Adverse Drug Reaction Classification System

Pharmaceutical Information
Drug Name Estradiol
Drug ID BADD_D00821
Description Estradiol is a naturally occurring hormone circulating endogenously in females. It is commercially available in several hormone therapy products for managing conditions associated with reduced estrogen, such as vulvovaginal atrophy and hot flashes. Some available forms of estradiol include oral tablets, injections, vaginal rings, transdermal patches, sprays, gels, and creams.[L11485,L11488,L11491, L11494,L11497,L11500,L11503] When used for oral or IM administration, estradiol is commonly synthesized as a pro-drug ester (such as [DB13952], [DB13953], [DB13954], [DB13955], and [DB13956]). Because it has a low oral bioavailability on its own, estradiol is commonly formulated with an ester side-chain. [DB00977] (EE) is a synthetic form of estradiol commonly used as the estrogenic component of most combination oral contraceptive pills (OCPs). Ethinyl estradiol is different from estradiol due to its higher biovailability and increased resistance to metabolism, rendering it more suitable for oral administration.
Indications and Usage Estradiol is indicated in various preparations for the treatment of moderate to severe vasomotor symptoms and vulvar and vaginal atrophy due to menopause, for the treatment of hypoestrogenism due to hypogonadism, castration, or primary ovarian failure, and for the prevention of postmenopausal osteoporosis. It is also used for the treatment of breast cancer (only for palliation therapy) in certain men or women with metastatic disease, and for the treatment of androgen-dependent prostate cancer (only for palliation therapy).[L11485,L11494,L11497] It is also used in combination with other hormones as a component of oral contraceptive pills for preventing pregnancy (most commonly as [DB00977], a synthetic form of estradiol). **A note on duration of treatment** Recommendations for treatment of menopausal symptoms changed drastically following the release of results and early termination of the Women's Health Initiative (WHI) studies in 2002 as concerns were raised regarding estrogen use.[A31626] Specifically, the combined estrogen–progestin group was discontinued after about 5 years of follow up due to a statistically significant increase in invasive breast cancer and in cardiovascular events.[A31627] Following extensive critique of the WHI results, Hormone Replacement Therapy (HRT) is now recommended to be used only for a short period (for 3-5 years postmenopause) in low doses, and in women without a history of breast cancer or increased risk of cardiovascular or thromboembolic disease.[A31628] Estrogen for postmenopausal symptoms should always be given with a progestin component due to estrogen's stimulatory effects on the endometrium; in women with an intact uterus, unopposed estrogen has been shown to promote the growth of the endometrium which can lead to endometrial hyperplasia and possibly cancer over the long-term.
Marketing Status approved; investigational; vet_approved
ATC Code G03CA03
DrugBank ID DB00783
KEGG ID D00105
MeSH ID D004958
PubChem ID 5757
TTD Drug ID D08QMX
NDC Product Code 72789-299; 0781-7133; 12860-0218; 68981-012; 13811-090; 42806-089; 50419-455; 63629-8804; 0378-4619; 65162-992; 65162-995; 68788-7102; 0430-0721; 68788-8481; 76420-022; 49452-2801; 52483-9254; 76420-048; 42291-962; 51655-229; 65162-226; 68968-6650; 70518-0920; 70771-1564; 71335-0226; 72189-183; 11014-0321; 38779-0869; 48087-0159; 52483-9104; 76420-680; 0078-0365; 13811-092; 24658-704; 50090-1882; 0013-2150; 50090-6363; 50419-451; 53746-226; 63187-741; 63629-8802; 0378-3350; 0378-4622; 0378-4641; 0430-3754; 68788-8374; 68788-8484; 68968-3437; 68968-3450; 69238-1295; 69238-1296; 70518-2829; 70771-1563; 71335-1488; 71335-1973; 54348-701; 65162-149; 65162-228; 65162-989; 0378-8770; 68025-065; 0430-0720; 68968-3475; 70518-2368; 70710-1193; 0574-2067; 71335-0430; 72162-2034; 72162-2035; 51552-0384; 60870-0218; 0093-3223; 43063-706; 0169-5176; 47781-104; 50090-3645; 50261-104; 60429-834; 63629-8654; 63629-8803; 0378-4643; 68025-066; 68025-086; 68788-7961; 0430-0722; 69238-1293; 69238-1632; 76420-021; 0781-7129; 0781-7134; 52483-9504; 0078-0344; 42806-087; 50090-1704; 51862-333; 63539-021; 0378-4623; 0378-4642; 0378-4644; 65162-150; 68968-6675; 69238-1633; 70518-2595; 70710-1194; 70710-1195; 0555-0886; 70771-1566; 72189-198; 0781-7119; 0781-7122; 0781-7156; 11014-0320; 44132-001; 13811-091; 13811-093; 