Classifications: hormones and synthetic substitutes; estrogen
Pregnancy Category: X
Assessment & Drug Effects
- Check BP on a regular basis in patients with conditions that may be influenced by fluid retention (migraine, cardiac or kidney dysfunction, asthma, epilepsy, hypertension).
- Supplement pyridoxine (vitamin B6) in patients on long-term therapy, especially if undernourished; levels are lowered by estrogens.
Patient & Family Education
- Be aware that risk of blood clot formation is high. Notify physician immediately of positive Homan’s sign (calf pain upon foot flexion) and the following symptoms of thromboembolic disorders: Tenderness, pain, swelling, and redness in extremity; sudden, severe headache or chest pain, slurring of speech; change in vision; sudden shortness of breath. If physician is not available, go to the nearest emergency room.
- Report severe abdominal pain and tenderness, or abdominal mass.
- Determine weight under standard conditions 1 or 2 times/wk and report sudden weight gain or other signs of fluid retention.
- Notify physician of yellow skin and sclera, pruritus, dark urine, and light-colored stools; history of jaundice in pregnancy increases the possibility of estrogen-induced jaundice. Estrogen therapy is usually interrupted pending clinical investigation.
- Abrupt withdrawal of vitamin C may lead to breakthrough bleeding; high vitamin C intake (e.g., 1 g/d) may increase ethinyl estradiol levels.
- Report symptoms of vaginal candidiasis (thick, white, curd-like secretions and inflamed congested introitus) to permit appropriate treatment.
- Note: Estrogen-induced feminization and impotence in male patients are reversible with termination of therapy.
- Decrease caffeine intake from sources such as tea, coffee, and cola; estrogenic depression of caffeine metabolism may cause caffeinism.
- Do not breast feed while taking this drug.