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[Dandelion]

Hi

I managed to get some gel called OEstrodose from my local chemist through my GP as there is no evorel.
I am currently on 0.75microgrammes of evorel.
I was under the impression that 1 pump of gel equalled 0.25mg oestrogen, but I dunno if that is oestrogel rather than oestrodose, the one I have.
On my box it says the following
"this cannister delivers 64 meetered doses. Each metered dose 1.25g contains 0.75milligrammes of estradiol.
Does this mean that I only need one pump of oestrodose rather than 3 pumps like I thought I would need, as I thought I was getting oestrogel.
Thanks
EDIT I just read more of the box and it also says on the back oestrogel pump pack.
How come one metered dose equals 0.75microgrammes when I thought that 0.75 microgramme patch equals 3 pumps?
Thanks and sorry for the confusion.

[Dotty]

Yes 2 pumps of gel is roughly equivalent to a 50 patch.  A 75 patch would be 3 pumps. A 100 patch is 4 pumps.

Oestrodose and Oestrogel are the same product.  X

[bear]

Hi

I managed to get some gel called OEstrodose from my local chemist through my GP as there is no evorel.
I am currently on 0.75microgrammes of evorel.
I was under the impression that 1 pump of gel equalled 0.25mg oestrogen, but I dunno if that is oestrogel rather than oestrodose, the one I have.
On my box it says the following
"this cannister delivers 64 meetered doses. Each metered dose 1.25g contains 0.75milligrammes of estradiol.
Does this mean that I only need one pump of oestrodose rather than 3 pumps like I thought I would need, as I thought I was getting oestrogel.
Thanks
EDIT I just read more of the box and it also says on the back oestrogel pump pack.
How come one metered dose equals 0.75microgrammes when I thought that 0.75 microgramme patch equals 3 pumps?
Thanks and sorry for the confusion.

Hi Dandelion,

One pump of Oestrogel has 0.75 mg or 750 µg of estradiol hemihydrate (dehydrated form).
One Evorel 75 patch has 4.8 mg of estradiol corresponding to a release rate of 75 µg of estradiol in 24 hours. The difference is that you have to use the gel daily and Evorel is applied twice weekly.

The pharmacokinetics of the gel is different from the patches, approximately only 10% of the estradiol in the gel is absorbed, hence the 10X difference in concentration of estradiol in the gel.

https://www.medicines.org.uk/emc/product/353/smpc

'Pharmacokinetic properties
Absorption

Pharmacokinetic studies indicate that, when applied topically to a large area of skin in a volatile solvent, approximately 10% of the oestradiol is percutaneously absorbed into the vascular system, regardless of the age of the patient.

Distribution

Daily application of 2.5 g or 5 g Oestrogel over a surface area of 400-750 cm2 results in a gradual increase in oestrogen blood levels to steady state after approximately 3-5 days and provides circulating levels of both oestradiol and estrone equivalent in absolute concentrations and in their respective ratio to those obtained during the early-mid follicular phase of the menstrual cycle.

Oestrogel was administered to 17 postmenopausal women once daily on the posterior surface of one arm from wrist to shoulder for 14 consecutive days.

Maximum serum concentrations (Cmax) of oestradiol and estrone on Day 12 were 117 pg/ml and 128 pg/ml, respectively.

The time-averaged serum oestradiol and estrone concentrations (Caverage) over the 24hour dose interval after administration of 2.5 g of Oestrogel on Day 12 were 76.8 pg/ml and 95.7 pg/ml, respectively.

Biotransformation

Metabolism of oestradiol takes place mainly in the liver under oestriol, estrone and their conjugated metabolites (glucuronides, sulphates). These metabolites also undergo enterohepatic recirculation.

When treatment is stopped, oestradiol and urinary conjugated oestradiol concentrations return to baseline in about 76 hours.

Elimination

Oestriol is the major urinary oestradiol metabolite. However, glucuronide and sulphate metabolites of oestradiol and oestrone are also found in urine and bile. Metabolites excreted in bile undergo enterohepatic recirculation or are excreted in the faeces.'

Hope this helps,

BeaR.

