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Overview	Photos	How To Use	Side Effects	Precautions	Missed Dose	Drug Interactions

Estring Vagl Uses This medication is a female estrogen hormone and is usually given to women who no longer produce the amount of estrogen they produced before menopause. It is a very effective treatment for reducing vaginal menopause symptoms (e.g., dryness, burning, itching) and urinary symptoms (e.g., frequent urges to urinate, painful urination). Notes Do not share this medication with others. Keep all medical and laboratory appointments. You should have a complete physical examination that includes blood pressure measurements and breast/pelvic examinations at regular intervals (e.g., once a year) or as directed by your doctor. Follow your doctor's instructions on how to examine your own breasts and report any lumps immediately. You should also be regularly screened for cervical cancer (e.g., Pap test) and have periodic mammograms as determined by your doctor. Consult your doctor for more details.To help manage hot flashes, keep a cool body temperature (e.g., use a fan, drink cool beverages, dress lightly/in layers, avoid hot/spicy foods). Limiting caffeine and alcohol, exercising regularly, and learning relaxation techniques may also help reduce hot flashes. Vaginal lubricants can help lessen discomfort during intercourse. Storage Store at room temperature between 59-86 degrees F (15-30 degrees C) away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets. Overdose This medicine may be harmful if swallowed. Symptoms of overdose may include: severe nausea/vomiting or excessive vaginal bleeding. How To Use Insert the ring into the upper third of the vagina as directed. Generally, the ring is left in place for 90 days and then removed and replaced with a new ring if therapy is continued. Do not leave a ring in place for longer than 90 days. Follow the dosing schedule carefully.Learn all usage instructions in the product package and ask your doctor or pharmacist if you are unclear about any of the information.When placed properly, you should not feel the ring and it will not interfere with sexual intercourse. If the ring moves into the lower part of your vagina, push it back into place with your finger. If the ring falls out of the vagina, rinse the ring with lukewarm water and re-insert. The ring is removed by hooking your finger through the ring and gently pulling it out. Discard the used ring in the trash container. Do not flush it down the toilet.Vaginal and urinary symptoms should improve within 2-3 weeks of starting this medication. If symptoms persist, contact your doctor.Read the Patient Information Leaflet available from your pharmacist. Consult your doctor or pharmacist if you have any questions. Side Effects Vaginal discomfort, increased vaginal discharge, dizziness, light-headedness, headache, stomach upset, bloating, nausea, weight changes, increased/decreased interest in sex, and breast tenderness may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.Remember that your doctor has prescribed this medication because the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor immediately if any of these unlikely but serious side effects occur: mental/mood changes (e.g., severe depression, memory loss), vision changes (e.g., change in contact lens fit, loss of vision), swelling of hands or feet, breast lumps, unusual vaginal bleeding (e.g., spotting, breakthrough bleeding, prolonged/recurrent bleeding), unusual vaginal discharge/itching/odor, yellowing eyes or skin.Seek immediate medical attention if any of these unlikely but very serious side effects occur: calf pain/swelling, sudden severe headache, chest pain, trouble breathing, weakness on one side of the body, slurred speech.Vaginal rings have rarely caused a very serious (possibly fatal) bacterial infection (toxic shock syndrome-TSS). Remove this product and seek immediate medical attention if you develop symptoms of toxic shock syndrome, including: high fever, severe/sudden dizziness, fainting, unusual muscle pain, sunburn-like rash, diarrhea.A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching, swelling, severe dizziness, trouble breathing.If you notice other effects not listed above, contact your doctor or pharmacist. Precautions Before taking estradiol, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies.This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: undiagnosed abnormal vaginal bleeding, certain cancers (e.g., breast cancer, especially non-metastatic type), blood clots, active/recent stroke, heart attack.Before using this medication, tell your doctor or pharmacist your medical history, especially of: family medical history (especially breast lumps and cancer), asthma, diabetes, seizures, migraine headaches, liver disease, heart disease (e.g., high blood pressure, heart attacks, congestive heart failure), kidney disease, low thyroid hormone (hypothyroidism), abnormal calcium level in the blood, depression, high blood pressure during pregnancy (toxemia), yellowing eyes or skin (cholestatic jaundice) during pregnancy or with past estrogen use, womb problems (e.g., uterine fibroids, endometriosis), vaginal conditions (e.g., recurring vaginal infections, prolapse, stenosis), cholesterol or lipid problems, gallbladder disease, excessive weight gain, certain blood disorder (porphyria).If you develop a vaginal infection while using the ring, it is recommended that you remove the ring and resume therapy after the infection has been treated. Consult your doctor or pharmacist for more information.If you will be having surgery or will be confined to a chair or bed for a long period of time (e.g., a long plane flight), notify your doctor beforehand. Special precautions may need to be taken in these circumstances while you are using this drug.This drug may make you dizzy; use caution engaging in activities requiring alertness such as driving or using machinery. Limit alcoholic beverages.This drug may cause a patchy darkening of the skin on the face (melasma). Sunlight may intensify this darkening and you may need to avoid prolonged sun exposure and sunlamps. Consult your doctor regarding use of sunscreens and protective clothing.Cigarette smoking can increase the chance of blood clots while taking this medication (especially in women over the age of 35).This medication must not be used during pregnancy. If you become pregnant or think you may be pregnant, inform your doctor immediately.This medication may pass into breast milk and may have undesirable effects on a nursing infant. Therefore, breast-feeding while using this medication is not recommended. Missed Dose Not applicable. However, if you have not inserted a new ring after 90 days, contact your doctor to establish a new schedule for using this medication. Drug Interactions Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with them first.Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription products you may use, especially of: other vaginal products.It is recommended that the ring be removed during treatment with other vaginal products. Consult your doctor or pharmacist for more information.This product can affect the results of certain lab tests. Make sure laboratory personnel and your doctors know you use this drug.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgement of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.