FDA-filed SPL labeling · retrieved through openFDA

Estradiol

Estradiol is a form of estrogen used across multiple products and routes to treat menopausal symptoms, low estrogen conditions, and to help prevent postmenopausal osteoporosis.

Brand names VivelleAloraMinivelleYuvafemImvexxy +11 more
Drug class Estrogen
Rx/OTC Forms 11 Routes Oral · Transdermal · Topical · Vaginal +1
Dr. Brian Staiger, PharmD, BCPS
Reviewed by Last reviewed Jul 10, 2026
🧬 Where this information comes from Click to expand

The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 37 clinical label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →

At a glance
Linked label effectiveJun 17, 2025
Clinical labels in scope 37
AvailabilityRx/OTC
Earliest approval/marketing year 1943
FDA-listed product records 724
Boxed warningYes
How we combine label and product data →
No current FDA shortage listed · checked Sep 19, 2026 🚨Recall on record · 4
Other forms & routes:
Estradiol at a glance The quick version — the full detail is in the Patient Information Guide below.
💊
HelloPharmacist Editorial Team Bottom Line
Estradiol is an effective hormone therapy for relieving menopausal symptoms, treating low-estrogen conditions, and preventing postmenopausal osteoporosis, but it carries real risks — including blood clots, stroke, and certain cancers — that require an honest conversation with your prescriber. Women with a uterus generally need to take a progestogen alongside it to protect against endometrial cancer. Use it at the lowest dose that works for you, for the shortest time needed, and get regular check-ins with your healthcare team.
⚠️ FDA Boxed Warning — the FDA’s strongest safety alert

Estradiol carries serious boxed warnings about cancer, heart and blood vessel problems, and dementia. Women with a uterus who use estrogen without also taking a progestogen (a second hormone) have a significantly higher risk of endometrial cancer (cancer of the uterine lining). Adding a progestogen reduces this risk. Unexplained vaginal bleeding should always be evaluated by a doctor.

Clinical studies have shown that estrogen therapy — alone or combined with progestin — increases the risk of stroke and blood clots (DVT). Estrogen plus progestin also raises the risk of heart attack, pulmonary embolism (blood clots in the lungs), invasive breast cancer, and probable dementia in women 65 and older. Do not use estradiol to prevent heart disease or dementia — it is not approved for these purposes and may cause harm. These risks should be discussed with your prescriber, who will aim for the lowest effective dose for the shortest time possible.

Read the full warning on DailyMed →

📖 Estradiol: Patient Information Guide

A plain-language walkthrough of Estradiol — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.

🎯What it's used for

Estradiol is an estrogen hormone therapy available in many forms, used across several conditions related to low estrogen levels.

  • Moderate to severe hot flashes (vasomotor symptoms) due to menopause — supported by most patch, gel, spray, and injection products
  • Moderate to severe vaginal and vulvar dryness, irritation, or atrophy due to menopause — supported by Climara, Dotti, Estradiol Transdermal System, EstroGel, Delestrogen, Estradiol Valerate injections, and vaginal insert products
  • Moderate to severe dyspareunia (painful intercourse) due to vaginal atrophy — Imvexxy (vaginal insert) is specifically approved for this symptom
  • Low estrogen due to hypogonadism (underactive ovaries), castration, or primary ovarian failure — supported by Climara, Dotti, Estradiol Transdermal System, Delestrogen, and Estradiol Valerate injections
  • Prevention of postmenopausal osteoporosis — supported by Climara, Dotti, Estradiol Transdermal System, Lyllana, and Menostar patches; Menostar is approved only for this use
  • Palliation (symptom relief) of advanced androgen-dependent prostate cancer — Delestrogen and Estradiol Valerate injections only

When estradiol is prescribed solely for vaginal symptoms or solely for osteoporosis prevention, prescribers are advised to consider non-estrogen or topical alternatives first.

⚙️How it works

Estradiol is the same estrogen the body makes naturally — and it's the most potent form. It works by attaching to estrogen receptors found in tissues throughout the body, including the reproductive organs, bones, and brain. When estrogen levels fall after menopause, levels of other hormones (LH and FSH) rise sharply, causing hot flashes and other symptoms. Estradiol helps bring these hormone levels back into balance, relieving symptoms and supporting bone density.

