📋 Indications & Clinical Dosage
*Treatment of moderate to severe vasomotor symptoms, vulvar and vaginal atrophy associated with the menopause:*
BY IM INJ: Adult (female): 10-20 mg every 4 weekly. Discontinue or taper at 3-6 months intervals.
*Treatment of female hypoestrogenism due to hypogonadism, castration or primary ovarian failure:*
BY IM INJ: Adult (female): 10-20 mg every 4 wk.
*Treatment of advanced androgen dependent carcinoma of the prostate, for palliation only:*
BY IM INJ: Adult (female): 30 mg or more admin-istered every 1-2 wk.
Children: Not recommended.
⛔ Contraindications
Active or recent arterial thromboembolicdisease (e.g. angina or myocardial infarction), active thrombophlebitis, Dubin-Johnson syndrome (or monitor closely), history of breast cancer, history of recurrentvenous thromboembolism (unless already on anticoagulant treatment), oestrogen-dependent cancer, Rotor syndrome (or monitor closely), thrombophilic disorder, undiagnosed vaginal bleeding, untreated endometrial hyperplasia, venous
thromboembolism, severe cardiac, hepatic or renal disease, pregnancy and lactation
⚠️ Precautions & Warnings
Hypertension, myocardial or renal disease, asthma, varicose veins, epilepsy, chloasma, uterine fibro-myomata, risk of breast cancer and endometrial carcinoma; examine BP, pelvic organs & breasts before & regularly during treatment.
🔄 Drug Interactions
Diuretics, antihypertensives, liver enzyme inducing drugs.
⚠️ Adverse Reactions / Side Effects
Nausea, vomiting, weight gain, breast tenderness & enlargement, withdrawal bleeding, sodium retention with oedema, liver function disorders, jaundice, rashes, chloasma, headache. Endometrial carcinoma in post menopausal women
📚 Official Regulatory & Clinical References
- Drug Regulatory Authority of Pakistan (DRAP): Drug Registration, S.R.O. Price Gazettes & National Essential Medicines List (NEML).
- World Health Organization (WHO): Collaborating Centre for Drug Statistics Methodology (ATC/DDD Index).
- Formulary Standards: British National Formulary (BNF) & Pakistan National Formulary (PNF) guidelines.