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Overview: Angeliq is used to treat hot flashes and vaginal dryness due to hormonal changes during menopause. Common side effects include stomach pain and headache. Before taking Angeliq, make sure to tell your health care provider about any health conditions you have or medicines you are taking. Get emergency help if you have trouble breathing, chest pain, or vision changes.

Uses

What is Angeliq used for?

Angeliq (drospirenone/estradiol) is commonly used to treat hot flashes and vaginal dryness and discomfort due to hormonal changes in menopause.

Angeliq may also be used for other conditions as determined by your health care provider.

How does Angeliq work (mechanism of action)?

Angeliq contains two kinds of hormones: drospirenone (a progestin) and estradiol (an estrogen). Estradiol works by replacing estrogen, a hormone your body makes less of during menopause. Drospirenone is a progestin hormone that helps balance the effect of estrogen, decreasing the chance of uterine cancer while taking an estrogen-containing medicine.

How is Angeliq supplied (dosage forms)?

Brands and other names

  • Angeliq

Dosage forms and strengths

  • 0.25 mg/0.5 mg, 0.5 mg/1 mg oral tablets

How should I store Angeliq?

Angeliq should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.

Side Effects

What are the most common side effects of Angeliq?

The most common side effects of Angeliq are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Stomach pain
  • Unusual vaginal bleeding or spotting 
  • Breast pain or discomfort
  • Headache
  • Nausea, vomiting, or diarrhea
  • Vaginal yeast infection
  • Moodiness
  • Fluid retention (see below)

There may be other side effects of Angeliq that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.canada.ca/en/health-canada/services/drugs-health-products/medeffect-canada or by calling 866-234-2345.

What are the serious side effects of Angeliq?

While less common, the most serious side effects of Angeliq are described below, along with what to do if they happen.

Severe Allergic Reactions. Angeliq may cause allergic reactions, which can be serious. Stop taking Angeliq and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Blood Clots. Angeliq may cause a blood clot in your arteries or veins and could cause a stroke, heart attack, or venous thromboembolism (VTE), including a blood clot in the lungs (pulmonary embolism), in the back of your eye (retinal vein occlusion), or in your legs or arms (deep venous thrombosis). Stop taking Angeliq and get emergency help if you have any of the following signs of a blood clot.

  • Chest pain or pressure
  • Fast or abnormal heartbeat
  • Trouble breathing
  • Pain in your back, jaw, throat, or arm
  • Sweating, upset stomach, vomiting, or dizziness
  • Sudden weakness on one side of your body
  • Sudden and severe headache
  • Slurred speech or trouble understanding speech
  • Pain, swelling, or tenderness in your arm or leg
  • Vision loss
  • Bulging eyes
  • Double vision

High Potassium Levels (Hyperkalemia). Angeliq can cause a high potassium level (hyperkalemia), which can be serious and may lead to death. Your health care provider may check your potassium levels, especially if you take certain other medicines. Call your health care provider right away if you have any of the following symptoms of a high potassium level.

  • Muscle weakness or unusual tiredness
  • Slow heartbeat or feeling of skipped heartbeats 
  • Nausea or vomiting
  • Trouble breathing
  • Abnormal heart rhythm

Cancer. Angeliq can cause a new cancer to develop, such as breast cancer, ovarian cancer, or endometrial cancer. Tell your health care provider about any new symptoms that you may get. Call your health care provider right away if you have any of the following symptoms.

  • New lump in your breast or armpit
  • Changes in the size, shape, texture, or temperature of your breast
  • Nipple changes
  • Unusual vaginal discharge
  • Belly or back pain
  • Need to pee more often or urgently
  • Unusual vaginal bleeding

Dementia. Angeliq may affect your brain, especially if you are 65 or older. Tell your health care provider right away if you or your friends or family notice that you have any of the following.

  • Memory problems, such as asking the same question over and over
  • Confusion or disorientation
  • Trouble with complex but familiar tasks, such as cooking a meal or paying your bills
  • Personality changes, such as depression, agitation, paranoia, and mood swings

Gallbladder Problems. Taking Angeliq can cause gallbladder problems, including cholecystitis and cholelithiasis (also known as gallstones). Call your health care provider right away if you have any of the following symptoms.

