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VAGIFEM Information: Common uses -This medicine is a female hormone and is usually given to women who do not produce the proper amount. It is used to reduce menopause symptoms (such as vaginal dryness). It may also be used to treat other conditions as determined by your doctor. Before using -WARNING: Estrogens have been reported to increase the chance of womb (endometrial) cancer in women who have been through menopause, especially in women with a uterus who receive estrogen-only hormone therapy. Estrogens may also increase the risk of cancer of the ovary/breast. Estrogen-containing medicines should not be used to prevent heart disease. Estrogen given in combination with another hormone (progestin) for replacement therapy can infrequently cause heart disease (e.g., heart attacks), stroke, serious blood clots, and cancer of the breast. These risks appear to depend on the length of time this medicine is used and the amount of estrogen per dose. Therefore, this medicine should be used for the shortest possible length of time at the lowest effective dose, so you obtain the benefits and minimize the chance of serious side effects from long-term treatment. Consult your doctor or pharmacist for details. If you use this medicine for an extended period, you should be evaluated at least once yearly (see CAUTIONS section). This medicine is not effective in preventing/treating a tendency toward miscarriages nor the threat of miscarriage. This medicine must not be used during pregnancy because its use may result in birth defects or cancer later in the child's life (see CAUTIONS section). INFORM YOUR DOCTOR OR PHARMACIST of all prescription and over-the-counter medicine that you are taking. ADDITIONAL MONITORING OF YOUR DOSE OR CONDITION may be needed if you are using other vaginal medicines. DO NOT START OR STOP ANY MEDICINE without doctor or pharmacist approval. Inform your doctor of any other medical conditions including a family medical history (e.g., especially breast lumps/cancer), asthma, diabetes, seizures, migraine headaches, liver or kidney disease, heart disease (e.g., high blood pressure, heart attacks, congestive heart failure), low thyroid hormone (hypothyroidism), abnormal calcium level in the blood, depression, high blood pressure during pregnancy, yellowing of eyes/skin during pregnancy or with past estrogen use, womb problems (e.g., uterine fibroids/endometriosis), cholesterol/lipid problems, gallbladder disease, excessive weight gain, certain blood disorder (porphyria), allergies, pregnancy, or breast-feeding. USE OF THIS MEDICINE IS NOT RECOMMENDED if you have certain medical conditions including undiagnosed abnormal vaginal bleeding, certain cancers (e.g., breast cancer, especially non-metastatic type), blood clots, or active/recent stroke or heart attack. Contact your doctor or pharmacist if you have any questions or concerns about taking this medicine. Directions -Follow the directions for using this medicine provided by your doctor. This medicine may come with a patient leaflet. Ask your doctor, nurse, or pharmacist any questions you may have about this medicine. Insert the applicator into the vagina as directed and push the plunger to release the medicine. Follow your dosing schedule closely. It is best to schedule each dose about the same time of the day. STORE THIS MEDICINE at room temperature 77 degrees F (25 degrees C), away from heat, moisture, and light. Brief storage between 59 and 86 degrees F (15-30 degrees C) is permitted. IF YOU MISS A DOSE OF THIS MEDICINE, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do NOT use 2 doses at once. Possible side effects -SIDE EFFECTS, that may go away during treatment, include dizziness, lightheadedness, headache, stomach upset, bloating, nausea, weight changes, increased/decreased interest in sex, or breast tenderness. If they continue or are bothersome, check with your doctor. CONTACT YOUR DOCTOR IMMEDIATELY if you experience mental/mood changes (e.g., severe depression), calf/pain swelling, sudden severe headache, chest pain, trouble breathing, one-sided weakness, slurred speech, vision changes (e.g., change in contact lens fit, loss of vision), breast lumps, swelling of hands/feet, changes in vaginal bleeding (e.g., spotting, breakthrough bleeding, or prolonged bleeding), unusual vaginal discharge/itching/odor, or yellowing of the eyes/skin. Drug interactions -Drug interactions can result in unwanted side effects or prevent a medicine from doing its job. Use our drug interaction checker to find out if your medicines interact with each other. Check drug interactions If you take too much -If overdose is suspected, contact your local poison control center or emergency room immediately. 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