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Pronunciation |
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(dye
en ES
trole) |
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U.S. Brand
Names |
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DV® Vaginal Cream;
Ortho®-Dienestrol
Vaginal |
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Generic
Available |
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No |
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Pharmacological Index |
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Estrogen Derivative |
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|
Use |
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Symptomatic management of atrophic vaginitis or kraurosis vulvae in
postmenopausal women |
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Pregnancy Risk
Factor |
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X |
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Contraindications |
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Pregnancy; should not be used during lactation or undiagnosed vaginal
bleeding |
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Warnings/Precautions |
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Use with caution in patients with a history of thromboembolism, stroke,
myocardial infarction (especially age >40 who smoke), liver tumor,
hypertension, cardiac, renal or hepatic insufficiency |
|
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Adverse
Reactions |
|
1% to 10%:
Cardiovascular: Peripheral edema
Gastrointestinal: Anorexia, abdominal cramping
<1%: Hypertension, thromboembolism, myocardial infarction, stroke,
migraine, dizziness, anxiety, depression, headache, chloasma, melasma, rash,
decreased glucose tolerance, alterations in frequency and flow of menses, breast
tenderness or enlargement, increased triglycerides and LDL, nausea, GI distress,
cholestatic jaundice, increased susceptibility to Candida infection
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Drug
Interactions |
|
No data reported |
|
|
Mechanism of
Action |
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Increases the synthesis of DNA, RNA, and various proteins in target tissues;
reduces the release of gonadotropin-releasing hormone from the hypothalamus;
reduces FSH and LH release from the pituitary |
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Pharmacodynamics/Kinetics |
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Time to peak serum concentration: Topical: Within 3-4 hours
Metabolism: In the liver |
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Usual Dosage |
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Adults: Vaginal: Insert 1 applicatorful once or twice daily for 1-2 weeks and
then 1/2
of that dose for 1-2 weeks; maintenance dose: 1 applicatorful 1-3 times/week for
3-6 months |
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Mental Health: Effects
on Mental Status |
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May cause anxiety or depression |
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Mental Health:
Effects on Psychiatric
Treatment |
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None reported |
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Dental Health: Local
Anesthetic/Vasoconstrictor
Precautions |
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No information available to require special precautions |
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Dental Health:
Effects on Dental Treatment |
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No effects or complications reported |
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Patient
Information |
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Use as directed. Insert cream high in vagina. Remain lying down for 30
minutes following insertion. Use of sanitary napkin following administration
will protect clothing; do not use a tampon. May cause breast tenderness or
enlargement (consult prescriber for relief). Discontinue use and report promptly
any pain, redness, warmth, or swelling in calves; sudden onset difficulty
breathing; headache; loss of vision; difficulty speaking; sharp or sudden chest
pain; severe abdominal pain; or unusual bleeding. Pregnancy/breast-feeding
precautions: Inform prescriber if pregnant. Do not
breast-feed. |
|
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Nursing
Implications |
|
Insert applicator high into vagina. Patients should inform their physician if
signs or symptoms of any of the following occur: Thromboembolic or thrombotic
disorders including sudden severe headache or vomiting, disturbance of vision or
speech, loss of vision, numbness or weakness in an extremity, sharp or crushing
chest pain, calf pain, shortness of breath, severe abdominal pain or mass,
mental depression, or unusual bleeding. Patients should discontinue taking the
medication if they suspect they are pregnant or become
pregnant. |
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Dosage Forms |
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Cream, vaginal: 0.01% (30 g with applicator; 78 g with
applicator) |
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