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Estradiol 0.6 mg/Estriol 2.4 mg/Testosterone 2 mg Slow Release (MEM4) Oral Capsules

FDA-approved generic
Dose form
Slow Release Capsules
Active ingredients
Estradiol
Estriol
Testosterone

The Estradiol 0.6 mg/Estriol 2.4 mg/Testosterone 2 mg Slow Release (MEM4) Oral Capsules are a compounded hormone replacement therapy designed to address symptoms associated with menopause, such as hot flashes, vaginal dryness, and osteoporosis prevention. Additionally, this formulation may be used in the management of hypoestrogenism, female hypogonadism, and testosterone deficiency in women. Each capsule contains a combination of estradiol, estriol, and testosterone, encapsulated with Methocel E4M, a controlled-release polymer.

Methocel E4M ensures a gradual release of the hormones over an extended period, which can lead to sustained therapeutic effects and reduced dosing frequency. This slow-release mechanism is particularly beneficial for maintaining stable hormone levels throughout the day, potentially minimizing the fluctuations that can lead to symptom recurrence. The use of Methocel E4M in these capsules aims to enhance patient compliance by simplifying the dosing regimen and improving the overall management of the indicated disease states.

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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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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
Testosterone
Slow Release Capsules
655e90c55d061aaa3d19d6ae
Service area

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Bayview fills prescriptions for patients in Connecticut, Florida, Maine, Massachusetts, New Hampshire, New Jersey, Pennsylvania and Rhode Island. New York patients are served on a limited basis while nonresident pharmacy registration is pending.

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Formula Information

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Our custom-compounded Estradiol 0.6 mg/Estriol 2.4 mg/Testosterone 2 mg Slow Release (MEM4) Oral Capsules are meticulously formulated to address hormone deficiencies and imbalances in patients requiring hormone replacement therapy (HRT). This unique combination of bioidentical hormones is encapsulated using Methocel E4M, a hydrophilic methylcellulose derivative that functions as a controlled-release polymer. This advanced delivery system ensures a gradual and consistent release of hormones into the bloodstream, mimicking the body's natural rhythms and maintaining stable hormone levels over time.

Estradiol and estriol are forms of estrogen, a hormone that plays a critical role in women's health, influencing reproductive function, bone density, and cardiovascular health. Estradiol is the most potent form of estrogen and is often used to alleviate symptoms of menopause such as hot flashes, vaginal dryness, and osteoporosis. Estriol, being a weaker estrogen, is thought to offer benefits with a potentially lower risk of side effects. Testosterone, while typically considered a male hormone, is also essential for women in smaller amounts. It contributes to libido, mood stabilization, and muscle maintenance. In men, testosterone replacement can address hypogonadism, characterized by low testosterone levels, and can help improve energy levels, libido, and muscle strength.

The slow-release formulation of these capsules is particularly beneficial for patients who may experience fluctuations in hormone levels with conventional HRT. By providing a steady release, our formulation aims to reduce the incidence of side effects and improve overall efficacy. This can lead to enhanced quality of life for patients suffering from conditions such as menopausal symptoms, androgen deficiency, and other hormonal imbalances that require precise and individualized dosing.

For prescribers, it is important to note that the dosages of estradiol, estriol, and testosterone in this formulation have been carefully selected to provide a balanced approach to hormone replacement. The use of Methocel E4M not only aids in the controlled release but also contributes to the stability and uniformity of the capsule contents. Prescribers should consider the patient's individual hormonal needs, medical history, and current medications when determining the appropriateness of this therapy.

At Bayview Pharmacy, we are committed to providing high-quality, patient-specific formulations. Our team of compounding pharmacists is available to answer any questions and provide guidance on the use of this specialized hormone replacement therapy. We understand the importance of personalized care and are here to support both patients and healthcare providers in achieving optimal therapeutic outcomes. If you have any questions or require further information about our Estradiol/Estriol/Testosterone Slow Release Oral Capsules, please do not hesitate to reach out to us.

Drug Interactions

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The formulation of Estradiol 0.6 mg/Estriol 2.4 mg/Testosterone 2 mg Slow Release (MEM4) Oral Capsules is a compounded bioidentical hormone replacement therapy (BHRT) designed to alleviate symptoms associated with hormonal imbalances or deficiencies, such as those experienced during menopause or andropause. The use of Methocel E4M, a hydrophilic matrix forming polymer, allows for a controlled and sustained release of the hormones, potentially minimizing fluctuations in hormone levels and reducing the frequency of dosing.

When considering the use of this formulation, it is important to be aware of potential drug interactions. Estradiol, estriol, and testosterone can interact with a variety of medications. For instance, they may alter the effects of oral anticoagulants, leading to an increased risk of bleeding. Patients taking anticoagulants should be closely monitored, and dosage adjustments may be necessary. Additionally, the metabolism of these hormones can be affected by certain medications such as enzyme inducers (e.g., phenytoin, carbamazepine, rifampicin) which can decrease hormone levels and reduce efficacy, or enzyme inhibitors (e.g., ketoconazole, itraconazole) which can increase hormone levels and the risk of side effects.

