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Estradiol 0.4 mg/ml/Estriol 0.6 mg/ml/Progesterone 30 mg/ml/Testosterone 0.25 mg/ml Topical Cream

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

Description: This topical cream is a compounded formulation containing a blend of bioidentical hormones: Estradiol (0.4 mg/ml), Estriol (0.6 mg/ml), Progesterone (30 mg/ml), and Testosterone (0.25 mg/ml). The cream is designed to be dispensed from a pump mechanism, ensuring a consistent and controlled dose with each application. The semisolid preparation is intended for transdermal delivery, where the active ingredients are absorbed through the skin to provide localized or systemic therapeutic effects. This hormone combination is commonly used in the management of menopausal symptoms, such as hot flashes, night sweats, vaginal dryness, and mood swings. Additionally, it may be prescribed for hormone replacement therapy in conditions of hormonal imbalance or insufficiency.

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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.
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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 Cream
655e44f011b75cb815c80280

Formula Information

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The compounded formulation of Estradiol 0.4 mg/ml, Estriol 0.6 mg/ml, Progesterone 30 mg/ml, and Testosterone 0.25 mg/ml topical cream is a specialized medication prepared to address various hormone-related conditions. This unique combination of bioidentical hormones is designed to mimic the body's natural hormones, providing a balanced approach to hormone replacement therapy (HRT). The cream is compounded in a semisolid base that allows for easy application and consistent dosing through a pump mechanism. This delivery system ensures that each dose contains the precise amount of each hormone, promoting optimal therapeutic outcomes.

Estradiol and Estriol are forms of estrogen, a hormone that plays a critical role in women's health, influencing reproductive functions, bone density, and cardiovascular health. Progesterone is another key hormone that works in tandem with estrogen to regulate the menstrual cycle and maintain the lining of the uterus. Testosterone, while typically considered a male hormone, is also important for women's health, contributing to muscle strength, bone density, and libido. The combination of these hormones in the topical cream can be used to alleviate symptoms associated with menopause, such as hot flashes, night sweats, vaginal dryness, and mood swings. It may also be beneficial for premenopausal women experiencing hormonal imbalances.

The topical route of administration allows for the hormones to be absorbed directly through the skin, bypassing the gastrointestinal tract and liver, which can minimize potential side effects and improve the hormones' bioavailability. This method of delivery can be particularly advantageous for patients who have difficulties with oral medications or for those who prefer a non-invasive option. The cream can be applied to areas of thin skin, such as the inner arms or thighs, where absorption is typically more efficient.

It is important for patients and prescribers to understand that this compounded formulation requires a prescription and should be used under the guidance of a healthcare professional experienced in hormone replacement therapy. The specific dose and regimen will be tailored to the individual patient's needs, based on their hormone levels and clinical symptoms. Regular monitoring and follow-up with the prescriber are essential to ensure the effectiveness of the treatment and to make any necessary adjustments.

For those considering this compounded hormone therapy, it is crucial to discuss the potential risks and benefits with a healthcare provider. While bioidentical hormones are often well-tolerated and considered to have a favorable safety profile, hormone therapy is not without risks. Patients should be aware of the signs of hormone imbalance or side effects and report any concerns to their prescriber promptly.

If you have any questions or require further information about this compounded formulation, please do not hesitate to reach out to us at Bayview Pharmacy. Our team of knowledgeable compounding pharmacists is here to provide support and guidance to both patients and healthcare providers, ensuring safe and appropriate use of this customized medication.

Drug Interactions

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This topical cream formulation contains a combination of hormones: estradiol, estriol, progesterone, and testosterone. Each of these hormones can interact with various medications, supplements, and health conditions, and it is important to consider these interactions to ensure safe and appropriate use of the cream.

Estradiol and estriol are forms of estrogen, and when used topically, they may still have systemic effects. Estrogens can interact with thyroid hormone replacement therapy, potentially necessitating an adjustment in the dose of thyroid medication. They may also reduce the effectiveness of anticoagulant medications like warfarin, increasing the risk of clotting. Estrogens can also interact with certain enzyme inducers, such as carbamazepine, phenytoin, and rifampicin, which can decrease estrogen levels and reduce the effectiveness of the cream. Additionally, estrogens can increase the plasma concentrations of corticosteroids and cyclosporine, requiring careful monitoring of patients on these medications.

