Sloand JA, Schiff MJ
Beneficial effect of low-dose transdermal estrogen on
bleeding time and clinical bleeding in uremia
Am J Kidney Dis
(Jul) 26:22-26 1995
The potential benefits of oral or intravenous estrogen therapy for
uremic bleeding are well established, but adverse effects of
prolonged therapy, especially with regard to coagulation, remain a
concern. In this study 6 patients with CRF or ARF and elevated
bleeding times were treated for at least 2 months with transdermal
paches containing 17-beta-estradiol (50-100 ug/24hr), applied every
3.5 days. Four patients had recurring GI bleeding and the number
of transfusions/2 month period was reduced in 3 of the four.
Bleeding time fell to <10 min in all patients. However, onset of
action and pharmacokinetics were not defined and blood levels of
estradiol were not measured. Theoretically, transdermal
administration is more efficient because hepatic metabolism of
orally administered estrogens is minimized.
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