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FEMRING (ESTRADIOL ACETATE)
- Atrophic vaginitis associated with menopause
- Atrophy of vulva
- Vasomotor symptoms associated with menopause
0.05 mg/24 hr vaginal
- Insert 1 vaginal ring (0.05 mg) by vaginal route every 3 months
0.1 mg/24 hr vaginal
- Insert 1 vaginal ring (0.1 mg) by vaginal route every 3 months
Atrophic vaginitis associated with menopause
- Insert 1 vaginal ring (0.05 mg) by vaginal route every 3 months
- Insert 1 vaginal ring (0.1 mg) by vaginal route every 3 months
Atrophy of vulva
- Insert 1 vaginal ring (0.1 mg) by vaginal route every 3 months
Vasomotor symptoms associated with menopause
- Insert 1 vaginal ring (0.05 mg) by vaginal route every 3 months
- Insert 1 vaginal ring (0.1 mg) by vaginal route every 3 months
- anastrozole
- Arimidex
- Aromasin
- exemestane
- Femara
- letrozole
Contraindicated
- None
Severe
Moderate
- A-hydrocort
- A-methapred
- Alagesic Lq
- amobarbital
- Amytal
- Anucort-hc
- Anusol-hc
- Aristospan Intra-articular
- Aristospan Intralesional
- Ascomp With Codeine
- Belladonna-phenobarbital
- betamethasone acet & sod phos
- Bivigam
- Brevital
- budesonide
- Bupap
- butabarbital
- Butalbital Compound W/codeine
- Butalbital Compound-codeine
- butalbital-acetaminop-caf-cod
- butalbital-acetaminophen
- butalbital-acetaminophen-caff
- butalbital-aspirin-caffeine
- Butisol
- Capacet
- Carimune Nf Nanofiltered
- Celestone Soluspan
- Cerebyx
- codeine-butalbital-ASA-caff
- Colocort
- Cortef
- Cortenema
- Cortifoam
- cortisone
- Depo-medrol
- dexamethasone
- Dexamethasone Intensol
- dexamethasone sodium phos (PF)
- dexamethasone sodium phosphate
- Dexpak 10 Day
- Dexpak 13 Day
- Dexpak 6 Day
- Dilantin
- Dilantin Extended
- Dilantin Infatabs
- Dilantin Kapseal
- Dilantin-125
- Donnatal
- Entocort Ec
- Esgic
- ethotoin
- Ez Use Joint-tunnel-trigger
- Fioricet
- Fioricet With Codeine
- Fiorinal
- Fiorinal-codeine #3
- First-duke's
- First-mary's Mouthwash
- Flebogamma Dif
- Flo-pred
- fludrocortisone
- fosphenytoin
- Gamastan S/d
- Gammagard Liquid
- Gammagard S-d (iga < 1 Mcg/ml)
- Gammagard S/d
- Gammaked
- Gammaplex
- Gamunex-c
- Grx Hicort 25
- Hemril-30
- Hizentra
- hydrocortisone
- hydrocortisone acetate
- hydrocortisone sod succ (PF)
- hydrocortisone sod succinate
- immune glob(IgG)(hum)-maltose
- immune globulin (human) (IgG)
- immune globulin(hum),capr(IgG)
- Kenalog
- Luminal
- Margesic
- Marten-tab
- Medrol
- Medrol (pak)
- methohexital
- methylprednisolone
- methylprednisolone acetate
- methylprednisolone sod suc(PF)
- methylprednisolone sodium succ
- methylprednisolone-bupivacaine
- Millipred
- Millipred Dp
- Mysoline
- Nembutal Sodium
- nystatin-hydrocortisone-diphen
- nystatin-TCN-HC-diphenhydramin
- Octagam
- Orapred
- Orapred Odt
- Pediapred
- Peganone
- pentobarbital sodium
- phenobarb-hyoscy-atropine-scop
- phenobarbital
- phenobarbital sodium
- Phenytek
- phenytoin
- phenytoin sodium
- phenytoin sodium extended
- Physicians Ez Use M-pred
- prednisolone
- prednisolone acetate
- prednisolone sodium phosphate
- prednisone
- Prednisone Intensol
- primidone
- Privigen
- Proctocort
- Rayos
- Rectacort-hc
- secobarbital sodium
- Seconal Sodium
- Solu-cortef
- Solu-cortef (pf)
- Solu-medrol
- Solu-medrol (pf)
- Tencon
- triamcinolone acetonide
- triamcinolone hexacetonide
- triamcinolone-lidocaine
- Uceris
- Veripred 20
- Zebutal
- Disease of liver
Contraindicated
- Carcinoma of breast
- Dementia
- Endometrial carcinoma
- Estrogen-dependent neoplasm
- Hepatic porphyria
- Hereditary angioedema
- Malignant neoplasm of the ovary
- Mammography abnormal
- Neoplasm of female genital organ
Severe
Moderate
- Diabetes mellitus
- Endometriosis
- Gallbladder disease
- Hypertension
- Hypertriglyceridemia
- Hypothyroidism
- Seizure disorder
- Systemic lupus erythematosus
- Tobacco smoker
- Uterine leiomyoma
FEMRING (ESTRADIOL ACETATE)
- Atrophic vaginitis associated with menopause
- Atrophy of vulva
- Vasomotor symptoms associated with menopause
- Abnormal vaginal bleeding
- Mastalgia
- Menorrhagia
- Abdominal distension
- Abdominal pain with cramps
- Vulvovaginal candidiasis
More Frequent
Severe
Less Severe
- None
- Headache disorder
- Urinary tract infection
- Uterine cramps
Less Frequent
Severe
Less Severe
Rare / Very Rare
Severe
