Estropipate

Estropipate Brand Names- Ogen | Ortho-Est

What is Estropipate

Estropipate is a synthesized estrogen, also known as piperazine-stabilized estrone sulfate.

On a weight basis, 1.2 mg of estropipate is equivalent to 1 mg of sodium estrone sulfate. Most of the commercially available estrogen products are synthesized. There is no evidence that ‘natural’ estrogens are more or less efficacious or safe than ‘synthetic’ estrogens.

Estropipate is used primarily as hormone replacement therapy (HRT) for moderate to severe vasomotor symptoms, atrophic vaginitis, and vulvar atrophy associated with menopause, and for the prevention of osteoporosis.

Estropipate is also used for abnormalities related to gonadotropin hormone dysfunction.

Estropipate was first FDA-approved in 1977. Historically, a vaginal cream was also available, but was discontinued in the U.S. in 2001.

Indications

1. atrophic vaginitis
2. hot flashes
3. hypogonadism
4. menopause
5. oophorectomy
6. osteoporosis prophylaxis
7. ovarian failure

For treatment of moderate to severe vasomotor symptoms (hot flashes) of menopause and/or related genitourinary symptoms including atrophic vaginitis, vulvar atrophy (kraurosis vulvae), whether menopause is natural or surgical (e.g., due to oophorectomy)

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. colitis
20. dementia
21. depression
22. diplopia
23. dizziness
24. dysmenorrhea
25. edema
26. elevated hepatic enzymes
27. emotional lability
28. endometrial cancer
29. endometrial hyperplasia
30. erythema multiforme
31. erythema nodosum
32. fatigue
33. fluid retention
34. galactorrhea
35. gingivitis
36. gynecomastia
37. headache
38. hepatitis
39. hirsutism
40. hypercalcemia
41. hyperglycemia
42. hypertension
43. hypocalcemia
44. impaired cognition
45. insomnia
46. irritability
47. jaundice
48. libido decrease
49. libido increase
50. maculopapular rash
51. mastalgia
52. melasma
53. menorrhagia
54. migraine
55. muscle cramps
56. myocardial infarction
57. nausea
58. new primary malignancy
59. ovarian cancer
60. pancreatitis
61. papilledema
62. peliosis hepatis
63. pruritus
64. pulmonary embolism
65. rash
66. retinal thrombosis
67. stroke
68. teratogenesis
69. thromboembolism
70. thrombosis
71. urinary incontinence
72. urticaria
73. vaginal bleeding
74. vaginitis
75. vomiting
76. weight gain

Monitoring Parameters

• pap smear
• pelvic exam

Contraindications

• 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
• hereditary angioedema
• history of angioedema
• hypercalcemia
• hypercholesterolemia
• hypertension
• hypertriglyceridemia
• hypocalcemia
• hypoparathyroidism
• hypothyroidism
• infants
• jaundice
• migraine
• myocardial infarction
• neonates
• 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

• Acarbose
• Acetaminophen; Propoxyphene
• Albiglutide
• Alogliptin; Metformin
• Alpha-glucosidase Inhibitors
• Amiodarone
• Amoxicillin; Clarithromycin; Lansoprazole
• Amoxicillin; Clarithromycin; Omeprazole
• Amprenavir
• Anastrozole
• Aprepitant, Fosaprepitant
• Azelastine; Fluticasone
• Barbiturates
• Beclomethasone
• Betamethasone
• Bexarotene
• Bosentan
• Bromocriptine
• Budesonide
• Budesonide; Formoterol
• Calcium
• Canagliflozin
• Canagliflozin; Metformin
• Carbamazepine
• Cenobamate
• Chenodiol
• Chloramphenicol
• Ciclesonide
• Cimetidine
• Clarithromycin
• Clobazam
• Conivaptan
• Corticosteroids
• Cortisone
• Cosyntropin
• Cyclosporine
• Danazol
• Dantrolene
• Dapagliflozin
• Dapagliflozin; Metformin
• Dapagliflozin; Saxagliptin
• Daratumumab; Hyaluronidase
• Darunavir
• Darunavir; Cobicistat
• Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
• Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
• Deflazacort
• Delavirdine
• Dexamethasone
• Diltiazem
• Dipeptidyl Peptidase-4 Inhibitors
• Dulaglutide
• Duloxetine
• Empagliflozin
• Empagliflozin; Linagliptin
• Empagliflozin; Linagliptin; Metformin
• Empagliflozin; Metformin
• 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
• Formoterol; Mometasone
• Fosamprenavir
• Fosphenytoin
• Glipizide; Metformin
• Glyburide; Metformin
• grapefruit juice
• Griseofulvin
• Hemin
• Hyaluronidase
• Hyaluronidase, Recombinant; Immune Globulin
• Hydantoins
• Hydralazine
• Hydralazine; Hydrochlorothiazide, HCTZ
• Hydralazine; Isosorbide Dinitrate, ISDN
• Hydrocortisone
• Icosapent ethyl
• Imatinib
• Incretin Mimetics
• Indinavir
• Insulin Degludec; Liraglutide
• Insulin Glargine; Lixisenatide
• Insulins
• Lenalidomide
• Letrozole
• Levothyroxine
• Levothyroxine; Liothyronine (Porcine)
• Levothyroxine; Liothyronine (Synthetic)
• Linagliptin; Metformin
• Liothyronine
• Liraglutide
• Lixisenatide
• Lopinavir; Ritonavir
• Lorlatinib
• Meglitinides
• Melatonin
• Metformin
• Metformin; Pioglitazone
• Metformin; Repaglinide
• Metformin; Rosiglitazone
• Metformin; Saxagliptin
• Metformin; Sitagliptin
• Methylprednisolone
• Metreleptin
• Metyrapone
• Mifepristone
• Miglitol
• Mineral Oil
• Minoxidil
• Modafinil
• Mometasone
• Nefazodone
• Nelfinavir
• Nevirapine
• Nitroprusside
• Ombitasvir; Paritaprevir; Ritonavir
• Ospemifene
• Oxcarbazepine
• Phentermine; Topiramate
• Phenytoin
• Pramlintide
• Prasterone, Dehydroepiandrosterone, DHEA (Dietary Supplements)
• Prasterone, Dehydroepiandrosterone, DHEA (FDA-approved)
• Prednisolone
• Prednisone
• Propoxyphene
• Raloxifene
• Ribociclib; Letrozole
• Rifamycins
• Ritonavir
• Rituximab; Hyaluronidase
• Ropinirole
• Saquinavir
• Semaglutide
• SGLT2 Inhibitors
• Somatropin, rh-GH
• St. John’s Wort, Hypericum perforatum
• Sulfonylureas
• Tacrine
• Tazemetostat
• Testolactone
• Thiazolidinediones
• Thyroid hormones
• Tipranavir
• Topiramate
• Toremifene
• Trandolapril; Verapamil
• Tranexamic Acid
• Trastuzumab; Hyaluronidase
• Triamcinolone
• Tricyclic antidepressants
• Ursodeoxycholic Acid, Ursodiol
• Valproic Acid, Divalproex Sodium
• Verapamil
• Warfarin
• Zafirlukast