Vagifem (other name Estrace)

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

abnormal vaginal bleeding

blood vessel disease or blood clots

breast, cervical, endometrial, ovarian, liver, or uterine cancer

dementia

diabetes

gallbladder disease

heart disease or recent heart attack

high blood pressure

high cholesterol

high level of calcium in the blood

hysterectomy

kidney disease

liver disease

migraine headaches

stroke

systemic lupus erythematosus (SLE)

tobacco smoker

an unusual or allergic reaction to estrogens, other hormones, medicines, foods, dyes, or preservatives

pregnant or trying to get pregnant

breast-feeding

How should I use this medicine?

Take this medicine by mouth. To reduce nausea, this medicine may be taken with food. Follow the directions on the prescription label. Take this medicine at the same time each day and in the order directed on the package. Do not take your medicine more often than directed.
Contact your pediatrician regarding the use of this medicine in children. Special care may be needed.
A patient information sheet will be given with each prescription and refill. Read this sheet carefully each time. The sheet may change frequently.
Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is less than four hours to your next dose, take only that dose and skip the missed dose. Do not take double or extra doses.

What may interact with this medicine?

Do not take this medicine with any of the following medications:

aromatase inhibitors like aminoglutethimide, anastrozole, exemestane, letrozole, testolactone

This medicine may also interact with the following medications:

carbamazepine

certain antibiotics used to treat infections

certain barbiturates or benzodiazepines used for inducing sleep or treating seizures

grapefruit juice

medicines for fungus infections like itraconazole and ketoconazole

raloxifene or tamoxifen

rifabutin, rifampin, or rifapentine

ritonavir

St. John's Wort

warfarin

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medicine?

Visit your doctor or health care professional for regular checks on your progress. You will need a regular breast and pelvic exam and Pap smear while on this medicine. You should also discuss the need for regular mammograms with your health care professional, and follow his or her guidelines for these tests.
This medicine can make your body retain fluid, making your fingers, hands, or ankles swell. Your blood pressure can go up. Contact your doctor or health care professional if you feel you are retaining fluid.
If you have any reason to think you are pregnant, stop taking this medicine right away and contact your doctor or health care professional.
Smoking increases the risk of getting a blood clot or having a stroke while you are taking this medicine, especially if you are more than 35 years old. You are strongly advised not to smoke.
If you wear contact lenses and notice visual changes, or if the lenses begin to feel uncomfortable, consult your eye doctor or health care professional.
This medicine can increase the risk of developing a condition (endometrial hyperplasia) that may lead to cancer of the lining of the uterus. Taking progestins, another hormone drug, with this medicine lowers the risk of developing this condition. Therefore, if your uterus has not been removed (by a hysterectomy), your doctor may prescribe a progestin for you to take together with your estrogen. You should know, however, that taking estrogens with progestins may have additional health risks. You should discuss the use of estrogens and progestins with your health care professional to determine the benefits and risks for you.
If you are going to have surgery, you may need to stop taking this medicine. Consult your health care professional for advice before you schedule the surgery.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue

breast tissue changes or discharge

changes in vision

chest pain

confusion, trouble speaking or understanding

dark urine

general ill feeling or flu-like symptoms

light-colored stools

nausea, vomiting

pain, swelling, warmth in the leg

right upper belly pain

severe headaches

shortness of breath

sudden numbness or weakness of the face, arm or leg

trouble walking, dizziness, loss of balance or coordination

unusual vaginal bleeding

yellowing of the eyes or skin

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

hair loss

ncreased hunger or thirst

ncreased urination

symptoms of vaginal infection like itching, irritation or unusual discharge

unusually weak or tired

Where should I keep my medicine?

Keep out of the reach of children.
Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F). Keep container tightly closed. Protect from light. Throw away any unused medicine after the expiration date.