General Drug Information

What Vagifem Is and What It’s Used For

Vagifem helps to manage symptoms of menopause such as vaginal dryness and itching. It is available in the form of tablets, inserted into the vagina with the help of an applicator.

The active ingredient in this medicine is estradiol, a female sex hormone necessary to maintain healthy reproductive and sexual function. Inserting the active ingredient directly into the vagina is a more effective and safer method compared to oral and injectable methods.

Usage and Application

A treating physician will prescribe a treatment course depending on the condition and patient response. Most patients use Vagifem once a day for the first two weeks of treatment, followed by twice-weekly insertions.

Patients should use this medication exactly as directed by their physician or pharmacist in order to experience the full benefits.

Vagifem is inserted with the help of a single-use plastic applicator. To ensure precise dosing, each applicator is connected to a tablet. To use, patients need to insert the applicator in the vagina and press the plunger to release the needed dose. Applicators should be disposed of after use.

Considerations Before Taking Vagifem

Before using Vagifem, patients need to discuss the possibility of allergic reactions, as well as any pre-existing conditions such as vaginal bleeding, blood clots or blood clotting disorders, seizures, stroke or heart disease with their doctor.

Patients should mention if they have had breast, uterine or ovarian cancer, or liver or kidney disease. They should also disclose a family history of breast lumps, cancer, blood clots or angioedema – swelling of the deep dermis which affects the lips, eyes, face or other parts of the body.

Women with high blood pressure, high cholesterol, diabetes, abnormal levels of calcium in their blood and lupus need to disclose this to their doctor. Conditions such as porphyria, hypoparathyroidism, fibroids, endometriosis, gallbladder disease, asthma, migraine, depression, and dementia also need to be mentioned to the treating physician.

Patients who use Vagifem should avoid smoking as it – combined with estrogen hormones in this medicine – increases the risk of stroke, blood clots, high blood pressure, and heart attack.

Having surgery or being confined to a chair for many hours (eg. a long flight) may increase the risk of blood clots, especially when combined with estrogen products such as Vagifem. Patients should discuss with their doctor whether to temporarily stop taking the medicine before surgery or long flights.

Some patients who use Vagifem may experience a skin condition called melasma. Symptoms can be evident in the form of facial pigmentation or blotchy skin. Women should avoid exposure to sunlight and avoid tanning rooms. To further protect skin, it is important to wear sunscreen and appropriate clothing at all times when outdoors.

In some cases, nearsighted patients who wear contact lenses may find it harder to wear them. Patients may also experience vision problems.

Pregnant women should not use Vagifem and should immediately speak with a doctor in the event they suspect pregnancy. This medicine passes into breast milk and can also reduce the quality and amount of milk a nursing mother can produce.

Delayed and Omitted Doses

Patients who miss a dose should take it as soon as they remember. If this happens near the time for the next dose, then patients should skip the missed dose and proceed as usual. Patients should not double up the dose in order to catch up.

Other Medications and Vagifem

Vagifem can interact with a number of other substances, potentially causing serious side effects. Before starting treatment, patients need to review all other prescription drugs and herbal supplements they are taking with their doctor. Starting, changing or stopping any medications should only happen with the doctor’s approval.

Vagifem interacts negatively with hormone-based medications used to treat breast cancer. These include aromatase inhibitors such as anastrozole, exemestane, and letrozole. Patients who use tamoxifen (sold under the brand name Soltamox) should also be cautious.

Fulvestrant – commercially known as Faslodex – can also interact negatively with Vagifem. Patients should be aware of negative interactions with Ospemifene, which is used to treat pain during sexual intercourse, and raloxifene, prescribed to prevent bone loss. Vagifem also interacts negatively with toremifene and tranexamic acid.

This medication may also interfere with laboratory test results, changing certain readings. Patients should inform their doctor of the possibility of wrong results.

Adverse Reactions

Most women using Vagifem do not experience serious side effects. Some possible negative symptoms include nausea, vomiting, bloating, diarrhea, breast tenderness, and weight changes.

Serious side effects include mood changes, memory loss, breast lumps, unusual vaginal bleeding, vaginal irritation and discharge, stomach pain, and swelling of the hands and feet. Patients should also monitor for yellowing eyes and skin, dark urine, increased thirst and urination.

In rare cases, some patients may develop blood clots, that may lead to serious problems like heart attack, stroke, deep vein thrombosis, and pulmonary embolism. Patients need to seek immediate medical help if they experience symptoms such as pain in the chest, left arm or jaw, or develop unusual sweating, severe headache, and weakness on one side of the body.

Other serious symptoms include confusion, slurred speech and vision changes, trouble breathing, coughing up blood and sudden dizziness or fainting.

Serious allergic reactions to Vagifem are rare, yet patients should be aware of rash, itching and swelling, severe dizziness and trouble breathing.

How to Store Vagifem

Vagifem should be stored away from light and moisture, and kept away from children and pets.

Unwanted medication should be disposed of properly and should not be poured into drains or flushed down the toilet. Patients should consult a pharmacist or their local waste disposal company to find out more about safe disposal methods.