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Depo-Estradiol (Estradiol Cypionate) Injection
Market Applicability Market DC GA KY MD NJ NY WA Applicable X X X X X X NA Depo-Estradiol (estradiol cypionate) injection Override(s) Approval Duration Prior Authorization 1 year Medications Depo-Estradiol (estradiol cypionate) injection APPROVAL CRITERIA Requests for Depo-Estradiol (estradiol cypionate) injection may be approved when the following criteria are met: I. Individual is using to treat moderate to severe vasomotor symptoms associated with menopause; OR II. Individual has been diagnosed with hypoestrogenism due to hypogonadism; OR III. Individual has a diagnosis of gender dysphoria or gender identity disorder (WPATH 2012, Endocrine Society 2017) ; AND IV. Individual is 16 years of age or older; AND V. The goal of treatment is male-to-female gender reassignment. Requests for Depo-Estradiol (estradiol cypionate) injection may not be approved for any of the following: I. Individual has undiagnosed abnormal genital bleeding; OR II. Individual has known or suspected cancer of the breast; OR III. Individual has known or suspected estrogen-dependent neoplasia; OR IV. Individual has active deep vein thrombosis, pulmonary embolism or history of these conditions; OR V. Individual has active or recent (within the past year) arterial thromboembolic disease (such as stroke or myocardial infarction); OR VI. Individual has liver dysfunction or disease. PAGE 1 of 2 02/24/2020 New Program Date 02/24/2020 CRX-ALL-0519-20 This policy does not apply to health plans or member categories that do not have pharmacy benefits, nor does it apply to Medicare. Note that market specific restrictions or transition-of-care benefit limitations may apply. -
PRESCRIBING INFORMATION OGEN* (Estropipate) Tablets 0.75 Mg, 1.5
PRESCRIBING INFORMATION OGEN* (estropipate) Tablets 0.75 mg, 1.5 mg, 3.0 mg Estrogen Pfizer Canada Inc. Date of Revision: 17,300 Trans-Canada Highway 25 May 2009 Kirkland, Quebec, H9J 2M5 Control No. 120830 * TM Pharmacia Enterprises S.A. Pfizer Canada Inc., licensee © Pfizer Canada Inc., 2009 OGEN* (estropipate) Prescribing Information Page 1 of 27 Table of Contents PART I: HEALTH PROFESSIONAL INFORMATION.........................................................3 SUMMARY PRODUCT INFORMATION ........................................................................3 INDICATIONS AND CLINICAL USE..............................................................................3 CONTRAINDICATIONS ...................................................................................................3 WARNINGS AND PRECAUTIONS..................................................................................4 ADVERSE REACTIONS..................................................................................................11 CLINICAL TRIAL ADVERSE DRUG REACTIONS.....................................................13 DRUG INTERACTIONS ..................................................................................................13 DOSAGE AND ADMINISTRATION..............................................................................15 OVERDOSAGE ................................................................................................................16 ACTION AND CLINICAL PHARMACOLOGY ............................................................16 -
Androgen Excess in Breast Cancer Development: Implications for Prevention and Treatment
26 2 Endocrine-Related G Secreto et al. Androgen excess in breast 26:2 R81–R94 Cancer cancer development REVIEW Androgen excess in breast cancer development: implications for prevention and treatment Giorgio Secreto1, Alessandro Girombelli2 and Vittorio Krogh1 1Epidemiology and Prevention Unit, Fondazione IRCCS – Istituto Nazionale dei Tumori, Milano, Italy 2Anesthesia and Critical Care Medicine, ASST – Grande Ospedale Metropolitano Niguarda, Milano, Italy Correspondence should be addressed to G Secreto: [email protected] Abstract The aim of this review is to highlight the pivotal role of androgen excess in the Key Words development of breast cancer. Available evidence suggests that testosterone f breast cancer controls breast epithelial growth through a balanced interaction between its two f ER-positive active metabolites: cell proliferation is promoted