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.
