Estrapak

What is it?

A combined oestrogen/ progestogen preparation available as a patch containing 50g oestradiol per 24 hours, and as red tablets, marked CG and LK, containing 1 mg norethisterone acetate.

Medical Uses

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

Dosage

Women only, apply patch to hairless skin below waist and replace with new patch in different site every 3 to 4 days. Take 1 tablet each day starting on 15th day through to 26th day of each period of 28 days of oestrogen replacement therapy. Therapy should begin within 5 days of the start of the period if this is present.

Special Care

Patients with a history, or considered to be at risk, of thrombosis, those with liver disease. Liver function should be monitored and breasts and pelvic organs examined periodically during the period of therapy. Women should self-examine breasts and take part in breast and cervical screening programmes. Women with any of the following require particularly careful monitoring: diabetes, kidney disorders, fibroids in uterus, multiple sclerosis, asthma, hypertension, tctany, epilepsy, SLE (systemic lupus crythematosus), nodules in breasts, porphyria, (inherited disorder involving porphyrins), gallstones, migraine, hypercalcaemia (raised blood calcium levels), otosclerosis, history of breast cancer (slight increased risk). If persistent breakthrough bleeding occurs, this should be reported and investigated, as necessary.

Avoid Use

Pregnancy, breast-feeding, thrombosis or thromboembolic disorders, serious heart, kidney or liver disease, endometriosis or vaginal bleeding which is undiagnosed, hormone- dependent cancers such as breast or uterine carcinoma, Dubin-Johrison or Rotor syndrome.

Possible Drug and Food Interactions

Drugs which induce liver enzymes.

Known Side Effects

Enlargement of and soreness in breasts, breakthrough bleeding, vomiting, nausea, gastro-intestinal disturbance, liver dysfunction, gain in weight, dizziness, headache, cholestatic jaundice, worsening varicose veins, nosebleeds, short-lived reddening of skin, itching, decreased glucose tolerance. Withdraw immediately if frequent, severe headaches or migraines occur, disordered vision, pregnancy, severe rise in blood pressure, hepatitis, frequent seizures, whole body itching, signs of thromboembolism, jaundice. Stop 6 weeks before planned surgery.