Progesterone can interact with benzodiazepines, increasing their sedative effects. It can also interact with certain anticonvulsants and antimicrobial agents, which may alter progesterone metabolism and efficacy. Patients using medications for liver conditions should be monitored closely, as progesterone metabolism may be affected by liver function.

Testosterone, even in small amounts, can interact with oral anticoagulants, potentially increasing the risk of bleeding. It may also affect blood sugar levels, which is particularly important for patients with diabetes; monitoring and possible adjustment of antidiabetic medications may be necessary. Testosterone can also interact with corticosteroids, leading to increased fluid retention and should be used cautiously in patients with heart, kidney, or liver diseases.

It is also important to note that the use of this hormone combination cream may be contraindicated in patients with a history of hormone-sensitive cancers, thromboembolic disorders, or undiagnosed vaginal bleeding. Patients with liver dysfunction, gallbladder disease, or a history of mental health issues should use this medication with caution and under close supervision by a healthcare provider.

Patients should be advised to inform their healthcare providers of all medications, supplements, and herbal products they are taking to avoid potential interactions. Additionally, patients should be aware that certain foods, alcohol, and tobacco may affect hormone levels and the effectiveness of this topical cream.

This formulation is designed to treat symptoms associated with hormonal deficiencies or imbalances, such as menopausal symptoms, androgen deficiency, and certain dermatological conditions. The combination of hormones works to replenish deficient hormone levels, alleviate symptoms, and improve the overall quality of life for patients. However, the specific treatment goals and outcomes may vary based on individual patient needs and should be discussed with a healthcare provider.

If you have any questions or require further information regarding this formulation and its potential interactions, please do not hesitate to reach out to us at Bayview Pharmacy. Our team of compounding pharmacists is here to provide guidance and support to both patients and prescribers.

How Does it Work

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The formulation of Estradiol 0.4 mg/ml, Estriol 0.6 mg/ml, Progesterone 30 mg/ml, and Testosterone 0.25 mg/ml topical cream is a compounded medication designed to deliver a combination of hormones directly through the skin. This semisolid preparation is dispensed in a pump mechanism, which allows for convenient and controlled application. The pump ensures that each dose is consistent, reducing the risk of dosing errors and improving patient compliance.

The active ingredients in this formulation are bioidentical hormones, which are chemically identical to those the human body naturally produces. Estradiol and estriol are forms of estrogen, progesterone is a progestogen, and testosterone is an androgen. These hormones play a crucial role in various physiological processes, including reproductive health, bone density regulation, and the maintenance of skin and muscle tone.

Estradiol is the most potent form of estrogen and is essential for many aspects of women's health. It can help alleviate symptoms of menopause, such as hot flashes, vaginal dryness, and mood swings. Estriol, a weaker estrogen, is thought to offer benefits with a potentially lower risk of side effects. It may also have protective effects on the skin and urinary tract. Progesterone is used to balance the effects of estrogen and can help with symptoms such as irregular menstrual cycles and mood fluctuations. Testosterone, while typically considered a male hormone, is also important for women's health, contributing to libido, energy levels, and overall well-being.

This topical cream is particularly useful for treating symptoms associated with hormonal imbalances or deficiencies, such as those experienced during menopause, perimenopause, or as part of hormone replacement therapy (HRT). By applying the cream to the skin, the hormones are absorbed directly into the bloodstream, bypassing the gastrointestinal tract and liver, which can metabolize and reduce the effectiveness of oral medications. This method of delivery can also minimize the risk of certain side effects associated with oral hormone therapies.

The specific combination of hormones in this formulation can be tailored to the individual needs of the patient, based on their symptoms and hormone levels. It is important for patients to work closely with their healthcare provider to monitor their response to treatment and adjust the dosage as necessary. For prescribers, it is crucial to consider the patient's medical history, current medications, and hormone levels when determining the appropriateness of this formulation.

If you have any questions about this formulation or how it can be integrated into a patient's treatment plan, please reach out to us at Bayview Pharmacy. Our team of compounding pharmacists is here to provide guidance and support to ensure the safe and appropriate use of this medication.