- Acute myocardial infarction
- Anaphylaxis
- Angioedema
- Cerebrovascular accident
- Cholecystitis
- Deep venous thrombosis
- Dementia
- Diarrhea
- Endometrial hyperplasia
- Erythema multiforme
- Erythema nodosum
- Fibrocystic breast disease
- Gallbladder obstruction
- Gastrointestinal obstruction
- Gynecomastia
- Hypertension
- Malignant neoplasm of the uterus
- Neoplasm of breast
- Nipple discharge
- Pancreatitis
- Peripheral edema
- Pulmonary thromboembolism
- Retinal thrombosis
- Thrombotic disorder
- Toxic shock syndrome
- Unspecified lump in breast
- Uterine leiomyoma
- Vaginal irritation
- Vaginal ulcer
- Visual changes
- Weight gain
Less Severe
- Body fluid retention
- Chest pain
- Depression
- Dizziness
- Hypercalcemia
- Hypertriglyceridemia
- Libido changes
- Migraine
- Mood changes
- Ovarian cyst
- Pruritus of skin
- Urticaria
- Vomiting
Contraindicated
None
Severe Precaution
None
Management or Monitoring Precaution
Estrogens, Vaginal
Not indicated in pediatrics.
- 1 Day – 18 Years
- Not indicated in pediatrics.
Estradiol
- Severity Level:
2
- Additional Notes: Not indicated during pregnancy; no known dev tox
Contraindicated
None
| General | Excretion Potential | Effect on Infant | Notes |
| None |
Precaution Exists
Estradiol
Limited data indicate higher excretion may occur w/vaginal vs transderm admin
| General | Excretion Potential | Effect on Infant | Notes |
| Evaluate use carefully | Excreted | Not known; no or inclusive data | Limited data indicate higher excretion may occur w/vaginal vs transderm admin |
No Known Risk
None
| General | Excretion Potential | Effect on Infant | Notes |
| None |
Contraindicated
None
Precaution Exists
Estrogenic Agents (vaginal)
General-Use lowest possible dose for shortest duration and in combination with a progestin as indicated to reduce the risk of endometrial hyperplasia and breast cancer. Low-dose intravaginal estrogen may be used for management of vaginal symptoms (e.g. dyspareunia, recurrent UTIs). Cardiovascular-Avoid with active or history of DVT,PE or thromboembolic disease.
| Organ / System | HEP | REN | CARD | ENDO | NEURO / PSYCH | PULM |
| Increased Risk / Adverse Effects | N | N | Y | Y | N | N |
BEERS: N HEDIS: N STOPP: N
No Known Risk
None
- Estrogens, either used alone or with another hormone (progestin), have rarely caused very serious side effects. Discuss the risks and benefits of hormone treatment with your doctor. Estrogens should not be used to prevent heart disease or dementia.<br /><br /> Estrogens can increase the risk of cancer of the uterus (endometrial cancer). Taking a progestin as directed by your doctor can help decrease this risk. Tell your doctor right away if you have any unusual vaginal bleeding.<br /><br /> In postmenopausal women, estrogens can increase the risk of cancer of the ovaries, stroke, dementia, and serious blood clots in the legs. Estrogens alone do not appear to increase the risk of breast cancer when used for up to 7 years. Estrogen, when used with a progestin, can increase the risk of heart disease (such as heart attacks), stroke, serious blood clots in the lungs/legs, dementia, and cancer of the breast/ovaries.<br /><br /> The risk for serious side effects may depend on the dose of estrogen and the length of time it is used. Therefore, this medication should be used at the lowest effective dose and for the shortest amount of time. Discuss the use of this medication with your doctor and check with him/her regularly (for example, every 3 to 6 months) to see if you still need to take this medication.<br /><br />If you will be taking this medication long-term, you should have regular complete physical exams (for example, once a year) as directed by your doctor. See also Notes section.
| Atrophic vaginitis associated with menopause | |
| N95.2 | Postmenopausal atrophic vaginitis |
| Atrophy of vulva | |
| N90.5 | Atrophy of vulva |
| Vasomotor symptoms associated with menopause | |
| N95.1 | Menopausal and female climacteric states |
| N95.9 | Unspecified menopausal and perimenopausal disorder |
| 0-9 | A-Z |
|---|---|
| N90.5 | Atrophy of vulva |
| N95.1 | Menopausal and female climacteric states |
| N95.2 | Postmenopausal atrophic vaginitis |
| N95.9 | Unspecified menopausal and perimenopausal disorder |
Formulary Reference Tool