by estradiol while it is inhibited by f ER-negative dihydrotestosterone. A chronic overproduction of testosterone (e.g. ovarian stromal f androgen/estrogen balance hyperplasia) results in an increased estrogen production and cell proliferation that f androgen excess are no longer counterbalanced by dihydrotestosterone. This shift in the androgen/ f testosterone estrogen balance partakes in the genesis of ER-positive tumors. The mammary gland f estradiol is a modified apocrine gland, a fact rarely considered in breast carcinogenesis. When f dihydrotestosterone stimulated by androgens, apocrine cells synthesize epidermal growth factor (EGF) that triggers the ErbB family receptors. These include the EGF receptor and the human epithelial growth factor 2, both well known for stimulating cellular proliferation. As a result, an excessive production of androgens is capable of directly stimulating growth in apocrine and apocrine-like tumors, a subset of ER-negative/AR-positive tumors. -
Pms-ESTRADIOL VALERATE INJECTION
PRODUCT MONOGRAPH Prpms-ESTRADIOL VALERATE INJECTION Estradiol Valerate 10 mg/mL Estrogen PHARMASCIENCE INC. Date of Revision: 6111 Royalmount Avenue, Suite 100 June 30, 2009 Montreal, Quebec H4P 2T4 Control Number: 120632 Table of Contents PART I: HEALTH PROFESSIONAL INFORMATION……………………………...3 SUMMARY PRODUCT INFORMATION……………………………………….3 INDICATIONS AND CLINICAL USE…………………………………………...3 CONTRAINDICATIONS…………………………………………………………4 WARNINGS AND PRECAUTIONS…………………………………….……….5 ADVERSE REACTIONS………………………………………………………...13 DRUG INTERACTIONS………………………………………………………...15 DOSAGE AND ADMINISTRATION…………………………………………...17 OVERDOSAGE………………………………………………………………….19 ACTION AND CLINICAL PHARMACOLOGY……………………………….19 STORAGE AND STABILITY…………………………………………………...22 DOSAGE FORMS, COMPOSITION AND PACKAGING……………………..22 PART II: SCIENTIFIC INFORMATION…………………………………………….23 PHARMACEUTICAL INFORMATION………………………………………...23 CLINICAL TRIALS……………………………………………………………...24 DETAILED PHARMACOLOGY………………………………………………..24 REFERENCES…………………………………………………………………...25 PART III: CONSUMER INFORMATION……………………………………………………27 2 PRODUCT MONOGRAPH Prpms- ESTRADIOL VALERATE INJECTION (Estradiol Valerate) 10 mg/mL PART I: HEALTH PROFESSIONAL INFORMATION SUMMARY PRODUCT INFORMATION Route of Dosage Form / Strength Clinically Relevant Nonmedicinal Administration Ingredients Intramuscular Injection / 10 mg/mL Sesame Oil For a complete listing see Dosage Forms, Composition and Packaging section. INDICATIONS AND CLINICAL USE pms-ESTRADIOL VALERATE INJECTION is indicated in the treatment of: I. amenorrhea (primary -
Affect Breast Cancer Risk
HOW HORMONES AFFECT BREAST CANCER RISK Hormones are chemicals made by the body that control how cells and organs work. Estrogen is a female hormone made mainly in the ovaries. It’s important for sexual development and other body functions. From your first monthly period until menopause, estrogen stimulates normal breast cells. A higher lifetime exposure to estrogen may increase breast cancer risk. For example, your risk increases if you start your period at a young age or go through menopause at a later age. Other hormone-related risks are described below. Menopausal hormone therapy Pills Menopausal hormone therapy (MHT) is The U.S. Food and Drug Administration also known as postmenopausal hormone (FDA) recommends women use the lowest therapy and hormone replacement dose that eases symptoms for the shortest therapy. Many women use MHT pills to time needed. relieve hot flashes and other menopausal Any woman currently taking or thinking symptoms. MHT should be used at the Birth control about taking MHT pills should talk with her lowest dose and for the shortest time pills (oral doctor about the risks and benefits. contraceptives) needed to ease menopausal symptoms. Long-term use can increase breast cancer Vaginal creams, suppositories Current or recent use risk and other serious health conditions. and rings of birth control pills There are 2 main types of MHT pills: slightly increases breast Vaginal forms of MHT do not appear to cancer risk. However, estrogen plus progestin and estrogen increase the risk of breast cancer. However, this risk is quite small alone. if you’ve been diagnosed with breast cancer, vaginal estrogen rings and suppositories are because the risk of Estrogen plus progestin MHT breast cancer for most better than vaginal estrogen creams. -
