When hugs and medications don’t mix

A hug can mean a lot of things, almost always positive. Unless it comes with something else. Hormones, for example.

Many medications contain hormones, medications that can be in the form of creams, gels and sprays. An example is Evamist, a drug that is prescribed to menopausal women suffering from hot flashes. Evamist contains estradiol, a form of estrogen hormone. It is administered as a spray inside the forearm between the elbow and wrist.

The US FDA issued a warning in July this year regarding adverse events associated with accidental exposure to Evamist, especially children and pets. Exposure may be through direct contact when Evamist is not safely stored or when a child or pet is hugged by an Evamist user and come in contact with area of application. The reported adverse effects in children are:

• premature puberty, nipple swelling, and breast development in girls
• breast enlargement in boys

Other accidental exposure includes pets licking application area or pet owners petting their animals after drug application, without proper hand washing. The effects in pets include:

• Enlargement of the nipples and swelling of the vulva in females in pets
• Fur loss
• Undersized sexual organs in male pets

To avoid inadvertent exposure to Evamist, the FDA gives the following recommendations:

• Do not allow children to come in contact with the area of the arm where Evamist was sprayed.
• Do not allow pets to lick or touch the arm where Evamist was sprayed. Small pets may be especially sensitive to the estrogen in Evamist. Contact a veterinarian if your pet shows signs of nipple and/or vulvar enlargement, or any other sign of illness.
• Wear a garment that covers the arm where Evamist was sprayed if they know they cannot keep a child or pet from making contact with it.
• Talk with their health care professional if they have questions about the possibility of exposing a child to Evamist.
• Read the patient package insert when picking up a prescription for Evamist.

Another drug called Dovonex, which is a hormone derivative of vitamin D, can also possibly cause similar effects. Dovonex is a cream used to treat the skin disorder psoriasis. Pet who inadvertently lick the cream present with “unusual thirst, appetite loss, and severe vomiting or diarrhea.”

What should you do if your child or pet comes in contact with these drugs. The US FDA recommends:

• washing the child’s skin with soap and water as soon as possible.
• contacting the child’s health care professional if the child begins to have any of the following signs or symptoms: nipple or breast swelling or breast tenderness in girls, or breast enlargement in boys. Be sure to tell the health care professional that the child may have been exposed to Evamist.