Depo-Estradiol
Depo-Estradiol (estradiol cypionate) injection is a hormone replacement therapy (HRT). It's used to relieve certain menopause symptoms, such as hot flashes and vaginal dryness. It can also raise estrogen levels in people who aren't making enough hormones. It's injected into the muscle about once every month. You can store Depo-Estradiol (estradiol cypionate) vials at room temperature, away from light. Some side effects of this medication include injection-site pain, headaches, and breast tenderness.
What is Depo-Estradiol (estradiol cypionate)?
What is Depo-Estradiol (estradiol cypionate) used for?
- Moderate-to-severe vasomotor symptoms (VMS) of menopause, like hot flashes and night sweats
- Low estrogen level caused by hypogonadism
How Depo-Estradiol (estradiol cypionate) works
Depo-Estradiol (estradiol cypionate) replaces estrogen hormones that your body loses during menopause or when your body can't make enough estrogen naturally. Replacing estrogen relieves symptoms of menopause, such as hot flashes and vaginal dryness.
Drug facts
Side effects of Depo-Estradiol (estradiol cypionate)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Injection-site pain
- Breast tenderness or growth
- Nausea or vomiting
- Headaches
- Stomach cramps
- Vaginal spotting or irregular bleeding
Less Common Side Effects
- Dizziness
- High blood pressure
- Melasma (dark patches of skin)
- Trouble tolerating contact lenses
- Mood changes
- Swelling from fluids
- Hair loss
Depo-Estradiol (estradiol cypionate) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Heart attack: chest pain or tightness, pain that radiates up to your shoulder, arm, neck, or jaw
- Stroke: sudden trouble talking, trouble walking, or numbness on one side of your body or face, severe headache
- Deep vein thrombosis (blood clot in the leg): leg cramp, swelling, pain, muscle tightness
- Pulmonary embolism (blood clot in the lung): cough, chest pain, trouble breathing, racing heart
- Liver or gallbladder problems: yellowing of the skin or the whites of the eyes, tiredness, pain in the right upper stomach, dark urine
- Unusual vaginal bleeding, vaginal discharge, or pelvic pain
The following Depo-Estradiol (estradiol cypionate) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Blood clot—pain, swelling, or warmth in the leg, shortness of breath, chest pain
- Breast tissue changes, new lumps, redness, pain, or discharge from the nipple
- Gallbladder problems—severe stomach pain, nausea, vomiting, fever
- Heart attack—pain or tightness in the chest, shoulders, arms, or jaw, nausea, shortness of breath, cold or clammy skin, feeling faint or lightheaded
- Heavy vaginal bleeding
- Increase in blood pressure
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- Stroke—sudden numbness or weakness of the face, arm, or leg, trouble speaking, confusion, trouble walking, loss of balance or coordination, dizziness, severe headache, change in vision
- Sudden eye pain or change in vision such as blurry vision, seeing halos around lights, vision loss
- Unusual vaginal discharge, itching, or odor
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
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Pros and cons of Depo-Estradiol (estradiol cypionate)
Pros
- Can be injected at home
- Typically injected once every 3 to 4 weeks
- Can be stored at room temperature
Cons
- Given as an injection
- Raises the risk of blood clots and strokes
- If you have your uterus, you have to use Depo-Estradiol (estradiol cypionate) with another hormone called progestin to lower your risk of uterine cancer.
Pharmacist tips for Depo-Estradiol (estradiol cypionate)
- Depo-Estradiol (estradiol cypionate) can be given at home. Before using it, your healthcare professional will train you or a caregiver on how to inject this medication safely and properly.
- Wash your hands with soap and water before giving Depo-Estradiol (estradiol cypionate) to prevent infection. Clean the area where you'll be injecting the medication with an alcohol wipe.
- Shake the vial before drawing Depo-Estradiol (estradiol cypionate) into a syringe. This can help dissolve any crystals that might've formed during storage. Use a new needle and syringe each time you give yourself Depo-Estradiol (estradiol cypionate).
- Throw away the used syringes and needles in a protective (sharps) container. Don't throw needles and syringes away in the regular trash to prevent needlestick injuries.
- Store Depo-Estradiol (estradiol cypionate) at room temperature, away from heat and direct light. Don’t keep the medication in the fridge or freezer because this can affect how well it works. If it gets too cold, it can form crystals. These can be dissolved again by shaking and warming the vial in your hands.
- Let your healthcare team know if you need surgery. They might ask you to stop using Depo-Estradiol (estradiol cypionate) temporarily, for about 4 to 6 weeks. Estrogen-containing medications can raise your risk of blood clots during and after surgery, especially if you're less mobile for an extended period of time during recovery.
