Valestra 1

Introduction
Valestra 1 is a female sex hormone (estrogen). This is a type of hormone replacement therapy (HRT) that is used to treat symptoms associated with menopause (hot flushes, vaginal dryness, and itching), estrogen deficiency, and thinning of bones (osteoporosis). In some cases, Valestra 1 is also used to treat breast cancer and prostate cancer along with other anticancer medicines. The medicine is to be swallowed with water. It can be taken with or without food, but remember to take it at a fixed time each day for better efficacy. The dose and duration will be decided by your doctor so that you get the right amount to control your symptoms. If you have missed a dose, take it as soon as you remember it. Do not skip any dose and finish the full course of treatment. The treatment should not be stopped abruptly without consulting your doctor as this may affect the potency of this medicine. The most common side effects of this HRT are headaches, breast pain, irregular vaginal bleeding or spotting, abdominal cramps or bloating, nausea, vomiting, and hair loss. Some of the warning signs and symptoms that need immediate medical attention are breast lumps, unusual vaginal bleeding, dizziness and faintness, severe headaches, chest pain, shortness of breath, pains in your legs, etc. Before taking this medicine, it is important to tell your doctor if you are taking or have recently taken any other medicines for the same disease or other diseases. Before you initiate with this HRT, you must consult the doctor if you have a history of unexplained vaginal bleeding or if you have ever had a blood clot in your legs or your lungs. If you are pregnant or breastfeeding, you should tell your doctor before taking this medicine. Your doctor may suggest you some diagnostic or laboratory tests to know the effects and side effects of this medicine on your body.

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Uses of Valestra 1
Hormone replacement therapy
Side effects of Valestra 1
Common
Headache
Nausea
Breast pain
Abdominal cramp
Bloating
Vaginal spotting
Vomiting
How to use Valestra 1
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Valestra 1 may be taken with or without food, but it is better to take it at a fixed time.
How Valestra 1 works
Valestra 1 is an estrogen (female sex hormone). In women who are undergoing or have attained menopause, it prevents symptoms such as hot flushes, night sweats and mood swings. It also prevents the bones from becoming porous and fragile (osteoporosis).
Quick Tips
You have been prescribed Valestra 1 as a part of hormone replacement therapy to relieve symptoms of menopause.
It may also be used for preventing osteoporosis in postmenopausal women who are at high risk of fractures.
Take it at the same time everyday to help you remember to take it.
Inform your doctor if you experience any unusual vaginal bleeding or spotting, abnormal vaginal discharge or vaginal discomfort while taking Valestra 1.
It may increase the risk of breast cancer. Have regular breast examinations.
Stop taking this medicine and inform your doctor immediately if you notice unexplained swelling and pain in your limbs, shortness of breath, chest pain, or changes in vision. These could be symptoms of a blood clot in a vein.
Brief Description
Indication
Moderate to severe vasomotor symptoms associated with menopause, Prophylaxis of osteoporosis in postmenopausal women, Hypogonadism, Atrophic vaginitis
Administration
May be taken with or without food.
Adult Dose
Oral Vulvar and Vaginal Atrophy in Menopause Adult: 1-2 mg PO once daily for 3 weeks, followed by 1 week off Prevention of osteoporosis: 0.5 mg PO once daily for 3 weeks, followed by 1 week off Metastatic breast cancer: 10 mg PO q8hr for 3 months Prostate cancer: 1-2 mg PO q8hr for ?3 months

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Contraindication
Hypersensitivity; undiagnosed vag bleeding; thrombophloebitis or thromboembolic disorders; breast carcinoma except in selected patients being treated for metastatic disease; oestrogen-dependent tumor; porphyria; pregnancy.
Mode of Action
Estradiol is a naturally occurring oestrogen. Oestrogens are responsible for the development and maintenance of the female reproductive system and secondary sexual characteristics. They modulate the pituitary secretion of gonadotrophins, LH and FSH through a negative feedback system.
Precaution
Conditions exacerbated by fluid retention; hypercalcaemia, cerebrovascular diorders, coronary artery disease, gall bladder diseases; lipid effects; familial defects of lipoprotein metabolism. May increase BP, risk of venous thromboembolism, breast cancer, benign hepatic adenoma, endometrial cancer and size of preexisting uterine leiomyomata. Dosage should be reduced in hepatic impairment. Lactation. Child. Lactation: Drug enters breast milk; use with caution

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Side Effect
Anxiety,Abdominal cramping,Amenorrhea,Bloating,Breakthrough bleeding,Breast enlargement,Breast tenderness,Delayed ejaculation,Depression,Dry mouth,Headache,Hypertension,Impotency,Influenza,Leukorrhea,Melasma,Muscle cramps,Nausea,Nervousness,Peripheral edema,Polydipsia,Pruritus,Rash,Swelling,Spotting,Syncope,Toothache,Vaginal discomfort, vaginal erosion, vaginal ulceration, adherence of the vaginal ring to the vaginal wall (Estring),Vomiting,Weight changes
Pregnancy Category Note
Pregnancy Therapy not indicated for use in pregnancy; there are no data with use in pregnant women; however, epidemiologic studies and meta-analyses have not found an increased risk of genital or nongenital birth defects (including cardiac anomalies and limb-reduction defects) following exposure to combined hormonal contraceptives (estrogen and progestins) before conception or during early pregnancy Lactation Therapy not indicated for use in females of reproductive potential; estrogens present in human milk and can reduce milk production in breast-feeding females; reduction can occur at any time but is less likely to occur once breast-feeding is well- established

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Interaction
CYP1A2 and CYP3A4 inducers e.g. aminoglutethimide, carbamazepine, phenobarbital, and rifampin may decrease the effects of estradiol. May enhance the effects of hydrocortisone and prednisolone when used together.