Appendix: Reference Table of HT Brand Names

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1 Appendix: Reference Table of HT Brand Names This is a full reference table in alphabetical order, of Brand Name drugs used in HT. It is the basis for prescription advice throughout this handbook. Drug name Company Drug type Activella Pharmacia Micronized Estradiol, Norethindrone Route of administration Oral E/P combination Alora Watson 17beta-estradiol Transdermal patch Cenestin Duramed/ Synthetic Solva conjugated estrogens Climera Berlex 17beta-estradiol Transdermal patch CombiPatch Aventis 17beta-estradiol and norethindrone Esclim Estrace Women First Warner- Chilcot Usual daily dosages 1 mg 17betaestradiol, 0.5 NE, continuous daily dosing 0.05, 0.075, 0.1 mg. 2x/week Oral 0.625, 0.9, 1.25 mg/continuous daily dosing 0.025, 0.05, 0.1 mg. One time per week Transdermal 0.05 mg 17betaestradiol patch/ and combined 0.14 mg NE, 0.05 mg 17betaestradiol and 0.25 mg NE. Twice per week 17beta-estradiol Transdermal 0.025, , 0.05, 0.075, 0.1 mg. Twice per week. 17beta-estradiol (micronized0 Vaginal estrogen (describe more) 0.5 mg, 1 mg daily to start, then 1-3 times per week (continued) K. Sherif, Hormone Therapy: A Clinical Handbook, DOI / , Springer Science+Business Media New York

2 120 Hormone Therapy Drug name Company Drug type Route of administration Usual daily dosages Estraderm Novartis 17beta-estradiol Transdermal 0.05, 0.1, twice per week Estratab Solvay Esterified estrogens Estratest Estratest-HS Solvay Conjugated equine estrogen and methyltestosterone (MT) Oral Oral combined cyclic estrogen/ testosterone Estring Pharmacia Estradiol Vaginal Estrogen Ring Fern HT Parke- Davis Conjugated equine estrogens and medroxyprogesterone acetate (MPA), ethinyl estradiol (EE), and norethindrone Menest Monarch Esterified estrogens Oral combined continuous estrogen/ progesterone 0.3, 0.625, 2.5 mg/ continuous daily dosing 12.5 mg CEE plus 2.5 mg MT; cyclic dosing: 3 week on, 1 week off 2 mg reservoir; replace every three months 5 m g EE plus 1 mg NE; continuous daily dosing Oral 0.3, 0.625, 1.25, 2.5 mg/cyclic dosing: 3 weeks on, 1 week off Ogen Pharmacia Estropipate Oral 0.625, 1.25, 2.5 mg/continuous daily dosing or cyclic dosing Ortho-EST Ortho- Prefest Ortho- Dienestrol Women First Ortho- McNeil Ortho- McNeil Estropipate Oral 0.625, 1.25, 2.5 mg/ continuous Micronized estradiol and norgestimate Dienestrol Oral combined estrogenprogestin continuous 1 mg 17betaestradiol (continuous) and 0.09 mg norgetimate (pulsed in 3-day cycles) Vaginal 0.1 mg/gram, daily (continued)

3 Appendix: Reference Table of HT Brand Names 121 Drug name Company Drug type Premarin Premarin Cream PremPhase PremPro Wyeth- Ayerst Wyeth- Ayerst Wyeth- Ayerst Wyeth- Ayerst Conjugated equine estrogens (CEE) Conjugated equine estrogens Conjugated equine estrogens and medroxyprogesterone acetate (MPA), ethinyl estradiol (EE), and norethindrone Route of administration Usual daily dosages Oral 0.3, 0.45, 0.625, 0.9, 1.25 mg/ continuous daily dosing or cyclic dosing Vaginal Oral combined cyclic estrogenprogestin Conjugated Oral equine estrogens Combined and medroxyprogesterone acetate progestin estrogen- (MPA), ethinyl estradiol (EE), and norethindrone mg/gram, daily Days 1 14: mg CEE Days 15 28: mg CEE plus 5 mg MPA mg CEE plus 2.5 MPA, mg CEE plus 5 mg MPA Vagifem Pharmacia Estradiol Vaginal First 2 weeks: 25 m g tablets daily Then 25 mg tablets two times per week Vivelle Dot Novartis 17beta-estradiol Transdermal patch , 0.05, 0.075, 0.1 mg. Two times per week Adapted from John David Gordon MD et al, Obstetrics, Gynecology and Infertility: Handbook for Clinicians, 6th edition (Scrub Hill Press, 2007)

