Esterified Estrogens Methyltestosterone

Esterified Estrogens Methyltestosterone Brand Names

Covaryx | Covaryx H.S. | EEMT | EEMT HS | Essian | Essian HS | Estratest | Estratest HS | Syntest DS | Syntest HS

What is Esterified Estrogens Methyltestosterone

Esterified estrogens and methyltestosterone are used together in an oral preparation to treat moderate to severe vasomotor symptoms associated with menopause in patients not improved by estrogens alone.

Esterified estrogens is a mixture of the sodium salts of the sulfate esters of estrogenic substances found in the urine of pregnant mares; the primary active estrogen is sodium estrone sulfate (approximately 80%), the other major component is sodium equilin sulfate (6 to 15%).

Esterified estrogens may be produced from natural sources or synthesized.

Methyltestosterone is structurally similar to testosterone, except it is methylated at the C-17 position, which increases the oral bioavailability of the hormone.

Esterified estrogens and methyltestosterone were first marketed in products prior to the modern FDA drug approval process and are considered unapproved drugs.

The FDA has required that all manufacturers of such products submit data supporting safety and effectiveness in order to remain on the market. Final status of these products with respect to FDA approval is pending; some products remain marketed.

Indications

• hot flashes
• menopause

For the treatment of moderate to severe vasomotor symptoms (hot flashes) associated with menopause in women not achieving adequate therapeutic response on estrogen replacement alone

Side Effects

1. abdominal pain
2. acne vulgaris
3. alopecia
4. amenorrhea
5. anaphylactoid reactions
6. angioedema
7. anxiety
8. biliary obstruction
9. breakthrough bleeding
10. breast cancer
11. breast discharge
12. breast enlargement
13. candidiasis
14. cervical dysplasia
15. cervicitis
16. cholecystitis
17. cholelithiasis
18. cholestasis
19. clitoromegaly
20. colitis
21. dementia
22. depression
23. diplopia
24. dizziness
25. dysmenorrhea
26. edema
27. elevated hepatic enzymes
28. emotional lability
29. endometrial cancer
30. endometrial hyperplasia
31. erythema multiforme
32. erythema nodosum
33. fatigue
34. fluid retention
35. galactorrhea
36. gingivitis
37. headache
38. hepatitis
39. hepatoma
40. hirsutism
41. hypercalcemia
42. hyperglycemia
43. hypertension
44. hypocalcemia
45. impaired cognition
46. insomnia
47. jaundice
48. libido decrease
49. libido increase
50. maculopapular rash
51. mastalgia
52. melasma
53. menorrhagia
54. menstrual irregularity
55. migraine
56. myocardial infarction
57. nausea
58. new primary malignancy
59. ovarian cancer
60. pancreatitis
61. peliosis hepatis
62. pruritus
63. pulmonary embolism
64. retinal thrombosis
65. stroke
66. teratogenesis
67. thromboembolism
68. thrombosis
69. urticaria
70. vaginal bleeding
71. vaginal discharge
72. vaginitis
73. virilization
74. visual impairment
75. vomiting
76. weight gain

Monitoring Parameters

• LFTs
• pap smear
• serum lipid profile

Contraindications

• angioedema
• asthma
• breast cancer
• breast-feeding
• cardiac disease
• cerebrovascular disease
• cervical cancer
• children
• contact lenses
• coronary artery disease
• dementia
• depression
• diabetes mellitus
• endometrial cancer
• endometrial hyperplasia
• endometriosis
• gallbladder disease
• geriatric
• hepatic disease
• hepatocellular cancer
• hepatotoxicity
• hereditary angioedema
• history of angioedema
• hypercalcemia
• hypercholesterolemia
• hypertension
• hypertriglyceridemia
• hypocalcemia
• hypoparathyroidism
• hypothyroidism
• infants
• jaundice
• migraine
• myocardial infarction
• new primary malignancy
• obesity
• ovarian cancer
• pancreatitis
• porphyria
• pregnancy
• protein C deficiency
• protein S deficiency
• renal disease
• seizure disorder
• stroke
• surgery
• systemic lupus erythematosus (SLE)
• thromboembolic disease
• thromboembolism
• thrombophlebitis
• thyroid disease
• tobacco smoking
• uterine cancer
• uterine leiomyomata
• vaginal bleeding
• vaginal cancer
• visual disturbance

