Before starting the patient on Estragyn Vaginal Cream:
- A complete physical examination including a blood pressure determination must be performed
- Breasts and pelvic organs should be appropriately examined
- Papanicolaou smear should be performed
- Endometrial biopsy should be done only when indicated
- Baseline tests should include mammography, measurements of blood glucose, calcium, triglycerides and cholesterol, and liver function tests
The importance of regular self-examination of the breasts should be discussed with the patient.
- The first follow-up examination should be done within 3-6 months after initiation of treatment
- Examinations should be made at intervals at least once a year
Non-medicinal ingredients of Estragyn Vaginal Cream are:
Arlacel 165, isopropyl myristate, methyl paraben, mineral oil, Peg 40 stearate, propyl paraben, sorbitan monostearate, stearic acid and water.
Estragyn Vaginal Cream is not suited for:
- Pregnant Women: Estragyn Vaginal Cream should not be used during pregnancy (please see CONTRAINDICATIONS)
- Nursing Women: Estragyn Vaginal Cream should not be used during lactation (please see CONTRAINDICATIONS)
- Pediatrics (<16 years of age): Estragyn Vaginal Cream is not indicated for use in children
- Patients should avoid grapefruit juice, a CYP3A4 inhibitor, as it may increase plasma concentrations of estrogens, possibly resulting in side effects
- Patients should avoid acute alcohol ingestion during HRT as it may lead to elevations in circulating estradiol levels
- Patients should avoid certain herbal products (e.g. St. John’s wort) which are available as over-the-counter (OTC) products, as they might interfere with steroid metabolism and therefore alter the efficacy and safety of estrogen/progestin products
Ask your patients about other non-prescription products, including herbal and natural products, concomitantly used with Estragyn Vaginal Cream.