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Monday, October 17, 2016

estrogen and progestin combination (ovarian hormone therapy)

Commonly used brand name(s)

In the U.S.

Activella

Alesse

Angeliq

Estinyl

Hemocyte

Loestrin 1/20

Mircette

Ortho-Novum

Prefest

Premphase

Available Dosage Forms:

Tablet

Tablet, Chewable

Uses For estrogen and progestin combination (ovarian hormone therapy)

Estrogens and progestins are female hormones. They are produced by the body and are necessary for the normal sexual development of the female and for the regulation of the menstrual cycle during the childbearing years.

The ovaries begin to produce less estrogen after menopause (the change of life). estrogen and progestin combination (ovarian hormone therapy) is prescribed to make up for the lower amount of estrogen. Estrogens help relieve signs of menopause, such as hot flashes and unusual sweating, chills, faintness, or dizziness. Progestins help to regulate the effects of estrogens.

Estrogens are prescribed for several reasons:

to provide additional hormone when the body does not produce enough of its own, such as during menopause. They can also help to relieve a genital skin condition called vaginal or vulvar atrophy.

to help prevent weakening of bones (osteoporosis) in women past menopause.

Estrogens may also be used for other conditions as determined by your doctor.

There is no medical evidence to support the belief that the use of estrogens will keep the patient feeling young, keep the skin soft, or delay the appearance of wrinkles. Nor has it been proven that the use of estrogens during menopause will relieve emotional and nervous symptoms, unless these symptoms are caused by other menopausal symptoms, such as hot flashes or hot flushes.

Estrogens and progestins are available only with your doctor's prescription.

Before Using estrogen and progestin combination (ovarian hormone therapy)

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to medicines in this group or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Geriatric

Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of estrogens and progestins in the elderly with use in other age groups.

Pregnancy

Estrogens and progestins are not recommended for use during pregnancy or right after giving birth. Becoming pregnant or maintaining a pregnancy is not likely to occur around the time of menopause.

Breast Feeding

Estrogens and progestins pass into the breast milk and can change the content or lower the amount of breast milk. Use of estrogen and progestin combination (ovarian hormone therapy) is not recommended in nursing mothers.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking any of these medicines, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using medicines in this class with any of the following medicines is not recommended. Your doctor may decide not to treat you with a medication in this class or change some of the other medicines you take.

Boceprevir

Using medicines in this class with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Boceprevir

Felbamate

Isotretinoin

Paclitaxel

Paclitaxel Protein-Bound

Theophylline

Tizanidine

Tranexamic Acid

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Proper Use of estrogen and progestin combination (ovarian hormone therapy)

Estrogens and progestins usually come with patient information or directions. Read them carefully before taking estrogen and progestin combination (ovarian hormone therapy).

Take estrogen and progestin combination (ovarian hormone therapy) only as directed by your doctor. Do not take more of it and do not take or use it for a longer time than your doctor ordered. Try to take the medicine at the same time each day to reduce the possibility of side effects and to allow it to work better.

For patients taking estrogens and progestins by mouth:

Nausea may occur during the first few weeks after you start taking estrogens. This effect usually disappears with continued use. If the nausea is bothersome, it can usually be prevented or reduced by taking each dose with food or immediately after food.

Dosing

The dose medicines in this class will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of these medicines. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For 17 beta-estradiol and norgestimate

For oral dosage forms (tablets):
- For treating a genital skin condition (vaginal or vulvar atrophy), or vasomotor symptoms of menopause:
  - Adults—Oral, 1 mg estradiol for three days followed by 1 mg of estradiol combined with 0.09 mg of norgestimate for three days. The regimen is repeated continuously without interruption.
- To prevent loss of bone (osteoporosis):
  - Adults—Oral, 1 mg estradiol for three days followed by 1 mg of estradiol combined with 0.09 mg of norgestimate for three days. The regimen is repeated continuously without interruption.

For ethinyl estradiol and norethindrone

For oral dosage forms (tablets):
- For treating vasomotor symptoms of menopause:
  - Adults—Oral, 2.5 mcg (0.025 mg) ethinyl estradiol and 0.5 mg norethindrone once daily.
- To prevent loss of bone (osteoporosis):
  - Adults—Oral, 2.5 mcg (0.025 mg) ethinyl estradiol and 0.5 mg norethindrone once daily.

For estradiol and norethindrone

For oral dosage forms (tablets):
- For treating vasomotor symptoms of menopause or treatment of vaginal or vulvar atrophy:
  - Adults—Oral, 1 mg estradiol and 0.5 mg norethindrone once daily.
- To prevent loss of bone (osteoporosis):
  - Adults—Oral, 1 mg estradiol and 0.5 mg norethindrone once daily.

Missed Dose

If you miss a dose of estrogen and progestin combination (ovarian hormone therapy), take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Keep out of the reach of children.

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using estrogen and progestin combination (ovarian hormone therapy)

It is very important that your doctor check your progress at regular visits to make sure estrogen and progestin combination (ovarian hormone therapy) does not cause unwanted effects. These visits will usually be every year, but some doctors require them more often.

It is not yet known whether the use of estrogens increases the risk of breast cancer in women. Therefore, it is very important that you regularly check your breasts for any unusual lumps or discharge. Report any problems to your doctor. You should also have a mammogram (x-ray pictures of the breasts) done if your doctor recommends it. Because breast cancer has occurred in men taking estrogens, regular breast self-exams and exams by your doctor for any unusual lumps or discharge should be done.

Tell the doctor in charge that you are taking estrogen and progestin combination (ovarian hormone therapy) before having any laboratory test because some results may be affected.

estrogen and progestin combination (ovarian hormone therapy) Side Effects

Women rarely have severe side effects from taking estrogens to replace estrogen. Discuss these possible effects with your doctor:

The prolonged use of estrogens has been reported to increase the risk of endometrial cancer (cancer of the lining of the uterus) in women after menopause. This risk seems to increase as the dose and the length of use increase. When estrogens are used in low doses for less than 1 year, there is less risk. The risk is also reduced if a progestin (another female hormone) is added to, or replaces part of, your estrogen dose. If the uterus has been removed by surgery (total hysterectomy), there is no risk of endometrial cancer, and no need to take an estrogen and progestin combination.

It is not yet known whether the use of estrogens increases the risk of breast cancer in women. Although some large studies show an increased risk, most studies and information gathered to date do not support this idea.

Check with your doctor immediately if any of the following side effects occur:

Check with your doctor as soon as possible if any of the following side effects occur:

More common

Breast pain or tenderness

dizziness or light-headedness

headache

rapid weight gain

swelling of feet and lower legs

vaginal bleeding

Rare

Breast lumps

change in vaginal discharge

discharge from nipple

nausea and vomiting

pains in chest, groin, or leg, especially calf

pains in stomach, side, or abdomen

pain or feeling of pressure in pelvis

severe or sudden headache

sudden and unexplained shortness of breath

sudden loss of coordination

sudden slurred speech

sudden vision changes

weakness or numbness in arm or leg

yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Back pain

bloating or gas

dizziness

general feeling of tiredness

flu-like symptoms

mental depression

muscle aches

nausea—taking tablet with food may decrease

vaginitis

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

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estrogen Vaginal

Commonly used brand name(s)

In the U.S.