Because estradiol bypasses the liver when given through the skin (transdermal route), it enters the bloodstream more directly than oral forms — meaning the body gets more of it per dose compared to swallowing a tablet.

💊How it's taken

Estradiol is taken very differently depending on the product. Patches such as Climara and Menostar are applied to the skin once a week; others like Dotti, Lyllana, and Minivelle are applied twice a week. Topical gels (EstroGel, Divigel, Elestrin, Estradiol Gel) are typically applied to the skin daily. Injections are given into the muscle by a healthcare provider at intervals your prescriber sets. Always follow the specific instructions for your product.

  • Apply patches to a clean, dry skin area as directed — usually the lower abdomen; avoid the breast
  • Never apply a higher dose or use more frequently than prescribed
  • Your prescriber will aim for the lowest effective dose and shortest treatment duration
  • Treatment should be reviewed regularly to confirm it's still needed
🤒Side effects — in detail

Like all hormone therapies, estradiol can cause side effects — some mild and common, others rare but serious.

  • Headache
  • Breast tenderness
  • Irregular vaginal bleeding or spotting
  • Nausea
  • Back pain
  • Depression or mood changes
  • Skin redness or irritation at the patch or gel application site
  • Upper respiratory infections, sinus congestion, or sinus headache

Serious reactions — including blood clots, stroke, heart attack, severe vision changes, and signs of an allergic reaction — require immediate medical attention. Call 911 or your doctor right away if any of these occur.

⚠️Warnings & precautions
  • Blood clots and stroke: Estradiol increases the risk of deep vein thrombosis (DVT), pulmonary embolism, and stroke. The risk is higher when combined with a progestin. Stop taking it and seek emergency care if you develop chest pain, leg swelling, or sudden neurological symptoms.
  • Endometrial cancer: Women with a uterus who take estrogen without a progestogen face a significantly higher risk of endometrial cancer. A progestogen is typically added to reduce this risk.
  • Breast cancer: Estrogen plus progestin therapy is linked to an increased risk of invasive breast cancer. Get regular breast exams and mammograms as recommended by your doctor.
  • Ovarian cancer: Hormone therapy has been associated with a modestly increased risk of ovarian cancer.
  • Probable dementia: In women 65 and older, both estrogen-alone and estrogen-plus-progestin therapy were linked to an increased risk of probable dementia in WHI studies.
  • Gallbladder disease: Estrogen use is associated with a 2- to 4-fold increased risk of gallbladder disease requiring surgery.
  • Not for heart disease or dementia prevention: Estradiol should never be used to try to prevent cardiovascular disease or dementia.
🔀What it interacts with

Estradiol is broken down by an enzyme in the liver called CYP3A4. Drugs or supplements that affect this enzyme can change how much estradiol is in your blood.

  • St. John's Wort, phenobarbital, carbamazepine, rifampin — these speed up breakdown of estradiol, lowering its levels and reducing effectiveness; they may also cause irregular bleeding
  • Erythromycin, clarithromycin, ketoconazole, itraconazole, ritonavir — these slow the breakdown of estradiol, increasing its levels and raising the risk of side effects
  • Grapefruit juice — can increase estradiol blood levels

This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.

📋Before taking it
  • Do not use estradiol if you have unexplained vaginal bleeding — it must be evaluated first
  • Do not use if you have or have had breast cancer or any estrogen-dependent cancer
  • Do not use if you have or have had blood clots (DVT or PE), stroke, or heart attack
  • Do not use if you have liver disease or liver impairment
  • Do not use if you have inherited clotting disorders such as Protein C, Protein S, or antithrombin deficiency
  • If you have a uterus, you will likely need to take a progestogen alongside estradiol
  • Tell your prescriber if you are pregnant — estradiol is not indicated during pregnancy
  • Estradiol passes into breast milk and can reduce milk production; discuss the risks and benefits with your doctor if you are breastfeeding
  • Estradiol is generally not for use in children; if bone growth is not complete, periodic bone monitoring is recommended
  • Women 65 and older face higher risks of stroke, breast cancer, and probable dementia with estrogen therapy and should discuss these risks carefully with their prescriber
🚑If you take too much

Taking too much estradiol may cause nausea, vomiting, breast tenderness, abdominal pain, drowsiness, fatigue, and vaginal bleeding. If you think you've used too much, remove the patch or stop applying the gel, and contact your prescriber or seek medical care right away.

