Estragyn

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

Follow-up examinations:

• 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.

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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

Dietary restrictions:

• 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