HRT Cream Grams (Provider Reference) walkthrough.
A quick reference for prescribers converting compounded HRT cream doses between grams, milligrams of active, and Topi-Click clicks. Useful when adjusting strengths mid-cycle or transitioning patients between dispenser types.
Step by step.
- 01
Confirm the cream concentration
Compounded HRT creams are typically labeled in mg/g or mg/mL. The concentration is the bridge between dose and volume.
- 02
Convert mg to grams
Divide the prescribed mg by the cream concentration. Example: 5 mg estradiol prescribed in a 1 mg/g cream = 5 grams of cream per dose.
- 03
Convert grams to Topi-Click clicks
Each Topi-Click click delivers 0.25 mL (~0.25 g for most cream bases). Divide grams by 0.25 to get clicks. Example: 5 g = 20 clicks (split twice-daily as 10 clicks BID).
- 04
Check feasibility
Patient compliance drops above ~6 clicks per dose. If your dosing requires high click counts, consider raising the cream concentration or splitting AM/PM.
- 05
Document on the prescription
Specify both: 'X mg in Y grams of cream' AND 'apply N clicks BID.' Reduces ambiguity at the pharmacy and patient level.
Notes
- Pluronic-based and PLO bases differ in volume per click — confirm with the pharmacy when switching bases.
- Bi-est and tri-est combinations should specify the ratio explicitly (e.g., 80/20 estriol/estradiol).
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