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Prescribing Information, including BOXED WARNINGPatient Information Indication
Patient Site
Reach for the Ring

Estring® (estradiol vaginal system) is a soft, flexible ring used after
menopause that continuously releases an estrogen over 3 months. Estring is for
the treatment of moderate to severe symptoms of vulvar and vaginal atrophy due
to menopause.

Live Pfizer Connect Health & Science Representatives

Personalized support and resources, call 1-833-WMN-HLTH       
(1-833-966-4584) 9 AM - 7 PM ET.

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Insertion & Removal Guide

In addition to the Instructions for Use in the Patient Information, this guide
will help your patients learn how to insert and remove Estring.

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Patient Education Brochure 

Help your patients learn more about moderate to severe symptoms of
postmenopausal vaginal atrophy and Estring with this informative brochure.

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Savings for eligible patients

Co-pay assistance may be available*

Download Savings CardsLoading*Terms and conditions apply.
Resources for you and
your patients
Materials

View materials for you and your patients

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Find videos and on-demand webinars

LoadingReferencesTerms and ConditionsReferencesBy using the Estring Co-Pay Card,
you acknowledge that you currently meet the eligibility criteria and will comply
with the terms and conditions described below:References
 * Patients are not eligible to use this card if they are enrolled in a state or
   federally funded insurance program, including but not limited to Medicare,
   Medicaid, TRICARE, Veteran Affairs health care, a state prescription drug
   assistance program, or the Government Health Insurance Plan available in
   Puerto Rico (formerly known as “La Reforma de Salud”).
 * Patient must have private insurance. Offer is not valid for cash paying
   patients. The value of this Co-Pay Card is limited to $100 per use or the
   amount of your co-pay, whichever is less.
 * Maximum savings of $400 per calendar year. 
 * This Co-Pay Card is not valid when the entire cost of your prescription drug
   is eligible to be reimbursed by your private insurance plan or other private
   health or pharmacy benefit programs. 
 * You must deduct the value of this Co-Pay Card from any reimbursement request
   submitted to your private insurance plan, either directly by you or on your
   behalf. 
 * You are responsible for reporting use of the Co-Pay Card to any private
   insurer, health plan, or other third party who pays for or reimburses any
   part of the prescription filled using the Co-Pay Card, as may be required.
   You should not use the Co-Pay Card if your insurer or health plan prohibits
   use of manufacturer Co-Pay Card. 
 * You must be 18 years of age or older to redeem the Co-Pay Card. 
 * This Co-Pay Card is not valid where prohibited by law. 
 * The benefit under the Co-Pay Card program is offered to, and intended for the
   sole benefit of, eligible patients and may not be transferred to or utilized
   for the benefit of third parties, including, without limitation, third party
   payers, pharmacy benefit managers, or the agents of either. 
 * Co-Pay Card cannot be combined with any other external savings, free trial or
   similar offer for the specified prescription (including any program offered
   by a third party payer or pharmacy benefit manager, or an agent of either,
   that adjusts patient cost-sharing obligations, through arrangements that may
   be referred to as “accumulator” or “maximizer” programs).
 * Third party payers, pharmacy benefit managers, or the agents of either, are
   prohibited from assisting patients with enrolling in the Co-Pay Card
   program. 
 * Co-Pay Card will be accepted only at participating pharmacies. 
 * This Co-Pay Card is not health insurance. 
 * Offer good only in the U.S. and Puerto Rico. 
 * Co-Pay Card is limited to 1 per person during this offering period and is not
   transferable. 
 * A Co-Pay Card may not be redeemed more than once per 90 days per patient. 
 * No other purchase is necessary. 
 * Data related to your redemption of the Co-Pay Card may be collected,
   analyzed, and shared with Pfizer, for market research and other purposes
   related to assessing Pfizer’s programs. Data shared with Pfizer will be
   aggregated and de-identified; it will be combined with data related to other
   Co-Pay Card redemptions and will not identify you.
 * Pfizer reserves the right to rescind, revoke or amend this offer without
   notice.
 * Offer expires 12/31/2025.

