Precautions and Warnings With Estropipate

Specific Precautions and Warnings With Estropipate

Warnings and precautions to be aware of prior to using estropipate include the following:
  • Estropipate should never be used to prevent heart disease (see Hormone Replacement Therapy and Heart Health), as it is not effective for this use.
  • For women who still have a uterus (who have not had a hysterectomy), taking estropipate alone (without a progestin) increases the risk of endometrial cancer (cancer of the lining of the uterus). Women who still have a uterus should take estropipate with a progestin medication.
  • Let your healthcare provider know if you have abnormal vaginal bleeding, such as heavy bleeding or bleeding between periods, while taking estropipate, as this may be a sign of precancerous or cancerous changes in the uterus. Your healthcare provider can perform the necessary tests to rule out cancer.
  • Studies have shown that estrogen hormone replacement therapy increases the risk of strokes and blood clots in the legs.
  • Your healthcare provider should make sure you are appropriately treated for any risk factors for heart disease or blood clots before you take estropipate. Risk factors include:
  • When possible, estropipate should be stopped four to six weeks before many surgeries in order to help prevent blood clots.
  • Estrogen drugs, with or without a progestin, may increase the risk of breast cancer. Proper screening and monitoring as determined by your healthcare provider, such as yearly mammograms and monthly self breast exams, is recommended.
  • Estrogen drugs, with or without a progestin, seem to increase the risk of dementia. In no case should estropipate be used to prevent or treat dementia, as it is not effective for this use.
  • Estropipate may worsen epilepsy, porphyria, asthma, diabetes, migraine headaches, lupus, and hepatic hemangiomas.
  • Women who take estrogen have an increased risk for gallbladder disease.
  • Let your healthcare provider know right away if you notice any vision changes while taking the drug. This can signal a blood clot in the retina, a possible side effect of estropipate.
  • Estropipate can cause high blood pressure (hypertension) or high triglycerides in some women. Your healthcare provider should monitor you for these problems during treatment.
  • If you have had jaundice (yellowing of the whites of the eyes or skin) due to estrogens or pregnancy in the past, estropipate could cause similar problems to recur. If this happens, your healthcare provider will probably advise you to stop taking the drug.
  • If you have an underactive thyroid (hypothyroidism), estropipate may increase your body's requirement for thyroid hormones. Your healthcare provider should monitor you and adjust the dose of your thyroid medications as necessary.
  • The medication can cause fluid retention. This can cause problems for people with congestive heart failure (CHF) or kidney problems.
  • Estropipate should be used with caution in people who have low calcium levels in the blood (known medically as hypocalcemia).
  • It is not clear whether estropipate increases the risk of ovarian cancer. Some studies have shown an increased risk, while others have not.
  • The medication can make endometriosis symptoms worse.
  • Estropipate can interact with a number of different medications (see Drug Interactions With Estropipate).
  • Estropipate should not be used during pregnancy (see Ogen and Pregnancy).
  • Estropipate does pass through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Ogen and Breastfeeding).
Last reviewed by: Kristi Monson, PharmD
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