Estradiol
Brand names: Divigel, Estradiol, Estradiol (Once Weekly), Estradiol (Twice Weekly), Estring, Estrogel, Lyllana, Menostar, Minivelle, Vagifem, Yuvafem, Climara, Dotti, Elestrin, Estrace, Evamist, Imvexxy, Vivelle-Dot
At a glance
- Medicare prescriptions, 2024
- 3,836,227
- Medicare drug cost
- $246.7M
- Average cost per prescription
- $64.30
- Clinicians who prescribed it
- 93,080
Where it is prescribed
List the prescribers in any state, county, city or ZIP code →
What it is used for
Estradiol tablets are indicated in the: Treatment of moderate to severe vasomotor symptoms associated with the menopause. Treatment of moderate to severe symptoms of vulvar and vaginal atrophy associated with the menopause. When prescribing solely for the treatment of symptoms of vulvar and vaginal atrophy, topical vaginal products should be considered. Treatment of hypoestrogenism due to hypogonadism, castration or primary ovarian failure. Treatment of breast cancer (for palliation only) in appropriately selected women and men with metastatic disease. Treatment of advanced androgen-dependent carcinoma of the prostate (for palliation only). Prevention of osteoporosis. When prescribing solely for the prevention of postmenopausal osteoporosis, therapy should only be considered for women at significant risk of osteoporosis and for whom non-estrogen medications are not considered to be appropriate. (See CLINICAL PHARMACOLOGY, Clinical Studies. ) The mainstays for decreasing the risk of postmenopausal osteoporosis
From the FDA-approved prescribing information (label dated July 2026). Full labels on DailyMed (opens in a new tab)
Boxed warning
ESTROGENS INCREASE THE RISK OF ENDOMETRIAL CANCER Close clinical surveillance of all women taking estrogens is important. Adequate diagnostic measures, including endometrial sampling when indicated, should be undertaken to rule out malignancy in all cases of undiagnosed persistent or recurring abnormal vaginal bleeding. There is no evidence that the use of “natural” estrogens results in a different endometrial risk profile than “synthetic” estrogens at equivalent estrogen doses. (See WARNINGS, Malignant neoplasms, Endometrial cancer.) CARDIOVASCULAR AND OTHER RISKS Estrogens with or without progestins should not be used for the prevention of cardiovascular disease. (See WARNINGS, Cardiovascular disorders.) The Women’s Health Initiative (WHI) study reported increased risks of myocardial infarction, stroke, invasive breast cancer, pulmonary emboli, and deep vein thrombosis in…
The FDA’s strongest warning on a label. It doesn’t mean the drug is unsafe for most people; talk to your doctor or pharmacist before stopping or changing any medicine.
Who prescribes it
- OB-GYN (Obstetrics & Gynecology) 32.4%
- Family Medicine 17.7%
- Nurse Practitioners 17.5%
- Internal Medicine 11.8%
- Physician Assistants 6.3%
- Urology 5.8%
- Urogynecology 4.8%
- Certified Nurse-Midwives 0.7%
- Endocrinology & Diabetes 0.5%
- Geriatric Medicine 0.5%
- General Practice 0.4%
- Gynecologic Oncology 0.3%
All prescribers, by place, name or specialty →
Share of Medicare prescriptions written by each specialty. Select one to list its prescribers.
Trend, 2019–2024
Medicare prescriptions rose 50% from 2019 to 2024.
Biggest change by state since 2019
- District of Columbia +97%
- Puerto Rico +92%
- Maine +80%
- Delaware +77%
- Maryland +77%
- Mississippi (smallest change) +19%
- West Virginia (smallest change) +20%
From CMS’s yearly state and national Part D summaries, which count every prescriber, including those CMS leaves out of its per-clinician data (fewer than 11 prescriptions). That is why these totals are higher than the count at the top of this page. Prescriptions include refills.
What it looks like
Pills from 3 makers on file. The same medicine can look different depending on who made it, so check the imprint (the letters and numbers on the pill) with your pharmacist if a refill looks different.
Pd-Rx Pharmaceuticals, Inc.
| Strength | Looks like | Imprint |
|---|---|---|
| 0.5 mg | white oval tablet, 9 mm, scored to split in 2 | N564 |
Redpharm Drug
| Strength | Looks like | Imprint |
|---|---|---|
| 1 mg | purple oval tablet, 9 mm, scored to split in 2 | N565 |
Sumitomo Pharma America, Inc
| Strength | Looks like | Imprint |
|---|---|---|
| 40 mg / 1 mg estradiol hemihydrate / 0.5 mg norethindrone acetate | yellow round tablet, 8 mm | MVT 415 |
Source: DailyMed (U.S. National Library of Medicine), from each maker’s FDA drug listing. A few makers are shown, not every one. Never take a pill you can’t identify; ask a pharmacist.
Industry payments about this drug
Drug makers reported $20,066 in payments to clinicians that named this drug in 2025 (meals, speaking, consulting and similar).
- Ascend Therapeutics US, LLC $20,000
- Acella Pharmaceuticals, LLC $66
Source: CMS Open Payments, general payments (not research), program year 2025. A payment is not evidence of wrongdoing. Payments by doctor
Recalls and shortages
Not on the FDA drug shortage list.
6 recalls since 2020
- May 2026 · Ani Pharmaceuticals, Inc. · Class II
Defective Container; packets were found to be either empty or partially full. - May 2024 · Zydus Pharmaceuticals (USA) Inc · Class III
Failed Impurities/Degradation Specifications. - Feb 2023 · Padagis US LLC · Class III
Failed Content Uniformity Specifications: The Spray Content Uniformity (SCU) requirement for Standard Deviation did not meet the requirement at the 18-month stability time point. - Jan 2022 · Cardinal Healthcare · Class II
CGMP Deviations: Products were exposed to temperatures outside of the products labeled storage conditions. - Apr 2021 · Noven Pharmaceuticals Inc · Class II
Defective Delivery System: Out of specification for release rate testing and shear, an attribute related to the adhesive properties of the transdermal patches. As a result, patients could experience patches that do not stick well to the skin. - Mar 2021 · Cardinal Health Inc. · Class II
CGMP Deviations: Intermittent exposure to temperature excursion during storage.
Recalls usually affect specific lots from one maker, not every version of a drug. Class I is the most serious; most drug recalls are Class II. FDA recalls (opens in a new tab)
Sources: CMS Medicare Part D Prescribers by Provider and Drug (2024; prescriptions include refills, and CMS hides counts under 11 per prescriber); U.S. Food and Drug Administration, openFDA (drug labels, NDC directory, enforcement reports, drug shortages); CMS Open Payments 2025; ClinicalTrials.gov. General information only, not medical advice; not yet reviewed by our medical reviewer.