Implementation

• Estrogens should be used in the lowest doses for the shortest period of time consistent with desired therapeutic outcome

• PO: Administer with or immediately after food to reduce nausea

• Vag: Manufacturer provides applicator with cream. Dose is marked on the applicator. Wash applicator with mild soap and warm water after each use

• IM: To reconstitute, withdraw at least 5 mL of air from dry container and then slowly introduce the sterile diluent (bacteriostatic water for injection) against the container side. Gently agitate container to dissolve; do not shake vigorously. Solution is stable for 60 days if refrigerated. Do not use if precipitate is present or if solution is darkened

» IV is preferred parenteral route because of rapid response

• Direct IV:

Diluent: Reconstitute as for IM. Inject into distal port tubing of free-flowing IV of 0.9% NaCl, D5W, or lactated Ringer's solution
Concentration: 5 mg/mL

• Rate:
Administer slowly (no faster than 5 mg/min) to prevent flushing

• Y-Site Compatibility:

» heparin

» hydrocortisone sodium succinate

» potassium chloride

» vitamin B complex with C

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