Thyroid function tests may also be influenced by the use of estrogens and androgens, as they can increase thyroid-binding globulin (TBG) levels, leading to increased circulating total thyroid hormone, as measured by protein-bound iodine (PBI), T4 levels (by column or by radioimmunoassay) or T3 levels (by radioimmunoassay). T3 resin uptake is decreased, reflecting the elevated TBG. Patients on thyroid replacement therapy may require higher doses of thyroid hormone.

These hormones may also affect the metabolism of other hormones and the binding of sex hormone-binding globulin (SHBG), which can impact the levels of other steroid hormones. Patients using other hormonal therapies, including oral contraceptives or hormone replacement therapies, should be evaluated for potential interactions.

Additionally, the use of testosterone in this formulation may interact with blood glucose levels. Patients with diabetes should be monitored closely as androgens may improve glucose tolerance and decrease the need for insulin or other antidiabetic medications.

It is also important to consider the potential for additive effects or interactions with other medications that have similar side effects or contraindications, such as other estrogens, androgens, or hepatotoxic agents. Patients should be advised to inform their healthcare provider of all medications, supplements, and herbal products they are taking to ensure safe and appropriate use of this BHRT formulation.

Due to the complexity of hormone interactions and the individualized nature of hormone therapy, prescribers should conduct a thorough medication review and consider potential interactions on a case-by-case basis. Monitoring hormone levels and adjusting doses as necessary can help mitigate the risk of adverse interactions. If you have any questions or require further information regarding this formulation and its potential drug interactions, please reach out to us at Bayview Pharmacy for assistance.

How Does it Work

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The formulation of Estradiol 0.6 mg/Estriol 2.4 mg/Testosterone 2 mg Slow Release (MEM4) Oral Capsules is a sophisticated blend of bioidentical hormones designed to mimic the body's natural hormonal balance. This combination of hormones is specifically tailored to address symptoms associated with menopause, andropause, and other hormonal imbalances. Estradiol and Estriol are forms of estrogen, the primary female sex hormone, which can alleviate symptoms such as hot flashes, night sweats, mood swings, and vaginal dryness. Testosterone, while commonly known as a male hormone, plays a crucial role in female health as well, contributing to libido, bone density, and muscle mass.

The key to this formulation's effectiveness lies in its controlled-release mechanism, achieved through the use of Methocel E4M. Methocel E4M is a hydrophilic methylcellulose derivative that forms a gel matrix when it comes into contact with gastric fluids. This gel matrix creates a barrier that controls the rate at which the active hormones are released into the bloodstream. The slow dissolution of the matrix allows for a steady absorption of the hormones, ensuring a consistent therapeutic level is maintained over an extended period. This controlled release reduces the need for multiple daily doses, which can enhance patient compliance and minimize the fluctuations in hormone levels that might otherwise lead to a recurrence of symptoms.

By utilizing Methocel E4M in the capsule formulation, patients can expect a more uniform release of hormones, which closely resembles the body's natural rhythm. This can lead to a reduction in the intensity of side effects often associated with hormone replacement therapy (HRT). The slow release also means that the hormones are available to the body over a longer duration, which can be particularly beneficial during the night when symptoms such as hot flashes can be most disruptive to sleep.

This formulation is intended for use under the guidance of a healthcare provider experienced in hormone replacement therapy. It is important to monitor hormone levels and adjust dosages as necessary to achieve the best therapeutic outcomes. If you have any questions about this formulation or how it can be integrated into a treatment plan, please reach out to us at Bayview Pharmacy. Our team of compounding pharmacists is dedicated to providing personalized care and support to both patients and prescribers.

Other Uses

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The Estradiol 0.6 mg/Estriol 2.4 mg/Testosterone 2 mg slow-release formulation encapsulated in Methocel E4M controlled-release polymer represents a multi-hormone replacement therapy primarily designed for women experiencing menopausal symptoms, such as hot flashes, mood fluctuations, and vaginal dryness. Additionally, this balanced combination of hormones may be prescribed off-label to enhance overall quality of life and possibly mitigate the effects of aging, though this is not within the recognized standard of care and should be approached with due caution.

One off-label application may involve individuals with conditions leading to hormonal deficiencies or imbalances outside of menopausal transition. In particular, the testosterone component might be prescribed for cases of hypoactive sexual desire disorder (HSDD) in women, a condition characterized by a lack of sexual desire causing marked distress, which is believed to be related to low levels of free testosterone. It is important to note, however, that the use of testosterone in women for HSDD is not FDA-approved and should be done under the guidance of a healthcare professional with appropriate advisory on potential risks versus benefits.

While typically employed in hormonal therapy for women, there is emerging interest in the application of this formulation in transgender hormone therapy, specifically for transgender women. The inclusion of estradiol and estriol aims at feminization while the controlled testosterone portion might assist in maintaining sexual function and well-being. The inclusion of testosterone in transgender women's therapy is controversial and under-researched, but some practitioners believe in its potential benefits when carefully monitored.

