Estradiol (injection)

Estradiol (injection) is used to help with certain menopause symptoms like hot flashes and vaginal dryness, burning, or itching. It is also used to address low estrogen levels caused by ovarian failure or a condition known as hypogonadism.

Some types of estradiol (injection) are used in men to relieve symptoms of prostate cancer. Estradiol helps only with the symptoms of prostate cancer and does not treat the cancer itself.

Estradiol (injection) may also be used for other reasons not mentioned in this medication guide.

Estradiol may raise your risk of getting uterine cancer. If you notice any unusual vaginal bleeding, let your doctor know immediately.

Taking estradiol can increase your risk of blood clots, stroke, heart attack, or cancer of the breast, uterus, or ovaries. Estrogens should not be used for preventing heart disease, stroke, or dementia.

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

• unusual vaginal bleeding;
• a history of heart attack, stroke, or blood clot;
• a history of hormone-related cancer, or cancer of the breast, uterus/cervix, or vagina; or
• liver disease.

Do not use estradiol if you are pregnant and tell your doctor right away if you become pregnant.

Ask a doctor if it is safe to breastfeed while using this medicine.

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

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

Tell your doctor if you have or have ever had:

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

Long-term use of estradiol may increase your risk of cancer of the breast, uterus, or ovaries. Talk with your doctor about this risk.

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

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

Estradiol may cause serious side effects. Call your doctor right away if you have:

• 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), severe headache, slurred speech, problems with vision or balance;
• signs of a blood clot--sudden numbness or weakness on one side of the body, chest pain, problems with vision or speech, pain or swelling in one leg;
• high calcium levels--confusion, tiredness, nausea, vomiting, loss of appetite, constipation, increased thirst or urination, weight loss;
• swelling or tenderness in your stomach;
• jaundice (yellowing of the skin or eyes);
• memory problems, confusion, unusual behavior;
• shortness of breath;
• dizziness, or feeling light-headed;
• unusual vaginal bleeding, pelvic pain; or
• a lump in your breast.

Common side effects of estradiol may include:

• changes in your menstrual periods, breakthrough bleeding;
• nausea, vomiting, bloating, stomach cramps;
• breast pain;
• headache; or
• hair loss.

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 FDA at 1-800-FDA-1088.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Estradiol is injected into a muscle, usually given once every 1 to 4 weeks, depending on the condition being treated. A healthcare provider may teach you how to properly use the medication by yourself.

Prepare an injection only when you are ready to give it. Call your pharmacist if the medicine looks cloudy, has changed colors or has particles in it.

Do not reuse a needle or syringe. Place them in a puncture-proof "sharps" container and dispose of it following state or local laws. Keep out of the reach of children and pets.

Estradiol may increase your risk of developing a condition that can lead to uterine cancer. To lower this risk, your doctor may also want you to take a progestin. Report any unusual vaginal bleeding right away.

If you need surgery or will be on long-term bed rest, tell the surgeon ahead of time that you are using estradiol. You may need to stop using the medicine for a short time.

Your doctor will need to check your progress on a regular basis. Self-examine your breasts for lumps on a monthly basis, and have regular mammograms while using estradiol.

Store at room temperature away from moisture and heat.

Call your doctor for guidance if you miss an appointment for your estradiol (injection).

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

• Grapefruit may interact with estradiol and cause side effects.
• Avoid consuming grapefruit products.

Tell your doctor about all the medicines you are currently taking. Many drugs can affect estradiol, especially:

• nefazodone;
• St. John's wort;
• an antibiotic--clarithromycin, rifabutin, rifampin, rifapentine, telithromycin;
• antifungal medicine--itraconazole, ketoconazole;
• antiviral medicine for HIV or hepatitis C--boceprevir, cobicistat, dasabuvir, elvitegravir, indinavir, lopinavir/ritonavir, nelfinavir, ombitasvir, paritaprevir, saquinavir, telaprevir, tipranavir;
• cancer medicine--apalutamide, enzalutamide, mitotane;
• seizure medicine--carbamazepine, oxcarbazepine, phenytoin, primidone; or
• steroid medicine--dexamethasone, prednisone.

This list is not complete, and many other drugs may affect estradiol. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.