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These brands contain the same active ingredient (Estradiol Valerate). Same strength and form. Confirm the switch with your doctor or pharmacist.
Valestra
Rx2 mg • Tablet
More from Valestra
Other strengths and forms by Nuvista Pharma PLC.
Indications & Uses
Valestra is indicated for:
Pharmacology
Estradiol passes freely into target cells (for example the female organs, breasts, hypothalamus and pituitary) and binds to a receptor inside the cell. Once the estrogen receptor has bound estradiol, it can move into the nucleus of the cell and regulate gene transcription, which leads to the formation of messenger RNA. The mRNA then interacts with ribosomes to make specific proteins, and these proteins produce the effect of estradiol on the cell. Estrogens increase the liver's production of sex hormone binding globulin (SHBG), thyroid-binding globulin (TBG) and other serum proteins. They also suppress follicle-stimulating hormone (FSH) from the anterior pituitary. Menopausal symptoms are mainly caused by a loss of estrogenic activity, so increasing the down-stream effects of Estrogen Receptor binding reverses some of them.
Absorption: After oral use, estradiol valerate is absorbed quickly and completely.
Metabolism: Estrogens given from outside the body are metabolized in the same way as the body's own estrogens. They are partly metabolized by cytochrome P450.
Excretion: Estradiol, estrone and estriol leave the body in the urine, together with glucuronide and sulfate conjugates.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Estradiol Valerate is an estrogen-only product. The dose is one 1 mg tablet taken daily. The time of day doesn't matter, but once the woman has chosen a time she should keep to it every day. Treatment is continuous, so the next pack follows straight away without a break.
To start and to continue treatment of menopausal symptoms, the lowest effective dose should be used for the shortest duration. Treatment should begin with the Estradiol Valerate 1 mg tablet. If it is considered necessary, Estradiol Valerate 2 mg should be used. Once treatment is established, the lowest effective dose needed to relieve the symptoms should be used.
In women with an intact uterus, a progestogen should be added to Estradiol Valerate 1 mg for at least 12-14 days each month/28 day cycle. In hysterectomised women, adding a progestogen is not recommended unless there is a previous diagnosis of endometriosis.
How to start Estradiol Valerate 1 mg
If the woman has an intact uterus and is still menstruating, a combination regimen with Valest and a progestogen, beginning with the oestrogen phase, should start on the first day of bleeding. If her periods are very infrequent, or if amenorrhoea is established, she may start at any time, provided that pregnancy has been excluded where appropriate.
Women who are changing from a continuous combined HRT product may start Estradiol Valerate on any day. Women who are changing from cyclic or continuous sequential HRT regimens should complete the cycle first, and then change over without a break in therapy.
Missed or lost tablets
If the woman forgets a tablet at the usual time, she may take it within the following 12 hours. If she is more than 12 hours late, she should not take the forgotten tablet. She should take the remaining tablets at the usual time on the right days. A missed dose may lead to breakthrough bleeding or spotting.
Pediatric population
Not recommended for children.
Method of administration
The tablets can be taken with or without food. Swallow them whole with a glass of water or milk, and take them at the same time each day.
Side Effects
Women using HRT are told they get the following diseases more often than women who don't use it: breast cancer, abnormal growth or cancer of the lining of the womb (endometrial hyperplasia or cancer), ovarian cancer, blood clots in the veins of the legs or lungs (venous thromboembolism), heart disease, stroke, and probable memory loss if HRT is started over the age of 65. Other side effects that have been linked to the use of Estradiol Valerate and other oral hormone replacement therapies During the first few months of treatment you may have some vaginal bleeding at unexpected times (breakthrough bleeding and spotting). These symptoms normally lessen as treatment continues. If they don't, contact your doctor (see section 2, HRT and cancer/Excessive thickening of the lining of the womb (endometrial hyperplasia) and cancer of the lining of the womb (endometrial cancer), for more information). Other effects reported with Estradiol Valerate are breast pain, tenderness or enlargement, and breast discharge. Painful periods, changes in vaginal secretions, pre-menstrual symptoms, increased size of fibroids in the womb, thrush and changes to the neck of the womb have also been reported. So have indigestion, a feeling of being bloated, passing wind, feeling or being sick, abdominal pain and gall bladder disease. Some women get skin rashes or discolouration, itching, eczema, acne, unusual hair loss or hair growth, increased skin pigment especially on the face (chloasma, see other conditions for more information), or some rare skin problems. Others have headache, migraine, dizziness, anxiety or depressive symptoms, and fatigue. A fast or irregular heartbeat (palpitations), high blood pressure, and inflammation of veins, usually in the legs, can also occur, as can fluid retention leading to swelling of parts of the body. The list goes on with changes in body weight and sex drive, increased appetite, muscle cramps and leg pains. Nose bleeds, visual disturbances (such as blurred vision), discomfort with contact lenses, allergic-type reactions, a worsening of glucose tolerance and bladder inflammation are also linked to these medicines. Rare disorders (porphyria, chorea) have been reported too.