The use of this formulation could also be explored for non-binary individuals seeking a more tailored approach to hormone therapy that doesn't fit within the standard male or female hormone profiles. It must be emphasized, however, that the practice of prescribing this custom-compounded formulation for such purposes is highly individualized and not widely studied. Prescribers would need to oversee treatment closely and adjust doses based on individual response and serum hormone levels while patients should be counselled on the lack of robust data supporting these uses.

Additionally, there may be interest in utilizing this formulation in the context of anti-aging treatments. Some proponents of anti-aging medicine theorize that the restoration of hormones to youthful levels may confer health benefits and a subjective sense of vitality. However, this application should be navigated with a thorough understanding of the current evidence, which is limited and often anecdotal.

In conclusion, while the Estradiol/Estriol/Testosterone slow-release formulation is primarily for menopausal symptom management, its potential applications extend into other areas of hormonal treatment, including off-label uses for sexual dysfunction, transgender medicine, non-binary hormone balancing, and anti-aging regimes. These applications require careful consideration for both efficacy and safety, and patients must be managed with a personalized approach to therapy. Anyone considering using this formulation for such purposes should engage in a comprehensive discussion with a healthcare professional. If you have any questions about alternative uses for this formulation or need more detailed information, please don't hesitate to reach out to us at Bayview Pharmacy.

Frequently Asked Questions

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What is MEM4 Oral Capsule?

The MEM4 Oral Capsule is a compounded formulation that contains a combination of hormones: Estradiol (0.6 mg), Estriol (2.4 mg), and Testosterone (2 mg). It is designed to be taken orally in a slow-release capsule form, which ensures a controlled release of the hormones over an extended period of time for sustained therapeutic effects.

How does the controlled release mechanism of MEM4 Oral Capsules work?

The controlled-release mechanism of MEM4 Oral Capsules is facilitated by Methocel E4M, a controlled-release polymer. Methocel E4M allows the medication to be released gradually into your system, providing consistent hormone levels and reducing the need for frequent dosing.

Why is Methocel E4M used in MEM4 Oral Capsules?

Methocel E4M is utilized in MEM4 Oral Capsules for its properties that allow for a prolonged release of the active ingredients. This controlled-release polymer helps to maintain consistent hormone levels in the bloodstream, thereby ensuring sustained therapeutic effects while minimizing potential side effects associated with fluctuating hormone levels.

What are the benefits of taking MEM4 Oral Capsules over traditional hormone replacement therapy (HRT)?

MEM4 Oral Capsules offer the benefit of a more consistent release of hormones compared to traditional HRT, potentially leading to more stable hormone levels and reduced side effects. The slow-release formulation also improves patient compliance by decreasing the frequency of dosing.

How often do I need to take MEM4 Oral Capsules?

The dosing frequency for MEM4 Oral Capsules can vary depending on individualized treatment plans prescribed by healthcare professionals. The slow-release formulation of the capsules is designed to reduce the number of doses needed. Always follow the dosing schedule provided by your physician.

Can MEM4 Oral Capsules be used for both men and women?

MEM4 Oral Capsules are typically tailored for hormone replacement therapy in women, but individual prescriptions may vary according to specific patient needs, including use in men if appropriate. Consult with your healthcare provider to determine if this medication is suitable for you.

What side effects might I experience with MEM4 Oral Capsules?

As with any hormone replacement therapy, you may experience side effects such as headaches, nausea, mood swings, and changes in weight or libido. However, the controlled release from MEM4 Oral Capsules may help mitigate these effects. Discuss any concerns with your healthcare provider.

Are MEM4 Oral Capsules safe for long-term use?

Long-term use of any hormone replacement therapy, including MEM4 Oral Capsules, should be regularly evaluated by a healthcare provider. While the slow-release formulation may offer benefits in terms of stability and reduced side effects, ongoing monitoring is essential to ensure safety and efficacy.

What should I do if I miss a dose of MEM4 Oral Capsules?

If you miss a dose of MEM4 Oral Capsules, take it as soon as you remember. However, if it's almost time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up. Consult your healthcare provider for specific guidance.

Can MEM4 Oral Capsules be customized for individual patient needs?

Yes, MEM4 Oral Capsules are a compounded formulation and can be tailored to the specific hormonal needs of individual patients by a compounding pharmacy under the direction of a healthcare provider.

Is a prescription required for MEM4 Oral Capsules?

Yes, a prescription is required for MEM4 Oral Capsules. As a compounded medication, it is specifically prepared by a pharmacy based on the prescription provided by your healthcare provider to meet your individual therapy needs.

How should I store MEM4 Oral Capsules?

Store MEM4 Oral Capsules at room temperature away from direct sunlight and moisture. Keep the capsules in their original container and out of reach of children and pets. Your pharmacist or healthcare provider can provide additional storage information if required.

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 0.6 mg/Estriol 2.4 mg/Testosterone 2 mg Slow Release (MEM4) Oral Capsules
Slow Release Capsules
controlled

Take 1 capsule by mouth

Once daily