Check out our most popular compounded medications! Get Started
Dashboard
Formulas

Estradiol 0.4 mg/Estriol 1.6 mg/Progesterone 50 mg/Testosterone 1 mg/ml Transdermal Gel

FDA-approved generic
Dose form
Topical Gel
Active ingredients
Estradiol
Estriol
Progesterone
Testosterone

The Estradiol 0.4 mg/Estriol 1.6 mg/Progesterone 50 mg/Testosterone 1 mg/ml Transdermal Gel is a compounded medication designed for the management of symptoms associated with menopause, such as hot flashes, night sweats, vaginal dryness, and osteoporosis prevention. Additionally, it may be used in hormone replacement therapy for individuals with hormonal imbalances or deficiencies. This semisolid formulation is dispensed through a pump mechanism, which allows for easy and precise dosing. The gel is applied topically, offering a convenient and non-invasive route of administration that facilitates the absorption of the active ingredients directly through the skin.

View more
For prescribers
Prescription details
RxThis formula
Dose formSee below
Quantity____
SigAs directed by prescriber
Refills____
PharmacyBayview Pharmacy, Warwick RI, NCPDP 4106882
Copy prescription detailsOrder form
Controlled substance: e-prescribe (EPCS) from your EHR. Faxed and phoned prescriptions cannot be accepted for this preparation.
Send it from your EHR, or fax to (401) 284-4506. How to e-prescribe this formula
Licensed to fill prescriptions for patients in RI, MA, CT, NJ, NH, FL, ME and PA. New York patients are served on a limited basis while nonresident registration is pending.
To prescribe, you must be a verified prescriber.
To prescribe, you must be in a state where we hold an active out-of-state pharmacy license.
Starting at
Get started as a patient
Get Started
This medication requires a prescription from your doctor

Licensed to fill prescriptions for patients in RI, MA, CT, NJ, NH, FL, ME and PA. New York patients are served on a limited basis while nonresident registration is pending.

For prescribersSign in for prescription details and order forms.
Compounded preparations are prepared by Bayview pursuant to a prescription for an individual patient. They are not FDA-approved and have not been evaluated by FDA for safety or effectiveness.
Estradiol
Estriol
Progesterone
Testosterone
Topical Gel
655e98024c35665f9c4d1d5d

Formula Information

A small arrow pointing down

This transdermal gel formulation combines estradiol, estriol, progesterone, and testosterone in specific concentrations to provide a comprehensive hormone replacement therapy (HRT) for patients experiencing symptoms of hormonal imbalance or deficiencies. The inclusion of both estrogens, estradiol at 0.4 mg and estriol at 1.6 mg, offers a balanced approach to estrogen replacement, which can alleviate symptoms of menopause such as hot flashes, night sweats, and vaginal dryness. Estriol, being a weaker estrogen, is often used to minimize the risk of estrogenic side effects while still providing relief from menopausal symptoms. Estradiol, the more potent form, supports overall estrogenic activity necessary for maintaining various physiological functions.

Progesterone at 50 mg is incorporated to counterbalance the effects of estrogen and reduce the risk of endometrial hyperplasia, which can occur with estrogen therapy alone. This is particularly important for women with an intact uterus. Progesterone also contributes to the improvement of sleep quality and mood stabilization. Testosterone at 1 mg/ml is added to address the often-overlooked decline in androgen levels in women, which can impact libido, energy levels, and muscle strength.

The transdermal delivery system of this gel allows for the direct application to the skin, ensuring a steady absorption of hormones into the bloodstream, bypassing the first-pass metabolism in the liver, and potentially reducing the risk of adverse effects associated with oral hormone therapies. The semisolid formulation dispensed through a pump mechanism ensures consistent dosing and ease of use for the patient. The gel-like consistency facilitates absorption through the skin and can be applied to areas recommended by healthcare providers for optimal hormone uptake.

This hormone combination therapy is tailored for women who are experiencing symptoms of menopause, perimenopause, or hormonal imbalances that require a customized approach. It is essential that patients and prescribers work closely to monitor hormone levels and adjust dosages as necessary to achieve the best therapeutic outcomes with minimal side effects. Regular follow-ups and assessments are crucial in managing the patient's response to the therapy.