📡Pharmacodynamics — effects in the body

Estradiol's blood level does not reliably predict how well it will work for any individual woman or what her risk of side effects will be. This means that comparing estradiol levels between different products or routes is not a reliable way to judge whether one will work better or be safer than another for a given person.

🔬Pharmacokinetics — how your body processes it

When estradiol is applied through the skin (transdermal route), it bypasses first-pass metabolism in the liver, making it roughly 20 times more bioavailable than when taken by mouth. Patches deliver estradiol continuously through the skin over their wear period (one week for once-weekly patches), producing steady blood levels with minimal accumulation. Studies show that applying the patch to the buttock rather than the abdomen results in somewhat higher estradiol levels, and that there is considerable variability in how much estradiol different people absorb through their skin.

📦How to store it

Store at 20° to 25°C (68° to 77°F). store unpouched.

📄 Written from Estradiol’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →

🩺 Pharmacist Counseling Corner

Quick, plain-English answers to the questions patients ask most about Estradiol — the kind of thing our pharmacy team would talk through with you at the counter.

What exactly is estradiol and why has my doctor prescribed it?
Estradiol is a form of estrogen — the main female sex hormone. When estrogen levels fall after menopause (or due to other conditions like ovarian failure), you can get symptoms like hot flashes, vaginal dryness, or bone loss. Estradiol replaces some of that lost estrogen to relieve those symptoms or, in some cases, to prevent osteoporosis. Your specific reason for taking it will depend on your symptoms and health history, so it's worth confirming the goal with your prescriber.
How do I use my estradiol patch correctly?
Apply the patch to a clean, dry area of skin — usually the lower abdomen. Never put it on your breasts. Press it firmly in place and leave it on for the full wear period — once a week for Climara, Menostar, and Estradiol Transdermal System, or twice a week for Dotti, Lyllana, and Minivelle. Rotate the spot where you apply it each time to avoid skin irritation. If a patch falls off, follow the instructions that came with it or call your pharmacist.
What side effects are most common and which ones should I call my doctor about right away?
Common side effects include headache, breast tenderness, nausea, spotting or irregular bleeding, back pain, and mild skin irritation where you apply the patch or gel. Those are worth mentioning at your next appointment but generally aren't emergencies. Call your doctor or 911 immediately if you have sudden chest pain, shortness of breath, leg pain or swelling, sudden vision changes, or any signs of a stroke — like sudden numbness, confusion, or trouble speaking. These can be signs of a serious blood clot or stroke.
I've heard estrogen increases cancer risk — should I be worried?
It's a real and important question. Estrogen therapy does carry some increased risks, including endometrial cancer (if you have a uterus and don't take a progestogen alongside it) and, with estrogen-plus-progestin therapy, a higher risk of breast cancer. That said, your prescriber weighs those risks against the benefit of treating your symptoms, uses the lowest effective dose, and should re-evaluate your treatment regularly. Keep up with yearly breast exams and mammograms, and report any unusual vaginal bleeding to your doctor promptly.
Are there any medications or supplements I should avoid while taking estradiol?
Yes — a few things can interfere with how estradiol works in your body. St. John's Wort (a common herbal supplement), as well as prescription drugs like rifampin, carbamazepine, and phenobarbital, can lower your estradiol levels and make it less effective. On the other side, antibiotics like erythromycin or clarithromycin, and antifungals like ketoconazole, can raise estradiol levels and increase side effects. Even grapefruit juice can have this effect. Always tell your prescriber and pharmacist about every supplement and medication you take.
How long will I need to take estradiol?
That's something to decide with your prescriber. The goal is always to use the lowest dose that helps your symptoms for the shortest time that makes sense for you. Your prescriber should check in with you regularly — at least every 3 to 6 months — to see if you still need it. Long-term use carries more risk, so the conversation about whether to continue, adjust, or stop is an ongoing one throughout your treatment.
Is Estradiol available over the counter?
Both — Estradiol is sold both over the counter and by prescription, according to its FDA labeling. Lower strengths or certain forms are often available without a prescription, while higher strengths or specialized forms still require one. Ask your pharmacist which version is right for you.
When was Estradiol first available?
Estradiol has been available in the United States since at least 1943, based on FDA approval history (Drugs@FDA) and product marketing records.
Who makes Estradiol?
Estradiol is supplied by 103 manufacturers listed in the FDA NDC Directory, including Bryant Ranch Prepack, Sandoz Inc, A-S Medication Solutions.