Estrace

Estring

Femring

Ortho Dienestrol

Premarin

Vagifem

In Canada

Estragyn

Neo-Estrone

Oestrilin

Available Dosage Forms:

Tablet

Cream

Insert, Extended Release

Suppository

Uses For estrogen

Estrogens are hormones produced by the body. Among other things, estrogens help develop and maintain female organs.

When your body is in short supply of this hormone, replacing it can ease the uncomfortable changes that occur in the vagina, vulva (female genitals), and urethra (part of the urinary system). Conditions that are treated with vaginal estrogens include a genital skin condition (vulvar atrophy), inflammation of the vagina (atrophic vaginitis), and inflammation of the urethra (atrophic urethritis).

Estrogens work partly by increasing a normal clear discharge from the vagina and making the vulva and urethra healthy. Using or applying an estrogen relieves or lessens:

Dryness and soreness in the vagina

Itching, redness, or soreness of the vulva

Feeling an urge to urinate more often then is needed or experiencing pain while urinating

Pain during sexual intercourse

When used vaginally or on the skin, most estrogens are absorbed into the bloodstream and cause some, but not all, of the same effects as when they are taken by mouth. Estrogens used vaginally at very low doses for treating local problems of the genitals and urinary system will not protect against osteoporosis or stop the hot flushes caused by menopause.

Estrogens for vaginal use are available only with your doctor's prescription.

Before Using estrogen

Allergies

Pediatric

Estrogen vaginal cream is not indicated in children. Studies have not been conducted.

Geriatric

Elderly women greater than 65 years of age may have an increased risk of certain side effects during treatment, especially stroke, invasive breast cancer, and memory problems.

Pregnancy

Estrogens should not be used during pregnancy, since an estrogen called diethylstilbestrol (DES) that is no longer taken for hormone replacement has caused serious birth defects in humans and animals.

Breast Feeding

Use of estrogen is not recommended in nursing mothers. Estrogens pass into the breast milk and may decrease the amount and quality of breast milk. Caution should be exercised in mothers who are using estrogen and breast-feeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Interactions with Food/Tobacco/Alcohol

Proper Use of estrogen

Vaginal estrogen products usually come with patient directions. Read them carefully before using estrogen.

Wash your hands before and after using the medicine. Also, keep the medicine out of your eyes. If estrogen does get into your eyes, wash them out immediately, but carefully, with large amounts of tap water. If your eyes still burn or are painful, check with your doctor.

Use estrogen only as directed. Do not use more of it and do not use it for a longer time than your doctor ordered. It can take up to 4 months to see the full effect of the estrogens. Your doctor may reconsider continuing your estrogen treatment or may lower your dose several times within the first one or two months, and every 3 to 6 months after that. Sometimes a switch to oral estrogens may be required for added benefits or for higher doses. When using the estradiol vaginal insert or ring, you will need to replace it every 3 months or remove it after 3 months.

For vaginal creams or suppositories:

Vaginal creams and some vaginal suppositories are inserted with a plastic applicator. Directions for using the applicator are supplied with your medicine. If you do not see your dose marked on the applicator, ask your health care professional for more information.

To fill the applicator for cream dosage forms:
- Screw the applicator onto the tube.
- Squeeze the medicine into the applicator slowly until it is measured properly.
- Remove the applicator from the tube. Replace the cap on the tube.

To fill the applicator for suppository dosage form:
- Place the suppository into the applicator.

To place the dose using the applicator for cream and suppository dosage forms:
- Relax while lying on your back with your knees bent or stand with one foot on a chair.
- Hold the full applicator in one hand. Slide the applicator slowly into the vagina. Stop before it becomes uncomfortable.
- Slowly press the plunger until it stops.
- Withdraw the applicator. The medicine will be left behind in the vagina.

To care for the applicator for cream and suppository dosage forms:
- Clean the applicator after use by pulling the plunger out of the applicator and washing both parts completely in warm, soapy water. Do not use hot or boiling water.
- Rinse well.
- After drying the applicator, replace the plunger.

For vaginal insert or ring dosage form:

To place the vaginal insert:
- Relax while lying on your back with your knees bent or stand with one foot on a chair.
- Pinch or press the sides of the vaginal insert together, between your forefinger and middle finger.
- With one hand, part the folds of skin around your vagina.
- Slide the vaginal insert slowly into the upper third of your vagina. Stop before it becomes uncomfortable. The exact location is not too important but it should be comfortable.
- If it seems uncomfortable, then carefully push the vaginal insert higher into the vagina.

To remove the vaginal insert:
- Stand with one foot on a chair.
- Slide one finger into the vagina and hook it around the closest part of the vaginal insert.
- Slowly pull the vaginal insert out.
- Dispose of the vaginal insert by wrapping it up and throwing it into the trash. Do not flush it down the toilet.

Dosing

For conjugated estrogens

For vaginal dosage form (cream):
- For treating inflammation of the vagina (atrophic vaginitis):
  - Adults—At first, 0.5 gram (g) of conjugated estrogens inserted into the vagina once a day or as directed by your doctor to achieve the lowest dose possible. Usually your doctor will want you to use estrogen for only three weeks of each month (three weeks on and one week off). Your doctor may increase your dose as needed. However, the dose is usually not more than 2 grams per day.
- For treating a genital skin condition (vulvar atrophy):
- Adults—0.5 gram (g) of conjugated estrogens inserted into the vagina two times per week. Usually your doctor will want you to use estrogen for only three weeks of each month (three weeks on and one week off).

For estradiol

For vaginal dosage form (cream):
- For treating a genital skin condition (vulvar atrophy) and inflammation of the vagina (atrophic vaginitis):
  - Adults—200 to 400 micrograms (mcg) of estradiol (two to four grams of cream) inserted into the vagina once a day for one to two weeks, decreasing the dose by one half over two and four weeks. After four weeks, your doctor will probably ask you to use the medicine less often, such as 100 mcg (one gram of cream) one to three times a week and for only three weeks of each month (three weeks on and one week off).

For vaginal dosage form (insert or ring):
- For treating a genital skin condition (vulvar atrophy), inflammation of the vagina (atrophic vaginitis) in postmenopausal women, and inflammation of the urethra (urethritis) in postmenopausal women:
  - Adults—One insert containing 2 to 24.8 milligrams (mg) of estradiol inserted into the vagina every three months. The insert will slowly release estradiol at a rate of 7.5 to 100 micrograms (mcg) every twenty-four hours with continuous use.

For estrone

For vaginal dosage form (cream):
- For treating a genital skin condition (vulvar atrophy) and inflammation of the vagina (atrophic vaginitis) in postmenopausal women:
  - Adults—2 to 4 milligrams (mg) of estrone (two to four grams of cream) inserted into the vagina once a day or as directed by your doctor.

For vaginal dosage form (suppository):
- For treating a genital skin condition (vulvar atrophy) and inflammation of the vagina (atrophic vaginitis) in postmenopausal women:
  - Adults—250 to 500 micrograms (mcg) inserted into the vagina once a day or as directed by your doctor.

Missed Dose

If you miss a dose of estrogen, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

When using the suppository or cream several times a week: If you miss a dose of estrogen and remember it within 1 or 2 days of the missed dose, use the missed dose as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

When using the cream or suppositories more than several times a week: If you miss a dose of estrogen, use it as soon as possible if remembered within 12 hours of the missed dose. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Keep out of the reach of children.

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using estrogen

It is very important that your doctor check your progress at regular visits to make sure estrogen does not cause unwanted effects. Plan on going to see your doctor every year, but some doctors require visits more often.

