Estradiol (medication)
Estradiol is available in a variety of different formulations, including oral, intranasal, transdermal/topical, vaginal, injectable, and implantable preparations. An ester may be attached to one or both of the hydroxyl groups of estradiol to improve its oral bioavailability and/or duration of action with injection. Such modifications give rise to forms such as estradiol acetate (oral and vaginal), estradiol valerate (oral and injectable), estradiol cypionate (injectable), estradiol benzoate (injectable), estradiol undecylate (injectable), and polyestradiol phosphate (injectable; a polymerized ester of estradiol), which are all prodrugs of estradiol.
Pharmacokinetics of estradiol
Estradiol is well-absorbed regardless of route of administration. However, the bioavailability of estradiol differs substantially with different routes of administration. Oral estradiol has an average bioavailability of around 5%, requiring relatively high dosages of estradiol for effects. Conversely, transdermal estradiol has much higher potency, with a 20-fold lower dosage of transdermal estradiol being equivalent in potency to oral estradiol. Estradiol administered in the form of an ester by intramuscular or subcutaneous injection has complete bioavailability.