A Guide to Feminizing Hormones – Estrogen
1 | Feminizing Hormones A Guide to Feminizing Hormones Hormone therapy is an option that can help transgender and gender-diverse people feel more comfortable in their bodies. Like other medical treatments, there are benefits and risks. Knowing what to expect will help us work together to maximize the benefits and minimize the risks. What are hormones? Hormones are chemical messengers that tell the body’s cells how to function, when to grow, when to divide, and when to die. They regulate many functions, including growth, sex drive, hunger, thirst, digestion, metabolism, fat burning & storage, blood sugar, cholesterol levels, and reproduction. What are sex hormones? Sex hormones regulate the development of sex characteristics, including the sex organs such as genitals and ovaries/testicles. Sex hormones also affect the secondary sex characteristics that typically develop at puberty, like facial and body hair, bone growth, breast growth, and voice changes. There are three categories of sex hormones in the body: • Androgens: testosterone, dehydroepiandrosterone (DHEA), dihydrotestosterone (DHT) • Estrogens: estradiol, estriol, estrone • Progestin: progesterone Generally, “males” tend to have higher androgen levels, and “females” tend to have higher levels of estrogens and progestogens. What is hormone therapy? Hormone therapy is taking medicine to change the levels of sex hormones in your body. Changing these levels will affect your hair growth, voice pitch, fat distribution, muscle mass, and other features associated with sex and gender. Feminizing hormone therapy can help make the body look and feel less “masculine” and more “feminine" — making your body more closely match your identity. What medicines are involved? There are different kinds of medicines used to change the levels of sex hormones in your body. -
Alpha-Fetoprotein: the Major High-Affinity Estrogen Binder in Rat
Proc. Natl. Acad. Sci. USA Vol. 73, No. 5, pp. 1452-1456, May 1976 Biochemistry Alpha-fetoprotein: The major high-affinity estrogen binder in rat uterine cytosols (rat alpha-fetoprotein/estrogen receptors) JOSE URIEL, DANIELLE BOUILLON, CLAUDE AUSSEL, AND MICHELLE DUPIERS Institut de Recherches Scientifiques sur le Cancer, Boite Postale No. 8, 94800 Villejuif, France Communicated by Frangois Jacob, February 3, 1976 ABSTRACT Evidence is presented that alpha-fetoprotein nates in hypotonic solutions, whereas in salt concentrations (AFP), a serum globulin, accounts mainly, if not entirely, for above 0.2 M the 4S complex is by far the major binding enti- the high estrogen-binding properties of uterine cytosols from immature rats. By the use of specific immunoadsorbents to ty. AFP and by competitive assays with unlabeled steroids and The relatively high levels of serum AFP in immature rats pure AFP, it has been demonstrated that in hypotonic cyto- prompted us to explore the contribution of AFP to the estro- sols AFP is present partly as free protein with a sedimenta- gen-binding capacity of uterine homogenates. The results tion coefficient of about 4-5 S and partly in association with obtained with specific anti-AFP immunoadsorbents (12, 13) some intracellular constituent(s) to form an 8S estrogen-bind- provided evidence that at low salt concentrations,'AFP ac-' ing entity. The AFP - 8S transformation results in a loss of antigenic reactivity to antibodies against AFP and a signifi- counts for most of the estrogen-binding capacity associated cant change in binding specificity. This change in binding with the 4-5S macromolecular complex. -
Mass Spectrometry Analysis of Hormones in Water by Direct Injection