It is not yet known whether the use of vaginal estrogens increases the risk of breast cancer in women. It is very important that you check your breasts on a regular basis for any unusual lumps or discharge. Report any problems to your doctor. You should also have a mammogram (x-ray picture of the breasts) done if your doctor recommends it.

It is important that you have a regular pelvic exam (pap smear). Your doctor will tell you how often this exam should be done.

Talk to your doctor if you have high blood pressure, high cholesterol (fats in the blood), or diabetes, use tobacco, or are overweight. You may have a higher risk for getting heart disease.

Although the chance is low, use of estrogen may increase your chance of getting cancer of the ovary or uterus (womb). Regular visits to your health professional can help identify these serious side effects early.

If you think that you may be pregnant, stop using the medicine immediately and check with your doctor.

Tell the doctor in charge that you are using estrogen before having any laboratory test, because some test results may be affected.

For vaginal creams or suppositories:

Avoid using latex condoms, diaphragms, or cervical caps for up to 72 hours after using estrogen vaginal creams. Certain estrogen products may contain oils in the creams that can weaken latex (rubber) products and cause condoms to break or leak, or cervical caps or diaphragms to wear out sooner. Check with your health care professional to make sure the vaginal estrogen product you are using can be used with latex devices.

estrogen is often used at bedtime to increase effectiveness through better absorption.

Vaginal creams or suppositories will melt and leak out of the vagina. A minipad or sanitary napkin will protect your clothing. Do not use tampons (like those used for menstrual periods) since they may soak up the medicine and make the medicine less effective.

Avoid exposing your male sexual partner to your vaginal estrogen cream or suppository by not having sexual intercourse right after using these medicines. Your male partner might absorb the medicine through his penis if it comes in contact with the medicine.

For estradiol vaginal inserts or rings:

Contact your doctor if you have problems removing your vaginal insert.

It is not necessary to remove the vaginal insert for sexual intercourse unless you prefer to remove it.

If you do take it out, or if it accidentally slips or comes out of the vagina, you can replace the vaginal insert in the vagina after washing it with lukewarm water. Never use hot or boiling water.

If it slips down, gently push it upwards and back into place.

Replace the vaginal insert every 3 months.

Talk to your doctor on a regular basis about how long to use the vaginal insert.

estrogen Side Effects

The risk of any serious adverse effect is unlikely for most women using low doses of estrogens vaginally. Even women with special risks have used vaginal estrogens without problems.

Check with your doctor immediately if any of the following side effects occur:

Less common

Breast pain

enlarged breasts

itching of the vagina or genitals

headache

nausea

stinging or redness of the genital area

thick, white vaginal discharge without odor or with a mild odor

Rare

Feeling of vaginal pressure (with estradiol vaginal insert or ring)

unusual or unexpected uterine bleeding or spotting

vaginal burning or pain (with estradiol vaginal insert or ring)

Incidence not known

Diarrhea

dizziness

fast heartbeat

feeling faint

fever

hives

hoarseness

itching

joint pain, stiffness, or swelling

muscle pain

rash

shortness of breath

skin redness

swelling of eyelids, face, lips, hands, or feet

tightness in the chest

trouble with breathing or swallowing

vomiting

wheezing

Less common

Abdominal or back pain

clear vaginal discharge (usually means the medicine is working)

Incidence not known

Acne

enlargement of penis or testes

growth of pubic hair

rapid increase in height

swelling of the breasts or breast soreness in males

Also, many women who are using estrogens with a progestin (another female hormone) will start having monthly vaginal bleeding that is similar to menstrual periods. This effect will continue for as long as the medicine is taken. However, monthly bleeding will not occur in women who have had the uterus removed by surgery (hysterectomy).

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

estropipate

Generic Name: estropipate (ES troe PIP ate)

Brand names: Ogen 0.625, Ogen 1.25, Ogen 2.5, Ortho-Est

What is estropipate?

Estropipate is a form of estrogen. Estrogen is a female sex hormone necessary for many processes in the body.

Estropipate is used to treat symptoms of menopause such as hot flashes, and vaginal dryness, burning, and irritation. It is also used to prevent osteoporosis.

Estropipate may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about estropipate?

Do not use this medication if you have any of the following conditions: a history of stroke or blood clot, circulation problems, a hormone-related cancer such as breast or uterine cancer, or abnormal vaginal bleeding. This medication can cause birth defects in an unborn baby. Do not use if you are pregnant. Use an effective form of birth control, and tell your doctor if you become pregnant during treatment.

Estropipate increases your risk of developing endometrial hyperplasia, a condition that may lead to cancer of the uterus. Taking progestins while using estropipate may lower this risk. If your uterus has not been removed, your doctor may prescribe a progestin for you to take while you are using estropipate.

Long-term estropipate treatment may increase your risk of breast cancer, heart attack, or stroke. Talk with your doctor about your individual risks before using estropipate long-term. Your doctor should check your progress on a regular basis (every 3 to 6 months) to determine whether you should continue this treatment.

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

What should I discuss with my health care provider before using estropipate?

Do not use estropipate if you have:

a bleeding or blood-clotting disorder;

a history of stroke or circulation problems;

abnormal vaginal bleeding that a doctor has not checked; or

any type of breast, uterine, or hormone-dependent cancer.

Before using estropipate, tell your doctor if you have:

high blood pressure, angina, or heart disease;

high cholesterol or triglycerides;

liver disease;

kidney disease;

asthma;

epilepsy or other seizure disorder;

migraines;

diabetes;

depression;

gallbladder disease; or

if you have had your uterus removed (hysterectomy).

If you have any of these conditions, you may not be able to use estropipate, or you may need a dosage adjustment or special tests during treatment.

Long-term estropipate treatment may increase your risk of stroke. Talk with your doctor about your individual risks before using estropipate long-term. Your doctor should check your progress on a regular basis (every 3 to 6 months) to determine whether you should continue this treatment.

FDA pregnancy category X. This medication can cause birth defects. Do not use estropipate if you are pregnant. Tell your doctor right away if you become pregnant during treatment. Use an effective form of birth control while you are using this medication. Estropipate can pass into breast milk and may harm a nursing baby. This medication may also slow breast milk production. Do not use if you are breast-feeding a baby.

How should I use estropipate?

Use this medication exactly as it was prescribed for you. Do not use the medication in larger amounts, or use it for longer than recommended by your doctor. Follow the directions on your prescription label.

Take this medication with a full glass of water. You may take estropipate with food or after a meal to reduce stomach upset.

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

Store this medication at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the medication as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. Symptoms of an estropipate overdose may include nausea, vomiting, or vaginal bleeding.

What should I avoid while using estropipate?

There are no restrictions on food, beverages, or activity while using estropipate unless your doctor has told you otherwise.

Estropipate side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:

chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;

sudden numbness or weakness, especially on one side of the body;

sudden headache, confusion, problems with vision, speech, or balance;

pain or swelling in your lower leg;

abnormal vaginal bleeding;

pain, swelling, or tenderness in your stomach;

jaundice (yellowing of the skin or eyes); or

a lump in your breast.

Other less serious side effects are more likely to occur, such as:

nausea, vomiting, loss of appetite;

swollen breasts;

acne or skin color changes;

decreased sex drive, impotence, or difficulty having an orgasm;

migraine headaches or dizziness;

vaginal pain, dryness, or discomfort;

swelling of your ankles or feet;

depression; or

changes in your menstrual periods, break-through bleeding.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.