[Dandelion]

Hi

I managed to get some gel called OEstrodose from my local chemist through my GP as there is no evorel.
I am currently on 0.75microgrammes of evorel.
I was under the impression that 1 pump of gel equalled 0.25mg oestrogen, but I dunno if that is oestrogel rather than oestrodose, the one I have.
On my box it says the following
"this cannister delivers 64 meetered doses. Each metered dose 1.25g contains 0.75milligrammes of estradiol.
Does this mean that I only need one pump of oestrodose rather than 3 pumps like I thought I would need, as I thought I was getting oestrogel.
Thanks
EDIT I just read more of the box and it also says on the back oestrogel pump pack.
How come one metered dose equals 0.75microgrammes when I thought that 0.75 microgramme patch equals 3 pumps?
Thanks and sorry for the confusion.

Hi Dandelion,

One pump of Oestrogel has 0.75 mg or 750 µg of estradiol hemihydrate (dehydrated form).
One Evorel 75 patch has 4.8 mg of estradiol corresponding to a release rate of 75 µg of estradiol in 24 hours. The difference is that you have to use the gel daily and Evorel is applied twice weekly.

The pharmacokinetics of the gel is different from the patches, approximately only 10% of the estradiol in the gel is absorbed, hence the 10X difference in concentration of estradiol in the gel.

https://www.medicines.org.uk/emc/product/353/smpc

'Pharmacokinetic properties
Absorption

Pharmacokinetic studies indicate that, when applied topically to a large area of skin in a volatile solvent, approximately 10% of the oestradiol is percutaneously absorbed into the vascular system, regardless of the age of the patient.

Distribution

Daily application of 2.5 g or 5 g Oestrogel over a surface area of 400-750 cm2 results in a gradual increase in oestrogen blood levels to steady state after approximately 3-5 days and provides circulating levels of both oestradiol and estrone equivalent in absolute concentrations and in their respective ratio to those obtained during the early-mid follicular phase of the menstrual cycle.

Oestrogel was administered to 17 postmenopausal women once daily on the posterior surface of one arm from wrist to shoulder for 14 consecutive days.

Maximum serum concentrations (Cmax) of oestradiol and estrone on Day 12 were 117 pg/ml and 128 pg/ml, respectively.

The time-averaged serum oestradiol and estrone concentrations (Caverage) over the 24hour dose interval after administration of 2.5 g of Oestrogel on Day 12 were 76.8 pg/ml and 95.7 pg/ml, respectively.

Biotransformation

Metabolism of oestradiol takes place mainly in the liver under oestriol, estrone and their conjugated metabolites (glucuronides, sulphates). These metabolites also undergo enterohepatic recirculation.

When treatment is stopped, oestradiol and urinary conjugated oestradiol concentrations return to baseline in about 76 hours.

Elimination

Oestriol is the major urinary oestradiol metabolite. However, glucuronide and sulphate metabolites of oestradiol and oestrone are also found in urine and bile. Metabolites excreted in bile undergo enterohepatic recirculation or are excreted in the faeces.'

Hope this helps,

BeaR.

Hi thanks and sorry for the delay in replying, so does that mean that I have to use 3 pumps per day? Sorry for my confusion. Thanks

[bear]

Hi again Dandelion,

Yes, a 75 µg patch would be equivalent to 3 pumps of Oestrogel, but as stellajane says you could start with 2 and see how you feel?
Source: https://thebms.org.uk/wp-content/uploads/2018/08/HRT-Practical-Prescribing-AUG2018.pdf

BeaR.

[Hurdity]

Hi Dandelion

Thereis no exact equivalence and as has been said many timnes before on this forum,  absorption is very variable between different women of the same dose of the same product, and in one woman between the different delivery methods. The equivalence is only an average equivalent from a group of women.

Neverthless as Dotty said there are approx equivalents published which are great as a starting point - firstly on this MM site (look on menu under treatments/HRT preparations) you can see ultra-low, low, medium,  etc) or this table which she posted earlier in presonse to another query and will requote here as it's such a useful ref!

https://thebms.org.uk/wp-content/uploads/2018/08/HRT-Practical-Prescribing-AUG2018.pdf

There is a table at the bottom of page 1 which gives you the equivalent dosages of different hrts . X

Hurdity x

[Tracey E]

I agree with Hurdity, my menopause symptoms are controlled on just 1 pump of Estrogel per day. I am quite slim in build so I wonder if I absorb more estrogen than most folk. If I up it to 2 pumps i get acid reflux and feel totally wired.

I would start on the lowest dose possible and work your way up from there. More isn't always best..