  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)
  • Fever
  • Pain in your upper stomach area
  • Stool (poop) that is clay-colored

Increased Blood Pressure (Hypertension). Angeliq may increase your blood pressure or make it worse if you have a history of high blood pressure. Call your health care provider if your blood pressure increases while taking this medicine.

If you measure your blood pressure and the top number (systolic) is 180 or higher or the bottom number (diastolic) is 120 or higher, get medical attention right away. Increases in blood pressure may not be noticeable, but look out for and tell your health care provider right away if you have any of the following symptoms of severely high blood pressure.

  • Sudden severe headache
  • Chest pain
  • Dizziness or confusion
  • Trouble breathing
  • Nausea or vomiting
  • Blurry or other changes to vision
  • Anxiety
  • Buzzing in the ears
  • Nosebleed
  • Feeling of skipped heartbeats

Fluid Retention (Edema). Angeliq can cause fluid retention, also called edema. Fluid retention can cause serious issues in people with certain conditions, such as heart failure or kidney problems. Call your health care provider right away if you have any of the following symptoms.

  • Chest pain
  • Irregular heartbeat
  • Shortness of breath
  • Stretched or shiny skin
  • Swollen body parts, such as the belly or ankles

Uterine Fibroids. Angeliq may cause tumors (fibroids) in your uterus to get bigger. Some fibroids are small and cause no symptoms, while others may grow and cause problems. Talk to your health care provider if you have any of the following symptoms.

  • Heavy, long, painful periods
  • Pain in the lower belly or back
  • Painful sex
  • Peeing often
  • Discomfort in the rectum

Warnings & Precautions

Who should not use Angeliq?

Allergies to Ingredients. People who are allergic to any of the following should not take Angeliq.

  • Angeliq 
  • Drospirenone
  • Estradiol
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in Angeliq.

Unusual Vaginal Bleeding. Angeliq should not be used if you have bleeding from the uterus or vagina that is not part of your period (menstrual cycle) or is unusual.

Cancer. Angeliq should not be used if you have, suspect, or had breast cancer or a cancer that is sensitive to estrogen. These conditions could worsen if you use Angeliq.

Blood Clots. Angeliq should not be used if you have or had blood clots, including a blood clot in the lungs (pulmonary embolism) or deep venous thrombosis (DVT). In addition, the medicine should not be used if you have a condition that makes your blood more prone to getting blood clots (thrombophilia). Angeliq can increase the risk of getting a blood clot that could be dangerous, even fatal.

Heart Attack or Stroke. Angeliq should not be used if you have or had a stroke or heart attack. Angeliq can increase the risk of having a heart attack or stroke that could be dangerous, even life-threatening.

Liver Problems. Angeliq should not be used if your liver is not working as well as it should be. If there is a concern about the health of your liver, your health care provider may do tests to determine if it is working well enough to take this medicine.

Kidney Problems. Angeliq should not be used if your kidneys are not working as well as they should be. If there is a concern about the health of your kidneys, your health care provider may do tests to determine if they are working well enough to take this medicine.

Adrenal Problems. Angeliq should not be taken if you have adrenal insufficiency, which is a condition where your adrenal glands stop making as much cortisol (the stress hormone). This condition could worsen if you take Angeliq.

What should I know about Angeliq before using it?

Do not take Angeliq unless it has been prescribed to you by a health care provider. Take it as prescribed.

Do not share Angeliq with other people, even if they have the same condition as you. It may harm them.

Keep Angeliq out of the reach of children.

Each pack of Angeliq contains 28 tablets. Do not take a break in between packs. You will start the next pack of Angeliq as soon as you finish the previous pack.

Swallow Angeliq tablets whole. Do not break, crush, dissolve, or chew the tablets.