50090-3327; 50419-454; 50419-459; 51655-860; 63629-4788; 0378-3349; 0378-3360; 65162-126; 65162-148; 66993-002; 68462-711; 68968-6610; 69238-1447; 69238-1631; 70710-1191; 71335-1719; 72162-2036; 76420-023; 45541-1124; 46144-400; 76420-681; 0078-0343; 0078-0346; 0093-3541; 24658-703; 42291-426; 43063-717; 0013-1042; 0037-4801; 0378-4621; 0378-4640; 68071-2675; 69238-1629; 0555-0887; 72162-2032; 0781-7167; 52483-9754; 17139-617; 42806-088; 45802-097; 50090-5494; 50090-6359; 50419-452; 51655-227; 63083-1557; 68025-067; 68071-2694; 68788-7332; 68788-8063; 68968-3410; 68968-6625; 69238-1630; 70518-0834; 70771-1565; 72162-2033; 0781-7104; 0781-7138; 52483-9124; 68981-013; 0078-0345; 13811-094; 50261-110; 50419-453; 54348-702; 63629-8713; 0378-3351; 0378-3352; 0378-3361; 0378-4620; 65162-993; 65162-997; 68025-083; 68968-3425; 68968-6637; 69238-1294; 70518-2369; 70710-1192; 0555-0899; 70771-1567; 71335-0797; 0781-7136; 0781-7144; 38779-2261; 44132-009; 24658-702; 50090-1876; 50419-456; 51862-334
UNII 4TI98Z838E
Synonyms Estradiol | Estradiol-17 beta | Estradiol 17 beta | Estradiol Anhydrous | Oestradiol | Estradiol-17beta | Estradiol 17beta | 17 beta-Estradiol | 17 beta Estradiol | 17 beta-Oestradiol | 17 beta Oestradiol | Progynova | Estradiol, (9 beta,17 alpha)-Isomer | Estradiol, (9 beta,17 beta)-Isomer | Estradiol, Monosodium Salt | Estradiol, Sodium Salt | Vivelle | Aerodiol | Estrace | Estraderm TTS | Estradiol Hemihydrate | Estradiol Hemihydrate, (17 alpha)-Isomer | Estradiol Monohydrate | Estradiol, (+-)-Isomer | Estradiol, (-)-Isomer | Estradiol, (16 alpha,17 alpha)-Isomer | Estradiol, (16 alpha,17 beta)-Isomer | Estradiol, (8 alpha,17 beta)-(+-)-Isomer | Estradiol, (8 alpha,17 beta)-Isomer | Estradiol Valerate | Estradiol Valeriante | Progynon-Depot | Progynon Depot | Delestrogen | Estradiol-17 alpha | Estradiol 17 alpha | Estradiol, (17-alpha)-Isomer | Ovocyclin
Chemical Information
Molecular Formula C18H24O2
CAS Registry Number 17916-67-5
SMILES CC12CCC3C(C1CCC2O)CCC4=C3C=CC(=C4)O
Chemical Structure
ADRs Induced by Drug
*The priority for ADR severity classification is based on FAERS assessment, followed by the most severe level in CTCAE rating. If neither is available, it will be displayed as 'Not available'.
**The 'Not Available' level is hidden by default and can be restored by clicking on the legend twice..
ADR Term ADReCS ID ADR Frequency (FAERS) ADR Severity Grade (FAERS) ADR Severity Grade (CTCAE)
Vaginal erosion21.08.01.0100.000240%Not Available
Cystitis noninfective20.03.02.001--
Application site discomfort12.07.01.034; 08.02.01.0340.000135%Not Available
Application site hypersensitivity12.07.01.014; 10.01.03.009; 08.02.01.0130.000360%Not Available
Skin haemorrhage23.06.07.001; 24.07.01.1030.000105%Not Available
Application site exfoliation08.02.01.022; 23.03.07.007; 12.07.01.0220.000314%Not Available
Exfoliative rash23.03.07.006--Not Available
Vulvovaginal mycotic infection11.03.05.004; 21.14.02.004--Not Available
Application site burn23.03.11.013; 12.07.01.038; 08.02.01.0380.000815%Not Available
Application site erosion23.07.03.011; 12.07.01.021; 08.02.01.0210.000188%Not Available
Ovarian haemorrhage24.07.03.009; 21.11.02.0060.000068%
Application site scab23.03.03.050; 12.07.01.042; 08.02.01.0420.000157%Not Available
Adverse reaction08.06.01.0180.000105%Not Available
Vulvovaginal burning sensation21.08.02.0070.001154%Not Available
Burning mouth syndrome17.02.06.016; 07.05.05.0130.000105%Not Available
Anal pruritus07.03.03.002--Not Available
Anorectal discomfort07.03.03.0030.000068%Not Available
Vulvovaginal pain21.08.02.0090.001834%
Abnormal withdrawal bleeding21.01.01.008; 08.06.02.001--Not Available
Vulvovaginal erythema23.03.06.017; 21.08.02.0110.000292%Not Available
Toxicity to various agents12.03.01.046--Not Available
Vulvovaginal swelling21.08.02.0160.000209%Not Available
Application site haemorrhage24.07.01.048; 12.07.01.040; 08.02.01.0400.000068%Not Available
Candida infection11.03.03.021--
Mouth swelling23.04.01.020; 10.01.05.020; 07.05.04.0070.000031%Not Available
Invasive breast carcinoma21.05.01.013; 16.10.01.005--Not Available
Administration site discomfort08.02.04.010; 12.07.04.010--Not Available
Complication associated with device08.07.01.011--Not Available
Liver function test increased13.03.04.031--Not Available
Frustration tolerance decreased19.04.02.0160.000209%Not Available
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ADReCS-Target
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