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Depo-Estradiol
estradiol cypionate
Black Box Warnings .
Endometrial Cancer Risk
unopposed estrogen use incr. risk if intact uterus; adding progestin may decr. risk of endometrial hyperplasia (possible precursor to endometrial CA); use adequate diagnostic measures such as endometrial sampling to rule out malignancy if undiagnosed persistent or recurrent abnormal genital bleeding
Cardiovascular and Other Risks
estrogens +/- progestins not indicated for cardiovascular dz or dementia prevention; incr. risk of stroke and DVT (from WHI estrogen-alone substudy) and MI, stroke, PE/DVT, and invasive breast CA (from WHI estrogen/progestin substudy) in postmenopausal women; incr. risk of probable dementia in postmenopausal women 65 yo and older on a WHI regimen x4-5y; WHI regimens = conj. estrogens 0.625 mg/day w/ or w/o medroxyprogesterone 2.5 mg/day, other doses or estrogen/progestin combos not studied, but assume similar risk; use lowest effective estrogen dose, shortest duration based on individual tx goals and risks
Adult Dosing .
Dosage forms: INJ: 5 mg per mL
vasomotor sx, mod-severe menopausal
- [1-5 mg IM q3-4wk]
- Info: add progestin x10-14 days/4wk cycle if intact uterus; use lowest effective estrogen dose, shortest effective tx duration
hypoestrogenism, hypogonadal
- [1.5-2 mg IM q4wk]
- Info: add progestin x10-14 days/4wk cycle if intact uterus
transgender hormone therapy, feminizing (off-label)
- [2-10 mg IM qwk]
- Info: adjust dose based on pt tx goals, clinical response, and estradiol levels; refer to WPATH or Endocrine Society guidelines
renal dosing
- [see below]
- renal dz: not defined, caution advised
- HD/PD: not defined, caution advised
hepatic dosing
- [see below]
- hepatic impairment: contraindicated
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.