Estropipate Dosing Information

Usual Adult Dose for Osteoporosis:

Dose depends on the presence or absence of an intact uterus.

Recommendations with intact uterus:

Regimen 1 (Continuous Unopposed Estrogen Therapy):

0.625 mg orally once a day.

Regimen 2 (Cyclic Combined Estrogen-Progestin Therapy):

0.625 mg orally once a day for 25 days AND Medroxyprogesterone acetate 5 to 10 mg orally once a day for 10 to 14 days of the cycle.

Regimen 3 (Continuous Combined Estrogen-Progestin Therapy):

0.625 mg orally once a day AND Medroxyprogesterone acetate 2.5 mg orally once a day.

Recommendation following hysterectomy:

0.625 mg orally once a day.

In addition to hormonal therapy, adequate calcium intake is important for postmenopausal women who require treatment or prevention of osteoporosis. The average diet of older American women contains 400 to 600 mg of calcium per day. The optimal intake suggested is 1500 mg per day. If dietary intake is insufficient to achieve 1500 mg per day, dietary supplementation may be useful in women who have no contraindication to calcium supplementation.

Long-term therapy (for more than 5 years) is generally necessary in order to obtain substantive benefits in reducing the risk of bone fracture. Maximal benefits are obtained if estrogen therapy is initiated as soon after menopause as possible. The optimal duration of therapy has not been definitively determined.

Usual Adult Dose for Postmenopausal Symptoms:

Dose depends on the presence or absence of an intact uterus.

Recommendations with intact uterus:

Regimen 1 (Continuous Unopposed Estrogen Therapy):

0.625 mg to 5 mg orally once a day.

Regimen 2 (Cyclic Combined Estrogen-Progestin Therapy):

0.625 mg to 5 mg orally once a day for 25 days AND Medroxyprogesterone acetate 5 to 10 mg orally once a day for 10 to 14 days of the cycle.

Regimen 3 (Continuous Combined Estrogen-Progestin Therapy):

0.625 mg to 5 mg orally once a day AND Medroxyprogesterone acetate 2.5 mg orally once a day.

Recommendation following hysterectomy:

0.625 mg to 5 mg orally once a day.

Many women may require higher dosages during the initiation of therapy. The dosage of estropipate should be adjusted to the minimum dose that will achieve the desired clinical effect.

In general, the duration of hormone therapy for the treatment of postmenopausal symptoms should be limited. Treatment for one to five years is generally sufficient. However, long-term therapy (for the treatment/prophylaxis of osteoporosis and for risk reduction of cardiovascular disease) may be considered during the time in which the patient is being treated for postmenopausal symptoms.

Usual Adult Dose for Atrophic Vaginitis:

Dose depends on the presence or absence of an intact uterus.

Recommendations with intact uterus:

Regimen 1 (Continuous Unopposed Estrogen Therapy):

0.625 mg to 5 mg orally once a day.

Regimen 2 (Cyclic Combined Estrogen-Progestin Therapy):

0.625 mg to 5 mg orally once a day for 25 days AND Medroxyprogesterone acetate 5 to 10 mg orally once a day for 10 to 14 days of the cycle.

Regimen 3 (Continuous Combined Estrogen-Progestin Therapy):

0.625 mg to 5 mg orally once a day AND Medroxyprogesterone acetate 2.5 mg orally once a day.

Recommendation following hysterectomy:

0.625 mg to 5 mg orally once a day.

Many women may require higher dosages during the initiation of therapy. The dosage of estropipate should be adjusted to the minimum dose that will achieve the desired clinical effect.

In general, the duration of hormone therapy for the treatment of postmenopausal symptoms like atrophic vaginitis, kraurosis vulvae, or atrophic urethritis should be limited. Treatment for one to five years is generally sufficient.

Usual Adult Dose for Atrophic Urethritis:

Dose depends on the presence or absence of an intact uterus.

Recommendations with intact uterus:

Regimen 1 (Continuous Unopposed Estrogen Therapy):

0.625 mg to 5 mg orally once a day.

Regimen 2 (Cyclic Combined Estrogen-Progestin Therapy):

0.625 mg to 5 mg orally once a day for 25 days AND Medroxyprogesterone acetate 5 to 10 mg orally once a day for 10 to 14 days of the cycle.

Regimen 3 (Continuous Combined Estrogen-Progestin Therapy):

0.625 mg to 5 mg orally once a day AND Medroxyprogesterone acetate 2.5 mg orally once a day.

Recommendation following hysterectomy:

0.625 mg to 5 mg orally once a day.

Many women may require higher dosages during the initiation of therapy. The dosage of estropipate should be adjusted to the minimum dose that will achieve the desired clinical effect.

In general, the duration of hormone therapy for the treatment of postmenopausal symptoms like atrophic vaginitis, kraurosis vulvae, or atrophic urethritis should be limited. Treatment for one to five years is generally sufficient.

Usual Adult Dose for Hypoestrogenism:

1.25 to 7.5 mg orally once a day for 21 days followed by an 8 to 10 day rest period. The dosage of estropipate should be adjusted to the minimum dose that will achieve the desired clinical effect. This schedule is repeated as necessary to produce bleeding. If satisfactory withdrawal bleeding does not occur, a progestin, like medroxyprogesterone acetate, is added on the last several days of the monthly treatment.

Treatment is usually initiated at the expected time of puberty and may continue for prolonged periods.

Therapeutic goals of estrogen-progestin treatment differ at different times in the life of a hypogonadal patient and titration of dosage is often necessary to achieve the desired level of developmental maturation and menstruation.

Usual Adult Dose for Primary Ovarian Failure:

1.5 mg to 7.5 mg

Dose depends on the presence or absence of an intact uterus.

Recommendations with intact uterus:

Regimen 1 (Continuous Unopposed Estrogen Therapy):

1.5 mg to 7.5 mg orally once a day.

Regimen 2 (Cyclic Combined Estrogen-Progestin Therapy):

1.5 mg to 7.5 mg orally once a day for 25 days AND Medroxyprogesterone acetate 5 to 10 mg orally once a day for 10 to 14 days of the cycle.

Regimen 3 (Continuous Combined Estrogen-Progestin Therapy):

1.5 mg to 7.55 mg orally once a day AND Medroxyprogesterone acetate 2.5 mg orally once a day.

Recommendation following hysterectomy:

1.5 mg to 7.5 mg orally once a day.

Many women may require higher dosages during the initiation of therapy. The dosage of estropipate should be adjusted to the minimum dose that will achieve the desired clinical effect.

Usual Adult Dose for Oophorectomy:

1.5 mg to 7.5 mg

Dose depends on the presence or absence of an intact uterus.

Recommendations with intact uterus:

Regimen 1 (Continuous Unopposed Estrogen Therapy):

1.5 mg to 7.5 mg orally once a day.

Regimen 2 (Cyclic Combined Estrogen-Progestin Therapy):

1.5 mg to 7.5 mg orally once a day for 25 days AND Medroxyprogesterone acetate 5 to 10 mg orally once a day for 10 to 14 days of the cycle.

Regimen 3 (Continuous Combined Estrogen-Progestin Therapy):

1.5 mg to 7.5 mg orally once a day AND Medroxyprogesterone acetate 2.5 mg orally once a day.

Recommendation following hysterectomy:

1.5 mg to 7.5 mg orally once a day.

