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Home » Medications » EstroGel® Gel 80 g (Estradiol 0.6 mg/g)

EstroGel® Gel 80 g (Estradiol 0.6 mg/g)

Transdermal Hormone Replacement Therapy (HRT)

Description

Generic Name: Estradiol hemihydrate
Brand Name: EstroGel
Drug Class: Estrogen replacement therapy (Estrogen receptor agonist)
This is a prescription medicine, which requires a valid prescription!

Indications

  • Moderate to severe menopausal hot flashes
  • Vulvar and vaginal atrophy symptoms
  • Prevention of postmenopausal osteoporosis in women at high fracture risk (when other therapies are unsuitable)
Mechanism of Action
  • Delivers estradiol through the skin into the bloodstream, where it binds estrogen receptors in the hypothalamus, bone, and urogenital tract, compensating for declining endogenous estrogen levels during menopause.
  • Storage
    • Store at 15–25 °C; protect from heat and open flame; keep out of reach of children.
Dosage and Administration
  • Form: Metered‑dose transdermal gel (pump‑pack)
  • Strength: 0.6 mg estradiol per gram of gel (each pump delivers 1.25 g gel = 0.75 mg estradiol)
  • Typical Regimen:
    • Symptom Relief: 1 pump once daily to a clean, dry area of the arm or thigh; let dry for 2–5 minutes
    • Osteoporosis Prevention: 2 pumps once daily
  • Progestogen Co‑administration: In women with an intact uterus, add a progestogen for at least 12 days each month to protect the endometrium
  • Application Tips: Prime the pump before first use, avoid breasts and genital area, wash hands after applying, and prevent skin contact with others until dry
Side Effects
  • Common: Headache, nausea, breast tenderness, vaginal yeast infections, local skin reactions (itching, burning)
  • Serious (Rare): Venous thromboembolism (DVT, PE), stroke, heart attack, endometrial hyperplasia or cancer
Contraindications

Do not use if any of the following apply:

  • Known or suspected estrogen‑dependent cancer (breast, endometrial)
  • Undiagnosed abnormal genital bleeding
  • Active or past history of venous or arterial thromboembolism
  • Severe liver dysfunction or disease
  • Hypersensitivity to estradiol or any excipient

Information

Warnings and Precautions:

  • Cardiovascular Risk: Assess for VTE and cardiovascular disease before prescribing
  • Cancer Risk: Use lowest effective dose for shortest duration; follow breast and endometrial screening guidelines
  • Liver Disease: Avoid during acute liver impairment until function normalizes
  • Fluid Retention: Exercise caution in patients with cardiac, renal, or hepatic impairment
  • Pediatric Exposure: Prevent accidental transfer; can cause hormonal effects in children
  • Flammability: Gel is alcohol‑based and flammable until fully dry

Drug Interactions:

  • Enzyme Inducers (e.g., rifampicin, phenytoin, carbamazepine, St. John’s wort): May lower estradiol levels
  • Anticoagulants: May alter warfarin/INR requirements
  • Corticosteroids: May increase cortisol‑binding globulin levels
  • Lamotrigine: May reduce lamotrigine concentrations—monitor seizure control
  • Topical Agents: Avoid strong soaps or keratolytics at application site, as they can remove gel

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