💬 Answers drafted from Estradiol’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →

🧰 Keep exploring

💊 How Estradiol comes

Estradiol is available in 11 forms. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.

Skin patch

Through the skin
Brands Climara Dotti Evamist Lyllana Menostar Minivelle
How this form is used
What it may be used for
  • Climara is used for moderate to severe menopausal hot flashes, vaginal and vulvar atrophy symptoms, low estrogen due to hypogonadism or ovarian failure, and prevention of postmenopausal osteoporosis
  • Dotti is used for moderate to severe menopausal hot flashes, vaginal and vulvar atrophy symptoms, low estrogen due to hypogonadism or ovarian failure, and prevention of postmenopausal osteoporosis
  • Lyllana is used for moderate to severe menopausal hot flashes and prevention of postmenopausal osteoporosis
  • Menostar is used only for prevention of postmenopausal osteoporosis
Important instructions
  • Climara is applied to the skin once weekly to a clean, dry area of the lower abdomen; do not apply to the breast
  • Dotti and Lyllana are applied to the skin twice weekly
  • Menostar is applied once weekly to a clean, dry area of the lower abdomen; do not apply to the breast
  • Estradiol Transdermal System is applied to the skin once weekly to the lower abdomen
Available strengths 17 strengths
Show 11 more strengths Show fewer strengths
240 FDA-listed product records

Tablet

By mouth
Brands Estrace
Available strengths 3 strengths
174 FDA-listed product records

Topical cream, ointment or gel

On the skin
Brands Divigel Elestrin EstroGel
How this form is used
What it may be used for
  • EstroGel 0.06% is used for moderate to severe menopausal hot flashes and moderate to severe vaginal and vulvar atrophy symptoms due to menopause
  • Divigel is used for moderate to severe menopausal hot flashes
  • Estradiol Gel 0.1% is used for moderate to severe menopausal hot flashes
Important instructions
  • These gels are applied to the skin; follow your prescriber's instructions for the specific product on application site and frequency
  • Use at the lowest effective dose for the shortest time consistent with your treatment goals
  • Women with a uterus should also take a progestogen to reduce the risk of endometrial cancer
Available strengths 7 strengths
Show 1 more strength Show fewer strengths
107 FDA-listed product records

Vaginal cream or gel

Vaginal
Brands Estrace
Available strengths 1 strength
44 FDA-listed product records

Injection

Into a muscle
Brands Delestrogen Depo-Estradiol
How this form is used
What it may be used for
  • Delestrogen is used for moderate to severe menopausal hot flashes, vaginal and vulvar atrophy symptoms, low estrogen due to hypogonadism or ovarian failure, and palliation of advanced androgen-dependent prostate cancer
  • Estradiol Valerate injection is used for moderate to severe menopausal hot flashes, vaginal and vulvar atrophy symptoms, low estrogen due to hypogonadism or ovarian failure, and palliation of advanced androgen-dependent prostate cancer
Important instructions
  • Delestrogen is given by deep injection into the upper, outer quadrant of the gluteal (buttock) muscle by a healthcare provider
  • Estradiol Valerate injection is given by deep intramuscular injection by a healthcare provider
  • Women with a uterus receiving injection therapy should also take a progestogen to reduce risk of endometrial cancer
  • Dosing intervals should be followed as directed by your prescriber; treatment need should be re-evaluated every 3 to 6 months
Available strengths 4 strengths
30 FDA-listed product records

Vaginal tablet

Vaginal
Brands Yuvafem
Available strengths 1 strength
11 FDA-listed product records

Insert or device

By mouth
How this form is used
What it may be used for
  • Vaginal estradiol inserts (such as Imvexxy) are used for moderate to severe dyspareunia (painful sex), a symptom of vulvar and vaginal atrophy due to menopause
Important instructions
  • Follow your prescriber's specific instructions for insertion technique and frequency
  • When used solely for vaginal symptoms, topical vaginal products should be considered first
Available strengths 2 strengths
3 FDA-listed product records

Oral solution

By mouth
Available strengths 1 strength
2 FDA-listed product records

Spray

By mouth
Available strengths 1 strength
1 FDA-listed product record

Topical (transdermal) gel

Through the skin
Available strengths 1 strength
1 FDA-listed product record

📊 Estradiol across the U.S. market

How Estradiol appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.