Many women may require higher dosages during the initiation of therapy. The dosage of estropipate should be adjusted to the minimum dose that will achieve the desired clinical effect.

What other drugs will affect estropipate?

Before using estropipate, tell your doctor if you are using any of the following drugs:

St. John's wort;

phenobarbital (Luminal, Solfoton);

phenytoin (Dilantin);

a blood thinner such as warfarin (Coumadin);

ritonavir (Norvir);

cimetidine (Tagamet);

carbamazepine (Carbatrol, Tegretol);

rifampin (Rifadin, Rifater, Rifamate, Rimactane); or

antibiotics such as clarithromycin (Biaxin), erythromycin (E-Mycin, E.E.S., Erythrocin, Ery-Tab), ketoconazole (Nizoral), or itraconazole (Sporanox);

If you are using any of these drugs, you may not be able to use estropipate or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect estropipate. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

More estropipate resources

Estropipate Dosage
Estropipate Use in Pregnancy & Breastfeeding
Drug Images
Estropipate Drug Interactions
Estropipate Support Group
3 Reviews for Estropipate - Add your own review/rating

Estropipate Prescribing Information (FDA)

Estropipate MedFacts Consumer Leaflet (Wolters Kluwer)

Estropipate, Esterified Estrogens Monograph (AHFS DI)

Ogen 1.25 Advanced Consumer (Micromedex) - Includes Dosage Information

Compare estropipate with other medications

Atrophic Urethritis
Atrophic Vaginitis
Hypoestrogenism
Oophorectomy
Osteoporosis
Postmenopausal Symptoms
Primary Ovarian Failure

Where can I get more information?

Your pharmacist can provide more information about estropipate.

Estrostep Fe

Generic Name: ethinyl estradiol and norethindrone (ETH in il ess tra DYE ole and nor ETH in drone)

Brand Names: Aranelle, Balziva, Brevicon, Briellyn, Cyclafem 1/35, Cyclafem 7/7/7, Estrostep Fe, Femcon FE, Generess Fe, Gildess FE 1.5/0.03, Gildess FE 1/0.2, Junel 1.5/30, Junel 1/20, Junel Fe 1.5/30, Junel Fe 1/20, Leena, Lo Loestrin Fe, Loestrin 21 1.5/30, Loestrin 21 1/20, Loestrin 24 Fe, Loestrin Fe 1.5/30, Loestrin Fe 1/20, Microgestin 1.5/30, Microgestin 1/20, Microgestin FE 1.5/30, Microgestin FE 1/20, Modicon, Necon 0.5/35, Necon 1/35, Necon 10/11, Necon 7/7/7, Norinyl 1+35, Nortrel 0.5/35, Nortrel 1/35, Nortrel 7/7/7, Ortho-Novum 1/35, Ortho-Novum 7/7/7, Ovcon 35, Ovcon 35 Fe, Ovcon 50, Tilia Fe, Tri-Legest Fe, Tri-Norinyl, Zenchent Fe, Zeosa

What is Estrostep Fe (ethinyl estradiol and norethindrone)?

Ethinyl estradiol and norethindrone contains a combination of female hormones that prevent ovulation (the release of an egg from an ovary). This medication also causes changes in your cervical mucus and uterine lining, making it harder for sperm to reach the uterus and harder for a fertilized egg to attach to the uterus.

Ethinyl estradiol and norethindrone are used as contraception to prevent pregnancy. It is also used to treat severe acne.

Ethinyl estradiol and norethindrone may also be used for purposes not listed in this medication guide.

What is the most important information I should know about Estrostep Fe (ethinyl estradiol and norethindrone)?

Do not use birth control pills if you are pregnant or if you have recently had a baby. Do not use this medication if you have any of the following conditions: a history of stroke or blood clot, circulation problems, a hormone-related cancer such as breast or uterine cancer, abnormal vaginal bleeding, liver disease or liver cancer, or a history of jaundice caused by birth control pills.

You may need to use back-up birth control, such as condoms or a spermicide, when you first start using this medication. Follow your doctor's instructions.

Taking hormones can increase your risk of blood clots, stroke, or heart attack, especially if you smoke and are older than 35.

Some drugs can make birth control pills less effective, which may result in pregnancy. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

What should I discuss with my healthcare provider before taking Estrostep Fe (ethinyl estradiol and norethindrone)?

This medication can cause birth defects. Do not use if you are pregnant. Tell your doctor right away if you become pregnant, or if you miss two menstrual periods in a row. If you have recently had a baby, wait at least 4 weeks before taking birth control pills (6 weeks if you are breast-feeding). You should not take birth control pills if you have:

coronary artery disease, a severe or uncontrolled heart valve disorder, untreated or uncontrolled high blood pressure;

a history of a stroke, blood clot, or circulation problems;

a hormone-related cancer such as breast or uterine cancer;

unusual vaginal bleeding that has not been checked by a doctor;

liver disease or liver cancer;

severe migraine headaches; or

a history of jaundice caused by pregnancy or birth control pills.

To make sure you can safely take this medication, tell your doctor if you have any of these other conditions:

high blood pressure or a history of heart disease;

high cholesterol, gallbladder disease, or diabetes;

migraine headaches or a history of depression; or

a history of breast cancer or an abnormal mammogram.

The hormones in birth control pills can pass into breast milk and may harm a nursing baby. This medication may also slow breast milk production. Do not use if you are breast-feeding a baby.

How should I take Estrostep Fe (ethinyl estradiol and norethindrone)?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. Take your first pill on the first day of your period or on the first Sunday after your period begins (follow your doctor's instructions).

You may need to use back-up birth control, such as condoms or a spermicide, when you first start using this medication. Follow your doctor's instructions.

The 28-day birth control pack contains seven "reminder" pills to keep you on your regular cycle. Your period will usually begin while you are using these reminder pills.

You may have breakthrough bleeding, especially during the first 3 months. Tell your doctor if this bleeding continues or is very heavy.

Take one pill every day, no more than 24 hours apart. When the pills run out, start a new pack the following day. You may get pregnant if you do not use this medication regularly. Get your prescription refilled before you run out of pills completely.

The chewable tablet may be chewed or swallowed whole. If chewed, drink a full glass of water just after you swallow the pill.

If you need surgery or medical tests or if you will be on bed rest, you may need to stop using this medication for a short time. Any doctor or surgeon who treats you should know that you are using birth control pills.

Your doctor will need to check your progress on a regular basis. Do not miss any scheduled appointments.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Missing a pill increases your risk of becoming pregnant. If you miss one "active" pill, take two pills on the day that you remember. Then take one pill per day for the rest of the pack.

If you miss two "active" pills in a row in week one or two, take two pills per day for two days in a row. Then take one pill per day for the rest of the pack. Use back-up birth control for at least 7 days following the missed pills.

If you miss two "active" pills in a row in week three, or if you miss three pills in a row during any of the first 3 weeks, throw out the rest of the pack and start a new one the same day if you are a Day 1 starter. If you are a Sunday starter, keep taking a pill every day until Sunday. On Sunday, throw out the rest of the pack and start a new one that day.

If you miss two or more pills, you may not have a period during the month. If you miss a period for two months in a row, call your doctor because you might be pregnant.

If you miss any reminder pills, throw them away and keep taking one pill per day until the pack is empty. You do not need back-up birth control if you miss a reminder pill.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include nausea, vomiting, and vaginal bleeding.

What should I avoid while taking Estrostep Fe (ethinyl estradiol and norethindrone)?