Cautions & Contraindications
Warnings & Precautions
When Estradiol Valerate is used for postmenopausal symptoms, HRT should be started only if the symptoms are hurting the woman's quality of life. The risks and benefits need to be weighed carefully at least once a year, and HRT should be continued only as long as the benefit is greater than the risk. Evidence on the risks of HRT in premature menopause is limited. But the absolute risk is low in younger women, so the balance of benefits and risks may be more favourable for them than for older women. Medical examination/follow-up: Before HRT is started or restarted, a complete personal and family medical history should be taken. The physical examination (including pelvic and breast) should be guided by this history and by the contraindications and warnings for use. During treatment, periodic check-ups are recommended, and how often they happen and what they cover should suit the individual woman. Women should be told which changes in their breasts they need to report to their doctor or nurse (see 'Breast cancer' below). Investigations, including appropriate imaging tools such as mammography, should follow currently accepted screening practices, adjusted to the clinical needs of the individual.
Contraindications
Estradiol Valerate must not be used in known, past or suspected breast cancer, or in known or suspected oestrogen-dependent malignant tumours, for example endometrial cancer. It must also not be used in undiagnosed genital bleeding or untreated endometrial hyperplasia. The same applies to previous idiopathic or current venous thromboembolism (deep venous thrombosis, pulmonary embolism), and to known thrombophilic disorders (for example protein C, protein S or antithrombin deficiency). Active or recent arterial thromboembolic disease, for example angina or myocardial infarction, is also a contraindication. Other contraindications are acute liver disease, or a history of liver disease as long as liver function tests have failed to return to normal, hypersensitivity to the active substances or to any of the excipients, and porphyria.
Pregnancy & Breastfeeding
Estradiol Valerate is not indicated during pregnancy. If pregnancy occurs while a woman is taking it, the treatment should be stopped immediately. Most epidemiological studies so far, which looked at accidental exposure of the foetus to oestrogens, show no teratogenic or foetotoxic effects. Estradiol Valerate is also not indicated during breast-feeding.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Overdose
Too much Estradiol Valerate can cause nausea and vomiting, and some women may have withdrawal bleeding. There is no specific antidote, so treatment is based on the symptoms.
⚠️ In an emergency call 999 or go to the nearest hospital emergency department.
Storage
Keep Estradiol Valerate in a dry place, below 30°C, and away from light. Keep it out of the reach of children.
Common questions about Valestra 2 mg
What is Valestra 2 mg Tablet?
Valestra 2 mg Tablet is a medicine that contains Estradiol Valerate. It is made by Nuvista Pharma PLC. It belongs to the Drugs for menopausal symptoms: Hormone replacement therapy group of medicines.
What is Valestra used for?
Valestra is used for: Osteoporosis.
What are the side effects of Valestra?
Women using HRT are told they get the following diseases more often than women who don't use it: breast cancer, abnormal growth or cancer of the lining of the womb (endometrial hyperplasia or cancer), ovarian cancer, blood clots in the veins of the legs or lungs (venous thromboembolism), heart disease, stroke, and probable memory loss if HRT is started over the age of 65. Other side effects that have been linked to the use of Estradiol Valerate and other oral hormone replacement therapies During the first few months of treatment you may have some vaginal bleeding at unexpected times (breakthrough bleeding and spotting).
Can I take Valestra during pregnancy or while breastfeeding?
Estradiol Valerate is not indicated during pregnancy. If pregnancy occurs while a woman is taking it, the treatment should be stopped immediately. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
What happens if I take too much Valestra?
Too much Estradiol Valerate can cause nausea and vomiting, and some women may have withdrawal bleeding. There is no specific antidote, so treatment is based on the symptoms. In an emergency call 999 or go to the nearest hospital emergency department.
How should I store Valestra?
Keep Estradiol Valerate in a dry place, below 30°C, and away from light. Keep it out of the reach of children.
Is there a cheaper medicine with the same ingredient?
Evadol by Renata PLC has the same ingredient and strength for ৳18.00 per unit, compared with ৳19.00 for Valestra. Ask your doctor or pharmacist before switching.
Do I need a prescription for Valestra?
Valestra is a prescription (Rx) medicine. Take it as your doctor advises.