For patients and prescribers interested in this transdermal hormone therapy, it is important to consider individual patient needs, existing medical conditions, and potential interactions with other medications. If you have any questions or require further information about this formulation, please reach out to us at Bayview Pharmacy. Our team of compounding pharmacists is dedicated to providing support and guidance to ensure appropriate treatment for our patients.

Drug Interactions

A small arrow pointing down

The transdermal gel formulation containing estradiol, estriol, progesterone, and testosterone is designed to deliver hormones directly through the skin into the bloodstream. This method of delivery can help in the management of various conditions such as menopausal symptoms, hormone imbalances, and certain cases of hormonal insufficiency. However, it is important to consider potential drug interactions when using this formulation.

Estradiol and estriol are forms of estrogen, a hormone that can interact with a variety of medications. Estrogens may reduce the efficacy of aromatase inhibitors, which are used in the treatment of certain types of breast cancer. Concurrent use with thyroid hormone replacement therapy may increase the requirements for thyroid hormones. Estrogens can also interfere with the metabolism of drugs that are substrates of cytochrome P450 enzymes, particularly CYP3A4, leading to either increased or decreased levels of these drugs. Examples include certain benzodiazepines, calcium channel blockers, and some statins.

Progesterone can also interact with CYP3A4 substrates. When used with drugs that induce this enzyme, such as rifampin or certain anticonvulsants, the effectiveness of progesterone may be reduced. Conversely, drugs that inhibit CYP3A4, like ketoconazole or erythromycin, could increase progesterone levels, potentially leading to adverse effects.

Testosterone, included in this formulation, can affect blood glucose levels, which may necessitate adjustments in antidiabetic medication dosages for patients with diabetes. Additionally, testosterone may enhance the anticoagulant effects of warfarin and other coumarin derivatives, increasing the risk of bleeding. Patients on anticoagulant therapy should be closely monitored when starting or stopping testosterone treatment.

It is also important to note that the use of any hormone therapy can influence the metabolism and effectiveness of other hormones, such as oral contraceptives or hormone replacement therapies. Patients should inform their healthcare provider of all medications, supplements, and herbal products they are taking to avoid unintended interactions.

Patients should be advised to avoid smoking while using this hormone-containing transdermal gel, as smoking can increase the risk of serious cardiovascular side effects associated with estrogen therapy. Additionally, the concurrent use of alcohol may alter the metabolism and effectiveness of the hormones in the gel.

Lastly, the transdermal route bypasses the first-pass metabolism in the liver, which may result in different interaction profiles compared to oral administration of these hormones. Therefore, prescribers should consider the route of administration when evaluating potential drug interactions.

For a comprehensive assessment of drug interactions and individualized advice, patients and prescribers are encouraged to reach out to us at Bayview Pharmacy. Our team of compounding pharmacists is available to provide detailed information and support to ensure safe and appropriate use of this transdermal gel formulation.

How Does it Work

A small arrow pointing down

The transdermal gel formulation containing Estradiol 0.4 mg, Estriol 1.6 mg, Progesterone 50 mg, and Testosterone 1 mg per milliliter is designed to deliver a combination of hormones directly through the skin into the bloodstream. This method of delivery is advantageous because it bypasses the gastrointestinal tract and liver, which can metabolize and alter hormones before they reach the systemic circulation. The gel is a semisolid dosage form that allows for a controlled release of the hormones, providing a steady absorption rate and maintaining consistent blood levels over time.

Estradiol and Estriol are forms of estrogen, a female hormone that regulates many processes in the body. Estradiol is the most potent form of estrogen and is crucial for reproductive and sexual function as well as bone health. Estriol is a weaker estrogen, often used in combination with other estrogens to treat menopausal symptoms. Progesterone is another female hormone that plays a role in the menstrual cycle and pregnancy. Testosterone, while typically considered a male hormone, is also present in females and contributes to libido, bone density, and muscle strength.

This hormone combination gel is primarily used to treat symptoms associated with menopause, such as hot flashes, vaginal dryness, and mood swings. It may also be used for hormone replacement therapy in women with conditions that cause a deficiency of these hormones. The testosterone in the formulation can help address decreased libido and energy levels that some women experience during menopause or due to other hormonal imbalances.

