PRECAUTIONS: Before taking estramustine, tell your doctor or pharmacist if you are allergic to it; or to estradiol or other estrogens; or to nitrogen mustard (e.g., mechlorethamine); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: history of stroke or other blood clots (e.g., in the legs, eyes, lungs), bone disease (e.g., bone metastases, high calcium levels), high cholesterol or triglyceride (blood fat) levels, depression, diabetes, severe headaches (e.g., migraine), heart disease (e.g., angina, heart attack, heart failure), high blood pressure, kidney disease, liver disease, seizure, long periods of sitting or lying down (e.g., immobility such as being bedridden), stroke, thyroid problems.Do not smoke cigarettes or use tobacco. Estrogens combined with smoking further increase your risk for stroke, blood clots, high blood pressure, and heart attacks.If you will be having surgery or will be confined to a chair or bed for a long time (e.g., a long plane flight), notify your doctor beforehand. Special precautions may need to be taken in these circumstances while you are taking this drug because of the increased risk for blood clots.If you have diabetes, estramustine may worsen control of blood glucose levels. Monitor your blood glucose levels regularly and inform your doctor of the results.If you are nearsighted or wear contact lenses, you may develop vision problems or trouble wearing your contact lenses. Contact your eye doctor if these problems occur.This drug may cause a patchy darkening of the skin on the face (melasma). Sunlight may worsen this darkening. Avoid prolonged sun exposure, tanning booths, and sunlamps. Use a sunscreen and wear protective clothing when outdoors.This medication may affect the production of sperm. Use a reliable form of birth control while on this medication. Consult your doctor.This medication is not usually used in women. Therefore, it is unlikely to be used during pregnancy or breast-feeding. Consult your doctor if you have any questions about this medication.
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