Vagifem (Estradiol)

Name: Vagifem
Brand: Novo Nordisk
SKU: 2337
Availability: InStock

Type

Product

Manufacturer

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Dosage

Qty-Price (USD)

Type:

Product: Vagifem

Manufacturer: Novo Nordisk

Country: Canada

Dosage: 10 mcg

Qty-Price (USD):

Type:

Product: Vagifem

Manufacturer: Novo Nordisk

Country: New Zealand

Dosage: 10 mcg

Qty-Price (USD):

Type:

Product: Vagifem

Manufacturer: Novo Nordisk

Country: Australia

Dosage: 10 mcg

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Type:

Product: Vagifem

Manufacturer: Novo Nordisk

Country: United Kingdom

Dosage: 10 mcg

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Generic Equivalent of Vagifem

Type

Product

Manufacturer

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Dosage

Qty-Price (USD)

Type:

Product: Estradiol

Manufacturer: Generic

Country: Australia

Dosage: 10 mcg

Qty-Price (USD):

Vagifem Information

medically reviewed by Carol Hou (BSc. Pharm) on August 29, 2025.

A licensed pharmacist (Licensed Community Pharmacies Directory | College of Pharmacists of British Columbia) with over 20 years of experience in medication management, specifically medication safety, she has reviewed the information for accuracy and completeness.

Vagifem and Estradiol Vaginal Inserts at CanadaPharmacyOnline.com

The brand name Vagifem (estradiol vaginal inserts), manufactured by Novo Nordisk, is available in many countries worldwide, including Canada, New Zealand, the United Kingdom, and Australia.

Generic estradiol vaginal inserts are sourced from manufacturers that meet applicable regulatory standards. The specific manufacturer of your dispensed medication may vary.

Important Information about Generic Estradiol Vaginal Inserts:

Generic estradiol vaginal inserts contain the same active ingredient as brand-name Vagifem and are required to meet the same safety, effectiveness, and quality standards. This means they are designed to work in the same way as Vagifem. Studies have shown that generic estradiol vaginal inserts are bioequivalent to brand-name Vagifem, meaning they have similar absorption rates and reach similar, though minimal, concentrations in the bloodstream. However, individual responses to medication can vary due to factors such as metabolism, genetics, and other health conditions.

For more information about generic drug approval and bioequivalence, you can visit the FDA website: https://www.fda.gov/drugs/generic-drugs/generic-drug-facts.

Dosage:

The brand-name medication Vagifem and its generic equivalents are commonly available as 10 mcg estradiol vaginal tablets, which are supplied with a disposable applicator for insertion.

The typical dosing regimen is as follows:
• Initial Dose (Loading): One 10 mcg tablet is inserted vaginally once daily for the first two weeks.
• Maintenance Dose: Following the initial two-week period, the dose is reduced to one 10 mcg tablet inserted vaginally twice weekly. A common schedule for this is, for example, every Tuesday and Friday.

Your doctor will determine the appropriate dose and duration of treatment based on your individual needs and medical conditions.

Usage:

Vagifem is a local estrogen replacement therapy primarily used to treat moderate to severe symptoms of vaginal atrophy in postmenopausal women. The medication is delivered directly to the vaginal tissues to provide targeted relief from common menopausal symptoms, including:
• Painful intercourse (dyspareunia)
• Vaginal dryness and itching
• Vaginal irritation

Mechanism of Action:
Vagifem's mechanism of action involves delivering estradiol directly to the vaginal tissues. Upon vaginal insertion, the estradiol binds to estrogen receptors on the cells of the vaginal lining. This localized action helps to:
• Increase lubrication.
• Restore the thickness, elasticity, and blood flow of the vaginal walls.
• Reverse the atrophic changes caused by estrogen deficiency during menopause.

Use Vagifem exactly as your doctor prescribes. Do not change your dosage or stop using the medication without consulting your doctor. Follow the instructions in the product monograph in Canada: https://pdf.hres.ca/dpd_pm/00073342.PDF. Consult your doctor for personalized guidance and safe use.

The information below summarizes some, but not all, potential side effects, risks, and interactions. Before using Vagifem, it is essential to discuss all possible side effects, risks, and interactions with your doctor or pharmacist.

Side Effects:

The information below outlines potential side effects associated with Vagifem (estradiol vaginal inserts). It is not an exhaustive list, and individual reactions can vary.

