Adverse Drug Reaction Classification System

Pharmaceutical Information
Drug Name Estradiol cypionate
Drug ID BADD_D00823
Description Estradiol Cypionate is a pro-drug ester of [DB00783], a naturally occurring hormone that circulates endogenously within the human body. Estradiol is the most potent form of all mammalian estrogenic steroids and acts as the major female sex hormone. As a pro-drug of estradiol, estradiol cypionate therefore has the same downstream effects within the body through binding to the Estrogen Receptor (ER) including ERα and ERβ subtypes, which are located in various tissues and organs such as the breasts, uterus, ovaries, skin, prostate, bone, fat, and brain. [DB00783] is commonly produced with an ester side-chain as endogenous estradiol has very low oral bioavailability on its own (2-10%). First-pass metabolism by the gut and the liver quickly degrades the estradiol molecule before it gets a chance to enter systemic circulation and exert its estrogenic effects [A12102]. Esterification of estradiol aims to improve absorption and bioavailability after oral administration (such as with Estradiol Valerate) or to sustain release from depot intramuscular injections (such as with Estradiol Cypionate) through improved lipophilicity. Following absorption, the esters are cleaved, resulting in the release of endogenous estradiol, or 17β-estradiol. Ester pro-drugs of estradiol are therefore considered to be bioidentical forms of estrogen [T84]. Estradiol cypionate is commercially available as Depo-Estradiol, an intramuscular depot injection used for the treatment of moderate to severe vasomotor symptoms associated with menopause and for the treatment of hypoestrogenism due to hypogonadism [FDA Label]. The primary source of estrogen in normally cycling adult women is the ovarian follicle, which secretes 70 to 500 mcg of estradiol daily, depending on the phase of the menstrual cycle. However, after menopause, most endogenous estrogen is produced by conversion of androstenedione, secreted by the adrenal cortex, to estrone by peripheral tissues. Thus, estrone and the sulfate conjugated form, estrone sulfate, are the most abundant circulating estrogens in postmenopausal women [FDA Label]. Although circulating estrogens exist in a dynamic equilibrium of metabolic interconversions, estradiol is the principal intracellular human estrogen and is substantially more potent than its metabolites, estrone and estriol at the receptor level. Because of the difference in potency between estradiol and estrone, menopause (and a change in primary hormone from estradiol to estrone) is associated with a number of symptoms associated with this reduction in potency and in estrogenic effects. These include hot flashes, vaginal dryness, mood changes, irregular menses, chills, and sleeping problems. Administration of synthetic and bioidentical forms of estrogen, such as estradiol cypionate, has shown to improve these menopausal symptoms.
Indications and Usage Depo-Estradiol intramuscular depot injection is indicated for the treatment of moderate to severe vasomotor symptoms and hypoestrogenism due to hypogonadism.
Marketing Status Prescription; Discontinued
ATC Code G03CA03
DrugBank ID DB13954
KEGG ID D04063
MeSH ID C007630
PubChem ID 9403
TTD Drug ID D0U0XD
NDC Product Code 73377-071; 71052-277; 51552-1056; 73774-003; 38779-1901; 49803-007; 0009-0271; 60592-210
Synonyms estradiol 17 beta-cypionate | estradiol 17 beta-cyclopentanepropionate | estradiol 17 beta-cyclopentylpropionate | estradiol cypionate | Depo-estradiol
Chemical Information
Molecular Formula C26H36O3
CAS Registry Number 313-06-4
SMILES CC12CCC3C(C1CCC2OC(=O)CCC4CCCC4)CCC5=C3C=CC(=C5)O
Chemical Structure
ADR Related Proteins Induced by Drug
ADR Term Protein Name UniProt AC TTD Target ID PMID
Not AvailableNot AvailableNot AvailableNot AvailableNot Available
ADRs Induced by Drug
ADR Term ADReCS ID ADR Frequency (FAERS) ADR Severity Grade (FAERS) ADR Severity Grade (CTCAE)
Rash23.03.13.001--Not Available
Tenderness08.01.08.005--Not Available
Tension19.06.02.005--Not Available
Thrombophlebitis24.01.02.001--Not Available
Thrombophlebitis superficial24.01.02.002--
Urticaria23.04.02.001; 10.01.06.001--
Uterine leiomyoma21.07.02.004; 16.04.02.001--Not Available
Vaginal haemorrhage24.07.03.005; 21.08.01.001--
Vaginal infection21.14.02.002; 11.01.10.002--
Vaginal inflammation21.14.02.001--
Vomiting07.01.07.003--
Vulvovaginal candidiasis21.14.02.003; 11.03.03.005--Not Available
Weight decreased13.15.01.005--
Weight increased13.15.01.006--
Deep vein thrombosis24.01.02.003--Not Available
Acute coronary syndrome24.04.04.011; 02.02.02.015--Not Available
Musculoskeletal discomfort15.03.04.001--Not Available
Haemorrhage24.07.01.002--Not Available
Libido disorder21.03.02.006; 19.08.03.004--Not Available
Porphyrin metabolism disorder03.08.01.006; 14.14.01.006; 09.01.10.004--Not Available
Corneal disorder06.08.01.004--Not Available
Retinal vascular thrombosis06.10.01.004; 24.01.07.001--Not Available
Vulvovaginal mycotic infection21.14.02.004; 11.03.05.004--Not Available
Abnormal withdrawal bleeding21.01.01.008; 08.06.02.001--Not Available
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