Generic Name and Formulations:
Estradiol 4mcg, 10mcg; vaginal inserts.
RECENT UPDATESMonograph added.
Indications for IMVEXXY:
Moderate-to-severe dyspareunia due to menopause.
Use lowest effective dose for the shortest duration. Initially one 4mcg insert intravaginally once daily for 2 weeks, then 1 insert twice weekly every 3–4 days. Reevaluate periodically.
Undiagnosed abnormal genital bleeding. Known, suspected, or history of breast cancer or estrogen-dependent neoplasia. Active DVT, PE, or history of these conditions. Active arterial thromboembolic disease (eg, stroke, MI) or a history of these conditions. Known protein C, protein S, or antithrombin deficiency, or other known thrombophilic disorders. Hepatic impairment or disease. Known anaphylactic reaction or angioedema.
Endometrial cancer. Cardiovascular disorders. Breast cancer. Probable dementia.
Increased risk of endometrial carcinoma or hyperplasia in women with intact uterus (adding progestin is essential). Not for prevention of cardiovascular disease or dementia. Increased risk of cardiovascular disorders (eg, stroke, DVT, VTE); discontinue if occurs or suspected. Manage risk factors for cardiovascular disease and venous thromboembolism appropriately. Discontinue at least 4–6 weeks before surgery type associated with increased risk of thromboembolism or during prolonged immobilization. Increased risk of breast or ovarian cancer. Risk of probable dementia in women ≥65yrs of age. Gallbladder disease. Bone disease associated with hypercalcemia. Visual abnormalities. History of hypertriglyceridemia. Discontinue if cholestatic jaundice, pancreatitis, hypercalcemia, or retinal vascular lesions occur. Monitor thyroid function. Conditions aggravated by fluid retention. Hypoparathyroidism. Endometriosis. Hereditary angioedema. Asthma. Diabetes. Epilepsy. Migraine. Porphyria. SLE. Hepatic hemangiomas. Do initial complete physical and repeat annually (include Pap smear, mammogram, BP). Reevaluate periodically.
May be antagonized by CYP3A4 inducers (eg, St. John's wort, phenobarbital, carbamazepine, rifampin). May be potentiated by CYP3A4 inhibitors (eg, erythromycin, clarithromycin, ketoconazole, itraconazole, ritonavir, grapefruit juice). Concomitant thyroid replacement; may need to increase thyroid dose. May interfere with lab tests (eg, thyroid, PT, coagulation factors, glucose tolerance, HDL/LDL, triglycerides, hormone concentrations, other binding or plasma proteins).
Headache; thromboembolism, neoplasms.
Vaginal inserts—8, 18
Sign Up for Free e-newsletters
Psychiatry Advisor Articles
- Age of Onset of Bipolar Disorder Linked With Substance Use Disorders
- Rapid Cycling in Bipolar Disorder: Overview and Expert Perspectives
- Low Testosterone Linked With Social Anxiety in Boys With Klinefelter Syndrome
- Posttraumatic Stress Disorder Associated With Reduced Brain Volume
- First-Episode Drug-Naive Patients With Schizophrenia More Likely to Attempt Suicide
- The Psychology of Hoarding Disorder: Approaches for Treatment
- Mind-Body Therapy and Psychiatry: Ancient Tools for Modern Practice
- Smartphone Applications for Depression and Anxiety: Are They Ready for Widespread Use?
- The Many Misconceptions of Catatonia: Treatment Is Often Successful With the Right Knowledge
- Marijuana Use Associated With Poorer Depression Outcomes, Increased Suicidal Ideation
- Healthcare Community Should Favor More Restrictive Alcohol Policies
- How to Respond to a Patient's Request for Prayer: A Clinician's Dilemma
- Major Barriers to Useful Risk Prediction Must Be Overcome to Reach the Full Potential of Big Data
- ACA Coverage Gains Include Workers Without Insurance
- Steps Provided for Discharging Patients From Practice