The gel is applied to the skin, usually on the arms, thighs, or abdomen, where it is absorbed transdermally. The pump mechanism ensures that a precise dose is dispensed each time, which is important for maintaining the correct hormone balance. Patients should follow the specific application instructions provided by their healthcare provider to ensure optimal absorption and efficacy of the medication.

It is important for both patients and prescribers to monitor hormone levels and symptoms regularly to adjust the dosage as needed. If you have any questions or require further information about this formulation and its use in treating specific disease states, please reach out to us at Bayview Pharmacy.

Other Uses

A small arrow pointing down

The primary use of our compounded transdermal gel containing Estradiol 0.4 mg, Estriol 1.6 mg, Progesterone 50 mg, and Testosterone 1 mg per ml is hormone replacement therapy (HRT) in individuals who may have a deficiency or imbalance in one or more of these hormones. However, it's important to note that this formulation may also have off-label applications that can be explored and prescribed based on a healthcare professional's discretion. For example, testosterone in the compound may be beneficial for women experiencing low libido or sexual dysfunction, as it plays a role in sexual arousal. The addition of progesterone may also aid in improving sleep quality and mood in certain individuals.

Moreover, the skin-tightening effects attributed to estrogens like Estradiol and Estriol can be of interest for patients seeking to improve the appearance of their skin, although the primary intent of the formulation is systemic hormone therapy rather than dermatologic use. Similarly, the anti-inflammatory properties of these hormones might provide ancillary benefits in reducing localized inflammation when applied to the skin. It’s also worth noting that some patients may experience an overall sense of well-being and improvement in cognitive functions when their hormone levels are restored to a more balanced state with the help of this gel.

It's essential that any alternative uses of this transdermal gel are carefully discussed with and monitored by a healthcare professional to ensure safety and efficacy. Every individual is unique, and hormone therapy can result in diverse responses, requiring personalized dosing and close clinical supervision. For further information on this formulation or if you have any questions about its potential applications, do not hesitate to reach out to us at Bayview Pharmacy. We are here to support both patients and prescribers with our expertise in compounding pharmacology.

Frequently Asked Questions

A small arrow pointing down

What is the purpose of this compounded hormone formulation?

This compounded formulation combines estradiol, estriol, progesterone, and testosterone in specific dosages to provide a balanced hormone replacement therapy. It is designed to address symptoms of hormone deficiency or imbalance such as hot flashes, vaginal dryness, decreased libido, and other symptoms associated with menopause or hormone disorders.

How do I use this transdermal gel?

Apply the gel as directed by your healthcare provider. Typically, the gel is applied to clean, dry skin on areas like the arms, thighs, or abdomen. Spread the gel in a thin layer and allow it to dry before covering with clothing. Do not apply to the breasts or genital areas unless specifically instructed.

Is the pump mechanism difficult to use?

No, the pump is designed for ease of use and provides a consistent dosage with each press. It allows for precise measurement of the gel, reducing the risk of dosing errors. If you are having trouble with the pump, consult with your pharmacist for assistance.

How often should I apply the gel?

The frequency of application will be determined by your healthcare provider based on your individual needs. Follow the dosing schedule provided by your provider for the best results.

Can I apply lotion or sunscreen over the gel?

It is recommended to wait until the gel is fully absorbed before applying other products to the same area. This typically takes a few minutes. Applying other products too soon can affect how the medication is absorbed through your skin.

What should I do if I miss a dose?

If you miss a dose, apply it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double doses to catch up.

Are there any side effects associated with this formulation?

As with any medication, side effects are possible. Common side effects may include skin irritation at the application site, headaches, breast tenderness, mood swings, and weight changes. If you experience any severe or persistent side effects, contact your healthcare provider immediately.

How should I store the compounded gel?

Store the gel at room temperature, away from heat and direct sunlight. Keep it out of reach of children and pets. Do not freeze the medication, and discard any unused gel after the expiration date or as instructed by your pharmacist.

Can this hormone therapy affect other medications I’m taking?

It is possible for this hormonal therapy to interact with other medications. Inform your healthcare provider about all the medications you are taking, including prescription, over-the-counter, and herbal products, to avoid potential interactions.

Do I need to follow any special precautions while using this gel?

