sinus pain, sore throat;
• weight gain;
• headache, back pain;
• breast pain;
• thinning scalp hair; or
• vaginal itching or discharge, changes in your menstrual periods, breakthrough bleeding.

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 the FDA at 1-800-FDA-1088.

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Avoid smoking. It can greatly increase your risk of blood clots, stroke, or heart attack while using Estrace.

Grapefruit and grapefruit juice may interact with Estrace and lead to unwanted side effects. Avoid the use of grapefruit products.

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

Many drugs can interact with estradiol. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Tell your doctor about all your current medicines and any medicine you start or stop using.

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