Do not smoke while using birth control pills, especially if you are older than 35. Smoking can increase your risk of blood clots, stroke, or heart attack caused by birth control pills.

Birth control pills will not protect you from sexually transmitted diseases--including HIV and AIDS. Using a condom is the only way to protect yourself from these diseases.

Estrostep Fe (ethinyl estradiol and norethindrone) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using this medication and call your doctor at once if you have any of these serious side effects:

sudden numbness or weakness, especially on one side of the body;

sudden severe headache, confusion, problems with vision, speech, or balance;

sudden cough, wheezing, rapid breathing, coughing up blood;

pain, swelling, warmth, or redness in one or both legs;

chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;

a change in the pattern or severity of migraine headaches;

pain in your upper stomach, jaundice (yellowing of the skin or eyes);

a lump in your breast;

swelling in your hands, ankles, or feet; or

symptoms of depression (sleep problems, weakness, mood changes).

Less serious side effects may include:

mild nausea or vomiting, appetite or weight changes;

breast swelling or tenderness;

headache, nervousness, dizziness;

problems with contact lenses;

freckles or darkening of facial skin, loss of scalp hair; or

vaginal itching or discharge.

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.

What other drugs will affect Estrostep Fe (ethinyl estradiol and norethindrone)?

Some drugs can make ethinyl estradiol and norethindrone less effective, which may result in pregnancy. Before using ethinyl estradiol and norethindrone, tell your doctor if you are using any of the following drugs:

acetaminophen (Tylenol) or ascorbic acid (vitamin C);

bosentan (Tracleer);

prednisolone (Orapred);

St. John's wort;

theophylline (Elixophyllin, Theo-24, Uniphyl);

an antibiotic;

HIV or AIDS medications;

phenobarbital (Solfoton) and other barbiturates; or

seizure medication.

This list is not complete and other drugs may interact with birth control pills. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

More Estrostep Fe resources

Estrostep Fe Side Effects (in more detail)
Estrostep Fe Use in Pregnancy & Breastfeeding
Drug Images
Estrostep Fe Drug Interactions
Estrostep Fe Support Group
0 Reviews for Estrostep Fe - Add your own review/rating

Estrostep Fe Prescribing Information (FDA)

Aranelle Prescribing Information (FDA)

Balziva Prescribing Information (FDA)

Brevicon Prescribing Information (FDA)

Briellyn Prescribing Information (FDA)

Cyclafem 1/35 Prescribing Information (FDA)

Cyclafem 7/7/7 Prescribing Information (FDA)

Femcon FE Prescribing Information (FDA)

Femcon Fe Chewable Tablets MedFacts Consumer Leaflet (Wolters Kluwer)

Femhrt Consumer Overview

Femhrt Prescribing Information (FDA)

Femhrt MedFacts Consumer Leaflet (Wolters Kluwer)

Jevantique Prescribing Information (FDA)

Jinteli Prescribing Information (FDA)

Leena Prescribing Information (FDA)

Lo Loestrin Fe MedFacts Consumer Leaflet (Wolters Kluwer)

Lo Loestrin Fe Consumer Overview

Lo Loestrin Fe Advanced Consumer (Micromedex) - Includes Dosage Information

Lo Loestrin Fe Prescribing Information (FDA)

Loestrin 24 FE Prescribing Information (FDA)

Loestrin 24 Fe Consumer Overview

Loestrin Fe 1/20 MedFacts Consumer Leaflet (Wolters Kluwer)

Ovcon 35 MedFacts Consumer Leaflet (Wolters Kluwer)

Tilia FE Prescribing Information (FDA)

Tri-Norinyl Prescribing Information (FDA)

Zenchent FE Prescribing Information (FDA)

Zeosa Prescribing Information (FDA)

Compare Estrostep Fe with other medications

Abnormal Uterine Bleeding
Acne
Birth Control
Endometriosis
Gonadotropin Inhibition
Menstrual Disorders
Polycystic Ovary Syndrome
Postmenopausal Symptoms
Prevention of Osteoporosis

Where can I get more information?

Your pharmacist can provide more information about ethinyl estradiol and norethindrone.

See also: Estrostep Fe side effects (in more detail)

ETH-Oxydose

Generic Name: oxycodone (ox i KOE done)

Brand Names: Dazidox, OxyCONTIN, Oxyfast, OxyIR, Percolone, Roxicodone, Roxicodone Intensol

What is ETH-Oxydose (oxycodone)?

Oxycodone is a narcotic pain reliever similar to morphine.

Oxycodone is used to treat moderate to severe pain. The extended-release form of this medication is for around-the-clock treatment of pain.

Oxycodone may also be used for purposes not listed in this medication guide.

What is the most important information I should know about ETH-Oxydose (oxycodone)?

Oxycodone may be habit-forming and should be used only by the person it was prescribed for. Keep the medication in a secure place where others cannot get to it. Do not drink alcohol while you are taking oxycodone. Dangerous side effects or death can occur when alcohol is combined with a narcotic pain medicine. Check your food and medicine labels to be sure these products do not contain alcohol. Never take oxycodone in larger amounts, or for longer than recommended by your doctor. Follow the directions on your prescription label. Tell your doctor if the medicine seems to stop working as well in relieving your pain. This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Do not stop using oxycodone suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using oxycodone.

What should I discuss with my healthcare provider before using ETH-Oxydose (oxycodone)?

Do not use this medication if you have ever had an allergic reaction to a narcotic medicine (examples include methadone, morphine, Oxycontin, Darvocet, Percocet, Vicodin, Lortab, and many others), or to a narcotic cough medicine that contains codeine, hydrocodone, or dihydrocodeine.

You should also not take oxycodone if you are having an asthma attack or if you have a bowel obstruction called paralytic ileus.

Oxycodone may be habit forming and should be used only by the person it was prescribed for. Never share oxycodone with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.

To make sure you can safely take oxycodone, tell your doctor if you have any of these other conditions:

asthma, COPD, sleep apnea, or other breathing disorders;

liver or kidney disease;

underactive thyroid;

trouble swallowing, or a blockage in your digestive tract (stomach or intestines);

curvature of the spine;

a history of head injury or brain tumor;

epilepsy or other seizure disorder;

low blood pressure;

gallbladder disease;

Addison's disease or other adrenal gland disorders;

enlarged prostate, urination problems;

mental illness; or

a history of drug or alcohol addiction.

FDA pregnancy category B. Oxycodone is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Oxycodone can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using oxycodone. Older adults may be more likely to have side effects from this medicine.

How should I use ETH-Oxydose (oxycodone)?

Take exactly as prescribed. Never take oxycodone in larger amounts, or for longer than recommended by your doctor. Follow the directions on your prescription label. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

Do not crush, chew, or break an extended-release tablet. Swallow it whole. Breaking the pill may cause too much of the drug to be released at one time. If your doctor has told you to take two or more oxycodone tablets per dose, take the tablets one at a time. Do not wet, presoak, or lick the tablet before placing it in your mouth. Drink plenty of water to make swallowing easier and to prevent choking.

Measure the liquid form of oxycodone with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one.

Drink plenty of water daily to help prevent constipation while you are using oxycodone. Ask your doctor about ways to increase the fiber in your diet. Do not use a stool softener (laxative) without first asking your doctor.

Do not stop using oxycodone suddenly after long-term use, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using oxycodone.

