Estradiol (HRT — Hormone Replacement Therapy)

SCOPE — THIS IS THE ORAL ROUTE ONLY, WHICH IS THIS PAGE'S LEAD ROUTE. The page's own brand list opens with 'Elleste Solo (oral)', its route field opens with 'Oral', and its existing dose opens with 'Systemic HRT (oral): estradiol 1–2mg OD' — and the fetched SPC is precisely that product, dosing precisely this page's indication (menopausal oestrogen replacement). ⚠️ NONE OF THE PAGE'S OTHER ROUTES ARE SOURCED BY THIS BUNDLE: the transdermal patch figure (25–100 micrograms/24h twice weekly), the Oestrogel figure (0.75–1.5 mg, 1–2 pumps daily), the Lenzetto spray, the Vagifem 10 microgram vaginal tablet regimen and the Estring 90-day ring all belong to separate products with their own SPCs, none of which was fetched. Do not read the 1 mg figure across routes — oral strengths are in MILLIGRAMS and patch strengths in MICROGRAMS/24 HOURS, a thousand-fold difference in unit. || THE 2 mg STRENGTH IS NAMED BUT NOT DOSED HERE. §4.2 verbatim: 'For initiation and continuation of treatment of post-and peri-menopausal symptoms, the lowest effective dose for the shortest duration (see also Section 4.4) should be used. Elleste Solo 2 mg is additionally indicated for prevention of osteoporosis in postmenopausal women at high risk of future fractures and who are intolerant of, or contraindicated for, other medicinal products approved for the prevention of osteoporosis.' The fetched SPC is the 1 mg product; the 2 mg product's own SPC was not fetched. || MAX DOSE DELIBERATELY LEFT EMPTY — §4.2 states no maximum dose. The nearest thing is a principle, not a ceiling: 'the lowest effective dose for the shortest duration ... should be used', reinforced by §4.4: 'HRT should only be initiated for symptoms that adversely affect quality of life. In all cases a careful appraisal of the risks and benefits should be undertaken at least annually and HRT should only be continued as long as the benefit outweighs the risk.' || STARTING AND SWITCHING, §4.2 verbatim: 'Therapy may start at any time in women with established amenorrhoea or who are experiencing long intervals between spontaneous menses. In patients who are menstruating, it is advised that therapy starts on the first day of bleeding. Patients changing from a cyclical or continuous sequential preparation should complete the cycle and may then change to Elleste Solo 1 mg without a break in therapy. Patients changing from a continuous combined preparation may start therapy at any time if amenorrhoea is established, or otherwise start on the first day of bleeding.' || MISSED OR EXTRA TABLET, §4.2 verbatim: 'If a tablet is missed it should be taken within 12 hours of when normally taken; otherwise the tablet should be discarded, and the usual tablet should be taken the following day. A missed dose may lead to break-through bleeding or spotting in non-hysterectomised women. If one extra tablet is taken inadvertently, the usual tablet should be taken the following day.' || ELDERLY, §4.2 verbatim: 'There are no special dosage requirements for elderly patients.' || PAEDIATRIC, §4.2 verbatim: 'Not to be used in children.' || ⚠️ §4.4 and §4.8 are truncated at the source-fetch limit, and §4.5 (interactions) was not retrieved at all, so the page's enzyme-inducer and thyroxine interaction items are not sourced from this bundle.