11
Dose forms
103
Manufacturers
27
Brand names
724
FDA-listed product records
1943
First marketed

FDA-listed product records by dose form (tablet variants merged) — FDA National Drug Code Directory. Record counts are not sales or prescription volume.

Also listed with the FDA, not a patient dose form: Powder (77) — bulk drug substance sold to compounders/manufacturers and multi-item kits. These aren’t counted in the dose-form total above.

Bryant Ranch Prepack8%
Sandoz Inc6%
A-S Medication Solutions6%
Mylan Pharmaceuticals Inc.6%
Amneal Pharmaceuticals NY LLC6%
Amneal Pharmaceuticals LLC6%
Other makers62%

Share of FDA-listed product records by manufacturer — FDA National Drug Code Directory. Record counts are not sales or prescription volume.

📈 How widely Estradiol is used

A general measure of how commonly Estradiol is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.

Think of this as a proxy for how widely Estradiol is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.

1,739,872
Medicaid prescriptions filled (Q1–Q4 2025)
$97.9M gross Medicaid reimbursement (before mandatory rebates — net cost is lower)

How commonly is Estradiol prescribed? Of the 1,596 medications we measure, Estradiol ranks #124 by Medicaid prescriptions — more than 92% of them.

Where Estradiol ranks among the drugs we measure · Q1–Q4 2025 · neighbors ±5

Utilization by Estradiol product

Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.

The 0.1 mg/mL vaginal cream is the most-dispensed Estradiol product — about 19% of these Medicaid prescriptions.

estradiol 0.1 MG/ML Vaginal Cream Most dispensed

335,253 Medicaid prescriptions (Q1–Q4 2025) 19% of Estradiol prescriptions shown $11.1M gross reimbursement (before rebates) ≈ $33 per prescription (gross)

Summed across the 6 of 19 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 310169

estradiol 2 MG Oral Tablet

268,590 Medicaid prescriptions (Q1–Q4 2025) 15% of Estradiol prescriptions shown $4M gross reimbursement (before rebates) ≈ $15 per prescription (gross)

Summed across the 8 of 80 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 197659

estradiol 1 MG Oral Tablet

233,121 Medicaid prescriptions (Q1–Q4 2025) 13% of Estradiol prescriptions shown $2.4M gross reimbursement (before rebates) ≈ $10 per prescription (gross)

Summed across the 8 of 123 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 197658

84 HR estradiol 0.00208 MG/HR Transdermal System

126,614 Medicaid prescriptions (Q1–Q4 2025) 7% of Estradiol prescriptions shown $10.5M gross reimbursement (before rebates) ≈ $83 per prescription (gross)

Summed across the 9 of 30 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 242891

estradiol 0.5 MG Oral Tablet

110,218 Medicaid prescriptions (Q1–Q4 2025) 6% of Estradiol prescriptions shown $1.1M gross reimbursement (before rebates) ≈ $9.69 per prescription (gross)

Summed across the 5 of 69 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 197657

84 HR estradiol 0.00417 MG/HR Transdermal System

107,036 Medicaid prescriptions (Q1–Q4 2025) 6% of Estradiol prescriptions shown $10.6M gross reimbursement (before rebates) ≈ $99 per prescription (gross)

Summed across the 9 of 29 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 242892

estradiol 0.01 MG Vaginal Insert

79,292 Medicaid prescriptions (Q1–Q4 2025) 5% of Estradiol prescriptions shown $9.3M gross reimbursement (before rebates) ≈ $118 per prescription (gross)

Summed across the 11 of 27 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 884707

estradiol valerate 20 MG/ML Injectable Solution

72,221 Medicaid prescriptions (Q1–Q4 2025) 4% of Estradiol prescriptions shown $7.5M gross reimbursement (before rebates) ≈ $104 per prescription (gross)

Summed across the 4 of 4 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 310190

