Before Using

Drug information provided by: Merative, Micromedex®

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to medicines in this group 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

Estrogen vaginal cream is not indicated in children. Studies have not been conducted.

Geriatric

Elderly women greater than 65 years of age may have an increased risk of certain side effects during treatment, especially stroke, invasive breast cancer, and memory problems.

Pregnancy

Estrogens should not be used during pregnancy, since an estrogen called diethylstilbestrol (DES) that is no longer taken for hormone replacement has caused serious birth defects in humans and animals.

Breastfeeding

Use of this medicine is not recommended in nursing mothers. Estrogens pass into the breast milk and may decrease the amount and quality of breast milk. Caution should be exercised in mothers who are using estrogen and breast-feeding.

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 any of these medicines, 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 medicines in this class with any of the following medicines is not recommended. Your doctor may decide not to treat you with a medication in this class or change some of the other medicines you take.

  • Dasabuvir
  • Ombitasvir
  • Paritaprevir
  • Ritonavir
  • Tranexamic Acid

Using medicines in this class 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.

  • Amifampridine
  • Apalutamide
  • Aprepitant
  • Armodafinil
  • Artemether
  • Belzutifan
  • Bexarotene
  • Boceprevir
  • Bosentan
  • Bupropion
  • Carbamazepine
  • Cenobamate
  • Ceritinib
  • Clobazam
  • Conivaptan
  • Dabrafenib
  • Darunavir
  • Dexamethasone
  • Dicloxacillin
  • Donepezil
  • Doxycycline
  • Efavirenz
  • Elagolix
  • Elvitegravir
  • Enasidenib
  • Encorafenib
  • Enzalutamide
  • Eslicarbazepine Acetate
  • Etravirine
  • Fosaprepitant
  • Fosnetupitant
  • Fosphenytoin
  • Griseofulvin
  • Isotretinoin
  • Ivosidenib
  • Lesinurad
  • Lixisenatide
  • Lorlatinib
  • Lumacaftor
  • Mavacamten
  • Meropenem
  • Minocycline
  • Mitapivat
  • Mitotane
  • Mobocertinib
  • Modafinil
  • Mycophenolic Acid
  • Nafcillin
  • Netupitant
  • Nevirapine
  • Nirmatrelvir
  • Oxcarbazepine
  • Phenobarbital
  • Phenylbutazone
  • Phenytoin
  • Pitolisant
  • Pixantrone
  • Prednisone
  • Primidone
  • Red Clover
  • Repotrectinib
  • Rifabutin
  • Rifampin
  • Rifapentine
  • Rufinamide
  • Secobarbital
  • St John's Wort
  • Sugammadex
  • Tazemetostat
  • Telaprevir
  • Theophylline
  • Topiramate
  • Ulipristal
  • Valproic Acid

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. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

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

  • Asthma or
  • Epilepsy or
  • Heart problems or
  • Kidney problems or
  • Migraine headaches—Estrogens may worsen these conditions.
  • Blood clotting problems—Although worsening of a blood clotting condition is unlikely, some doctors do not prescribe vaginal estrogens for patients with blood clotting problems or a history of these problems.
  • Breast cancer (active, suspected, or past history)—Estrogens should not be used.
  • Certain cancers, including cancers of the breast, bone, or uterus (active or suspected)—Estrogens may interfere with the treatment of breast or bone cancer or worsen cancer of the uterus when these conditions are present.
  • Cholestatic jaundice (flow of bile from the liver is blocked), past history—Caution should be used when this condition is present.
  • Diabetes mellitus (sugar diabetes)—Estrogens may alter your body's response to sugar in your diet.
  • Endometriosis or
  • Fibroid tumors of the uterus—Estrogens may worsen endometriosis or increase the size of fibroid tumors.
  • Gallbladder problems (gallstones)—Estrogens may increase your chance of getting a gallbladder attack.
  • Heart attack or
  • Stroke (active or past history)—Estrogens should not be used.
  • Hepatic hemangioma (noncancerous tumors of the liver)—Estrogens may worsen this medical problem.
  • High blood pressure—Estrogens may worsen this medical problem.
  • Hypercalcemia (too much calcium in your blood)—Estrogens may worsen this medical problem.
  • Hypertriglyceridemia (too much triglycerides in your blood)—Estrogens may increase your chance of getting pancreatitis or other side effects.
  • Hypocalcemia (too little calcium in your blood)—Your doctor should treat the low calcium in your blood before starting estrogen therapy.
  • Irritation or infection of the vagina—Usually estrogens decrease infections or irritation of the vagina, but sometimes these conditions may become worse.
  • Liver disease or
  • Liver problems—Estrogens should not be used.
  • Lupus erythematosus, systemic (SLE or lupus)—Estrogens may worsen this medical problem.
  • Physical problems within the vagina, such as narrow vagina, vaginal stenosis, or vaginal prolapse—Estradiol vaginal insert or ring may be more likely to slip out of place or cause problems, such as irritation of the vagina.
  • Porphyria—Estrogens may worsen this medical problem.
  • Thyroid problems (underactive thyroid)—Estrogens may alter your body's response to your thyroid medication. Your doctor may alter the amount of thyroid replacement that you take while on estrogen therapy.
  • Vision changes, sudden onset including
  • Bulging eyes or
  • Double vision or
  • Migraine headache or
  • Vision loss, partial or complete—Estrogens may cause these problems. Tell your doctor if you have had any of these problems.
  • Unusual genital or vaginal bleeding of unknown causes—Use of estrogens may delay diagnosis or worsen the condition. The reason for the bleeding should be determined before estrogens are used.

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Portions of this document last updated: April 01, 2024

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