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Estrogens

Systems	Reproductive and endocrine system.
Category	Hormones

Pharmacokinetics

Both synthetic and natural estrogens can be absorbed via the skin and mucous membranes and produce systemic effects. Natural estrogens are inactive orally due to rapid metabolism in liver. Estradiol esters injected I.M are slowly absorbed and exert prolonged action. Ethinylestradiol and stilbestrol are metabolised very slowly-orally active and more potent.

Indications

Estrogen may relieve the postmenopausal symptoms, such as hot flushes and unusual sweating, chills, faintness, or dizziness. Estrogen is used in the following: senile vaginitis, delayed puberty in girls, postmenopausal osteoporosis, contraceptives[commonest use], dysmenorrhea, acne, hirsutism and dysfunctional uterine bleeding.

Routes of Administration and Dosage

Estradiol, micronized 1 mg, 2mg tablets orally. Injection 1mg/ml in 10 ml vials. Ethinyl estradiol: prostrate cancer = 1-2 mg daily. Diethylstilbesterol dipropionate: 0.5 - 5 mg daily.

Contra Indications

Estrogens are contraindicated in patients with markedly impaired liver fuction, family history of malignancy (breast and genitals), undiagnosed vaginal bleeding, pregnancy, estrogen dependent neoplasia and in hypersensitivity.

Precautions

Special precautions have to be taken in patients with asthma, epilepsy, migraine, cardiovascular disorders, renal dysfunction, diabetes, pregnancy,lactation,hypercalcemia and in gall bladder disease

Interactions

Acetaminophen, Amiodarone, anabolic steroids, Antithyroid agents, Daunorubicin, Disulfiram, Gold salts, Hydroxychloroquine, Mercaptopurine, Methotrexate, Methyldopa, Phenothiazines, Plicamycin, Valproic acid : estrogens used with these drugs can cause hepatic damage. Cyclosporine: Estrogens can increase the chances of toxic effects in the kidney or liver from cyclosporine because estrogens can interfere with the body's ability to extract the cyclosporine from the blood.

Brand Names

LYNORAL (Infar), NC NORM E (Unicure), PROGYNON-C (German Remedies)