Interactions

• Abarelix
• Acarbose
• Acetaminophen; Propoxyphene
• Albiglutide
• Alogliptin
• Alogliptin; Metformin
• Alogliptin; Pioglitazone
• Alpha-glucosidase Inhibitors
• Amiodarone
• Amoxicillin; Clarithromycin; Lansoprazole
• Amoxicillin; Clarithromycin; Omeprazole
• Amprenavir
• Anastrozole
• Anticoagulants
• Antithrombin III
• Apixaban
• Aprepitant, Fosaprepitant
• Argatroban
• Atazanavir
• Atazanavir; Cobicistat
• Azelastine; Fluticasone
• Barbiturates
• Beclomethasone
• Betamethasone
• Betrixaban
• Bexarotene
• Bivalirudin
• Bosentan
• Bromocriptine
• Budesonide
• Budesonide; Formoterol
• Calcium
• Canagliflozin
• Canagliflozin; Metformin
• Carbamazepine
• Cenobamate
• Chenodiol
• Chloramphenicol
• Ciclesonide
• Cimetidine
• Clarithromycin
• Clobazam
• Conivaptan
• Corticosteroids
• Cortisone
• Cosyntropin
• Cyclosporine
• Dabigatran
• Dalteparin
• Danaparoid
• Danazol
• Dantrolene
• Dapagliflozin
• Dapagliflozin; Metformin
• Dapagliflozin; Saxagliptin
• Daratumumab; Hyaluronidase
• Darbepoetin Alfa
• Darunavir
• Darunavir; Cobicistat
• Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
• Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
• Deflazacort
• Degarelix
• Delavirdine
• Desirudin
• Dexamethasone
• Diltiazem
• Dipeptidyl Peptidase-4 Inhibitors
• Dulaglutide
• Duloxetine
• Edoxaban
• Empagliflozin
• Empagliflozin; Linagliptin
• Empagliflozin; Linagliptin; Metformin
• Empagliflozin; Metformin
• Enoxaparin
• Epoetin Alfa
• Ertugliflozin
• Ertugliflozin; Metformin
• Ertugliflozin; Sitagliptin
• Erythromycin
• Erythromycin; Sulfisoxazole
• Ethotoin
• Exemestane
• Exenatide
• Felbamate
• Fludrocortisone
• Flunisolide
• Fluoxetine
• Fluoxetine; Olanzapine
• Fluticasone
• Fluticasone; Salmeterol
• Fluticasone; Umeclidinium; Vilanterol
• Fluticasone; Vilanterol
• Fondaparinux
• Formoterol; Mometasone
• Fosamprenavir
• Fosphenytoin
• Glipizide; Metformin
• Glyburide; Metformin
• Goserelin
• grapefruit juice
• Griseofulvin
• Hemin
• Heparin
• Histrelin
• Hyaluronidase
• Hyaluronidase, Recombinant; Immune Globulin
• Hydantoins
• Hydralazine
• Hydralazine; Hydrochlorothiazide, HCTZ
• Hydralazine; Isosorbide Dinitrate, ISDN
• Hydrocortisone
• Icosapent ethyl
• Imatinib
• Imipramine
• Incretin Mimetics
• Indinavir
• Insulin Degludec; Liraglutide
• Insulin Glargine; Lixisenatide
• Insulins
• Itraconazole
• Ketoconazole
• Lenalidomide
• Lepirudin
• Letrozole
• Leuprolide
• Leuprolide; Norethindrone
• Levothyroxine
• Levothyroxine; Liothyronine (Porcine)
• Levothyroxine; Liothyronine (Synthetic)
• Linagliptin
• Linagliptin; Metformin
• Liothyronine
• Liraglutide
• Lixisenatide
• Lopinavir; Ritonavir
• Lorlatinib
• Meglitinides
• Melatonin
• Metformin
• Metformin; Pioglitazone
• Metformin; Repaglinide
• Metformin; Rosiglitazone
• Metformin; Saxagliptin
• Metformin; Sitagliptin
• Methotrexate
• Methoxy polyethylene glycol-epoetin beta
• Methylprednisolone
• Metreleptin
• Metyrapone
• Mifepristone
• Miglitol
• Mineral Oil
• Minoxidil
• Modafinil
• Mometasone
• Nafarelin
• Nefazodone
• Nelfinavir
• Nevirapine
• Nitroprusside
• Ombitasvir; Paritaprevir; Ritonavir
• Ospemifene
• Oxcarbazepine
• Pentosan
• Phentermine; Topiramate
• Phenytoin
• Pramlintide
• Prasterone, Dehydroepiandrosterone, DHEA (Dietary Supplements)
• Prasterone, Dehydroepiandrosterone, DHEA (FDA-approved)
• Prednisolone
• Prednisone
• Propoxyphene
• Raloxifene
• Ribociclib; Letrozole
• Rifamycins
• Ritonavir
• Rituximab; Hyaluronidase
• Rivaroxaban
• Ropinirole
• Saquinavir
• Saw Palmetto, Serenoa repens
• Saxagliptin
• Semaglutide
• SGLT2 Inhibitors
• Simvastatin; Sitagliptin
• Sitagliptin
• Somatropin, rh-GH
• St. John’s Wort, Hypericum perforatum
• Sulfonylureas
• Tacrine
• Tazemetostat
• Testolactone
• Thiazolidinediones
• Thyroid hormones
• Tinzaparin
• Tipranavir
• Topiramate
• Toremifene
• Trandolapril; Verapamil
• Tranexamic Acid
• Trastuzumab; Hyaluronidase
• Triamcinolone
• Tricyclic antidepressants
• Triptorelin
• Ursodeoxycholic Acid, Ursodiol
• Valproic Acid, Divalproex Sodium
• Verapamil
• Warfarin
• Zafirlukast