Medicine Supply Notification: Estradiol (Estring®)7.5microgram/24hours vaginal delivery system

MSN/2021/067

Tier 2 – medium impact

Date of issue: 09/12/2021

Department of Health and Social Care (DHSC) has issued a medicine supply notification for Estradiol (Estring®) 7.5microgram/24hours vaginal delivery system.

  • Estring® 7.5microgram/24hours vaginal delivery system is out of stock until early January 2022.
  • Alternative estradiol and estriol vaginal products remain available.

Supporting information

Estring® is licensed for the treatment of atrophic vaginitis (due to oestrogen deficiency) in postmenopausal women. Once inserted it is left in the vagina continuously for 90 days and replaced by a new ring as appropriate. The following oestrogen products for vaginal application are also licensed for the treatment of vaginal atrophy due to oestrogen deficiency in postmenopausal women, but have a more frequent dosing schedule. SPS MI have advised that these are suitable clinical alternatives:

Alternative estradiol or estriol preparations Active ingredient Dose Availability
Vagirux® vaginal tablet Estradiol 10microgram One vaginal tablet daily for
2 weeks followed by
maintenance dose of
one vaginal tablet twice a
week.
Can support an uplift in
demand.
Vagifem® vaginal tablet
Estradiol 10mcg vaginal
tablet (Advanz)
Imvaggis® pessary Estriol 30microgram One pessary daily for first
3 weeks followed by maintenance dose of one
pessary twice a week.
Can support an uplift in
demand.
Estriol 0.01% cream
(Marlborough)
Estriol 100microgram per
1gram
One applicator full per day
until restoration of vaginal
mucosa has been
achieved then
maintenance dose of one
applicator full twice a
week
Can support an uplift in
demand
Ovestin® 0.1% Cream Estriol 1000microgram per
1gram
One application per day for
the first weeks (maximally
4 weeks), followed by a
gradual reduction, based
on relief of symptoms, until
a maintenance dosage
(e.g. 1 application twice a
week) is reached
Can support a partial uplift
in demand.

The DHSC Medicine Supply Team provide a monthly update on potential supply issues affecting both primary and secondary care. This update is uploaded on the Specialist Pharmacy Services (SPS) website. To register, you will need  an NHS email address. Once set up and logged in, you will be able to access it online.

New shortages not listed on the SPS website, can be reported using our shortage reporting tool.

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