4 Index A Abnormal menstrual bleeding breakthrough bleeding, 87 combined HT regimens, 86 differential diagnosis, 85 evaluation, 86 HT and periods, 86 American Association of Clinical Endocrinology (AACE), Androgen, 27 Antidepressants and anticonvulsants, 95 Autoimmune disease, 94 B Bioidentical hormones compounded bioidentical hormones advantages, 46 compounding pharmacy/ pharmacist, 47 definitionfi, FDA-approval, 47 pharmacy location navigation, definitionfi, designer estrogen phenomenon, estrogen forms, 48 invention, 45 medical associations, 50 misconceptions and facts, 47 natural HT, natural or semi-synthetic sources, 43, 44 standardized bioidentical hormones, 45, 46 Suzanne Somers approach, 49 synthetic sources, 43, 44 types, 45 Breakthrough bleeding, 80 82, 87 Breast cancer adverse effects, contraindications, 73 heart disease and, risks, 104 Breast tenderness, 79, 80 C Cardiovascular disease, Cognition HRT benefitsfi, 31 mood and, Colorectal cancer, 29 Compounded bioidentical hormones advantages, 46 compounding pharmacy/ pharmacist, 47 definitionfi, FDA-approval, 47 pharmacy location navigation, Conjugated equine estrogen (CEE), 43 K. Sherif, Hormone Therapy: A Clinical Handbook, DOI / , Springer Science+Business Media New York

5 124 Index D Dementia, 30 Diethylstilbestrol (DES), E Endometrial cancer, 85, Estradiol, 91, bioidentical hormones, 11 12, 49 drug interactions, estrogen deficiency, 11 vs. estrone and estriol, 8 9 hot flushes, 65 patches and gels, perimenopause, 4 5 spray, transdermal vs.oral, 64 vulvar discomfort and/or vaginal discomfort, 70 Estrogen and Thromboembolism (ESTHER) study, bioidentical hormones, 12, 55 drug interactions, estrogen deficiency, 11 vs. estrone and estriol, 8 9 hot flushes, 71 patches and gels, perimenopause, 4 5 spray, 66 transdermal vs.oral, 70 vulvar discomfort and/or vaginal discomfort, 76 Estrogen, See also Transdermal estrogen AACE guidelines, bioidentical hormones, breakthrough bleeding, breast cancer, deficiency, 11, 27 effects, 10 estradiol, 8 9 estrone, 9 FDA approvals, 22 history blood clots, 109 confusions and controversy, 99 diethylstilbestrol (DES), heart disease, HERS study, Nurses Health Study, osteoporosis, PEPI trial, premarin, 108 synthetic estrogen manufacture, uterine/endometrial cancer, WHI (see Women s Health Initiative (WHI)) youthfulness and femininity, low, 80 menopausal hormone, 11 ovarian cancer, 33 principles of practice, 18, 19 Estrogen. See also Transdermal estrogen AACE guidelines, bioidentical hormones, breakthrough bleeding, breast cancer, deficiency, 11, 31 effects, estradiol, 8 9 estrone, 9 FDA approvals, 26 history blood clots, 115 confusions and controversy, 105 diethylstilbestrol (DES), heart disease, HERS study, Nurses Health Study, osteoporosis, PEPI trial, premarin, 114 synthetic estrogen manufacture, uterine/endometrial cancer,

6 Index 125 WHI (see Women s Health Initiative (WHI)) youthfulness and femininity, low, 86 menopausal hormone, 11 ovarian cancer, 37 principles of practice, 20, 21 F FDA approvals and contraindications, 22 Follicle stimulating hormone (FSH), 7, 74 H Heart and Estrogen/Progestin Replacement Study (HERS study), Heart disease Nurses Health Study, PEPI trial, prevention, 117 Hormone replacement (HRT) AACE, adverse effects breast cancer, endometrium, 33 mammography, 32 ovarian cancer, 33 stroke, 31 venous thromboembolism, 31 androgen, 27 benefitsfi cardiovascular disease, cognition, 31 colorectal cancer, 29 connective tissues, 29 dementia, 30 postmenopausal osteoporosis, urogenital symptoms, class effect, risks and benefitsfi, 25 counseling, 26 duration, 25 early menopause, 25 FDA approvals and contraindications, 22 governing principles, NAMS guidelines, 23 nonhormonal therapies, progestogen, safety considerations, WHI, 21 Hormone routes of administration comparison table, 60 cream, estradiol spray, gel, 58 oral, 58 patches, 58 pellets, 59 transbuccal lozenges/ trouches, 59 transdermal, 58 vaginal, 58 WHI evaluation, 57 Hormone (HT) antidepressants and anticonvulsants, 95 autoimmune disease, 94 bioidentical hormones, definitionfi, 11 duration, estrogen history (see Estrogen, history) estrogen loss and aging, 12 liver s role, 13 monitoring effects and side effects breakthrough bleeding, 80, 82 contraindications, 82 corrective treatment, 80, 81 drug interactions, menopause symptoms, 79 symptomatic signs, 80 prescription, 19 beginning of, 73 contraindications and cautions, drugs interactions, duration of treatment, 74 FSH and BMI, 74

