Common use

Estriol Cream is a female hormone that is estrogen-like in nature. It is uses include managing vaginal dryness, irritation, and inflammation in postmenopausal women, maintaining bone mineral density to prevent or treat postmenopausal osteoporosis, and relieving urinary symptoms like frequent urination, incontinence, and recurrent infections in postmenopausal women.

Dosage and direction

Always use this medicine exactly as your doctor or pharmacist has told you. The usual dose is 1 applicator up to the ring (0.5 mg estriol in 0.5 g of cream) a day for the first 2 to 3 weeks (maximally 4 weeks). Then the dose is 1 applicator up to the ring twice a week. Use the applicator to apply the cream in the vagina. A good time to do this is before going to bed. The applicator has a ring marked on the body. Fill the applicator up to the ring mark with this medicine to get the correct dose.

Precautions

Tell your doctor if you have ever had any of the following problems, before you start the treatment, as these may return or become worse during treatment with this medicine. If so, you should see your doctor more often for check-ups: fibroids inside your womb; growth of womb lining outside your womb (endometriosis) or a history of excessive growth of the womb lining (endometrial hyperplasia); increased risk of developing blood clots (see “Blood clots in a vein (thrombosis)”); increased risk of getting an estrogen-sensitive cancer (such as having a mother, sister or grandmother who has had breast cancer); high blood pressure; a liver disorder, such as a benign liver tumor; diabetes; gallstones; migraine or severe headaches; a disease of the immune system that affects many organs of the body (systemic lupus erythematosus, SLE); epilepsy; asthma; a disease affecting the eardrum and hearing (otosclerosis); fluid retention due to cardiac or kidney problems; hereditary and acquired angioedema.

Contraindications

Do not use this medicine:If you have or have ever had breast cancer, or if you are suspected of having it; If you have cancer which is sensitive to estrogens, such as cancer of the womb lining (endometrium), or if you are suspected of having it; If you have any unexplained vaginal bleeding; If you have excessive thickening of the womb lining (endometrial hyperplasia) that is not being treated; If you have or have ever had a blood clot in a vein (thrombosis), such as in the legs (deep venous thrombosis) or the lungs (pulmonary embolism); If you have a blood clotting disorder (such as protein C, protein S, or antithrombin deficiency); If you have or recently have had a disease caused by blood clots in the arteries, such as a heart attack, stroke or angina; If you have or ever have had a liver disease and your liver function tests have not returned to normal; If you have a rare blood problem called “porphyria” which is passed down in families (inherited); If you are allergic (hypersensitive) to estriol or any of the other ingredients of this medicine (listed in section 6 Contents of the pack and further information); If any of the above conditions appear for the first time while using this medicine, stop taking it at once and consult your doctor immediately.

Possible side effect

See your doctor straight away, if you notice any of the following serious side effects – your doctor may decide to stop you using the cream: your blood pressure rises; your skin or the whites of your eyes go yellow (jaundice); you suddenly have migraine-type headaches; you have signs of a blood clot.
Other side effects include: irritation or itching of the skin in or around your vagina when you start to use this medicine; increased vaginal discharge, bleeding or spotting; gall bladder problems; skin problems such as a rash or an allergy to the sun; breasts become swollen, tender or painful; headaches; feeling sick or being sick; flu-like symptoms.

Drug interaction

This medicine may interact with anticoagulants (such as warfarin and heparin), antiplatelet agents (like aspirin and clopidogrel), antidiabetic medications (including metformin and insulin), antihypertensives (such as amlodipine and lisinopril), corticosteroids (including prednisone), immunosuppressants like cyclosporine and tacrolimus, seizure medications including lamotrigine, thyroid hormones like levothyroxine, and bronchodilators such as theophylline.

Missed dose

If you miss a dose of Estriol Cream, take it as soon as you remember. However, if it is nearly time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for the forgotten one.

Overdose

An overdose of Estriol Cream may lead to excessively high estrogenic effects such as severe nausea, vomiting, and vaginal bleeding. If you experience these symptoms, it is crucial to seek medical assistance promptly.

Storage

Keep out of the reach and sight of children. Do not use this medicine after the "use by" date on the pack. Do not store above 25°C. Do not freeze.