The combination of tipranavir/ritonavir and ethinyl estradiol/norethindrone was associated with a high incidence of skin rash.

Indium 111 Capromab Pendetide: Estrogen Derivatives may diminish the diagnostic effect of Indium 111 Capromab Pendetide. During therapy, age appropriate breast and pelvic exams; blood pressure; unscheduled bleeding lasting >6 months for endometrial pathology (sooner in patients who are obese, diabetic, or have a history of endometrial cancer); serum triglycerides (2 weeks after starting therapy in patients with baseline level >200 mg/dL); TSH (6 to 12 weeks after starting oral therapy in patients taking thyroid replacement) (ES [Stuenkel 2015]).Vasomotor symptoms: Efficacy beginning 1 to 3 months after starting therapy, then every 6 to 12 months as appropriate. Percentages reported in postmenopausal women following oral use.Central nervous system: Headache (26% to 32%), pain (17% to 20%)Genitourinary: Vaginal hemorrhage (2% to 14%), mastalgia (7% to 12%)Neuromuscular & skeletal: Back pain (13% to 14%), arthralgia (7% to 14%)Respiratory: Pharyngitis (10% to 12%), sinusitis (6% to 11%)Central nervous system: Depression (5% to 8%), dizziness (4% to 6%), nervousness (2% to 5%)Gastrointestinal: Diarrhea (6% to 7%), flatulence (6% to 7%)Genitourinary: Vaginitis (5% to 7%), leukorrhea (4% to 7%), vulvovaginal candidiasis (5% to 6%)Neuromuscular & skeletal: Weakness (7% to 8%), leg cramps (3% to 7%)Frequency not defined (injection): Local: Injection site phlebitis, pain at injection site, swelling at injection site<1%, postmarketing, and/or case reports: Abnormal uterine bleeding, alopecia, anaphylaxis, angioedema, bloating, breast hypertrophy, breast tenderness, cerebrovascular accident, change in cervical secretions, change in libido, chloasma, cholestatic jaundice, contact lens intolerance, decreased glucose tolerance, deep vein thrombosis, dementia, dysmenorrhea, edema, endometrial carcinoma, endometrial hyperplasia, erythema multiforme, erythema nodosum, exacerbation of asthma, exacerbation of epilepsy, exacerbation of hepatic hemangioma, exacerbation of porphyria, fibrocystic breast changes, galactorrhea, gallbladder disease, growth potentiation of benign meningioma, gynecomastia, hirsutism, hypersensitivity reaction, hypertension, increased serum triglycerides, irritability, ischemic colitis, malignant neoplasm of breast, migraine, mood changes, myocardial infarction, nausea, nipple discharge, ovarian carcinoma, pancreatitis, pelvic pain, pulmonary embolism, retinal thrombosis, skin rash, superficial venous thrombosis, thrombophlebitis, urticaria, uterine fibroids (increased size), vomiting, vulvovaginal candidiasis, weight changesThere is an increased risk of endometrial cancer in a woman with a uterus who uses unopposed estrogens. If an association is present, the absolute risk is likely rare and may be influenced by duration of therapy (AACE [Goodman 2011]; ES [Stuenkel 2015]; NAMS 2017).• Retinal vascular thrombosis: Estrogens may cause retinal vascular thrombosis; discontinue pending examination if migraine, loss of vision, proptosis, diplopia, or other visual disturbances occur; discontinue permanently if papilledema or retinal vascular lesions are observed on examination.• Asthma: Use caution in patients with asthma; may exacerbate disease.• Carbohydrate intolerance: May impair glucose tolerance; use caution in patients with diabetes. Management: Concurrent use of enzalutamide with CYP3A4 substrates that have a narrow therapeutic index should be avoided. If concomitant therapy cannot be avoided, monitor clinical effects of the substrate closely (particularly therapeutic effects).Dantrolene: Estrogen Derivatives may enhance the hepatotoxic effect of Dantrolene. Women on thyroid replacement therapy may require higher doses of thyroid hormone while receiving estrogens.• Pediatric: Prior to puberty, estrogens may cause premature closure of the epiphyses.

Estrogens modulate the pituitary secretion of gonadotropins, luteinizing hormone, and follicle-stimulating hormone through a negative feedback system; estrogen replacement reduces elevated levels of these hormones in postmenopausal women.Widely distributes throughout the body; sex hormone target organs contain higher concentrationsHepatic via CYP3A4; estradiol is converted to estrone and estriol; estrone is also converted to estriol and is converted to estradiol (Urine (primarily estriol, also as estradiol, estrone, and conjugates)Limitations of use: For short term use only to provide a rapid and temporary increase in estrogen levels.Limitations of use: For use only in women at significant risk of osteoporosis; consider use of nonestrogen medications.Limitations of use: When used solely for the treatment of vulvar and vaginal atrophy, topical vaginal products should be considered. Management: Doses of CYP3A4 substrates may need to be adjusted substantially when used in patients being treated with mitotane.Mivacurium: Estrogen Derivatives may increase the serum concentration of Mivacurium.