Make sure to keep all follow up appointments with your health care provider. They will use these appointments to check if your dose or medicine needs to be changed. Estrogen-containing medicines like Angeliq should be used at the lowest possible dose for only as long as it is needed.

Angeliq may cause some laboratory tests to give false readings, including thyroid function tests, certain hormone tests, and cholesterol blood work. Talk to your health care provider if you have any concerns.

Perform monthly self-exams of your breasts and get regular pelvic exams, breast exams (done by a health care provider), and mammograms (X-rays to look closely at breast tissue) before taking Angeliq and during treatment with it.

What should I tell my health care provider before using Angeliq?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if Angeliq is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

Tobacco Use. Smoking and tobacco use can increase your risk of getting heart disease, which increases your risk of having a heart attack, stroke, or blood clots. Tell your health care provider if you use any tobacco products before starting Angeliq.

Upcoming Surgery or Bed Rest. You may be at increased risk for some side effects of Angeliq if you do not move around normally for an extended period of time. Tell your health care provider if you have any upcoming surgeries or need to be on bed rest. Your health care provider can tell you if or when you need to stop taking Angeliq.

High Triglyceride Levels. If you have high triglyceride levels, Angeliq may make your triglycerides even higher. Very high triglyceride levels can lead to inflammation of the pancreas, which is called pancreatitis. Tell your health care provider if you have high triglyceride levels.

Hysterectomy. Angeliq contains a progestin to decrease the chances of getting cancer of the uterus. Tell your health care provider if you have had a hysterectomy and do not have a uterus.

Other Medicines and Supplements. Angeliq may interact with other medicines and supplements. Before taking Angeliq, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. People who can become pregnant are not usually prescribed Angeliq. Tell your health care provider if you are pregnant or plan to become pregnant. If you become pregnant while using Angeliq, stop taking the medicine right away and contact your health care provider.

Breastfeeding. Angeliq passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should take Angeliq while breastfeeding.

How can I get more information about Angeliq?

For more information about Angeliq, you can visit the manufacturer’s website at www.angeliq-us.com or call them at 888-842-2937.

Interactions

Does Angeliq interact with foods or drinks?

Eating grapefruit or drinking grapefruit juice while using Angeliq increases levels of the medicine in your body and increases the risk for side effects. Talk to your health care provider if you eat grapefruit or drink grapefruit juice.

Drinking alcohol while using Angeliq may increase levels of the medicine in your body. The risk of side effects may be increased if you drink alcohol while taking Angeliq. It is best to limit the amount of alcohol that you drink.

Does Angeliq interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

 In particular, make sure that you discuss if you are using any of the following before taking Angeliq.

  • A medicine for HIV, AIDS, or hepatitis C
  • Clarithromycin or erythromycin (Ery-Tab and others), which is a medicine used for bacterial infections
  • St. John’s wort, which is a supplement that may be used for depression
  • Fluconazole (Diflucan), itraconazole (Sporanox, Tolsura), ketoconazole, posaconazole (Noxafil), or voriconazole (Vfend), which are medicines used for fungal infections
  • Carbamazepine (Carbatrol, Tegretol, and others), which is a medicine commonly used to treat seizures or nerve pain
  • Rifampin (Rifadin), which is a medicine commonly used to treat an infection called tuberculosis
  • Diltiazem (Cardizem CD and others) or verapamil (Verelan, Verelan PM), which are medicines used for high blood pressure or other conditions
  • Amiloride (Midamor), eplerenone (Inspra), spironolactone (Aldactone, Carospir), or triamterene (Dyrenium), which are diuretics, also called a water pill
  • Potassium chloride (Klor-Con and others), which is a medicine used to raise potassium levels
  • Eplerenone (Inspra), which is a medicine used to treat heart failure and high blood pressure

Some other medicines may alter the blood levels of Angeliq, and vice versa. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with Angeliq. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much Angeliq?

If you or someone else has used too much Angeliq, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of Angeliq?

If you miss a dose, take it as soon as you remember. If it has been more than 24 hours since the missed dose, skip the missed dose and only take the next dose. Do not take double or extra doses.

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