Never crush a tablet or other pill to mix into a liquid for injecting the drug into your vein. This practice has resulted in death with the misuse of oxycodone and similar prescription drugs.

Store at room temperature, away from heat, moisture, and light.

Keep track of the amount of medicine used from each new bottle. Oxycodone is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

Always check your bottle to make sure you have received the correct pills (same brand and type) of medicine prescribed by your doctor. Ask the pharmacist if you have any questions about the medicine you receive at the pharmacy.

After you have stopped using this medication, flush any unused pills down the toilet. Throw away any unused liquid oxycodone that is older than 90 days.

What happens if I miss a dose?

Since oxycodone is taken as needed, you may not be on a dosing schedule. If you are taking the medication regularly, 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.

Extended-release oxycodone is not for use on an as-needed basis for pain.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of oxycodone can be fatal.

Overdose symptoms may include extreme drowsiness, muscle weakness, confusion, cold and clammy skin, pinpoint pupils, shallow breathing, slow heart rate, fainting, or coma.

What should I avoid while using ETH-Oxydose (oxycodone)?

Do not drink alcohol while you are taking this medication. Dangerous side effects or death can occur when alcohol is combined with oxycodone. Check your food and medicine labels to be sure these products do not contain alcohol. Oxycodone may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

ETH-Oxydose (oxycodone) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using oxycodone and call your doctor at once if you have a serious side effect such as:

shallow breathing, slow heartbeat;

seizure (convulsions);

cold, clammy skin;

confusion;

severe weakness or dizziness; or

feeling like you might pass out.

Less serious side effects are more likely to occur, such as:

nausea, vomiting, constipation, loss of appetite;

dizziness, headache, tired feeling;

dry mouth;

sweating; or

itching.

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.

What other drugs will affect ETH-Oxydose (oxycodone)?

Before using oxycodone, tell your doctor if you regularly use other medicines that make you sleepy or slow your breathing (such as cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). Dangerous side effects may result.

Tell your doctor about all other medicines you use, especially:

pentazocine (Talwin);

nalbuphine (Nubain);

butorphanol (Stadol); or

buprenorphine (Buprenex, Subutex).

This list is not complete and other drugs may interact with oxycodone. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

More ETH-Oxydose resources

ETH-Oxydose Side Effects (in more detail)
ETH-Oxydose Use in Pregnancy & Breastfeeding
ETH-Oxydose Drug Interactions
ETH-Oxydose Support Group
0 Reviews for ETH-Oxydose - Add your own review/rating

Eth-Oxydose Advanced Consumer (Micromedex) - Includes Dosage Information

OxyContin Sustained-Release Tablets MedFacts Consumer Leaflet (Wolters Kluwer)

OxyContin Prescribing Information (FDA)

Oxycodone Monograph (AHFS DI)

Oxycodone MedFacts Consumer Leaflet (Wolters Kluwer)

Oxycodone Prescribing Information (FDA)

Oxycontin Consumer Overview

Oxyfast Concentrate MedFacts Consumer Leaflet (Wolters Kluwer)

Roxicodone Prescribing Information (FDA)

Compare ETH-Oxydose with other medications

Pain

Where can I get more information?

Your pharmacist can provide more information about oxycodone.

See also: ETH-Oxydose side effects (in more detail)

Estradiol/Norethindrone Patch (Bi-weekly)

Pronunciation: ES-tra-DYE-ol/nor-ETH-in-drone
Generic Name: Estradiol/Norethindrone
Brand Name: CombiPatch

Estrogens have been reported to increase the chance of womb (endometrial) cancer. Estrogen-containing products should not be used to prevent heart disease or dementia. Estrogen given alone or in combination with another hormone (progestin) for replacement therapy may increase your risk for heart disease (eg, heart attacks), stroke, serious blood clots in the legs (deep vein thrombosis) or lungs (pulmonary embolism), dementia, or breast cancer. These risks appear to depend on the length of time Estradiol/Norethindrone Patch (Bi-weekly) is used and the amount of estrogen per dose. Therefore, Estradiol/Norethindrone Patch (Bi-weekly) should be used for the shortest possible length of time at the lowest effective dose, so that you obtain the benefits and minimize the chance of serious side effects from long-term treatment. Consult your doctor or pharmacist for details.

Estradiol/Norethindrone Patch (Bi-weekly) is used for:

Treating certain symptoms (eg, hot flashes; vaginal itching, burning, or dryness) caused by menopause. It is also used to replace estrogen when your body does not produce enough.

Estradiol/Norethindrone Patch (Bi-weekly) is a combination of progestin and estrogen hormones. It works by replacing natural progestin and estrogen in women who do not produce enough of these hormones.

Do NOT use Estradiol/Norethindrone Patch (Bi-weekly) if:

you are allergic to any ingredient in Estradiol/Norethindrone Patch (Bi-weekly)

you are pregnant or suspect you may be pregnant, have recently given birth or are breast-feeding, have vaginal bleeding of abnormal or unknown cause, or have cancer of the uterus

you have a history of serious blood clots (eg, in the legs, lungs, eyes), liver problems, or breast cancer; you may have breast cancer; or you have cancers that are estrogen-dependent

you have had a recent heart attack or stroke

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

Before using Estradiol/Norethindrone Patch (Bi-weekly):

Some medical conditions may interact with Estradiol/Norethindrone Patch (Bi-weekly). Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

if you are pregnant, planning to become pregnant, or are breast-feeding

if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement

if you have allergies to medicines, foods, or other substances

if you have a family history of breast cancer, or you have breast lumps or disease or an abnormal mammogram

if you have yellowing of the whites of the eyes or skin during pregnancy or with past estrogen use, or high blood pressure during pregnancy (toxemia)

if you have a vaginal infection or womb problems (eg, uterine fibroids/endometriosis, abnormal vaginal bleeding, other uterine problems)

if you have abnormal calcium levels in the blood, asthma, cancer, cholesterol or lipid problems, depression, diabetes, gallbladder disease, heart disease or other heart problems, circulation problems, high blood pressure, kidney or liver disease, low thyroid hormone levels, lupus, the blood disease porphyria, migraine headaches, pancreas disease, seizures, or yellowing of the skin or eyes

if you smoke, are very overweight, or will be having surgery

if you have had your uterus removed (hysterectomy)

Some MEDICINES MAY INTERACT with Estradiol/Norethindrone Patch (Bi-weekly). Tell your health care provider if you are taking any other medicines, especially any of the following:

Azole antifungals (eg, ketoconazole), HIV protease inhibitors (eg, ritonavir), or macrolide antibiotics (eg, clarithromycin) because they may increase the risk of Estradiol/Norethindrone Patch (Bi-weekly)'s side effects

Barbiturates (eg, phenobarbital), carbamazepine, hydantoins (eg, phenytoin), nevirapine, rifampin, or St. John's wort because they may decrease Estradiol/Norethindrone Patch (Bi-weekly)'s effectiveness

Anticoagulants (eg, warfarin), corticosteroids (eg, prednisone), succinylcholine, or tacrine because the risk of their side effects may be increased by Estradiol/Norethindrone Patch (Bi-weekly)

Anticoagulants (eg, warfarin) because their effectiveness may be decreased by Estradiol/Norethindrone Patch (Bi-weekly)

This may not be a complete list of all interactions that may occur. Ask your health care provider if Estradiol/Norethindrone Patch (Bi-weekly) may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Estradiol/Norethindrone Patch (Bi-weekly):

Use Estradiol/Norethindrone Patch (Bi-weekly) as directed by your doctor. Check the label on the medicine for exact dosing instructions.

