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This medication, containing estrogen, should be used with caution due to potential serious side effects. It is important to discuss the risks and benefits with your healthcare provider before starting treatment. Below are key safety considerations and warnings:

• Cancer Risks:

  • Uterine Cancer: Using estrogen alone increases the risk of endometrial cancer. If you have a uterus, taking a progestin with estrogen can mitigate this risk. Report any unusual vaginal bleeding to your doctor immediately.
  • Breast and Ovarian Cancer: There is an increased risk of these cancers in postmenopausal women taking estrogen, with or without progestin. Regular self-examinations and annual check-ups are advised.

• Cardiovascular Risks:

  • Heart Disease and Attacks: Estrogen should not be used to prevent heart disease. It may increase the risk of heart attacks, especially when combined with progestin.
  • Blood Clots and Strokes: Estrogen can raise the risk of strokes and blood clots in the lungs and legs. Inactivity and certain surgeries can heighten these risks, so consult your doctor for advice if you have surgery scheduled.

• Dementia: Individuals over 65 using estrogen are at increased risk for dementia. Report any cognitive difficulties to your healthcare provider.

• Gallbladder and Liver Issues: Estrogen may worsen gallbladder and liver conditions. Use cautiously if you have a history of these issues.

• Calcium Levels: Estrogen can cause high calcium levels, especially in those with certain cancers. Report symptoms like stomach pain or confusion to your healthcare provider.

• Vision Problems: Estrogen may lead to retinal vascular thrombosis. Seek medical help if you experience sudden vision changes.

• Triglycerides and Thyroid Levels: Estrogen can increase triglyceride levels and affect thyroid hormone levels. Regular monitoring may be necessary.

• Fluid Retention: Estrogen can cause fluid retention, which may exacerbate heart or kidney issues. Notify your doctor if you experience unusual swelling.

• Other Health Conditions: Inform your healthcare provider if you have asthma, lupus, seizures, migraines, or diabetes, as estrogen may worsen these conditions.

• Contraindications: Avoid using this medication if you have abnormal vaginal bleeding, a history of breast cancer (unless for cancer pain), estrogen-dependent tumors, blood clot conditions, liver issues, or if you are pregnant.

In case of overdose or severe side effects, seek emergency medical attention promptly. Use the lowest effective dose for the shortest duration necessary, and maintain regular consultations with your healthcare provider to assess the need for ongoing treatment.

Common side effects:

• stomach upset
• nausea
• vomiting
• bloating
• breast tenderness or pain
• headache
• weight changes
• hair loss

Less common but important to monitor:

• abnormal vaginal bleeding or spotting
• stomach cramps
• high blood pressure
• liver issues
• high blood sugar
• fluid retention
• growth of non-cancerous tumors in the uterus
• spotty darkening of the skin and face
• yeast infections

Serious side effects:

• stroke symptoms (weakness or numbness on one side of the body, slurred speech, sudden severe headache)
• heart attack symptoms (chest pain or discomfort, trouble breathing)
• blood clots (pain or swelling in the legs, trouble breathing)
• breast lumps
• unusual vaginal bleeding
• very serious allergic reaction (rash, itching, swelling of face, tongue, or throat, severe dizziness, difficulty breathing)

Interactions with high risk of serious adverse effects and should be avoided:

• Tranexamic Acid

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Aromatase inhibitors (such as Anastrozole, Exemestane, Letrozole)
• Fezolinetant
• Fulvestrant
• Ospemifene
• Raloxifene
• Tamoxifen
• Toremifene
• Abametapir
• Amifampridine
• Amoxicillin
• Ampicillin
• Amprenavir
• Apalutamide
• Aprepitant
• Armodafinil
• Artemether
• Bacampicillin
• Betamethasone
• Bexarotene
• Bosentan
• Brigatinib
• Bupropion
• Carbamazepine
• Carbenicillin
• Cefaclor
• Cefadroxil
• Cefdinir
• Cefditoren
• Cefixime
• Cefpodoxime
• Cefprozil
• Ceftazidime
• Ceftibuten
• Cefuroxime
• Cenobamate
• Ceritinib
• Clavulanic Acid
• Clobazam
• Cloxacillin
• Colesevelam
• Conivaptan
• Cyclacillin
• Cyclosporine
• Dabrafenib
• Darunavir
• Dexamethasone
• Dicloxacillin
• Donepezil
• Doxycycline
• Efavirenz
• Elagolix
• Elvitegravir
• Encorafenib
• Enzalutamide
• Eslicarbazepine Acetate
• Etravirine
• Fosamprenavir
• Fosaprepitant
• Fosnetupitant
• Fosphenytoin
• Griseofulvin
• Guar Gum
• Isotretinoin
• Ivosidenib
• Lesinurad
• Lixisenatide
• Lorlatinib
• Lumacaftor
• Minocycline
• Mitotane
• Modafinil
• Mycophenolate Mofetil
• Mycophenolic Acid
• Nafcillin
• Nelfinavir
• Netupitant
• Nevirapine
• Octreotide
• Oxacillin
• Oxcarbazepine
• Oxytetracycline
• Penicillin G
• Penicillin G Procaine
• Penicillin V
• Phenobarbital
• Phenylbutazone
• Phenytoin
• Pitolisant
• Pixantrone
• Prednisone
• Primidone
• Rifabutin
• Rifampin
• Rifapentine
• Ritonavir
• Rufinamide
• Secobarbital
• St John's Wort
• Sugammadex
• Sultamicillin
• Tazemetostat
• Telaprevir
• Tetracycline
• Theophylline
• Ticarcillin
• Tigecycline
• Tizanidine
• Topiramate
• Ulipristal
• Valproic Acid

Interactions with low risk that usually do not require a change in therapy:

• Atazanavir
• Diazepam
• Ginseng
• Lamotrigine
• Levothyroxine
• Licorice
• Lorazepam
• Prednisolone
• Selegiline
• Tacrine
• Temazepam
• Tipranavir
• Triazolam
• Troleandomycin
• Voriconazole
• Warfarin