Confused about Oestrogel vs Sandrena - switched due to shortages

[LadyFanny]

I was on Oestrogel, 2 pumps a day, but with the current shortages I can't get hold of Oestrogel, so my GP has switched me to Sandrena 1.0 mg gel, 1 sachet a day. The GP says this is an equivalent dose to 2 pumps of Oestrogel. Historically, my GP has got my HRT dosing wrong, so I want to double-check that 1 sachet of Sandrena is actually the equivalent to 2 pumps of Oestrogel, but now I'm confused.

I can't find direct comparisons of Oestrogel dosing vs Sandrena, but BMS has guidance for switching women from Evorel Sequi patches to transdermal gels, and that says that an Evorel 50 patch is the same as 2 pumps of Oestrogel or 1 sachet of 1.0 mg Sandrena. But when I check the ingredients, 2 pumps of Oestrogel contains 1500 micrograms of estradiol, whereas 1 sachet of Sandrena contains 1000 micrograms of estradiol. So surely it's not the equivalent dose?

My doc told me 1 pump of Oestrogel is .75 (750) of oestrogen. My prescription is for 1.5 so I use 2 pumps. Sandrena can come in 0.5 or 1mg. Therefore I used 1 and a half sachets if 1mg each sachet, or 3 sachets if 0.5.

@LadyFanny There is guidance on the Women's Health Concern website which is the 'patient arm' of the BMS- look under HRT.

If you still have some Oestrogel left you should find on the side of the cardboard carton (or it's online under the product info too) that 1 pump = 0.75mgs estrogen.

So to get the same as before, you need to use one and a half packets of Sandrena.

It also comes in 0.5mgs sachets so if dividing is too hard you could always ask for 2 prescriptions in future for 1 mgs and 0.5 mgs.

Bit scary your GP can't do the maths!

HTH

Thanks so much. Agree - my GP keeps getting the doses of HRT wrong: I have to carefully check all her prescriptions

I am thinking of switching from estrogel to sandrena due to shortages but also due to the gel becoming weaker about a third way through the canister.
I take 4 pumps of estrogel and understood I would need two 1 mg sachets of sandrena to get the equivalent as sandrena is more potent.

I was always told to not use the first few pumps and the last in Oestrogel.

I too have just been given Sandera ( after a " well we could give you this if you don't want to do without"). I usually use 2 pumps and 2 pumps contain 1.5. The Sandrena is 0.5 so that means I have to use 3 sachets a day for equivalent like you @Journeynotdestination. Sadly this means that one box will only last 9 days .

This is a right pain in the arse.

@ChickenStripper The only reason for not using the first blob of gel is that it's not an exact measure of 1 pump. (The leaflet talks about 'priming' the pump by pressing the plunger once.)

It's not that important. I've used gel for nearly 14 years. Sometimes I use 2 pumps but mainly now I use 1 and a bit. The 'bit' is not an exact measure - it's about half a measure- because I don't press the plunger right down.

IMO it's not really an issue, and the same applies to using the first measure that comes out or the very last one. Very few women will find any difference between a tiny drop less with their dose.

There is also no difference in the product whether it's the first or last drop. This is a pharmaceutical grade medicine. There is no way that the dose varies within the pump (if it did, the instructions would say shake the bottle. The gel is contained within a soft plastic pouch in the outer hard plastic cannister.) This plastic pouch gradually deflates when the gel is used up.

Ok thank you.

I have been using Sandrena 1mg sachets 3 a day. Believe it or not the chemist now can’t get hold of it anymore 😢but has plenty of Oestrogel. I was told to use 4 pumps of Oestrogel which equates to 3 mg of Sandrena ie 0.75 x 4 = 3.

I found the oestrogel and sandrena much harder to get right.
However, I reluctantly switched to the patch (due to gel shortages)and find it actually suits me better.

I know this is an old thread, but I have 2 and a bit boxes of Sandrena 0.5mg, and 1 and a bit boxes of Vagifem 10, if anyone can make use of them, for just the postage cost? It seems awful to throw them away when there have been these supply problems in the past.

Bump!

Hi, also bumping an old thread rather than starting one of my own.
I've been on estradiol for 2 years (1 pump) and I'd asked my practice (I can't really say my GP because I never get the same one twice) for a new prescription of Zopiclone (sleeping tablets which I use about one of a month due to erratic work schedules).

The doc on the phone seemed totally focused with getting me to change my HRT to Sandrina for my sleeping issues because one sachet would be a higher dose for me. I explained it's just an occasional thing and is affected by late work shifts and sleeping away from home, but she was insistent I try it.
However I'm a week in and it's really making my boobs sore. Is it ok to switch back to estradiol? I can't get an appointment to speak to anyone at the practice for 4 weeks so I'm hoping someone here might know...

You'd be better off starting a new thread.

I opened this one to read thinking there are problems getting Estrogel again and then realised it was started in 2022 and there isn't!