Elestrin Gel: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Elestrin Gel contains estradiol 0.06%, a form of estrogen delivered through a non-aerosol, metered-dose pump. It is used to reduce moderate to severe hot flashes after menopause by replacing estrogen the body stops making in sufficient amounts. It is applied once daily to the upper arm and comes with specific precautions due to risks linked to estrogen therapy.

What is Elestrin Gel

Elestrin is a gel containing estradiol 0.06%, packaged in a non-aerosol, metered-dose pump. Estradiol is a form of estrogen, a female sex hormone normally made in the ovaries that controls many processes in the body.

Elestrin Gel uses

• Reducing moderate to severe hot flashes after menopause

Benefits of Elestrin Gel

• Helps relieve moderate to severe hot flashes associated with menopause.
• Helps reduce night sweats and other vasomotor symptoms.
• Replaces some of the estrogen lost after menopause.
• Can help improve sleep and daily comfort when symptoms are related to low estrogen.
• Provides transdermal estradiol therapy, allowing estrogen to be absorbed through the skin.

How Elestrin Gel works

Elestrin contains man-made estradiol, a form of estrogen the body naturally makes. During menopause, estrogen levels fall, causing hot flashes and night sweats. Elestrin works by replacing this estrogen to relieve those symptoms.

Elestrin Gel dosage

Use exactly as prescribed by your doctor and follow all directions on your prescription label. Do not use in larger or smaller amounts or for longer than recommended. Follow the patient instructions that come with the gel pump, including how to prime it before first use.

Apply only to clean, dry, unbroken skin. Do not apply to skin that is red or irritated. Never apply to the breasts. Apply once daily to the upper arm using the metered-dose pump, at the same time each day. Do not rub the gel in. Let it dry on your skin for at least 5 minutes before dressing. Wash your hands with soap and water after applying the gel.

Avoid letting other people, especially children, come into contact with skin where you applied the gel. If contact happens, wash the area thoroughly with soap and water. Cover treated skin with clothing to protect others from contact.

Apply the gel after your bath or shower, and wait a while before swimming, since washing the area too soon can reduce how much medicine your body absorbs. Wait at least 25 minutes after applying before putting on sunscreen on the same area, and avoid using sunscreen there too often since it can increase absorption. Avoid getting the gel in your eyes; rinse with water if this happens.

If you miss a dose, apply it as soon as you remember, but if it has been more than 12 hours, skip that dose. Do not use extra medicine to make up for a missed dose.

Your doctor should check your progress regularly, generally every 3 to 6 months, to see if you should keep using this medicine. Self-examine your breasts for lumps monthly, and get regular mammograms while using this medicine.

If you need surgery, medical tests, or bed rest, you may need to stop using this medicine for a short time; tell any treating doctor or surgeon that you use estradiol. The gel is flammable, so avoid fire, flames, or smoking until the application site has dried.

Available forms and strengths

• Gel (metered-dose pump), estradiol 0.06%

Side effects of Elestrin Gel

Common

• Breast pain
• Headache
• Vaginal itching or discharge
• Changes in menstrual periods, light vaginal bleeding or spotting
• Thinning scalp hair
• Nausea, vomiting, bloating, stomach cramps
• Common cold symptoms
• Abnormal vaginal bleeding
• Breast tenderness
• Upper respiratory tract infection
• Vaginal yeast infection
• High blood pressure
• Dizziness
• Mood changes
• Weight changes
• Changes in sex drive

Serious

• Heart attack symptoms - chest pain or pressure, pain spreading to jaw or shoulder, nausea, sweating
• Signs of a blood clot - sudden numbness or weakness, sudden vision loss, slurred speech, stabbing chest pain, coughing up blood, pain or warmth in one or both legs
• Swelling or tenderness in the stomach, severe stomach pain spreading to the back, nausea and vomiting
• Jaundice (yellowing of the skin or eyes)
• Memory problems, confusion, unusual behavior
• Unusual vaginal bleeding, pelvic pain
• A lump in the breast
• High calcium levels - confusion, tiredness, nausea, vomiting, loss of appetite, constipation, increased thirst or urination, weight loss
• Signs of an allergic reaction - hives, difficulty breathing, swelling of face, lips, tongue, or throat

Warnings and precautions

• Do not use Elestrin if you are pregnant or may become pregnant. Use effective birth control while using this medicine.
• Estradiol can pass into breast milk and may harm a nursing baby, and may also slow breast milk production. Do not use Elestrin if you are breastfeeding.
• Fluid retention can occur, especially in people with kidney problems. Tell your doctor if you have kidney disease.
• You should not use Elestrin if you have liver disease, since the liver processes this medicine and liver problems can increase side effects.
• Do not use Elestrin if you have undiagnosed vaginal bleeding, liver disease, bleeding problems, an increased risk of blood clots, if you will have major surgery, or if you have ever had a heart attack, stroke, blood clot, or cancer of the breast, uterus/cervix, or vagina.
• This medicine may increase your risk of a condition that can lead to uterine cancer. Report any unusual vaginal bleeding to your doctor right away.
• Using this medicine can increase your risk of blood clots, stroke, heart attack, or cancer of the breast, uterus, or ovaries. It should not be used to try to prevent heart disease, stroke, or dementia.
• The medicine is absorbed through the skin and can cause side effects, including early puberty, in a child who comes into contact with treated skin.
• Estrogens like this medicine can raise the risk of serious blood clots that can be life-threatening, in the brain, eyes, heart, lungs, or legs.
• This medicine can thicken the lining of the uterus, which can lead to uterine (endometrial) cancer. Taking a progestin along with it can help lower this risk.
• There is a higher risk of breast cancer when taking this medicine together with a progestin, and the risk increases the longer it is used.
• People using this type of hormone therapy may have a higher risk of dementia, especially if treatment starts after age 65.
• This medicine can cause gallbladder and liver problems, and some people have needed gallbladder surgery after starting it.

Storage

• Store at 20–25°C (68–77°F) at controlled room temperature.
• Keep the pump container tightly closed and in its original packaging.
• Protect from excessive heat, moisture, and direct sunlight.
• Keep away from open flames, sparks, and smoking, as the gel is alcohol-based and flammable until dry.
• Keep out of reach and sight of children and pets.

When to see a doctor

• Get emergency medical help right away if you have signs of an allergic reaction: hives, difficulty breathing, or swelling of your face, lips, tongue, or throat.
• Stop using this medicine and call your doctor right away if you have symptoms of a heart attack, such as chest pain or pressure, pain spreading to your jaw or shoulder, nausea, or sweating.
• Get medical help right away if you have signs of a blood clot, such as sudden numbness or weakness, sudden vision loss, slurred speech, stabbing chest pain, coughing up blood, or pain or warmth in one or both legs.
• Call your doctor if you have jaundice (yellowing of the skin or eyes), memory problems, confusion, unusual behavior, unusual vaginal bleeding, pelvic pain, or a lump in your breast.
• Contact your doctor if you have signs of high calcium levels, such as confusion, tiredness, nausea, vomiting, loss of appetite, constipation, increased thirst or urination, or weight loss.
• Call your doctor if a child who has close contact with you develops swollen nipples or enlarged breasts.

Alternatives

• Vivelle-Dot
• Climara
• EstroGel (Estradiol Gel)
• Divigel