Avoid contact with water or engaging in activities that may cause sweating for at least an hour after application to ensure proper absorption. Also, avoid transferring the medication to others through skin contact, and wash your hands thoroughly after application.

Can men use this transdermal gel?

This particular formulation is typically designed for female hormone replacement therapy and may not be suitable for men. Men should consult with a healthcare provider for appropriate treatments tailored to their specific hormonal needs.

About this compounded preparation

This formulation is compounded by Bayview Pharmacy on a prescriber's order for an individual patient. It is not an FDA-approved drug product, and the FDA has not evaluated it for safety, effectiveness, or manufacturing quality.

The conditions listed on this page are indications prescribers have ordered this preparation for. They are not FDA-approved indications, and listing them is not a statement that this preparation is effective for them.

A valid prescription is required. Availability depends on Bayview's licensure in your state. This page is general information, not medical advice — discuss your situation with a licensed healthcare provider.

This preparation is a controlled substance. Additional prescribing, refill, and shipping restrictions apply, and the states Bayview can dispense it to are narrower than for non-controlled preparations.

Formulas and/or material listed are not to be interpreted as a promise, guarantee or claim of therapeutic efficacy or safety. The information contained herein is not intended to replace or substitute for conventional medical care, or encourage its abandonment. Every patient is unique, and formulas should be adjusted to meet their individual needs.

No compounded medications are reviewed by the FDA for safety or efficacy.
For prescribers

How to e-prescribe this formula

Controlled substance: e-prescribe only (EPCS). Faxed, phoned, and handwritten prescriptions cannot be filled. Rhode Island law (R.I. Gen. Laws § 21-28-3.18) requires Schedule II to V prescriptions to be transmitted electronically.
1

Find Bayview in your EHR's pharmacy directory

Search by NCPDP 4106882, or by name and ZIP: Bayview Pharmacy, Warwick, RI 02886. Select it as the destination pharmacy and save it as a favorite. Click any value to copy it.

NCPDP4106882NPI1750455143Address3844 Post Rd, Warwick, RI 02886Phone(401) 284-4505Fax(401) 284-4506
2

Enter the formula as a compound

Compounded preparations have no NDC, so this formula will not appear in your EHR's drug search. Use your system's compound, non-formulary, or free-text prescription entry and name the preparation exactly as written in step 3. If your EHR forces you to pick a listed drug, pick the closest entry for the active ingredient and put the full formula in the prescription body (the Sig or directions field), not in Notes to Pharmacy.

Compounded preparations have no NDC and will not appear in your drug search. For EPCS to validate, select a drug entry your EHR recognizes as controlled, usually the bulk powder entry for the active ingredient (for example Ketamine (bulk) powder, not a branded product), then put the full formula from step 3 in the prescription body. A free-text entry that does not validate as controlled will be rejected by your EPCS module.

3

Copy the prescription details

RxFormula name
Dose formDose form
Quantity________
SigAs directed by prescriber
Refills____
PharmacyBayview Pharmacy, Warwick RI, NCPDP 4106882
Copy prescription details

Quantity and directions are starting points for this dose form, not treatment recommendations. Dosing remains the prescriber's responsibility.

4

Send it

Transmit from your EHR. For this non-controlled preparation we also accept fax to (401) 284-4506 and phoned orders at (401) 284-4505. Order forms are on the formulation pages and in the prescriber portal.

Transmit with two-factor authentication through your EPCS-enabled EHR. No order form is offered for this preparation; e-prescribing guides for our controlled preparations are on the formulation pages.

Do not use Notes to Pharmacy for the formula. Some EHRs keep that field internal and never transmit it. A prescription that arrives without the formula is delayed while we call your office.

Licensed to dispense in RI, MA, CT, NJ, NH, FL, ME, and PA; New York is served on a limited basis while nonresident registration is pending. Compounded preparations are not FDA-approved. A valid prescription is required. Full guide, including steps by EHR: How to e-prescribe to Bayview. Questions about this formula: call (401) 284-4505.

Estradiol 0.4 mg/Estriol 1.6 mg/Progesterone 50 mg/Testosterone 1 mg/ml Transdermal Gel
Topical Gel
60 g
controlled

Apply topically to affected area(s)