84 HR estradiol 0.00104 MG/HR Transdermal System

72,119 Medicaid prescriptions (Q1–Q4 2025) 4% of Estradiol prescriptions shown $5.9M gross reimbursement (before rebates) ≈ $82 per prescription (gross)

Summed across the 8 of 29 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 248478

84 HR estradiol 0.00156 MG/HR Transdermal System

62,128 Medicaid prescriptions (Q1–Q4 2025) 4% of Estradiol prescriptions shown $5.4M gross reimbursement (before rebates) ≈ $88 per prescription (gross)

Summed across the 8 of 32 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 241946

168 HR estradiol 0.00208 MG/HR Transdermal System

48,422 Medicaid prescriptions (Q1–Q4 2025) 3% of Estradiol prescriptions shown $3.6M gross reimbursement (before rebates) ≈ $75 per prescription (gross)

Summed across the 3 of 13 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 238003

168 HR estradiol 0.00104 MG/HR Transdermal System

48,226 Medicaid prescriptions (Q1–Q4 2025) 3% of Estradiol prescriptions shown $3.7M gross reimbursement (before rebates) ≈ $76 per prescription (gross)

Summed across the 3 of 13 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 242333

84 HR estradiol 0.00313 MG/HR Transdermal System

45,762 Medicaid prescriptions (Q1–Q4 2025) 3% of Estradiol prescriptions shown $4M gross reimbursement (before rebates) ≈ $88 per prescription (gross)

Summed across the 8 of 29 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1149632

168 HR estradiol 0.00417 MG/HR Transdermal System

29,190 Medicaid prescriptions (Q1–Q4 2025) 2% of Estradiol prescriptions shown $2.2M gross reimbursement (before rebates) ≈ $75 per prescription (gross)

Summed across the 3 of 13 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 238004

estradiol valerate 40 MG/ML Injectable Solution

29,074 Medicaid prescriptions (Q1–Q4 2025) 2% of Estradiol prescriptions shown $4.3M gross reimbursement (before rebates) ≈ $146 per prescription (gross)

Summed across the 4 of 4 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 310191

168 HR estradiol 0.00156 MG/HR Transdermal System

20,828 Medicaid prescriptions (Q1–Q4 2025) 1% of Estradiol prescriptions shown $1.6M gross reimbursement (before rebates) ≈ $75 per prescription (gross)

Summed across the 3 of 13 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 403922

168 HR estradiol 0.00312 MG/HR Transdermal System

10,433 Medicaid prescriptions (Q1–Q4 2025) <1% of Estradiol prescriptions shown $822,542 gross reimbursement (before rebates) ≈ $79 per prescription (gross)

Summed across the 3 of 13 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 241527

estradiol valerate 10 MG/ML Injectable Solution

8,210 Medicaid prescriptions (Q1–Q4 2025) <1% of Estradiol prescriptions shown $812,882 gross reimbursement (before rebates) ≈ $99 per prescription (gross)

Summed across the 3 of 3 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 310189

estradiol cypionate 5 MG/ML Injectable Solution

7,080 Medicaid prescriptions (Q1–Q4 2025) <1% of Estradiol prescriptions shown $1.7M gross reimbursement (before rebates) ≈ $234 per prescription (gross)

Summed across the 1 of 1 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 310187

90 DAY estradiol 0.000313 MG/HR Vaginal System

5,507 Medicaid prescriptions (Q1–Q4 2025) <1% of Estradiol prescriptions shown $3M gross reimbursement (before rebates) ≈ $543 per prescription (gross)

Summed across the 1 of 2 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 848328

168 HR estradiol 0.0025 MG/HR Transdermal System

2,706 Medicaid prescriptions (Q1–Q4 2025) <1% of Estradiol prescriptions shown $161,926 gross reimbursement (before rebates) ≈ $60 per prescription (gross)

Summed across the 3 of 13 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 403923

500 MG estradiol 0.001 MG/MG Topical Gel

2,448 Medicaid prescriptions (Q1–Q4 2025) <1% of Estradiol prescriptions shown $256,975 gross reimbursement (before rebates) ≈ $105 per prescription (gross)

Summed across the 6 of 18 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 2619679

1000 MG estradiol 0.001 MG/MG Topical Gel

1,904 Medicaid prescriptions (Q1–Q4 2025) <1% of Estradiol prescriptions shown $213,595 gross reimbursement (before rebates) ≈ $112 per prescription (gross)

