CONJUGATED ESTROGENS (Premarin) is used for treating certain symptoms of menopause (eg, hot flashes, vaginal dryness or itching). It is used to prevent osteoporosis (weak bones) after menopause in certain patients. It is used in certain patients to treat low estrogen levels, breast cancer or prostate cancer. Premarin is a mixture of female estrogen hormones. It works by replacing natural estrogens in a woman who can no longer produce enough estrogen. It works for advanced prostate cancer by antagonizing male hormones.
CONJUGATED ESTROGENS (Premarin®, Cenestin™) contains a mixture of estrogen hormones. Estrogens are essential for maintaining normal female functions. Conjugated estrogens can help relieve symptoms of the menopause (hot flashes, night sweats, mood changes, and vaginal dryness and irritation), and also help to prevent osteoporosis (thin weak bones). Conjugated estrogens can also help improve female functions in women with hormonal imbalance or problems with their ovaries. This drug may also be given to patients with inoperable breast cancers (in men or women) or prostate cancer (men). Estrogens are occasionally prescribed for other purposes. Generic conjugated estrogen tablets are not yet available.
What should I tell my health care provider before I take this medicine?
They need to know if you have any of these conditions:
asthma
blood vessel disease, blood clotting disorder, or suffered a stroke
breast, cervical, endometrial, ovarian or uterine cancer
diabetes
endometriosis
fibroids in the womb
heart disease
high blood lipids or cholesterol
high blood pressure
high level of calcium in the blood
low level of calcium in the blood
hysterectomy
kidney disease
liver disease
mental depression
migraine
porphyria
systemic lupus erythematosus (SLE)
thyroid disease
tobacco smoker
vaginal bleeding
an unusual or allergic reaction to estrogens, other hormones, medicines, foods, dyes, or preservatives
pregnant or trying to get pregnant
breast-feeding
How should I take this medicine?
Take conjugated estrogen tablets by mouth. Follow the directions on the prescription label. Swallow the tablet with a drink of water. Take the tablets with food. Take your doses at regular intervals, at the same time each day. Do not take your medicine more often than directed.
For all uses of this medicine:
Before starting this medication, read the paper on your prescription provided by your pharmacist or health care professional. This paper will tell you about the specific product you are taking. Make certain you understand the instructions.
Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed.
What if I miss a dose?
If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.
What drug(s) may interact with conjugated estrogens?
some antibiotics used to treat infections
anastrozole
barbiturates or benzodiazepines used for inducing sleep or treating seizures (convulsions)
bromocriptine
carbamazepine
cimetidine
cyclosporine
dantrolene
exemestane
medications for diabetes
methotrexate
griseofulvin
hydrocortisone, cortisone, or prednisolone
isoniazid (INH)
letrozole
methotrexate
mineral oil
phenytoin
raloxifene or tamoxifen
rifabutin, rifampin, or rifapentine
testolactone
thyroid hormones
topiramate
tricyclic antidepressants
warfarin
Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.
What side effects may I notice from taking conjugated estrogens?
Side effects that you should report to your prescriber or health care professional as soon as possible:
breakthrough bleeding and spotting
breast enlargement, tenderness, unusual discharge or milk production
chest pain
confusion, forgetfulness
leg, arm or groin pain
nausea, vomiting
severe headaches
stomach pain (severe)
sudden shortness of breath
swelling of the hands, feet or ankles, or rapid weight gain
vision or speech problems
yellowing of the eyes or skin
Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):
change in sexual desire
mild stomach upset
mood changes, anxiety, depression, frustration, anger, or emotional outbursts
increased or decreased appetite
skin rash, acne, or brown spots on the face
tiredness
urinary incontinence
vaginal yeast infection (irritation and white discharge)
weight gain
What should I watch for while taking conjugated estrogens?
Visit your prescriber or health care professional for regular checks on your progress. You should have a complete check-up every 6 months. You will need a regular breast and pelvic exam and 'Pap' smear while on conjugated estrogens therapy. You should also discuss the need for regular mammograms with your health care professional, and follow his or her guidelines for these tests.
Conjugated estrogens can make your body retain fluid, making your fingers, hands, or ankles swell. Your blood pressure can go up. Contact your prescriber or health care professional if you feel you are retaining fluid.
If you have any reason to think you are pregnant; stop taking conjugated estrogens at once and contact your prescriber or health care professional.
Tobacco smoking increases the risk of getting a blood clot or having a stroke while you are taking conjugated estrogens, especially if you are more than 35 years old. You are strongly advised not to smoke.
If you wear contact lenses and notice visual changes, or if the lenses begin to feel uncomfortable, consult your eye care specialist or health care professional.
In women who still have their uterus, estrogens increase the risk of developing a condition (endometrial hyperplasia) that may lead to cancer of the lining of the uterus. Taking progestins, another hormone drug, with estrogens lowers the risk of developing this condition. Therefore, if your uterus has not been removed (by a hysterectomy), your doctor may prescribe a progestin for you to take together with your estrogen. You should know, however, that taking estrogens with progestins may have additional health risks. You should discuss the use of estrogens and progestins with your health care professional to determine the benefits and risks for you.
If you are going to have elective surgery, you may need to stop taking your estrogens one month beforehand. Consult your health care professional for advice prior to scheduling the surgery.
Where can I keep my medicine?
Keep out of the reach of children in a container that small children cannot open.
Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Throw away any unused medicine after the expiration date.
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