Common Side Effects - The following are some common side effects of Vagifem; however, other side effects may also occur. Contact your doctor promptly if any side effects are persistent, worsening, or concerning, or if you experience any other concerning symptoms.
• Back pain
• Breast pain or tenderness
• Fluid retention
• Hair loss
• Headache
• Irregular vaginal bleeding or spotting
• Stomach or abdominal cramps, bloating, nausea, and vomiting
• Vaginal stinging, itching, or discomfort
• Vaginal yeast infection
• Weight gain

Serious Side Effects: These are rare but potentially severe side effects. Seek immediate medical attention or call emergency services if you experience any of the following:
• Allergic reaction: Hives, difficulty breathing, or swelling of the face, lips, tongue, or throat.
• Breast lumps
• Changes in vision or sudden vision loss
• Severe stomach pain
• Signs of a blood clot in the leg or lung: pain, swelling, or tenderness in your arm or leg; or sudden chest pain, shortness of breath, or coughing up blood.
• Signs of a stroke: Sudden numbness or weakness on one side of the body, slurred speech or trouble understanding speech, or a sudden, severe headache.
• Unusual vaginal bleeding, especially after several months of use.
• Yellowing of the skin or eyes (jaundice)

Important Warnings (Associated with Systemic Estrogen)
Note: While Vagifem has minimal systemic absorption, the following risks are associated with systemic estrogen use and are included in the official prescribing information for awareness.
• Blood clots (DVT and PE), stroke, and heart attack.
• Dementia, observed in women 65 years of age and older treated with systemic estrogen.
• High blood pressure and gallbladder disease.
• Increased risk of certain cancers, including endometrial, breast, and ovarian cancer.

Contraindications:

The following is not an exhaustive list of contraindications. Before starting Vagifem, it is crucial to discuss all your medical conditions, past and present, and all medications you are taking with your doctor or pharmacist.

Vagifem should not be used if you have any of the following conditions:
• A history of partial or complete loss of vision due to ophthalmic vascular disease. (While Vagifem has minimal systemic absorption, this is a serious consideration with any estrogen therapy.)
• A known allergy to estradiol or any of the other ingredients in Vagifem.
• A known or suspected estrogen-dependent cancer, including breast cancer and cancer of the lining of the womb (endometrial cancer).
• An active or past history of arterial thromboembolic disease, such as a heart attack, stroke, or angina.
• An active or past history of venous thromboembolic disease, including deep vein thrombosis (DVT), pulmonary embolism (PE), or retinal vein thrombosis.
• Liver dysfunction or disease.
• Porphyria (a rare, inherited blood disorder).
• Undiagnosed abnormal genital bleeding.
• Untreated endometrial hyperplasia (excessive thickening of the womb lining).

Tell your doctor about all of your medical conditions, past and present, before starting Vagifem. This is crucial because certain conditions can affect whether Vagifem is right for you. These conditions may include, but are not limited to:
• Endocrine and Metabolic Conditions: Such as diabetes, thyroid disorder, or gallbladder disease/gallstones.
• Neurological Conditions: Including epilepsy or other seizure disorders (requires careful monitoring) and migraines or severe headaches.
• Other Medical Conditions: Including asthma, kidney disease, lupus, or otosclerosis.
• Vaginal and Reproductive System Conditions: Including any recent vaginal or reproductive system surgery, or an active vaginal infection.

Drug Interactions:

Before taking Vagifem, it is essential to discuss all potential risks and interactions with your doctor or pharmacist. For complete and up-to-date information, please visit the patient medication information from Novo Nordisk Canada at: https://www.novonordisk.ca/content/dam/nncorp/ca/en/products/vagifem-en-consumer-information-01-november-2023.pdf.

