Hormones 2016

Oestrogel
Cmax of estradiol and estrone on Day 12 were 117 pg/ml and 128 pg/ml,
respectively.
The time-averaged serum estradiol and estrone concentrations Cavg 36 over
the 24 hour dose interval after administration of 2.5 g of Oestrogel on Day
12 were 76.8 pg/ml and 95.7 pg/ml, respectively.
Metabolism of estradiol takes place mainly in the liver under oestriol,
estrone and their conjugated metabolites (glucuronides, sulphates). These
metabolites also undergo enterohepatic recirculation.
When treatment is stopped, estradiol and urinary conjugated estradiol
concentrations return to baseline in about 76 hours (emc, 2013).
Shelf Life
36 months (emc, 2013).
Notes
Apply gel to clean, dry, intact areas of skin such as arms, shoulders, or inner
thighs and allow to dry for 5 minutes before covering skin with clothing.
Not to be applied on or near breasts or on vulval region (BNF, 2016a).
Anecdotally I’ve heard of it being applied to inner thighs and inner arms
only, as it can only penetrate one layer of skin and in these regions the skin
is thinnest.
Conditions which need supervision
If any of the following conditions are present, have occurred previously,
and/or have been aggravated during pregnancy or previous hormone
treatment, the patient should be closely supervised. It should be taken into
account that these conditions may recur or be aggravated during treatment
with Oestrogel, in particular -
• Leiomyoma (uterine fibroids) or endometriosis,
• Risk factors for thromboembolic disorders,
• Risk factors for oestrogen dependent tumours, e.g.
heredity for breast cancer,
• Hypertension,
• Liver disorders (e.g. liver adenoma),
• Diabetes mellitus with or without vascular involvement,
• Cholelithiasis,
• Migraine or (severe) headache,
• Systemic lupus erythematosus (SLE),
36 the average plasma concentration of a drug after administration
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first degree