Estracon Vaginal Cream

✔️ Uses of Estracon Vaginal Cream

• Vaginal atrophy
• Post-menopausal symptoms

✔️ How does Estracon Vaginal Cream work?

Conjugated Estrogen contains the hormone 'conjugated estrogens,' used in hormone replacement therapy (HRT) to counter low estrogen levels during menopause. It replaces this hormone and regulates pituitary gland secretions like luteinizing hormone (LH) and follicle-stimulating hormone (FSH), critical for sexual function and the menstrual cycle. These actions alleviate menopausal symptoms.

✔️ Side Effects of Estracon Vaginal Cream

• Vaginal bleeding
• Vaginal discharge

✔️ Quick Suggestions:

1. Wear loose, layered clothing at night to prevent hot flushes.
2. Manage weight through regular exercise if overweight.
3. Seek psychological support for emotional issues and sleep problems.
4. Use moisturizers to prevent skin dryness.
5. Limit alcohol and quit smoking.
6. Consume iron and Vitamin C-rich foods like red meat, eggs, and leafy greens.
7. Inform doctors of Conjugated Estrogen use during blood tests.
8. Estracon Vaginal Cream is for menopause symptom relief.
9. Apply externally or with the provided applicator.
10. Minimize exposure, reducing side effects compared to pills.
11. Wait after use before sexual activity to prevent absorption by a partner.
12. Report vaginal bleeding or discomfort to the doctor.
13. Avoid Estracon Vaginal Cream if pregnant, breastfeeding, over 35, a smoker, or with a clot/heart history.
14. Take calcium and vitamin D supplements for bone health.
15. Blood tests may be advised by your doctor for medication risks.

✔️ Indication of Estracon Vaginal Cream

Estracon 15gm Vaginal Cream is indicated in the following indications-

• Vasomotor symptoms range from mild to severe due to estrogen insufficiency.
• Osteoporosis prevention and treatment in women with estrogen insufficiency.
• Kraurosis Vulvae and atrophic vaginitis
• Hypoestrogenism in women.
• Dyspareunia treatment for mild to severe cases.

✔️ Pharmacology

Endogenous estrogens play a crucial role in shaping the female reproductive system and secondary sexual characteristics. While estrogen levels continually shift through metabolic processes, the most influential intracellular estrogen is estradiol, which surpasses estrone and estriol in receptor potency. In menstruating women, the primary source of estrogen—generating 70 to 500 mcg of estradiol daily—stems from the ovarian follicle, with production varying based on the menstrual phase.

Following menopause, endogenous estrogen primarily arises from the peripheral tissue conversion of adrenal cortex-secreted androstenedione into estrone. This results in the abundance of estrone and its sulfate-conjugated form, estrone sulfate, in postmenopausal women.

Estrogens function by binding to nuclear receptors within estrogen-responsive tissues, with two types of estrogen receptors recognized, their presence varying among tissues. Circulating estrogens regulate the secretion of pituitary gonadotropins—luteinizing hormone (LH) and follicle-stimulating hormone (FSH)—via negative feedback. In postmenopausal women, estrogens act to reduce elevated gonadotropin levels.

✔️ Dosage & Administration of Estracon Vaginal Cream

For the treatment of atrophic vaginitis and kraurosis vulvae, the administration of Conjugated Estrogens involves the following steps:

Dosage and Regimen: Start with a 0.5 gm dosage strength. Administer intravaginally using a cyclic regimen of 21 days of daily use followed by 7 days off.

Dosage Adjustment: Depending on individual response, the dosage can be adjusted within the range of 0.5 to 2 gm.

For moderate to severe dyspareunia (painful intercourse) due to vulvar and vaginal atrophy:

Dosage: Use 0.5 gm intravaginally.

Frequency: Apply twice weekly, for example, on Mondays and Thursdays. This can be done either in a continuous regimen or in a cyclic regimen of 21 days of daily administration followed by 7 days off.

Here's how to administer the medication using an applicator:

• Tube Preparation: Remove the cap from the tube.
• Applicator Attachment: Screw the nozzle end of the applicator onto the tube.
• Cream Filling: Gently squeeze the tube from the bottom to fill the applicator barrel with enough cream to provide the prescribed dose.
• Applicator Separation: Unscrew the applicator from the tube.
• Application: Insert the applicator into the vaginal opening.
• Medication Delivery: To deliver the medication, press the plunger downward.

To clean the applicator:

• Plunger Removal: Pull the plunger out of the barrel.
• Cleaning: Wash the plunger with mild soap and warm water. Do not boil it.

It's essential to follow the prescribed dosage, regimen, and administration instructions provided by your healthcare provider. If you have any doubts or concerns, always consult your doctor or healthcare professional for clarification.

✔️ Interaction

Conjugated Estrogen can interact with various medications:

1. Anticonvulsants (phenobarbital, phenytoin, carbamazepine)
2. Tuberculosis drugs (rifampicin, rifabutin)
3. HIV medications (nevirapine, efavirenz, ritonavir, nelfinavir)
4. Antibiotics (erythromycin, clarithromycin)
5. Antifungal medicines (ketoconazole, itraconazole)
6. Herbal preparations like St. John's wort (Hypericum perforatum)
7. Cushing's syndrome treatment (metyrapone)
8. Stomach ulcer medication (cimetidine)
9. Corticosteroids (dexamethasone)

Avoid grapefruit/grapefruit juice while on Conjugated Estrogen to reduce side effect risk.

Conjugated Estrogen should not be used in conditions such as breast/endometrial cancer, unexplained vaginal bleeding, untreated endometrial hyperplasia, blood clot history, heart issues, inherited porphyria, or liver disease.

✔️ Contraindications

Conjugated Estrogen use is contraindicated in the following situations:

1. Severe liver impairment
2. Breast carcinoma (cancer)
3. Thromboembolic disorders (history of blood clot-related conditions)
4. Cardiovascular (CV) disease (heart and blood vessel issues)
5. Undiagnosed vaginal bleeding
6. Estrogen-dependent neoplasms (tumors influenced by estrogen)
7. Hypersensitivity (allergic reactions)
8. Pregnancy

It's important to adhere to these contraindications and consult a healthcare professional before starting or discontinuing any medication.

✔️ Pregnancy & Lactation

If pregnancy occurs while undergoing treatment with Conjugated estrogen, the medication should be stopped promptly. The existing epidemiological studies suggest that accidental fetal exposure to estrogens is not associated with teratogenic (malformation-inducing) or fetotoxic (harmful to the fetus) effects. However, it's still crucial to consult a healthcare professional in such situations to ensure appropriate management and advice regarding the continuation of treatment or any potential risks to the pregnancy.

✔️ Precautions & Warnings

Before starting treatment with Conjugated Estrogen, it's crucial to inform your doctor if you're allergic to it or have conditions like fibroids, endometriosis, thickened womb lining, blood clot risk, family history of estrogen-sensitive cancer, high blood pressure, liver/kidney/heart diseases, fluid retention, diabetes, gallbladder stones, migraines, lupus, epilepsy, asthma, osteosclerosis, low blood calcium, or high blood fat levels.

Conjugated Estrogen raises the risk of endometrial hyperplasia and cancer, prompting the potential prescription of 'progesterone' to counter this. If pregnant or breastfeeding, avoid using Conjugated Estrogen, as it's not recommended. Prolonged high-dosage usage may heighten risks of heart attack, stroke, clots, dementia, and breast/uterine cancer. Consult your doctor, especially if you still have a uterus, to discuss progestin use.

✔️ Storage Conditions

Store in a cool (below 30°C) and dry place, protected from light and moisture.