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HRT preparations: Estrogens


Please note: Patients should consult a health professional to decide on the appropriate treatment option to be prescribed.

The products marked * are licensed for prevention and/or treatment of osteoporosis.
Prices are for 84 tablets, ie 3 months.

TABLET

a. Low dose - recommended starting dose.

ELLESTE SOLO 1mg estradiol £5.06
PROGYNOVA 1mg estradiol valerate £7.30
PREMARIN 0.3mg conjugated estrogens £6.07
ZUMENON 1mg estradiol £5.06

b. Medium dose

BEDOL 2mg estradiol £5.06
ELLESTE SOLO* 2mg estradiol £5.06
PREMARIN* 0.625mg conjugated estrogens £4.02
PROGYNOVA* 2mg estradiol valerate £7.30
ZUMENON* 2mg estradiol £6.90

c. Higher dose - when symptoms are not controlled by the above.

PREMARIN* 1.25mg conjugated estrogens £3.58

NON-TABLET - Transdermal

Transdermal estrogen only preparations are available as patches, gel, spray or, less commonly, implants. There is no "best". Some women absorb best from patch, others from gel and some from spray. Each have pros and cons and changes may be required.

a. Patches - convenient, twice weekly or weekly but sometimes poor adherence and/or skin irritation. Visibility can be a concern for some women. Can be matrix (M) or reservoir (R) Matrix tend to cause less skin irritation and adhere better. Patches can be changed once or twice weekly.
Prices are for 4 weeks.

Low dose

Estraderm MX 2 x wkly M 25 mcg estradiol / 24hrs. £5.50
Estradot 2 x wkly M 25 mcg estradiol / 24hrs £5.99
Estradot 2 x wkly M 37.5 mcg estradiol / 24hrs £6.00
Evorel 2 x wkly M 25 mcg estradiol / 24hrs. £3.42

Medium dose

Elleste Solo MX 2 x wkly M 40 mcg estradiol / 24hrs. £5.19
Estraderm MX 2 x wkly M 50 mcg estradiol / 24hrs.* £5.51
Estradot 2 x wkly M 50 mcg estradiol / 24hrs.* £6.02
Evorel 2 x wkly M 50 mcg estradiol / 24hrs.* £3.88
FemSeven 1 x wkly M 50 mcg estradiol / 24hrs.* £6.04
Progynova TS 1 x wkly M 50 mcg estradiol / 24hrs.* £6.30

High dose

Elleste Solo MX 2 x wkly M 80 mcg estradiol / 24hrs.* £5.99
Estraderm MX 2 x wkly M 75 mcg estradiol / 24hrs. £6.42
Estradot 2 x wkly M 75 mcg estradiol / 24hrs.* £7.00
Evorel 2 x wkly M 75 mcg estradiol / 24hrs.* £4.12
FemSeven 1 x wkly M 75 mcg estradiol / 24hrs.* £6.98

Higher dose

Estraderm MX 2 x wkly M 100 mcg estradiol / 24hrs. £6.66
Estradot 2 x wkly M 100 mcg estradiol / 24hrs.* £7.27
Evorel 2 x wkly M 100 mcg estradiol / 24hrs.* £4.28
FemSeven 1 x wkly M 100 mcg estradiol / 24hrs.* £7.28
Progynova TS 1 x wkly M 100 mcg estradiol / 24hrs.* £6.90

b. Gels - Invisible, and useful if transdermal treatment is the option preferred but skin irritation occurs with patches. Skin irritation may still occur and daily application is required.

OESTROGEL 2* measures once daily (1.5mg estradiol) increased if necessary to max 4 daily (3.0mg estradiol) £4.20 for
64-dose pump
SANDRENA 1 application daily 0.5mg or 1mg -dose range 0.5 to 1.5mg daily. £5.08 & £5.85

c. Spray - Invisible. Daily application required

LENZETTO 1.53mg estradiol per spray. Starting dose once daily to forearm. Up to 3 sprays daily £3.45- £6.90

d. Implants - usually used as a last resort in patients post-hysterectomy when symptoms are not controlled by other means.

ESTRADIOL IMPLANT 25, 50 or 100 mg 6 monthly -recommended is 25 or 50mg implant. Limited availability.  

All estrogen only preparations can be used in patients who have not had a hysterectomy, as long as an appropriate progestogen is given in addition.

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