DOSING: The usually recommended dose for treating menopause is 0.75 to6 mg orally daily; cycling is 21 days on the medication followed by about 7- 10 days not taking the drug. The dose for osteoporosis prevention is 0.75 mg daily for 25 days then off for 6 days.
DRUG INTERACTIONS: Estrogens can inhibit the metabolism of cyclosporine, resulting in increased cyclosporine levels in blood. Such increased blood levels can result in kidney and/or liver damage. If this combination cannot be avoided, cyclosporine concentrations can be monitored, and the dose of cyclosporine can be adjusted to assure that its blood levels are not elevated.
Estrogens appear to increase the risk of liver disease in patients receiving dantrolene through an unknown mechanism. Women over 35 years of age and those with a history of liver disease are especially at risk. Estrogens increase the liver's ability to manufacture clotting factors. Because of this, patients receiving warfarin (Coumadin) need to be monitored for loss of the anticoagulant (blood thinning) effect of warfarin if estrogens like estropipate are added.
Rifampin (Rifadin), barbiturates, carbamazepine (Tegretol), griseofulvin, phenytoin (Dilantin) and primidone (Mysoline), all can increase the elimination of estrogens by enhancing the liver's ability to metabolize (break down) the estrogens. Thus, concurrent use of these drugs and estrogens may result in reduction of the beneficial effects of estrogens.
Quick GuideWhat to Expect During Menopause as You Age
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