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)
Depersonalisation/derealisation disorder19.14.01.004--Not Available
Genito-pelvic pain/penetration disorder21.03.02.022; 19.08.05.006--Not Available
Coeliac disease14.02.01.007; 10.04.04.012; 07.17.01.008--Not Available
Stress urinary incontinence20.02.02.0220.000120%Not Available
Dermal absorption impaired23.03.03.064; 08.06.01.030--Not Available
Application site bruise24.07.06.026; 23.03.11.026; 12.07.01.048; 08.02.01.0480.000157%Not Available
Application site laceration23.03.11.027; 12.07.01.052; 08.02.01.0520.000120%Not Available
Application site mass12.07.01.053; 08.02.01.0530.000157%Not Available
Application site odour12.07.01.054; 08.02.01.0540.000157%Not Available
Atypical haemolytic uraemic syndrome17.02.10.027; 07.11.01.032; 01.06.02.003; 20.01.03.0270.000031%Not Available
Discharge08.01.03.0860.000209%Not Available
Drug effective for unapproved indication12.09.02.001; 08.06.01.0370.000338%Not Available
Drug ineffective for unapproved indication08.06.01.038; 12.09.02.0020.000695%Not Available
Heavy menstrual bleeding21.01.03.005--Not Available
Intermenstrual bleeding21.01.01.0150.000674%Not Available
Malabsorption from application site12.07.01.072; 08.02.01.0720.000120%Not Available
Pseudoprecocious puberty21.03.02.029; 05.05.03.0080.000083%Not Available
Superficial vein thrombosis24.01.02.0160.000031%Not Available
Symptom recurrence08.01.03.101--Not Available
Therapeutic product effect decreased08.06.01.0500.000920%Not Available
Therapeutic product effect incomplete08.06.01.0520.000689%Not Available
Therapeutic product effect increased08.06.01.0530.000209%Not Available
Therapeutic product effect variable08.06.01.055--Not Available
Therapeutic product ineffective08.06.01.0570.000157%Not Available
Therapeutic response changed08.06.01.0590.000120%Not Available
Vaginal polyp21.08.03.011; 16.04.04.0040.000031%Not Available
Vulvovaginal adhesion21.08.01.0210.000120%Not Available
Vulvovaginal inflammation21.14.02.0140.000209%Not Available
Paraesthesia mucosal17.02.06.058; 08.01.06.032--Not Available
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ADReCS-Target
Drug Name ADR Term Target
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