Application Note Environmental Mass Spectrometry Analysis of Hormones in Water by Direct Injection Using the Agilent 6470 Triple Quadrupole Mass Spectrometer Authors Abstract Imma Ferrer, E. Michael Thurman, and Some hormones are included in the Contaminant Candidate List CCL4 of the Jerry A. Zweigenbaum Environmental Protection Agency (EPA) to be assessed for regulation in drinking University of Colorado and water. These compounds are also of regulatory interest in the EU, China, and other Agilent Technologies, Inc. countries. Therefore, the environmental community often desires the analysis of these compounds in water samples. This Application Note describes the methodology used for the determination of eight hormones (17-α-ethinylestradiol, 17-β-estradiol, estriol, 4-androstene-3,17-dione, equilin, estrone, progesterone, and testosterone) in tap water using an Agilent 6470 triple quadrupole mass spectrometer. A direct injection method using 100 µL of water sample was carried out. This method saves time, reduces handling errors and analytical variability, and is sensitive enough to detect hormones in surface and drinking water at ng/L levels. Introduction Both positive and negative ion modes and stored at −18 °C. A mix of all were used, depending on the specific the hormones was prepared at a The presence of hormones in compound. We also used a novel concentration of 1 μg/mL. Serial dilutions environmental waters has always been mobile phase approach that included were prepared to obtain a calibration controversial because either none have ammonium fluoride to enhance the curve ranging from 1 to 500 ng/L. been detected, or very low traces have negative ion signal4. -
Antiestrogenic Action of Dihydrotestosterone in Mouse Breast
Antiestrogenic action of dihydrotestosterone in mouse breast. Competition with estradiol for binding to the estrogen receptor. R W Casey, J D Wilson J Clin Invest. 1984;74(6):2272-2278. https://doi.org/10.1172/JCI111654. Research Article Feminization in men occurs when the effective ratio of androgen to estrogen is lowered. Since sufficient estrogen is produced in normal men to induce breast enlargement in the absence of adequate amounts of circulating androgens, it has been generally assumed that androgens exert an antiestrogenic action to prevent feminization in normal men. We examined the mechanisms of this effect of androgens in the mouse breast. Administration of estradiol via silastic implants to castrated virgin CBA/J female mice results in a doubling in dry weight and DNA content of the breast. The effect of estradiol can be inhibited by implantation of 17 beta-hydroxy-5 alpha-androstan-3-one (dihydrotestosterone), whereas dihydrotestosterone alone had no effect on breast growth. Estradiol administration also enhances the level of progesterone receptor in mouse breast. Within 4 d of castration, the progesterone receptor virtually disappears and estradiol treatment causes a twofold increase above the level in intact animals. Dihydrotestosterone does not compete for binding to the progesterone receptor, but it does inhibit estrogen-mediated increases of progesterone receptor content of breast tissue cytosol from both control mice and mice with X-linked testicular feminization (tfm)/Y. Since tfm/Y mice lack a functional androgen receptor, we conclude that this antiestrogenic action of androgen is not mediated by the androgen receptor. Dihydrotestosterone competes with estradiol for binding to the cytosolic estrogen receptor of mouse breast, […] Find the latest version: https://jci.me/111654/pdf Antiestrogenic Action of Dihydrotestosterone in Mouse Breast Competition with Estradiol for Binding to the Estrogen Receptor Richard W. -
Estradiol-17Β Pharmacokinetics and Histological Assessment Of
animals Article Estradiol-17β Pharmacokinetics and Histological Assessment of the Ovaries and Uterine Horns following Intramuscular Administration of Estradiol Cypionate in Feral Cats Timothy H. Hyndman 1,* , Kelly L. Algar 1, Andrew P. Woodward 2, Flaminia Coiacetto 1 , Jordan O. Hampton 1,2 , Donald Nickels 3, Neil Hamilton 4, Anne Barnes 1 and David Algar 4 1 School of Veterinary Medicine, Murdoch University, Murdoch 6150, Australia; [email protected] (K.L.A.); [email protected] (F.C.); [email protected] (J.O.H.); [email protected] (A.B.) 2 Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Melbourne 3030, Australia; [email protected] 3 Lancelin Veterinary Hospital, Lancelin 6044, Australia; [email protected] 4 Department of Biodiversity, Conservation and Attractions, Locked Bag 104, Bentley Delivery Centre 6983, Australia; [email protected] (N.H.); [email protected] (D.A.) * Correspondence: [email protected] Received: 7 September 2020; Accepted: 17 September 2020; Published: 21 September 2020 Simple Summary: Feral cats (Felis catus) have a devastating impact on Australian native fauna. Several programs exist to control their numbers through lethal removal, using tools such as baiting with toxins. Adult male cats are especially difficult to control. We hypothesized that one way to capture these male cats is to lure them using female cats. As female cats are seasonal breeders, a method is needed to artificially induce reproductive (estrous) behavior so that they could be used for this purpose year-round (i.e., regardless of season). -
