Drug Name
Estrace (Estradiol)

Drug Uses
Estrace is used for treating conditions due to menopause (e.g., hot flashes; vaginal itching, burning, or dryness), treating vulval or vaginal atrophy, and preventing osteoporosis (brittle bones).

It is also used for estrogen replacement therapy after failure of the ovaries and to relieve the symptoms of breast cancer.

How to use
Use Estrace as directed by your doctor.

• Take Estrace by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation.
• Grapefruit and grapefruit juice may increase the risk of Estrace 's side effects. Talk to your doctor before including grapefruit or grapefruit juice in your diet while you are taking Estrace.

Ask your health care provider any questions you may have about how to use Estrace.

Drug Class and Mechanism
Estrace is a female estrogen hormone. It works by replacing natural estrogens in a woman who can no longer produce enough estrogen. It works for advanced prostate cancer by antagonizing male hormones.

Missed Dose
If you miss a dose of Estrace, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Storage
Store Estrace between 68 and 77 degrees F (20 and 25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Estrace out of the reach of children and away from pets.

Warnings/Precautions
Do not use Estrace if:

• you are allergic to any ingredient in Estrace;
• you are pregnant or suspect you may be pregnant, have recently given birth or are breast-feeding, or have vaginal bleeding of abnormal or unknown cause;
• you have known or suspected breast cancer (unless directed by your doctor) or you have cancers that are estrogen-dependent;
• you have blood clots, vein inflammation, or liver disease;
• you have had a recent stroke or heart attack.

Contact your doctor or health care provider right away if any of these apply to you.

Important:

• Estrace may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Estrace with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
• Limit alcoholic beverages while you are taking Estrace.
• Estrace may cause dark skin patches on your face (melasma). Exposure to the sun may make these patches darker and you may need to avoid prolonged sun exposure and sunlamps. Consult your doctor regarding the use of sunscreens and protective clothing.
• Estrace may increase the risk of blood clots. The risk may be greater if you smoke (especially in women older than 35 years of age).
• Contact your doctor if vaginal bleeding of unknown cause occurs. This could be a sign of a serious condition requiring immediate medical attention.
• Contact your doctor if vaginal discomfort occurs or if you suspect you have developed an infection while taking Estrace.
• Follow your doctor's instructions for examining your breasts and report any lumps immediately.
• Additional monitoring of your dose or condition may be necessary if you are presently taking an azole antifungal (e.g., itraconazole), carbamazepine, a macrolide antibiotic (e.g., erythromycin), ritonavir, cimetidine, or St. John's wort.
• If you will be having surgery or will be confined to a chair or bed for a long period of time (e.g., a long plane flight), notify your doctor beforehand. Special precautions may need to be taken in these circumstances while you are taking Estrace.
• Nonprescription therapy to help prevent bone loss includes a weight-bearing exercise plan, as well as adequate daily calcium and vitamin D intake. Consult your doctor or pharmacist for more details.
• Estrace may interfere with certain lab tests. Be sure your doctor and lab personnel know you are taking Estrace.
• Diabetes patients - Estrace may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
• Lab tests, including physical exams and blood pressure, may be performed while you use Estrace . You should have breast and pelvic exams, and a Pap test at least once a year. You should also have periodic mammograms as determined by your doctor. Be sure to keep all doctor and lab appointments.
• Pregnancy and breast-feeding: Do not use Estrace if you are pregnant. Avoid becoming pregnant while you are taking it. If you think you may be pregnant, contact your doctor right away. Estrace may be found in breast milk. If you are or will be breast-feeding while you use Estrace, check with your doctor. Discuss any possible risks to your baby.

Possible Side Effects
Check with your doctor if any of these most common side effects persist or become bothersome:

• breast pain or tenderness; headache; hair loss; mild nausea or vomiting; spotting or breakthrough bleeding; stomach cramps or bloating.

Seek medical attention right away if any of these severe side effects occur:

• severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); back pain;breast discharge or lump in the breast; calf or leg pain or swelling; chest pain; coughing up blood; dark urine; depression; dizziness; fainting; fever; memory problems; mental or mood changes; muscle pain; one-sided weakness; painful or difficult urination; persistent or severe breast pain or tenderness; persistent or severe headache, nausea, or vomiting; severe stomach pain or swelling; slurred speech; sudden shortness of breath; sunburn-like rash; swelling of hands, legs, or feet; unusual vaginal bleeding, discharge, itching, or odor; vision changes; vomiting; weakness or numbness of an arm or leg; yellowing of the skin or eyes.

More Information
If you have any questions about Estrace, please talk with your doctor, pharmacist, or other health care provider.
Estrace is to be used only by the patient for whom it is prescribed. Do not share it with other people.