Gina - estradiol vaginal tablets Flashcards
1
Q
Sx for supply
A
- Vaginal atrophy
- Dryness
- Soreness
- Itching
- Burning
- Irritation
- Painful intercourse
2
Q
dose
A
initiall: 1 vaginal tablet daily for 2 weeks
maintenance: 1 tablet twice a week
3
Q
When to use maintenance dose?
A
- if Sx return after break
- if Sx not resolved initial then maintenance
4
Q
supply criteria for Gina
A
- postmenopausal women
- 50+ yrs
- Not had period for at least 1yr
- +/- uterus (low systemic absorption so can give with uterus)
5
Q
contraindications
A
- allergies to oestradiol of excipients
- undiagnosed genital bleeding
- untreated endometrial hyperplasia (thickening of uterus)
- woman with intact uterus previously treated with unopposed systemic oestrogens
- angina, heart attack, ischaemic stroke (current/recent)
- Hx oestrogen dependent cancer (breast, ovarian, endometrial)
- Hx VTE
- porphyria (blood disorder)
- vaginal infection, untreated (unusual discharge, severe itching, irregular bleeding – can use after treated)
- vulval dermatosis (change to colour/texture)
- acute/previous liver disease (LFTs not returned to normal)
6
Q
referral for oestradiol
A
- No Sx improvement in 7 weeks
- <50yrs
- Menstruation <1yr ago
- Hx endometriosis/ endometrial hyperplasia
7
Q
application of Gina
A
- intravaginal application
- open the blister pack at the plunger end
- insert applicator into the vagina until resistance is met (8-10cm)
- release the tablet by pressing the plunger
- withdraw the applicator and discard
8
Q
s/e of Gina
A
- Headache
- abdominal pain
- vaginal discomfort
- discharge
- bleeding
- steroid dependent cancer
9
Q
serious s/e - urgent medical attention with Gina
A
- jaundice or deterioration in LFTs
- significant inc in BP
- new onset of migraine type headaches
- pregnancy (use contraception)
10
Q
max duration for Gina
A
no max duration
11
Q
counselling for Gina
A
- benefit can take 8-12 weeks
- application
- s/e
- serioud s/e