An extra patient leaflet is available with Estradiol/Norethindrone Patch (Bi-weekly). Talk to your pharmacist if you have questions about this information.

The patch is usually replaced twice a week (about every 3 to 4 days), or as directed by your doctor. Follow the dosing schedule carefully.

Do not open the sealed pouch containing the patch until ready to use. Open the pouch and remove the patch from the protective liner. Apply to an area of clean, dry skin on the lower stomach area below the belly button. Press the patch firmly against the skin for about 10 seconds to be sure the patch stays on. If the system lifts, press down to reapply. Wear only 1 system at any one time.

Do not place the patch on the breast. Make sure the application site is not oily, damaged, or irritated. Avoid applying to the waistline because tight clothing may rub the patch off. Do not put the patch on areas where sitting may loosen it. Do not apply to a site that is exposed to sunlight. Contact with water while bathing, showering, or swimming will not affect the patch.

After removing the used patch, fold it in half with the sticky sides together. Discard the patch out of the reach of children and away from pets.

Apply a new patch to a different area to prevent skin irritation. Use a different site when replacing the patch and do not repeat the same site for at least 1 week. If the area around the patch becomes red, itchy, or irritated, try a new site. If the irritation continues or becomes worse, notify your doctor right away.

Grapefruit and grapefruit juice may increase the risk of side effects from Estradiol/Norethindrone Patch (Bi-weekly). Talk with your doctor before including grapefruit or grapefruit juice in your diet while taking Estradiol/Norethindrone Patch (Bi-weekly).

If you forget to change the patch as scheduled, change it as soon as possible and go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use Estradiol/Norethindrone Patch (Bi-weekly).

Important safety information:

Estradiol/Norethindrone Patch (Bi-weekly) may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Estradiol/Norethindrone Patch (Bi-weekly) with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.

Limit alcoholic beverages.

Estradiol/Norethindrone Patch (Bi-weekly) may cause dark skin patches on your face. Avoid the sun, sunlamps, or tanning booths until you know how you react to Estradiol/Norethindrone Patch (Bi-weekly). Use a sunscreen or wear protective clothing if you must be outside for more than a short time.

Estradiol/Norethindrone Patch (Bi-weekly) may increase the risk of stroke, heart attack, blood clots, high blood pressure, or similar problems. The risk may be greater if you smoke (especially in women older than 35 years old).

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 using Estradiol/Norethindrone Patch (Bi-weekly).

Follow your doctor's instructions for examining your breasts, and report any lumps immediately.

If you wear contact lenses and you develop problems with them, contact your doctor.

If you will be having surgery or will be confined to a chair or bed for a long period of time (eg, a long plane flight), notify your doctor beforehand. Special precautions may need to be taken in these circumstances while you are using Estradiol/Norethindrone Patch (Bi-weekly).

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.

Estradiol/Norethindrone Patch (Bi-weekly) may increase the risk of breast and endometrial cancer.

Diabetes patients - Estradiol/Norethindrone Patch (Bi-weekly) may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.

Estradiol/Norethindrone Patch (Bi-weekly) may interfere with certain lab tests. Be sure your doctor and lab personnel know you are using Estradiol/Norethindrone Patch (Bi-weekly).

Lab tests, including physical exams and blood pressure, may be performed while you use Estradiol/Norethindrone Patch (Bi-weekly). 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. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

Estradiol/Norethindrone Patch (Bi-weekly) should not be used in CHILDREN; safety and effectiveness in children have not been confirmed.

PREGNANCY and BREAST-FEEDING: Do not use Estradiol/Norethindrone Patch (Bi-weekly) if you are pregnant. Avoid becoming pregnant while you are using it. If you think you may be pregnant, contact your doctor right away. It is not known if Estradiol/Norethindrone Patch (Bi-weekly) is found in breast milk after topical use. If you are or will be breast-feeding while you use Estradiol/Norethindrone Patch (Bi-weekly), check with your doctor. Discuss any possible risks to your baby.

Possible side effects of Estradiol/Norethindrone Patch (Bi-weekly):

All medicines may cause side effects, but many people have no, or minor side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Back pain; diarrhea; headache; irregular vaginal bleeding or spotting; mild breast pain; mild hair loss; nausea; runny or stuffy nose; stomach pain, cramps, or bloating; vomiting; weakness.

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); breast lumps; calf pain or tenderness; changes in vision or speech (eg, loss of vision); chest pain; coughing of blood; mental/mood changes (eg, depression, memory loss); pain, swelling, or tenderness in the stomach; severe headache or vomiting; severe or persistent breast pain; severe or unusual vaginal bleeding; sudden shortness of breath; swelling of hands or feet; unusual vaginal discharge, itching, or odor; weakness or numbness of an arm or leg; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include excessive vaginal bleeding; severe nausea; vomiting.

Proper storage of Estradiol/Norethindrone Patch (Bi-weekly):

Store Estradiol/Norethindrone Patch (Bi-weekly) at room temperature, below 77 degrees F (25 degrees C), in the original sealed pouch. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Estradiol/Norethindrone Patch (Bi-weekly) out of the reach of children and away from pets.

General information:

If you have any questions about Estradiol/Norethindrone Patch (Bi-weekly), please talk with your doctor, pharmacist, or other health care provider.

Estradiol/Norethindrone Patch (Bi-weekly) is to be used only by the patient for whom it is prescribed. Do not share it with other people.

If your symptoms do not improve or if they become worse, check with your doctor.

Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Estradiol/Norethindrone Patch (Bi-weekly). If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012

Database Edition 12.1.1.002

More Estradiol/Norethindrone Patch (Bi-weekly) resources

Estradiol/Norethindrone Patch (Bi-weekly) Use in Pregnancy & Breastfeeding
Estradiol/Norethindrone Patch (Bi-weekly) Drug Interactions
Estradiol/Norethindrone Patch (Bi-weekly) Support Group
4 Reviews for Estradiol/Norethindrone (Bi-weekly) - Add your own review/rating

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estrogen and progestin combination (ovarian hormone therapy)

Commonly used brand name(s)

Uses For estrogen and progestin combination (ovarian hormone therapy)

Before Using estrogen and progestin combination (ovarian hormone therapy)

Allergies

Geriatric

Pregnancy

Breast Feeding

Interactions with Medicines

Interactions with Food/Tobacco/Alcohol

Other Medical Problems

Proper Use of estrogen and progestin combination (ovarian hormone therapy)

Dosing

Missed Dose

Storage

Precautions While Using estrogen and progestin combination (ovarian hormone therapy)

estrogen and progestin combination (ovarian hormone therapy) Side Effects

estrogen Vaginal

Commonly used brand name(s)

Uses For estrogen

Before Using estrogen

Allergies

Pediatric

Geriatric

Pregnancy

Breast Feeding

Interactions with Medicines

Interactions with Food/Tobacco/Alcohol

Other Medical Problems

Proper Use of estrogen

Dosing

Missed Dose

Storage

Precautions While Using estrogen

estrogen Side Effects

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Estradiol/Norethindrone Patch (Bi-weekly)

Estradiol/Norethindrone Patch (Bi-weekly) is used for:

Do NOT use Estradiol/Norethindrone Patch (Bi-weekly) if:

Before using Estradiol/Norethindrone Patch (Bi-weekly):