Bazedoxifene–Conjugated Estrogens for Treating Endometriosis Endometriosis: Nina S
Endometriosis: Case Report Bazedoxifene–Conjugated Estrogens Teaching Points for Treating Endometriosis 1. The estrogen receptor (ER) is a definitive down- stream target in endometriosis. As an endometrial ER antagonist, bazedoxifene assures not only block- Valerie A. Flores, MD, ade of estrogen binding, but it also has the ability to Nina S. Stachenfeld, PhD, degrade the receptor. This unique property of baze- and Hugh S. Taylor, MD doxifene blocks estrogen action and makes it an attractive treatment option for endometriosis. 2. Conjugated estrogens paired with bazedoxifene do BACKGROUND: Endometriosis is a gynecologic disorder not require a progestin to block endometrial affecting 6–10% of reproductive-aged women. First-line growth, thus avoiding the side effects associated therapies are progestin-based regimens; however, failure with progestin-based regimens. 08/19/2018 on BhDMf5ePHKbH4TTImqenVGLGjjqParD6K7Nl5tTGGFqgjMmLRmuIlIgbkUbgVXoQ by http://journals.lww.com/greenjournal from Downloaded rates are high, often requiring alternative hormonal agents, each with unfavorable side effects. Bazedoxifene with con- ’ 1 Downloaded that can have a significant effect on patients lives. jugated estrogens is approved for treatment of menopausal Treatment consists of agents that induce atrophy of symptoms, and use in animal studies has demonstrated from regression of endometriotic lesions. As such, it represents endometriotic lesions. There is tremendous need for http://journals.lww.com/greenjournal a potential treatment option for endometriosis. therapies that are effective, have favorable side effect profiles, and can be used long term in women with CASE: A patient with stage III endometriosis referred for symptomatic endometriosis, especially for those not management of dysmenorrhea and cyclic pelvic pain was treated with 20 mg bazedoxifene and 0.45 mg conjugated responding to progestin-based regimens. -
Structure and Origin of Uterine and Extragenital L=Ibroids Induced
Structure and Origin of Uterine and Extragenital l=ibroids Induced Experimentally in the Guinea Pig by Prolonged Administration of Estrogens* Alexander Lipschotz, M.D., and Louis Vargas, Jr., M.D. (From Department o/ Experimental Medicine, National Health Service o/the Republic o/Chile, Santiago, Chile) (Received for publication December 13, x94o) The purpose of this communication is to present the These experimentally induced abdominal tumors findings of a detailed microscopical study of the sites present a smooth surface formed of a capsule com- of origin and stages of development of the subserous posed of flattened superficial cells (Plate 2, Figs. 2-A fibroid tumors induced in guinea pigs by prolonged and 2-B). The cells beneath the capsule resemble administration of estrogens. Details of treatment of fibroblasts. These cells have definite boundaries or the animals are given in the explanations of Plates I- 5. they are separated from each other by collagenous Subserous uterine tumors which can be induced in fibers (Plate 4, Fig. ix-C). guinea pigs by prolonged administration of estrogens, The masses of fibroid tumors arising from the apex as described by Nelson (26, 27), were found to be of the uterine horn may enclose the tubes or large fibroids. Lipschiitz, Iglesias, and Vargas (i3, 18, 22) tubal cysts. The demarcation between the muscular have shown that extragenital tumors in the abdominal coat of the tube and the tumor is not always sharp. cavity, induced by estrogens, also were fibroids. The In some instances, especially when the apical fibroid localization of these tumo~:s at various sites on the is small, the tumor is in close contact with an abun- uterus, pancreas, kidney, spleen, etc., have been de- dance of smooth muscle and adipose tissue (Plate 2, scribed by Iglesias (5), Vargas and Lipschiitz (32), Fig.