Before Using

Drug information provided by: Merative, Micromedex®

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of estradiol vaginal gel, insert, or ring in the pediatric population. Use of estradiol vaginal gel, insert, or ring is not indicated for use in children.

Geriatric

Although appropriate studies on the relationship of age to the effects of estradiol vaginal gel, insert, or ring have not been performed in the geriatric population, no geriatric-specific problems have been documented to date. However, elderly patients are more likely to have breast cancer, strokes, or dementia, which may require caution in patients receiving estradiol vaginal gel, insert, or ring.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Tranexamic Acid

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Abametapir
  • Amifampridine
  • Amoxicillin
  • Ampicillin
  • Amprenavir
  • Apalutamide
  • Aprepitant
  • Armodafinil
  • Artemether
  • Bacampicillin
  • Belzutifan
  • Betamethasone
  • Bexarotene
  • Bosentan
  • Bupropion
  • Carbamazepine
  • Carbenicillin
  • Cefaclor
  • Cefadroxil
  • Cefdinir
  • Cefditoren
  • Cefixime
  • Cefpodoxime
  • Cefprozil
  • Ceftazidime
  • Ceftibuten
  • Cefuroxime
  • Cenobamate
  • Ceritinib
  • Clarithromycin
  • Clobazam
  • Cloxacillin
  • Colesevelam
  • Conivaptan
  • Cyclacillin
  • Cyclosporine
  • Dabrafenib
  • Darunavir
  • Dexamethasone
  • Dicloxacillin
  • Donepezil
  • Doxycycline
  • Efavirenz
  • Elagolix
  • Elvitegravir
  • Enasidenib
  • Encorafenib
  • Enzalutamide
  • Eslicarbazepine Acetate
  • Etravirine
  • Fedratinib
  • Fexinidazole
  • Fosamprenavir
  • Fosaprepitant
  • Fosnetupitant
  • Fosphenytoin
  • Griseofulvin
  • Guar Gum
  • Isotretinoin
  • Itraconazole
  • Ivosidenib
  • Lesinurad
  • Lixisenatide
  • Lorlatinib
  • Lumacaftor
  • Mavacamten
  • Meropenem
  • Minocycline
  • Mitapivat
  • Mitotane
  • Mobocertinib
  • Modafinil
  • Mycophenolate Mofetil
  • Mycophenolic Acid
  • Nafcillin
  • Nelfinavir
  • Netupitant
  • Nevirapine
  • Octreotide
  • Oxacillin
  • Oxcarbazepine
  • Oxytetracycline
  • Penicillin G
  • Penicillin G Procaine
  • Penicillin V
  • Phenobarbital
  • Phenylbutazone
  • Phenytoin
  • Pitolisant
  • Pixantrone
  • Prednisolone
  • Prednisone
  • Primidone
  • Repotrectinib
  • Rifabutin
  • Rifampin
  • Rifapentine
  • Ritonavir
  • Rufinamide
  • Secobarbital
  • Somatrogon-ghla
  • St John's Wort
  • Sugammadex
  • Sultamicillin
  • Tazemetostat
  • Telaprevir
  • Tetracycline
  • Theophylline
  • Ticarcillin
  • Tigecycline
  • Tirzepatide
  • Tizanidine
  • Topiramate
  • Ulipristal
  • Valproic Acid

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Atazanavir
  • Diazepam
  • Ginseng
  • Lamotrigine
  • Levothyroxine
  • Licorice
  • Lorazepam
  • Selegiline
  • Tacrine
  • Temazepam
  • Tipranavir
  • Triazolam
  • Troleandomycin
  • Voriconazole
  • Warfarin

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

  • Caffeine

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Abnormal or unusual vaginal bleeding or
  • Blood clots (eg, deep vein thrombosis, pulmonary embolism), active or history of or
  • Breast cancer, known or suspected, or a history of or
  • Heart attack, active or history of or
  • Liver disease or
  • Protein C, protein S, or other known blood clotting disorders or
  • Stroke, active or history of or
  • Surgery with a long period of inactivity or
  • Tumors (estrogen-dependent), known or suspected—Should not be used in patients with these conditions.
  • Angioedema or anaphylaxis—Should not be used in patients who have experienced these conditions with previous use of estradiol vaginal ring and insert.
  • Asthma or
  • Cancer, history of or
  • Diabetes or
  • Edema (fluid retention or body swelling) or
  • Endometriosis or
  • Epilepsy (seizures) or
  • Gallbladder disease or
  • Hereditary angioedema (swelling of the face, lips, tongue, or throat) or
  • Hypercalcemia (high calcium in the blood) or
  • Hypertension (high blood pressure) or
  • Hypertriglyceridemia (high triglycerides or fats in the blood) or
  • Hypocalcemia (low calcium in the blood) or
  • Hypothyroidism (an underactive thyroid) or
  • Jaundice during pregnancy or from using hormonal therapy in the past or
  • Liver tumors or
  • Migraine headache or
  • Porphyria (an enzyme problem) or
  • Systemic lupus erythematosus (SLE)—Use with caution. May make these conditions worse.