- Let your prescriber know if you experience unusual vaginal bleeding, lumps in your breast, changes to your vision, or severe headaches after starting Depo-Estradiol (estradiol cypionate). These are not typical side effects and could be a sign of more serious problems.
Common questions about Depo-Estradiol (estradiol cypionate)
Depo-Estradiol (estradiol cypionate) is suspended in cottonseed oil. Cottonseed allergies are possible, but rare. Talk to your prescriber about all of your allergies so they can make sure this medication is safe for you to take.
People who've taken estrogen replacement therapy, like Depo-Estradiol (estradiol cypionate), have reported hair loss. But it's unclear whether the hair loss was a side effect of the medications. People who are going through menopause can experience hair loss as a result of hormone changes. If you notice more hair falling out than usual or that your hair is getting thinner, talk to your healthcare professional. They can help you determine the cause and offer tips to keep your hair healthy.
Depo-Estradiol (estradiol cypionate) is FDA-approved for injection into a muscle, usually into the outside of the upper arm, thigh, or buttocks. Work with your prescriber to find the best injection site for you. Never inject Depo-Estradiol (estradiol cypionate) into skin that's hard, tender, damaged, or bruised. Also, don't inject this medication into a vein.
For most people, Depo-Estradiol (estradiol cypionate) will keep working for about a month. If your hot flashes or night sweats come back sooner, you might need a dose as often as every 3 weeks. Your prescriber can adjust your dosing schedule based on your response to the medication.
Yes, Depo-Estradiol (estradiol cypionate) is available. But you need a prescription from a healthcare professional to use it.
No, Depo-Estradiol (estradiol cypionate) isn't a controlled substance. It isn't known to have a risk of addiction or dependence.
Both Depo-Estradiol (estradiol cypionate) and estradiol valerate (Delestrogen) are estrogen injections. One difference between them is that estradiol valerate (Delestrogen) is FDA-approved to treat more conditions than Depo-Estradiol (estradiol cypionate), including pain due to advanced prostate cancer. Another difference is that estradiol valerate (Delestrogen) is suspended in sesame oil or castor oil, whereas Depo-Estradiol (estradiol cypionate) is in cottonseed oil. Follow up with your healthcare professional (HCP) to learn more differences between these two injections.
Yes, Depo-Estradiol (estradiol cypionate) is considered a bioidentical hormone because it's made to be similar to the estrogen that's naturally found in your body.
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Risks and warnings for Depo-Estradiol (estradiol cypionate)
Depo-Estradiol (estradiol cypionate) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Uterine or endometrial cancer
- Risk factors: Estrogen therapy without additional progestin | People with a healthy uterus | Using Depo-Estradiol (estradiol cypionate) for more than 1 year | High estrogen dose
Because Depo-Estradiol (estradiol cypionate) injection works like estrogen, it can change the lining of the uterus (endometrium). Uncontrolled growth of the uterus lining can cause uterine or endometrial cancer in people with a healthy uterus. If you have a healthy uterus, your healthcare team will lower your risk of cancer by also prescribing a progestin to balance out estrogen's effect on the growth of the uterine lining. Let your healthcare team know right away if you have symptoms of uterine or endometrial cancer, such as unexpected vaginal bleeding; they can examine you and let you know if you need more medical attention.
Breast cancer
- Risk factors: Personal or family history of breast cancer | Using estrogen and progestin together for more than one year
There's a higher risk of developing breast cancer when taking estrogen medications, such as Depo-Estradiol (estradiol cypionate). To lower your risk of breast cancer, your prescriber will prescribe the lowest dose of estrogen for the shortest period of time possible. It's important that you regularly check your breasts for any changes and get breast scans (mammograms) done. Let your healthcare professional know if you notice any unusual changes in breast shape, size, or color.
Blood clots, heart attacks, and strokes
- Risk factors: Personal or family history of blood clots | High blood pressure | Diabetes | High cholesterol | Smoking | Larger body size | Systemic lupus erythematosus (SLE)
Depo-Estradiol (estradiol cypionate) can raise your risk of blood clots, which can lead to a heart attack, stroke, or pulmonary embolism (life-threatening blood clot in the lungs). Your risk for blood clots is higher if you smoke or have had blood clots in the past. Be sure to discuss all your past and present medical conditions with your prescriber before starting Depo-Estradiol (estradiol cypionate). Call 911 or get medical help right away if you have pain in your legs or arms, chest pain, sudden severe headaches, trouble breathing, or sudden changes in your speech or vision.
Risk of dementia
- Risk factors: Females 65 years of age and older
People taking estrogen/progestin combinations or estrogen-only therapy might be at greater risk for dementia. Your risk is higher if you start hormonal therapy such as Depo-Estradiol (estradiol cypionate) after age 65. Estrogen/progestin combination and estrogen-only therapies shouldn't be used to prevent dementia. Early symptoms of dementia include new forgetfulness, confusion, getting lost, and wandering out into the neighborhood. If the risk of dementia worries you, talk to your HCP.