Summed across the 6 of 17 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 2619683

estradiol 0.0006 MG/MG Topical Gel

1,514 Medicaid prescriptions (Q1–Q4 2025) <1% of Estradiol prescriptions shown $234,370 gross reimbursement (before rebates) ≈ $155 per prescription (gross)

Summed across the 3 of 7 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 226597

250 MG estradiol 0.001 MG/MG Topical Gel

1,231 Medicaid prescriptions (Q1–Q4 2025) <1% of Estradiol prescriptions shown $133,591 gross reimbursement (before rebates) ≈ $109 per prescription (gross)

Summed across the 6 of 17 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 2619677

estradiol 1.53 MG/ACTUAT Topical Spray

1,161 Medicaid prescriptions (Q1–Q4 2025) <1% of Estradiol prescriptions shown $197,465 gross reimbursement (before rebates) ≈ $170 per prescription (gross)

Summed across the 1 of 2 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 728118

750 MG estradiol 0.001 MG/MG Topical Gel

970 Medicaid prescriptions (Q1–Q4 2025) <1% of Estradiol prescriptions shown $99,461 gross reimbursement (before rebates) ≈ $103 per prescription (gross)

Summed across the 6 of 16 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 2619681

1250 MG estradiol 0.001 MG/MG Topical Gel

860 Medicaid prescriptions (Q1–Q4 2025) <1% of Estradiol prescriptions shown $92,028 gross reimbursement (before rebates) ≈ $107 per prescription (gross)

Summed across the 5 of 14 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 2619685

168 HR estradiol 0.000583 MG/HR Transdermal System

393 Medicaid prescriptions (Q1–Q4 2025) <1% of Estradiol prescriptions shown $91,298 gross reimbursement (before rebates) ≈ $232 per prescription (gross)

Summed across the 1 of 5 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 476545

90 DAY estradiol 0.00417 MG/HR Vaginal System

365 Medicaid prescriptions (Q1–Q4 2025) <1% of Estradiol prescriptions shown $305,841 gross reimbursement (before rebates) ≈ $838 per prescription (gross)

Summed across the 1 of 1 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 848342

90 DAY estradiol 0.00208 MG/HR Vaginal System

190 Medicaid prescriptions (Q1–Q4 2025) <1% of Estradiol prescriptions shown $152,258 gross reimbursement (before rebates) ≈ $801 per prescription (gross)

Summed across the 1 of 1 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 848331

Other Estradiol products — combination packs and listings not yet matched to a specific clinical product (kept visible so every prescription is accounted for)

6,806 Medicaid prescriptions (Q1–Q4 2025) <1% of Estradiol prescriptions shown $2.6M gross reimbursement (before rebates) ≈ $387 per prescription (gross)

Summed across the 5 of 226 listed NDC products with Medicaid activity.

Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.

Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Estradiol, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 152 of 883 listed Estradiol NDCs with Medicaid activity.

🔍 Compare Estradiol products

A representative set of FDA-listed product records for Estradiol — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)

Showing 200 of 724 products — FDA National Drug Code Directory. See every product, package size and price: browse all 724 Estradiol NDCs →

RxNorm Concept Web — From Ingredient to Every Form and Strength

This page starts with one ingredient concept (IN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). Combination products remain separate concepts with their own pages.

Ingredient (IN) Estradiol RxCUI 4083 11 dose forms · 45 strengths
  1. Dose form (SCDF) Drug Implant RxCUI 109022 In current FDA listings
    Clinical drug / strength (SCD) 25 MG RxCUI 251098 50 MG RxCUI 199547 100 MG RxCUI 199545
  2. Dose form (SCDF) Nasal Spray RxCUI 393138 No current FDA listing
    Clinical drug / strength (SCD) 0.15 MG/ACTUAT RxCUI 389138
  3. Dose form (SCDF) Oral Tablet RxCUI 372078 In current FDA listings
    Clinical drug / strength (SCD) valerate 1 MG RxCUI 978948 valerate 3 MG RxCUI 978941 0.45 MG RxCUI 577027 0.5 MG RxCUI 197657 0.9 MG RxCUI 483169 1 MG RxCUI 197658 1.5 MG RxCUI 205333 1.8 MG RxCUI 577029 2 MG RxCUI 197659 4 MG RxCUI 250213
  4. Dose form (SCDF) Topical Lotion RxCUI 402382 In current FDA listings
    Clinical drug / strength (SCD) 2.5 MG/ML RxCUI 688507
  5. Dose form (SCDF) Topical Spray RxCUI 728117 No current FDA listing
    Clinical drug / strength (SCD) 1.53 MG/ACTUAT RxCUI 728118
  6. Dose form (SCDF) Transdermal System RxCUI 1805869 In current FDA listings
  7. Dose form (SCDF) Vaginal Cream RxCUI 378615 In current FDA listings
    Clinical drug / strength (SCD) 0.1 MG/ML RxCUI 310169
  8. Dose form (SCDF) Vaginal Insert RxCUI 2109138 In current FDA listings
    Clinical drug / strength (SCD) 0.004 MG RxCUI 2048917 0.01 MG RxCUI 884707 0.025 MG RxCUI 199607