Provide your doctor with a complete list of all your medications, including prescriptions, over-the-counter (OTC) drugs, vitamins, and herbal supplements. It is also important to inform your doctor about any herbal teas, recreational drugs, or significant dietary changes you are making, as these could potentially interact with Vagifem. Vagifem may interact with other medicines, but is not limited to:
• Enzyme Inhibitors and Inducers (affecting CYP3A4): Medications that can affect the metabolism of estrogens may alter the effectiveness of Vagifem.
o Inhibitors: Antifungals (e.g., ketoconazole, itraconazole, voriconazole), certain antibiotics (e.g., clarithromycin, erythromycin), and antivirals for HIV/AIDS (e.g., amprenavir, atazanavir, ritonavir) can increase estrogen levels.
o Inducers: Anticonvulsants (e.g., carbamazepine, phenytoin, phenobarbital) and antibiotics (e.g., rifampin, rifabutin) can decrease estrogen levels.
• Fezolinetant: If you are using this medication for hot flashes, discuss it with your doctor to ensure your overall treatment plan for menopausal symptoms is optimized.
• Lamotrigine: Estrogens can decrease the blood levels of this anticonvulsant, potentially reducing its effectiveness in controlling seizures. Your doctor may need to adjust your lamotrigine dose.
• Levothyroxine: Estrogen can increase the need for thyroid hormone replacement, so that dose adjustments may be necessary. • Tranexamic Acid: The use of estrogens with this medication may increase the risk of blood clots.

Alcohol
Vagifem is a localized estrogen therapy with minimal systemic absorption, so a direct, severe interaction with alcohol is not expected. However, excessive alcohol consumption can generally affect hormone levels and liver function. For this reason, it is always best to discuss your alcohol intake with your healthcare provider to ensure safety with any medication.

Grapefruit
Grapefruit and grapefruit juice can inhibit the CYP3A4 enzyme, which is involved in metabolizing estrogens. While this could theoretically lead to slightly higher systemic levels of estradiol, the clinical significance of this interaction with Vagifem is generally considered low due to its minimal systemic absorption. Nonetheless, it is prudent to discuss your consumption of grapefruit products with your doctor or pharmacist.

Smoking
Smoking is a significant risk factor for serious cardiovascular events, including blood clots, heart attack, and stroke. While Vagifem is a localized therapy, it is always important to consider pre-existing cardiovascular risk factors, such as smoking, when using any estrogen-containing medication. It is strongly advised to avoid all tobacco use for overall health and to discuss your smoking habits with your doctor to ensure the safest possible treatment plan.

Pregnancy and Breastfeeding

Vagifem (estradiol vaginal inserts) is contraindicated for use during pregnancy. You should stop using it immediately and contact your doctor if you are pregnant or become pregnant while taking the medication. While data on its direct harm to a fetus are limited, it is not recommended for use during pregnancy.

Vagifem is also contraindicated during breastfeeding. Estrogens can pass into breast milk and may significantly reduce both the quantity and quality of milk supply, especially if initiated early postpartum. Because of the potential for adverse effects on the infant, a decision must be made whether to stop nursing or discontinue the drug, with guidance from a healthcare professional.

Always inform your doctor about your pregnancy status or if you are breastfeeding before using Vagifem.

Frequently Asked Questions about Vagifem at Canada Pharmacy Online:

Why is Vagifem more affordable in Canada than in the United States?

Prescription drug prices, including Vagifem, are generally lower in Canada than in the US due to a combination of factors, primarily government price regulations, differing market dynamics, and other economic considerations. In Canada, provincial and federal governments negotiate drug prices with pharmaceutical companies, which often results in lower costs compared to the U.S., where market forces play a more significant role. For more information, see the FAQs on Prescription Drug Importation from the Kaiser Family Foundation (KFF): https://www.kff.org/health-costs/issue-brief/faqs-on-prescription-drug-importation/.

How much is the shipping?

Our shipping fee is a flat rate of $10.00 per order. Our pharmacy is dedicated to providing you with the lowest prices on high-quality products.

How do I place an order with your pharmacy?

Ordering from us is very simple. You can purchase online or call Customer Service at 1866.920.3784 for more information or to learn about the ordering process. Visit our How to Order page for details.

Is there a limit on the number of tablets I can order at one time?

CanadaPharmacyOnline.com can only dispense a maximum of a three-month supply of Vagifem at a time, as per your doctor's prescription.

Can I buy over the counter from you?

No, Vagifem requires a valid prescription from your doctor. We do not sell this product without a valid prescription.

Do you ship to the United States?

Yes, we do. It usually takes 7 to 18 business days to receive your order from our pharmacy.

Is there a generic for Vagifem?

Yes, there is a generic alternative for this product called estradiol vaginal inserts.

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The information on this page is sourced from independent third parties contracted by CanadaPharmacyOnline. While we cannot guarantee its medical accuracy, we strongly recommend consulting a healthcare professional for personalized advice regarding medications or medical conditions.

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