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| Trade names | Harmogen, Improvera, Ogen, Ortho-Est, Sulestrex, others |
| Other names | Piperazine estrone sulfate; Estrone sulfate piperazine salt; Pipestrone |
| AHFS/Drugs.com | Monograph |
| Routes of administration | By mouth |
| Drug class | Estrogen;Estrogen ester |
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| ECHA InfoCard | 100.027.906 |
| Chemical and physical data | |
| Formula | C22H32N2O5S |
| Molar mass | 436.57 g·mol−1 |
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Estropipate, also known aspiperazine estrone sulfate and sold under the brand namesHarmogen,Improvera,Ogen,Ortho-Est, andSulestrex among others, is anestrogen medication which is used mainly inmenopausal hormone therapy in the treatment ofmenopausalsymptoms.[1][2][3][4] It is asalt ofestrone sulfate andpiperazine, and istransformed intoestrone andestradiol in the body.[2][3] It is takenby mouth.[1]
Estropipate is used to:[1][additional citation(s) needed]
| Route/form | Estrogen | Low | Standard | High | |||
|---|---|---|---|---|---|---|---|
| Oral | Estradiol | 0.5–1 mg/day | 1–2 mg/day | 2–4 mg/day | |||
| Estradiol valerate | 0.5–1 mg/day | 1–2 mg/day | 2–4 mg/day | ||||
| Estradiol acetate | 0.45–0.9 mg/day | 0.9–1.8 mg/day | 1.8–3.6 mg/day | ||||
| Conjugated estrogens | 0.3–0.45 mg/day | 0.625 mg/day | 0.9–1.25 mg/day | ||||
| Esterified estrogens | 0.3–0.45 mg/day | 0.625 mg/day | 0.9–1.25 mg/day | ||||
| Estropipate | 0.75 mg/day | 1.5 mg/day | 3 mg/day | ||||
| Estriol | 1–2 mg/day | 2–4 mg/day | 4–8 mg/day | ||||
| Ethinylestradiola | 2.5–10 μg/day | 5–20 μg/day | – | ||||
| Nasal spray | Estradiol | 150 μg/day | 300 μg/day | 600 μg/day | |||
| Transdermal patch | Estradiol | 25 μg/dayb | 50 μg/dayb | 100 μg/dayb | |||
| Transdermal gel | Estradiol | 0.5 mg/day | 1–1.5 mg/day | 2–3 mg/day | |||
| Vaginal | Estradiol | 25 μg/day | – | – | |||
| Estriol | 30 μg/day | 0.5 mg 2x/week | 0.5 mg/day | ||||
| IMTooltip Intramuscular orSC injection | Estradiol valerate | – | – | 4 mg 1x/4 weeks | |||
| Estradiol cypionate | 1 mg 1x/3–4 weeks | 3 mg 1x/3–4 weeks | 5 mg 1x/3–4 weeks | ||||
| Estradiol benzoate | 0.5 mg 1x/week | 1 mg 1x/week | 1.5 mg 1x/week | ||||
| SC implant | Estradiol | 25 mg 1x/6 months | 50 mg 1x/6 months | 100 mg 1x/6 months | |||
| Footnotes:a = No longer used or recommended, due to health concerns.b = As a single patch applied once or twice per week (worn for 3–4 days or 7 days), depending on the formulation.Note: Dosages are not necessarily equivalent.Sources: See template. | |||||||
Estropipate was available in the form of 0.75, 1.5, 3, and 6 mg oral tablets and 1.5 mg/gram vaginal cream. Estropipate is no longer available in the United States.
Estropipate is aprodrug ofestrone andestradiol. Hence, it is anestrogen, or anagonist of theestrogen receptors.
| Estrogen | HFTooltip Hot flashes | VETooltip Vaginal epithelium | UCaTooltip Urinary calcium | FSHTooltip Follicle-stimulating hormone | LHTooltip Luteinizing hormone | HDLTooltip High-density lipoprotein-CTooltip Cholesterol | SHBGTooltip Sex hormone-binding globulin | CBGTooltip Corticosteroid-binding globulin | AGTTooltip Angiotensinogen | Liver |
|---|---|---|---|---|---|---|---|---|---|---|
| Estradiol | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
| Estrone | ? | ? | ? | 0.3 | 0.3 | ? | ? | ? | ? | ? |
| Estriol | 0.3 | 0.3 | 0.1 | 0.3 | 0.3 | 0.2 | ? | ? | ? | 0.67 |
| Estrone sulfate | ? | 0.9 | 0.9 | 0.8–0.9 | 0.9 | 0.5 | 0.9 | 0.5–0.7 | 1.4–1.5 | 0.56–1.7 |
| Conjugated estrogens | 1.2 | 1.5 | 2.0 | 1.1–1.3 | 1.0 | 1.5 | 3.0–3.2 | 1.3–1.5 | 5.0 | 1.3–4.5 |
| Equilin sulfate | ? | ? | 1.0 | ? | ? | 6.0 | 7.5 | 6.0 | 7.5 | ? |
| Ethinylestradiol | 120 | 150 | 400 | 60–150 | 100 | 400 | 500–600 | 500–600 | 350 | 2.9–5.0 |
| Diethylstilbestrol | ? | ? | ? | 2.9–3.4 | ? | ? | 26–28 | 25–37 | 20 | 5.7–7.5 |
Sources and footnotes Notes: Values are ratios, with estradiol as standard (i.e., 1.0).Abbreviations:HF = Clinical relief ofhot flashes.VE = Increasedproliferation ofvaginal epithelium.UCa = Decrease inUCaTooltip urinary calcium.FSH = Suppression ofFSHTooltip follicle-stimulating hormone levels.LH = Suppression ofLHTooltip luteinizing hormone levels.HDL-C,SHBG,CBG, andAGT = Increase in the serum levels of theseliver proteins. Liver = Ratio of liver estrogenic effects to general/systemic estrogenic effects (hot flashes/gonadotropins).Sources: See template. | ||||||||||
Estropipate ishydrolyzed intoestrone in the body.[5] Estrone can then betransformed intoestradiol by17β-hydroxysteroid dehydrogenase.
Estropipate was introduced for medical use byAbbott in 1968.[6] It was approved by theFDATooltip Food and Drug Administration in theUnited States in 1991.[7]
Estropipate is thegeneric name of the drug and itsINNTooltip International Nonproprietary Name,USANTooltip United States Adopted Name, andBANTooltip British Approved Name.[2][3][8][5][9]
Estropipate was marketed under the brand names Genoral, Harmogen, Improvera, Ogen, Ortho-Est, and Sulestrex among others.[9][2][8][5]
Estropipate has been discontinued in theUnited States. In the past, estropipate has also been marketed inCanada, theUnited Kingdom,Ireland,Switzerland,Australia,South Africa,Mexico, andIndonesia.[9][8][5]