Gallbladder problems
Depo-Estradiol (estradiol cypionate) can cause you to have problems with your gallbladder. Some people have even needed to have their gallbladder removed after starting this medication. If you experience stomach pain, nausea or vomiting that doesn't go away, fever, or a yellowing of the skin and eyes (jaundice), speak with your prescriber or get medical attention.
Changes in calcium levels in the blood
- Risk factors: Breast cancer | Cancer that has spread to the bones | Low parathyroid hormone levels
Estrogen therapy can change the calcium levels in your blood. Females with breast cancer that has spread to the bones are at higher risk of very high calcium levels. Symptoms of high calcium levels include feeling tired and having muscle weakness, nausea, vomiting, or constipation.
On the other hand, females with low parathyroid hormone levels from the parathyroid gland are at higher risk of low calcium levels during estrogen therapy. Symptoms of low calcium levels include muscle spasms or twitching and numbness and tingling in your fingers, toes, or around your mouth.
Let your HCP know if you notice any of these symptoms. You might need regular blood tests done so that your HCP can check your calcium levels while you're taking Depo-Estradiol (estradiol cypionate).
Vision problems
Although very rare, some people taking estrogens have had vision problems due to clot formation in the eyes. If you have sudden partial or complete vision loss, bulging eyes, double vision, or migraines, stop Depo-Estradiol (estradiol cypionate) and tell your prescriber.
Low thyroid hormone levels (hypothyroidism)
- Risk factors: Low thyroid hormone levels
Depo-Estradiol (estradiol cypionate) can affect thyroid hormone levels in your blood. If you take medications for low thyroid hormone levels, you might require higher doses of thyroid replacement therapy. Your prescriber might have you perform regular blood tests to check your thyroid hormone levels.
Fluid Retention
- Risk factors: History of heart or kidney problems
Depo-Estradiol (estradiol cypionate) might cause some fluid retention, or edema. This could worsen symptoms of certain conditions, like heart conditions (e.g., congestive heart failure) or kidney problems. If you notice unusual swelling in any part of your body or if you suddenly gain weight over a short period of time, let your prescriber know.
Higher risk of side effects
- Risk factors: History of or current liver problems
Depo-Estradiol (estradiol cypionate) is processed (broken down) by the liver, so if your liver isn't working properly, you might experience more side effects from this medication. Because of this, if you have or have had any problems with your liver, including liver problems during a past pregnancy, you shouldn't use Depo-Estradiol (estradiol cypionate).
High triglycerides
- Risk factors: High levels of triglycerides
Estrogens can raise the amount of your body's blood fats (triglycerides), which can cause heart problems or inflammation of the pancreas. Your prescriber might order regular blood tests to watch for this while you're using Depo-Estradiol (estradiol cypionate). If you experience sudden stomach or back pain, nausea, vomiting, sudden weight loss, or a fast heart rate, contact your prescriber or get medical care right away.
Worsening of other medical conditions
Taking estrogen-containing medications can worsen certain medical conditions. These include high blood pressure, hereditary angioedema, asthma, diabetes, migraine, and seizures. Before you start Depo-Estradiol (estradiol cypionate), let your healthcare team know about your past medical history so they can talk with you about the risks and benefits of taking this medication.
Depo-Estradiol (estradiol cypionate) dosage
Vial| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 5ml of 5mg/ml | 1 vial | $209.89 | $209.89 |
Typical dosage for Depo-Estradiol (estradiol cypionate)
Your healthcare team will prescribe the lowest dose of Depo-Estradiol (estradiol cypionate) for the shortest period of time needed to treat your symptoms. They'll check in with you every 3 to 6 months to see if they can taper you off this medication.
- Hot flashes: The typical dose ranges from 1 mg to 5 mg injected into a muscle every 3 to 4 weeks.
- Low estrogen due to hypogonadism: The typical dose ranges from 1.5 mg to 2 mg injected into a muscle once a month.
How much does Depo-Estradiol (estradiol cypionate) cost?
$209.89
Depo-Estradiol (estradiol cypionate) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Depo-Estradiol (estradiol cypionate) will not be safe for you to take.
- Abnormal vaginal bleeding that your gynecologist doesn’t know about or you haven’t gone to them about
- Currently have or have had breast cancer
- Estrogen-dependent cancers (e.g., endometrial cancer, ovarian cancer)
- High risk for developing a blood clot
- History of blood clots, stroke, or heart attack
- Have a bleeding disorder
- Liver problems
- Currently pregnant
What are alternatives to Depo-Estradiol (estradiol cypionate)?
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