Other Uses

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While the primary use of this topical cream containing estradiol, estriol, progesterone, and testosterone is for hormone replacement therapy (HRT) to alleviate symptoms of menopause, deficiency, or imbalance, there are other potential applications. This hormonal cream might also be considered for off-label use in addressing skin aging due to its constituents' potential impact on skin hydration and elasticity. Some studies have indicated that topically applied estrogens may help improve skin thickness and collagen content, which declines with age. Additionally, testosterone could promote skin health by possibly enhancing dermal strength.

Patients with a history of estrogen-sensitive cancers or thromboembolic disorders should use caution, as systemic absorption, although not the primary aim of this formulation, may still occur. It is crucial to tailor hormone therapy to an individual's health profile, and as such, this formulation may be adapted to serve in a patient-specific compounded therapy plan to address unique deficiencies or conditions.

Beyond dermatological health, these hormones in combination have been shown to have synergistic effects on mood, energy levels, and sexual function, which may be a secondary benefit for patients using this compound. Some patients with libido concerns or sexual dysfunctions may experience improvement in these areas when using a cream with this hormone blend, although more research is needed in this domain.

Importantly, as with any medication, the use of hormone-containing topical creams can have side effects and risks. It is vital for both patients and prescribers to weigh the benefits and risks of use on a case-by-case basis. Regular monitoring, follow-up testing, and adjustments in therapy may be required to ensure optimal outcomes and minimize potential risks.

If there are questions or concerns about this formulation or its appropriate use, we encourage patients and healthcare providers to reach out to Bayview Pharmacy. Our team of compounding pharmacists has the expertise to provide further information, guidance, and support, ensuring that each patient receives personalized care and the most appropriate therapy for their individual health needs.

Frequently Asked Questions

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What is this topical cream used for?

This compounded formulation is designed for hormone replacement therapy, delivering a combination of hormones – Estradiol, Estriol, Progesterone, and Testosterone – through the skin to manage symptoms associated with hormonal imbalances or deficiencies, such as those occurring during menopause.

How do I apply this compounded hormone cream?

The cream should be applied as directed by your healthcare provider. Use the pump mechanism to dispense the recommended amount and spread evenly on the skin.

Is this formulation safe for all skin types?

While the formulation is designed to be gentle, skin sensitivity can vary. If you have sensitive skin or a history of skin conditions, consult your healthcare provider before starting treatment. Patch testing may be recommended to check for reactions.

How does the pump mechanism work?

The pump is designed to dispense a controlled amount of cream with each press. This helps ensure consistent dosing. Prime the pump as instructed before first use, and then press down fully to dispense the prescribed dose.

Can I apply this cream to my face?

Unless directed by your healthcare provider, it is generally not recommended to apply this hormone cream to your face. Hormonal preparations are typically applied to areas as recommended by your healthcare provider to ensure proper absorption and reduce the risk of skin irritation.

What should I do if I miss a dose?

If you miss a dose, apply it as soon as you remember. However, if it's almost time for your next dose, skip the missed one and return to your regular application schedule. Do not apply extra cream to make up for a missed dose.

Will this cream affect my clothing?

Allow the cream to fully absorb into the skin before dressing to minimize the risk of transferring it to clothing. It is recommended to wait a few minutes after application before putting on any fabrics that might come in contact with the treated area.

Can this cream be used during pregnancy?

This compound should not be used during pregnancy unless specifically prescribed by your healthcare provider. Some of the hormones in the cream can potentially affect fetal development, so it is important to discuss any potential risks with your doctor.

How should I store this cream?

Store the cream at room temperature away from heat and direct sunlight. The container should be kept tightly closed when not in use.

Can I use this cream in conjunction with other medications?

Always inform your healthcare provider about all the medications and supplements you are taking before starting any new treatment, including this hormone cream. Some substances can interact with hormonal treatments, potentially altering their effects or increasing side effects.

What side effects can I expect from using this topical cream?

Side effects can vary depending on the individual and typically include local reactions such as redness, itching, or irritation at the application site. Systemic side effects may include changes in mood, weight, or libido. Contact your healthcare provider if you experience any side effects, especially if they persist or worsen.

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/ml/Estriol 0.6 mg/ml/Progesterone 30 mg/ml/Testosterone 0.25 mg/ml Topical Cream
Topical Cream
30 g
controlled

Apply topically to affected area(s)