 | c How to Use Estrace
Estrogens have been reported to increase the chance of womb (endometrial) cancer in women who have been through menopause, especially in women with a uterus who receive estrogen-only hormone therapy. Estrogens may also increase the risk of cancer of the ovary or breast. Estrogen-containing products should not be used to prevent heart disease. Estrogen given in combination with another hormone (progestin) for replacement therapy can infrequently cause heart disease (e.g., heart attacks), stroke, serious blood clots (pulmonary embolism/deep venous thrombosis), dementia, and cancer of the breast. These risks appear to depend on the length of time this medicine is used and the amount of estrogen per dose. Therefore, this medicine should be used for the shortest possible length of time at the lowest effective dose, so you obtain the benefits and minimize the chance of serious side effects from long-term treatment. Consult your doctor/pharmacist for details. If using this medicine for an extended period, you should be evaluated at least once a year (see CAUTIONS section). This medicine is not effective in preventing or treating a tendency toward miscarriage nor the threat of miscarriage. This medicine must not be used during pregnancy because its use may result in birth defects or cancer later in the child's life (see CAUTIONS section). Some medicines or medical conditions may interact with this medicine. INFORM YOUR DOCTOR/PHARMACIST of all prescription and over-the-counter medicine that you are taking. ADDITIONAL MONITORING OF YOU DOSE OR CONDITION may be needed if you are taking corticosteroids (e.g., prednisone); hydantoins (e.g., phenytoin); warfarin; or any medicines that affect certain liver enzymes (CYP450-3A4), such as azole antifungals (e.g., ketoconazole, itraconazole), carbamazepine, macrolide antibiotics (e.g., clarithromycin, erythromycin), phenobarbital, rifamycins (e.g., rifampin), ritonavir, cimetidine, or St. John's wort. DO NOT START OR STOP any medicine without doctor/pharmacist approval. Inform your doctor of any other medical conditions including a family medical history (especially breast lumps/cancer), asthma, diabetes, seizures, migraine headaches, heart disease (e.g., high blood pressure, heart attacks, congestive heart failure), kidney disease, low thyroid hormone (hypothyroidism), abnormal calcium level in the blood, depression, high blood pressure during pregnancy (toxemia), yellowing of eyes/skin (cholestatic jaundice) during pregnancy or with past estrogen use, womb problems (e.g., uterine fibroids/endometriosis), cholesterol/lipid problems, gallbladder disease, excessive weight gain, certain blood disorder (porphyria), allergies, pregnancy, or breast-feeding. USE OF THIS MEDICINE IS NOT RECOMMENDED if you have undiagnosed abnormal vaginal bleeding, cancer (e.g., breast cancer - also see COMMON USES section), blood clots, liver disease, or active/recent stroke/heart attack.
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