II. Indications
-
Osteoporosis Prevention in postmenopausal women (Estraderm or Estrasorb)
- As of 2015, Estrogen is not recommended by ACOG or AAFP for chronic condition prevention
- Hot Flashes (Evanmist, Estrogel, Elestrin, Divigel)
III. Advantages
- Studies suggest no increased Thromboembolism risk
IV. Efficacy: Osteoporosis Prevention (Estraderm or Estrasorb)
-
Placebo
- Hip BMD: 2.04% loss
- Lumbar Spine BMD: 2.49% loss
- Dose: 0.025 mg estradiol patch
- Hip BMD: 0.26% gain
- Lumbar Spine BMD: 2.37% gain
- Dose: 0.05 mg estradiol patch
- Hip BMD: 2.85% gain
- Lumbar Spine BMD: 4.09% gain
- Dose: 0.06 mg estradiol patch
- Hip BMD: 3.05% gain
- Lumbar Spine BMD: 3.28% gain
- Dose: 0.1 mg estradiol patch
- Hip BMD: 2.03% gain
- Lumbar Spine BMD: 4.70% gain
- References
V. Preparations: Transdermal Combination Progesterone and Estrogen
- Activella (17B-Estradiol-Norethindrone Acetate)
- Contains 1 mg Estradiol with 0.5 mg Norethindrone
- Climara Pro (17B-Estradiol-Levonorgestrel)
- Patch contains 0.045 mg estradiol with 0.015 Levonorgestrel
- Patch applied weekly
- Combipatch (17B-Estradiol-Norethindrone Acetate)
- Patch contains 0.05 mg estradiol with 0.014 or 0.25 mg Norethindrone
- Patch applied twice weekly
VI. Preparations: Agents used for Osteoporosis (Transdermal Estradiol)
- Preparations must be taken with Progesterone if Uterus intact (Endometrial Hyperplasia risk)
- Estrasorb (Transdermal Estradiol)
- Two foil packs equivalent to 0.05 mg Estradiol
- Rub one packet on right top of thigh, back of calf
- Repeat with second packet on left leg
- Do not apply with Sunscreen (increases absorption)
- Estraderm (Transdermal Estradiol Patch)
VII. Preparations: Agents used for Menopausal Hot Flashes (Transdermal Estradiol)
- Preparations must be taken with Progesterone if Uterus intact (Endometrial Hyperplasia risk)
- Evanmist
- Dosing: 1-3 sprays per day on inner Forearm to adjacent areas (not overlapping)
- Allow skin to dry for 30 minutes
- Estrogel (0.06% estradiol)
- Pump delivers 0.75 mg of estradiol (64 actuations per device)
- Apply gel from one wrist to the Shoulder, spreading thinly
- Elestrin (0.06% estradiol)
- Pump delivers 0.52 mg of estradiol (100 actuations per device)
- Apply to upper arm and Shoulder
- Allow to dry for 2 hours before immersing in water (e.g. swimming)
- Divigel (0.1% estradiol)
- Foil packet delivers either 0.25 mg, 0.5 mg or 1.0 mg estradiol per packet
- Apply packet contents to one upper thigh (5x7 inch area)
- Alternate to opposite side on subsequent application days
- Allow to dry for 1 hour before washing the area
Images: Related links to external sites (from Bing)
Related Studies (from Trip Database) Open in New Window
| elestrin (on 10/19/2016 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| ELESTRIN 0.06% GEL | $3.42 per gram | |
| divigel (on 2/3/2017 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| DIVIGEL 0.25 MG GEL PACKET | $3.73 each | |
| DIVIGEL 0.5 MG GEL PACKET | $3.67 each | |
| DIVIGEL 1 MG GEL PACKET | $3.72 per gram | |
| minivelle (on 2/22/2017 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| MINIVELLE 0.025 MG PATCH | $17.77 each | |
| MINIVELLE 0.0375 MG PATCH | $17.97 each | |
| MINIVELLE 0.05 MG PATCH | $18.03 each | |
| MINIVELLE 0.075 MG PATCH | $18.03 each | |
| MINIVELLE 0.1 MG PATCH | $18.03 each | |
Ontology: Estraderm (C0720290)
| Concepts | Pharmacologic Substance (T121) , Hormone (T125) , Steroid (T110) |
| English | Estraderm, estraderm |
Ontology: Estrasorb (C1320235)
| Concepts | Steroid (T110) , Pharmacologic Substance (T121) , Hormone (T125) |
| SnomedCT | 406454003 |
| English | estrasorb, Estrasorb (product), Estrasorb |
| Spanish | Estrasorb (producto), Estrasorb |
Ontology: transdermal estrogen (C1831768)
| Definition (NCI) | A transdermal formulation containing the synthetic form of estradiol, the most potent, endogenously produced estrogen. Upon topical administration, estradiol diffuses through the cell membrane and binds to and activates specific intracellular estrogen receptors located on estrogen-responsive tissues, including the reproductive tract, breast, pituitary, hypothalamus, liver, and bone. The activated ligand-receptor complex binds to estrogen response elements on DNA and promotes the transcription of genes involved in the functioning of the female reproductive system and secondary sex characteristics. In addition, estradiol inhibits the pituitary secretion of the gonadotropins luteinizing hormone (LH) and follicle stimulating hormone (FSH) through a negative feedback mechanism. |
| Definition (PDQ) | A transdermal formulation containing the synthetic form of estradiol, the most potent, endogenously produced estrogen. Upon topical administration, estradiol diffuses through the cell membrane and binds to and activates specific intracellular estrogen receptors located on estrogen-responsive tissues, including the reproductive tract, breast, pituitary, hypothalamus, liver, and bone. The activated ligand-receptor complex binds to estrogen response elements on DNA and promotes the transcription of genes involved in the functioning of the female reproductive system and secondary sex characteristics. In addition, estradiol inhibits the pituitary secretion of the gonadotropins luteinizing hormone (LH) and follicle stimulating hormone (FSH) through a negative feedback mechanism. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=472200&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=472200&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C61440" NCI Thesaurus) |
| Concepts | Pharmacologic Substance (T121) , Steroid (T110) , Hormone (T125) |
| English | transdermal estrogen, Transdermal Estrogen, Estrodiol Gel |
