Medication Safety Issues
Geriatric Patients: High-Risk Medication:
Beers Criteria: Estrogens (oral or topical patch products only), with or without progestins, are identified in the Beers Criteria as potentially inappropriate medications to be avoided in patients ≥65 years (independent of diagnosis or condition) due to their carcinogenic potential (breast and endometrium) and lack of cardioprotection or cognitive protection in older women. Low-dose intravaginal estrogen (vaginal creams or tablets) are acceptable for dyspareunia, recurrent lower urinary tract infections, and other vaginal symptoms. Of note, women with a history of breast cancer not responding to nonhormonal therapies are advised to discuss the risks/benefits of low-dose vaginal estrogen (estradiol <25 mcg twice weekly) with their health care provider (Beers Criteria [AGS 2019]).
International issues:
Sound-alike/look-alike issues: Estriol may be confused with estradiol, estrone
Product Availability (US)
Not available in US
Storage/Stability
Store between 15°C to 30°C (60°F to 85°F). Protect from light and moisture.
Adverse Reactions
Frequency not defined.
Endocrine & metabolic: Fluid retention, spotty menstruation
Gastrointestinal: Nausea
Genitourinary: Change in cervical secretions, mastalgia
Respiratory: Flu-like symptoms
