FDA: Hormones get box warning, label changes
Estrogen products will contain more data on labels for
physicians and patients.
By AMNews staff. Jan. 27, 2003. Additional
information
The labeling of all estrogen and estrogen with progestin
products for use by postmenopausal women will undergo important safety
changes, according to a Food and Drug Administration announcement earlier
this month.
These changes reflect the FDA's analysis of data from an arm of the
Women's Health Initiative that raised concerns last summer and are part of
a series of actions to provide advice to physicians who prescribe these
products and risk management information to women.
"FDA's actions will help inform health care providers and their
patients so that they can appropriately balance the benefits and risks to
make the best possible decisions about use of these drugs," said FDA
Commissioner Mark McClellan, MD, PhD.
In addition, the agency issued a new boxed warning that reflects the
new risk information. It also outlines specific changes to indications for
which these products are approved.
Overall, these warning and label changes are designed to emphasize the
importance of individualized decisions that appropriately balance the
benefits and the potential risks involved.
The FDA advises that nonestrogen treatments be considered first for
postmenopausal osteoporosis.
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The boxed warning, the highest level of warning information in
labeling, also highlights the increased risks for heart disease, heart
attacks, strokes and breast cancer associated with these hormones. It
notes that these products are not approved for heart disease prevention.
Approved indications also have been modified to clarify that the drugs
should be used only when the benefits clearly outweigh risks.
For instance, when prescribed solely for the prevention of
postmenopausal osteoporosis, approved nonestrogen treatments should be
carefully considered.
While the FDA did not make any modification for the treatment of
moderate to severe vasomotor symptoms, it did advise prescribing these
therapies at the lowest dose, for the shortest duration of time.
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ADDITIONAL INFORMATION:
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Drug information on estrogen and estrogen with progestin therapies
from the FDA's Center for Drug Evaluation and Research (http://www.fda.gov/cder/drug/infopage/estrogens_progestins/)
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Copyright 2003 American Medical Association. All
rights reserved.