ReferencesNo membership fees apply. For help with the Estring Savings Card, call
1‑800‑631‑1181, or write: Pfizer Inc, 66 Hudson Boulevard East, New York, NY
10001-2192, or visit www.pfizer.com.

To report an adverse event, please call 1-800-438-1985

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Pfizer for Professionals 1-800-505-4426

This site is intended only for U.S. healthcare professionals. The products
discussed in this site may have different product labeling in different
countries. The information provided is for educational purposes only.

© 2024 Pfizer Inc. All rights reserved.

PP-EST-USA-0613
Indication Estring® (estradiol vaginal system) is indicated for the treatment of
moderate to severe symptoms of vulvar and vaginal atrophy due to menopause.
Important Safety Information There is an increased risk of endometrial cancer in
a woman with a uterus who uses unopposed estrogens. Adding a progestin to
estrogen therapy has been shown to reduce the risk of endometrial hyperplasia,
which may be a precursor to endometrial cancer. Adequate diagnostic measures,
including directed or random endometrial sampling when indicated, should be
undertaken to rule out malignancy in postmenopausal women with undiagnosed
persistent or recurring abnormal genital bleeding. 

Estrogens with or without progestins should not be used for the prevention of
cardiovascular disease or dementia.

The Women’s Health Initiative (WHI) estrogen-alone substudy reported increased
risks of stroke and deep vein thrombosis (DVT) in postmenopausal women with
daily oral conjugated estrogens (CE) alone. The WHI estrogen plus progestin
substudy reported increased risks of DVT, pulmonary embolism, stroke, and
myocardial infarction in postmenopausal women with daily oral CE combined with
medroxyprogesterone acetate (MPA). In the absence of comparable data, these
risks should be assumed to be similar for other dosage forms of estrogens.

The WHI Memory Study (WHIMS) reported an increased risk of developing probable
dementia in postmenopausal women 65 years of age or older, in both the estrogen
alone and estrogen plus progestin arms. It is unknown whether these findings
apply to younger postmenopausal women.

The WHI estrogen plus progestin substudy demonstrated an increased risk of
invasive breast cancer.

Estrogens with or without progestins should be prescribed at the lowest
effective dose and for the shortest duration consistent with treatment goals and
risks for the individual woman.

Estring should not be used in women with any of the following conditions:
undiagnosed abnormal genital bleeding; known, suspected, or a history of breast
cancer; known or suspected estrogen-dependent neoplasia; active deep vein
thrombosis, pulmonary embolism, or a history of these conditions; active
arterial thromboembolic disease (e.g., stroke, myocardial infarction), or a
history of these conditions; anaphylactic reaction, angioedema, or
hypersensitivity to Estring; liver impairment or disease; thrombophilic
disorders; pregnancy.

The WHI estrogen plus progestin sub-study reported a statistically
non-significant increased risk of ovarian cancer. A meta-analysis of 17
prospective and 35 retrospective epidemiology studies found that women who used
hormonal therapy for menopausal symptoms had an increased risk for ovarian
cancer. The exact duration of hormone therapy use associated with an increased
risk of ovarian cancer, however, is unknown.

Estrogens increase the risk of gallbladder disease. Discontinue estrogen if
severe hypercalcemia, loss of vision, severe hypertriglyceridemia or cholestatic
jaundice occurs. Monitor thyroid function in women on thyroid replacement
therapy, because estrogens may be associated with increased thyroid binding
globulin (TBG) levels.

The most frequently (≥ 5 percent) reported adverse events associated with
Estring were headache, leukorrhea, back pain, genital moniliasis, upper
respiratory tract infection, vaginitis, and vaginal discomfort/pain.
IndicationEstring is indicated for the treatment of moderate to severe symptoms
of vulvar and vaginal atrophy due to menopause.

Please see full Prescribing Information, including BOXED WARNING and Patient
Information.
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to all outside sites are provided as a resource to our visitors. Pfizer accepts
no responsibility for the content of sites that are not owned and operated by
Pfizer. PP-MCL-USA-0367




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