Estracombi

What is it?

A combined oestrogen, progestogen preparation available in the form of patches delivering either 50µg oestradiol per 24 hours, or 50µg of oestradiol and 250µg of norethisterone acetate per 24 hours, marked CG EFE and CG FNF, respectively.

Medical Uses

Hormone replacement therapy for menopausal women. Prevention of osteoporosis after the menopause.

Dosage

Patch is applied to hairless skin below waist twice and changed every 3 to 4 days, being placed on a different area of skin each time. Start with oestradiol-only patch and apply twice weekly for two weeks, then use combined patch, in same way, for 2 weeks.

Special Care

Patients considered to be at risk of thrombosis, those with diabetes, epilepsy, hypertension, multiple sclerosis, migraine, fibroids in uterus, fibrocystic disease, breast nodules, osteosclerosis, tetany, liver disease (monitor liver function), porphyria, kidney disorder, cholelithiasis. All this group should be monitored closely. Regular examination of breasts and pelvic organs should be carried out and blood pressure checked. Persistent breakthrough bleeding. Women should self-examine breasts, attend for mammography (if applicable) and have cervical smear tests.

Avoid Use

Pregnancy, breast-feeding, hormone-dependent cancers, breast or uterus cancer, endometriosis, undiagnosed vaginal bleeding. Serious heart, kidney or liver disease, thrombophlebitis and thromboembolic diseases. Patients suffering from Dublin- Johnson syndrome or Rotor syndrome.

Possible Drug and Food Interactions

Drugs which induce liver enzymes.

Known Side Effects

Weight gain, enlargement and tenderness of breasts, fluid retention, cramps, gastro-intestinal upset, nausea and vomiting, headaches, breakthrough bleeding, dizziness. Cholestatic jaundice, effects on liver function, migraine, nose bleeds, worsening of varicose veins, lowered glucose tolerance, itching and reddening of skin (usually short-lived). Withdraw if migraines or other severe headaches occur for first time, or serious vision disturbances, signs of thromboembolic disorders, seizures, jaundice, hepatitis, serious, whole body itching, pregnancy. Stop 6 weeks before planned surgery or prolonged immobilisation.