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Estradiol and Norgestimate

Generic name: estradiol and norgestimate [ES-tra-DYE-ol-and-nor-JES-ti-mate]

Brand names: Prefest, Ortho-Prefest
Oral tablet: biphasic oral tablet
Drug classes: Combinations of sex hormones

What is Estradiol and Norgestimate?

Estradiol is a type of estrogen. It is a female hormone that regulates several processes within the body.The female hormone progesterone is known as norgestimate. It regulates ovulation, menstruation, and other important processes.Combination medicine consisting of estradiol (and norgestimate) is used for the treatment of menopause symptoms such as hot flashes, vaginal changes, and the prevention of osteoporosis in women who are menopausal.This medication guide does not list all possible uses for estradiol or norgestimate.

Side effects of Estradiol and Norgestimate

If you experience any of the following symptoms of an allergy reaction, seek immediate medical attention: difficulty breathing, hives, swelling in your lips, face, throat, or tongue.

Both estradiol (or norgestimate) and norgestimate can cause severe side effects. If you experience:

  • Heart attack symptoms: chest pain, pressure or pain in your shoulder or jaw, nausea, and sweating.
  • Signs of a stroke: sudden numbness (especially on one side), severe headache; slurred or mumbled speech.
  • Signs of blood clots: sudden vision loss, chest pain that stabs, shortness of breath, blood in the cough, or pain or heat in both legs.
  • You may experience swelling in the stomach or tenderness.
  • Jaundice
  • Memory problems, confusion, and unusual behavior
  • Unusual vaginal bleeding and pelvic pain
  • A lump on your breast,
  • High levels of calcium are accompanied by nausea, vomiting, and constipation. Other symptoms include muscle weakness, pain in the bones, fatigue, or increased thirst.

Some of the common side effects associated with estradiol or norgestimate include:

  • Nausea, vomiting, bloating, and stomach cramps;
  • Fluid retention (swelling, rapid weight gain);
  • Headache;
  • Breast pain
  • Hair loss on the scalp
  • Bleeding, vaginal itching, or discharge.

There may be other side effects. For medical advice on side effects, call your doctor.Report side effects to the FDA by calling their toll-free number 1-800-FDA-1088.


Estradiol or norgestimate should be avoided if a woman has had a hysterectomy or suffers from undiagnosed bleeding in the vaginal area, liver disease or bleeding disorders, is undergoing major surgery, or if she's had heart attacks, strokes, blood clots, cancers of the breast, uterus/cervix, or vagina.Avoid using it if pregnant.Estradiol or norgestimate can increase the risk that you will develop a condition that could lead to uterine cancer. Do not ignore any abnormal vaginal bleeding.This medicine may increase the risk of stroke, blood clots, or breast cancer. It is not recommended to be taken in order to treat heart disease or stroke.

Before you take this drug

This medicine should not be used if:

  • Unusual vaginal bleeding not checked by your doctor
  • Liver disease
  • A history of heart attacks, strokes, or blood clots;
  • A history of cancers of the breast, uterus, cervix, or vagina

If you get pregnant while on treatment, tell your doctor immediately.This medicine increases your risk of blood clots and strokes. This medicine can increase your risk of blood clots, strokes, and heart attacks.This medicine can actually increase the risk of heart disease, stroke, or dementia.

If you've ever:

  • Heart disease
  • If you have liver disease or jaundice due to pregnancy, taking hormones, or being pregnant,
  • Kidney disease
  • Gallbladder Disease
  • Asthma;
  • Epilepsy
  • Migraines;
  • Lupus;
  • Porphyria
  • Endometriosis or uterine fibroid tumors;
  • A thyroid disease;
  • High levels of calcium are found in the blood.

Estradiol can increase the risk of breast cancer, uterine cancer, or ovarian cancer. Speak to your doctor regarding this possibility.Breast milk production can be slowed by estradiol or norgestimate. Inform your doctor that you are breastfeeding.

How to take Estradiol and Norgestimate?

Read all the instructions or guides that come with your medication and follow all the directions. Follow the directions on your prescription label.Usually, estradiol or norgestimate comes in a different-colored pack of tablets. Most often, you'll take one pill for three consecutive days and then the opposite color the following three consecutive days. The cycle will be repeated for the duration of your treatment.Start each new pack with the very first pill in the row. You may receive stickers that mark the weekdays on your medicine pack.Have a fresh pack of estradiol or norgestimate on hand the next day, after you finish completing a full pack.You may be at greater risk of developing conditions that can lead to uterine carcinoma if you use estradiol. If you experience any abnormal vaginal bleeding, call your doctor immediately.

You may have to temporarily stop taking this medication if you are going through major surgery or if you will need long-term rest. You should let any doctor who treats you know if you use estradiol or norgestimate.You should have your doctor check on you regularly (every three to six months) in order to decide whether or not to continue the treatment. You should self-examine for lumps in your breasts every month and get a mammogram once a year when using estradiol or norgestimate.Keep away from heat, moisture, and light.

What happens if I miss the dose?

As soon as possible, take the missed dose.If your next dose is approaching quickly, skip any missed ones.You should not take more medicine to compensate for a missed dose.You should only take one tablet per day if you have missed two doses. If you have missed more than two doses, call your doctor.

What happens if I overdose?

Call 1-800-222-1222 for poison help or seek immediate medical attention.

What should be avoided?

Smoking is harmful. While using estradiol or norgestimate, your chances of having a stroke, heart attack, blood clot, and other serious health problems can be greatly increased.Grapefruit can cause unwanted side effects when combined with estradiol or norgestimate. Use grapefruit-based products sparingly.

Interaction with other drug

It is sometimes not safe to take certain drugs at the same time. Some medications can cause side effects that increase or decrease the effectiveness of another drug you are taking.Estradiol can be affected by many drugs. These include prescription, over-the-counter, and herbal medicines. This list does not include all interactions. Inform your doctor of all medications you are currently taking and those that you will stop or start using.



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