Elestrin Dosage and Administration
Flexible dose titration
Elestrin (estradiol gel 0.06%) is a clear topical gel formulation of topical estradiol that is applied once daily to a small area of the upper arm/shoulder and dries in approximately 5 minutes. It is dispensed via a metered-dose pump and is available in 2 approved doses: 1 or 2 pumps.
- 1 pump of Elestrin = 0.52 mg of estradiol daily
- 2 pumps of Elestrin = 1.04 mg of estradiol daily
Patients are typically started at the lowest effective dose of Elestrin, which is one pump (0.52 mg of estradiol) per day. However, dosage is ultimately a clinical decision made by the healthcare professional.
Regardless, the prescribed dosage should be periodically reassessed by the HCP. Dosage adjustment may be made based upon the individual patient response. Use of estrogen should be with the lowest effective dose and for the shortest duration, based on the treatment goals and risks for the individual woman.
When estrogen is prescribed for postmenopausal women with a uterus, a progestin should also be initiated to reduce the risk of endometrial cancer. A woman without a uterus usually does not need progestin.
Elestrin isn't right for everyone. Elestrin should not be prescribed for women who have: undiagnosed abnormal genital bleeding; known, suspected, or history of breast cancer; known or suspected estrogen-dependent neoplasia; active deep vein thrombosis, pulmonary embolism, or history of these conditions; active arterial thromboembolic disease (for example, stroke and MI), or a history of these conditions; known anaphylactic reaction or angioedema to Elestrin; known liver impairment or disease; known protein C, protein S, or antithrombin deficiency, or other known thrombophilic disorders; or known or suspected pregnancy.
Convenient application for patients
Elestrin is a clear gel. Patients apply Elestrin to clean, dry skin and allow it to dry for 5 minutes. After applying Elestrin, the patient should wash her hands with soap and water.
Estradiol absorption was increased when sunscreen was applied 10 minutes before Elestrin application. Sunscreen should not be applied to the same site until at least 25 minutes after the application of Elestrin. Avoid applying sunscreen to the application area for an extended period of 7 or more days. If taking a bath, showering, or using a sauna, patients should apply Elestrin afterward. If swimming, patients should leave as much time as possible, at least 2 hours, between applying Elestrin and going into the water. Patients should prevent others from contacting the application area for 2 hours.
As part of the FDA approval process, the potential for estradiol transfer between treated postmenopausal female subjects and their untreated male partners was evaluated2:
- Two and 8 hours after women applied 2.6 g of Elestrin to one arm (12 women per time point), they engaged in direct arm-to-arm contact with a male partner for 5 minutes. No significant changes in estradiol pharmacokinetic parameters were observed in the male partners after contact.
- Less than 10% of the estradiol dose was measured on the skin at 2 and 8 hours after application.
- After washing the application site with soap and water at 8 hours after application, about 1% of the dose of estradiol was measurable.
This study evaluated the transfer from female to male; no transfer studies to children or pets were conducted. If someone else is exposed to Elestrin by direct contact with the gel, that person should wash the area of contact with soap and water as soon as possible. The longer the gel is in contact with the skin before washing, the greater is the chance that the other person will absorb some of the estrogen hormone. This is especially important for men and children.
Your patients may pay as little as $25 on their Elestrin prescriptions.