Estraderm

Generic Name: Oestradiol
Product Name: Estraderm

Indication

Estraderm is a transdermal patch containing the female hormone oestradiol (oestrogen). Estraderm is used as hormone replacement therapy in women deficient in oestrogen as a result of menopause. Estraderm is useful for short-term treatment of menopausal symptoms (e.g. hot flushes, night sweats and irritability) and preventing the development of osteoporosis (brittle bones due to a reduction in bone density) in post-menopausal women.

Action

Oestradiol is the primary sex hormone found in females. Following menopause, the body is unable to produce the same levels of oestradiol, which produces post-menopausal symptoms such as hot flushes, sleep disturbances, irritability, vaginal dryness and decreased libido. Many women also develop osteoporosis (brittle bones as a result of a loss in bone density) due to a lack of oestrogen in the body. Estraderm is a transdermal patch system that is designed to deliver oestrogen into the body in order to replace oestrogen that the body can no longer produce. This relieves menopausal symptoms and prevents the development of osteoporosis.

Dose advice

• Estraderm is available only on prescription through your doctor.
• Always tell your doctor you are being treated with Estraderm before being prescribed other medication or purchasing over the counter medicines.
• Estraderm should not be used in patients with certain medical conditions – be sure to tell your doctor if you suffer from any medical conditions before being prescribed Estraderm.
• Estraderm should not be used in patients who are pregnant (ADEC Pregnancy Category B1) or breastfeeding – always tell your doctor you are pregnant or breast feeding before using Estraderm.
• Estraderm should be applied to clean, dry skin on the lower abdomen, lower back or buttock region. Application to the buttocks may cause less skin irritation.
• Estraderm should never be applied to the breasts.
• Bathing, showering and swimming should not affect the adhesive lining of the patch. Should the patch fall off, it can be reapplied to the same site.
• Estraderm patches should not be applied to the same site twice in succession (in order to prevent skin irritation).
• Estraderm patches should never be cut or torn.
• Applied Estraderm patches should not be exposed to direct sunlight or worn in a solarium.
• Seek urgent medical attention if you develop signs of red, swollen or painful legs, or sudden onset of difficulty in breathing or chest pain.
• Tell your doctor immediately if you develop changes in your breasts – check your breasts regularly for signs of lumps or skin/nipple changes.
• Tell your doctor immediately if you develop changes in vaginal bleeding after starting hormone replacement therapy (e.g. heavy or irregular bleeding, or bleeding after sex).

Schedule

Schedule 4

Common side effects

All medicines may cause side effects. Your doctor has weighed the risks against the benefits of you taking Estraderm. Consult your doctor if any of the below side effects concern you. The following side effects occur in 1% or more of patients taking Estraderm:

• Skin irritation and redness at application site
• Headache
• Change in mood
• Change in libido
• Weight change
• Irregular or abnormal vaginal bleeding
• Leg cramps
• Dry eyes (in patients using oestrogen-only hormone replacement therapy)

Uncommon side effects

Hormone replacement therapy has been shown to carry a small but increased risk of blood clotting disorders (including deep vein thrombosis, heart attack, pulmonary embolism (PE) and stroke). Your doctor has carefully weighed the risks against the benefits of you undertaking hormone replacement therapy.

It is important for you to be able to recognize these rare but serious side effects. Signs and symptoms of deep vein thrombosis, heart attack, pulmonary embolism and stroke include:

• Deep vein thrombosis: red, swollen or painful legs or arms.
• Pulmonary embolism: sudden onset of difficulty breathing, chest pain and coughing.
• Heart attack: sudden onset of chest pain, shortness of breath, loss of consciousness, heart palpitations or confusion.
• Stroke: confusion, inability to speak, memory loss, loss of sensation or strange sensations down one side of the body, loss of consciousness.

Hormone replacement therapy has also been associated with an increased risk of developing certain cancers, including breast and ovarian cancers. Hormone replacement therapy should be used for the shortest possible duration to minimize the risk of developing cancers. Women should examine their breasts at regular intervals for signs of changes.

Abnormal or irregular vaginal bleeding should be reported to your doctor as soon as possible while undertaking hormone replacement therapy.

References

1. Australian Medicines Handbook 2007, Adelaide, Pharmaceutical Society of Australia, 2007.
2. MIMS Online. [Monograph online] MIMS Australia Pty Ltd 2003. [Cited December 9, 2007]. Available from: [URL Link]
3. Golan DE, Tashjian AH, Armstrong EJ, Galanter JM, Armstrong AW, Arnout RA, Rose HS. Principles of Pharmacology; The Pathophysiologic Basis of Drug Therapy. Philadelphia: Lippincott Williams & Wilkins; 2005.
4. Lazo J, Gilman A, Brunton L et al. Goodman & Gilman’s The Pharmacological Basis of Therapeutics. 11th ed. New York: McGraw-Hill; 2006.

For further information talk to your doctor.