7 126 Index Hormone (HT) (cont.) side effects, 75 surgical menopause, returning to, 91 routes of administration, 18 testosterone role in, 9 10 thyroid disease, uterine fibroidsfi, 93 withdrawal, Hot flushesfl, 40, 65 HRT. See Hormone replacement (HRT) HT. See Hormone (HT) Hypothyroidism, 93 I Intermenstrual spotting, 79 International Menopause Society, 24 K Kronos Early Estrogen Prevention (KEEPS) study, 55 L Luteal out-of-phase (LOOP), 11 Late reproductive age, 14 Luteal out-of-phase (LOOP), 11 M Mammography, 32 Menopause age, 6 cardiovascular disease, definitionfi, 6 early and natural menopause, 7 8, 25 estrogens (see Estrogens) HT (see Hormone (HT)) perimenopause definitionfi, 4 estradiol level patterns, 4 5 symptoms, 5 6 (see also Perimenopausal symptoms) postmenopause, 7 premenopause, 3 principles of practice, progesterone (see Progesterone) STRAW definitionsfi, 3, 4 reproductive stages identificationfi, 7, 8 surgical and medical menopause, 7 Mood and cognition, N Night sweats, 40 North American Menopause Society (NAMS), 23 Nurses Health Study, O Oral estrogen, 23, 71 Osteoporosis postmenopausal, prevention, , 117 Ovarian cancer, 33 P Patches, 53, 58 Perimenopausal symptoms cognitive issues and mood swings, 65 commonly reported, estradiol levels and, 63 FDA-approved hormone formulations, 71 heavy menstrual bleeding, 68 high, 80 hot flushesfl, 65 low libido, 66 menopause and postmenopause, 40 mood and cognition, premenstrual symptoms, 68 prescribing regimens, progestogens, sleep issues, 41

8 Index 127 transdermal estrogen, ( see also Transdermal estrogen) urogenital symptoms, 41 vasomotor symptoms, 40 vulvar discomfort and/or vaginal discomfort, 70 Perimenopause, 14 definitionfi, 4 estradiol level patterns, 4 5 symptoms, 5 6 (see also Perimenopausal symptoms) Postmenopausal bleeding, 85 Postmenopausal Estrogen/Progestin Interventions (PEPI) trial, Postmenopausal osteoporosis, Premarin, 108 Premenopause, 3 Progesterone bioidentical hormones, 45, 48 breakthrough bleeding, 80 cream and pellets, 58, 59 effects, 13 estrogen deficiencyfi, 11 menopause, 7 perimenopause, 4 principles of practice, 18 production, 9 progestins and, progestogen and progestin, 12 receptors location, 12 Progestogen, 26 27, S Sleep issues, 41 Stages of Reproductive Aging Workshop (STRAW) definitionsfi, 3, 4 identification methodfi, 7, 8 Stroke, 31 Suzanne Somers approach, 49 T Testosterone cream and pellets, 58, 59 roles in HT, 9 10 Thyroid disease, Transbuccal lozenges/trouches, 59 Transdermal estrogen advantages, 53 contraindications, 54 ESTHER study, formulations, KEEPS study, 55 U Urogenital symptoms, 27 28, 41 Uterine/endometrial cancer, Uterine fibroidsfi, 93 V Vaginal estrogen creams, 58, 70 Vasomotor symptoms, 33 34, 40 Venous thromboembolism, 31 Vivelle, 44, 46 W Women s Health Initiative (WHI), 21 criticisms, estrogen-only/surgical menopause section, lifestyle changes, 117 outcomes, 110, 111 postmenopausal women and HT, 116 post-whi, 112 protocol, younger users, 116 Women s Health Initiative Memory Study (WHIMS), 110

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