Look up RxCUI 4083 in the RxCUI Atlas →

RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.

🏷️ Sold under these brand names

Vivelle Alora Minivelle Yuvafem Imvexxy Estrace Depo-Estradiol Delestrogen Dotti Lyllana Divigel Climara Menostar EstroGel Elestrin Evamist

🏭 Manufacturers & labelers

Bryant Ranch Prepack 50 Sandoz Inc 38 A-S Medication Solutions 36 Mylan Pharmaceuticals Inc. 35 Amneal Pharmaceuticals NY LLC 35 Amneal Pharmaceuticals LLC 33 Noven Therapeutics, LLC 25 Zydus Pharmaceuticals USA Inc. 24 Xiromed, LLC 24 ANI Pharmaceuticals, Inc. 22 Bayer HealthCare Pharmaceuticals Inc. 21 Trigen Laboratories, LLC 20 Remedyrepack Inc. 20 Teva Pharmaceuticals USA, Inc. 15 Vertical Pharmaceuticals, LLC 15 NorthStar Rx LLC 14 Valdepharm 14 Preferred Pharmaceuticals Inc. 12 Asclemed USA, Inc. 12 Zydus Lifesciences Limited 12 Padagis Israel Pharmaceuticals Ltd 12 NuCare Pharmaceuticals,Inc. 10 Encube Ethicals, Inc. 7 PD-Rx Pharmaceuticals, Inc. 7

…and 16 more on the FDA NDC directory.

RxNorm drug class

Estradiol belongs to the Radioactive Diagnostic Agent class.

Pharmacologic class Radioactive Diagnostic Agent, Estrogen
Drug family (ATC) Natural and semisynthetic estrogens, plain, Progestogens and estrogens, sequential preparations
How it works Positron Emitting Activity, Estrogen Receptor Agonists

Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.

🔬 Where this comes from

Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.

📄
FDA-filed drug labels (SPL) Uses, dosing, warnings & side effects from SPL records retrieved through openFDA; the linked representative set can be verified on DailyMed. ✓ Linked label effective Jun 17, 2025
🏭
Forms, brands & labelersAggregated from ingredient-matched FDA National Drug Code Directory product records for Estradiol.
📈
Real-world reportsThe FDA Adverse Event Reporting System (FAERS), served through openFDA.
🚨
Recalls & shortagesopenFDA drug-enforcement reports and the FDA drug-shortage database.
🧾 Clinical label set — FDA-filed SPL labels retained for Estradiol after exact ingredient or ingredient-combination matching and applicable route/form matching
Clinical labels in scope
37
NDC products indexed
724
Distinct labelers/manufacturers represented
103
Linked representative label
Mylan Pharmaceuticals Inc.
Linked label effective
Jun 17, 2025
Composite sections available
26
Linked SPL Set ID
d28bec8f-762e-4f05-a20d-96a42970d6a7
Linked SPL Document ID
e1deb37a-8362-4275-a04c-7abcbb2e9f56
Open the linked representative label on DailyMed ↗

How we combine label and product data

HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 37 FDA-filed SPL label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.

For canonical ingredient pages, bounded product-attributed indication and administration excerpts may be added to the AI evidence, and the generator is instructed to preserve available product, brand, route, and form qualifiers instead of treating one label as universal. Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. Mylan Pharmaceuticals Inc. is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.

This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.