Drug Name

Premarin (Conjugated equine estrogens)

Drug Uses

Conjugated estrogens are used for treating the symptoms of menopause including hot flashes, vaginal dryness, as well as vaginal atrophy. They as well as are used as therapy when the body does not produce enough estrogen due to castration, ovarian failure or underdevelopment of hormone-secreting organs (hypogonadism). Conjugated estrogens as well as may be beneficial in treating advanced prostate as well as breast cancer. Although estrogens are approved for treating osteoporosis, other drugs usually are prescribed for this purpose.

How Taken

Tablets: 0.3, 0.45, 0.625, 0.9, as well as 1.25 mg. To minimize side effects, the lowest effective oral dose of conjugated estrogens is used. The usual starting dose for treating symptoms associated with menopause as well as for preventing postmenopausal osteoporosis is 0.3 mg/day. The dose should be increased based on the response of patients' symptoms.

Hypogonadism is treated with doses of 0.3 mg or 0.625 daily with a cyclical interval of three weeks on treatment followed by one week off treatment. The dose for women who possess been castrated or possess ovarian failure is 1.25 mg daily in a cyclical interval of three weeks on treatment as well as one week off treatment. (In reality, most women take estrogens continuously since during the week off treatment, symptoms return because of the lack of estrogen.) For treatment of breast cancer the recommended dose is 10 mg daily for three months.

Drug Class as well as Mechanism

Estrogens are one of the two major classes of womanly hormones. (Progestins comprise the subordinate major class.) Estrogens are used primarily to treat the symptoms of menopause as well as states in which there is a deficiency of estrogen, for example, in women who possess had their ovaries removed.

Conjugated equine estrogens are a mixture of several dissimilar estrogens that are derived from the urine of pregnant mares. Estrogens possess widespread effects on many tissues in the body. Estrogens cause growth as well as development of the womanly sexual organs as well as maintain womanly sexual characteristics such as the growth of underarm as well as pubic hair as well as the shape of body contours as well as skeleton. Estrogens as well as increase secretions from the cervix as well as growth of the inner lining of the uterus (endometrium).

Missed Dose

Take the missed dose as soon as you remember then return to your normal dosing schedule. Do not take a double dose of this medication unless otherwise directed by your doctor.

Storage

Conjugated equine estrogens should be stored at room temperature between 15-30°C (59-8677°F).

Warnings/Precautions

There are no restrictions on food, beverages, or activity while using conjugated estrogens unless your doctor directs otherwise. Estrogens should not be given to pregnant women due to the risk of harm to the fetus. Estrogens are secreted in breast milk as well as cause unpredictable effects in the infant. They should not be used by women who are breast-feeding.

Likely Side Effects

The most ordinary side effects of conjugated estrogens are headache, nausea, back pain, joint pain as well as vaginal bleeding. Patients may as well as experience vaginal spotting, loss of periods or excessively prolonged periods, breast pain, breast enlargement as well as an increase or decrease in sexual drive. Effects of estrogen on the skin include rash, as well as melasma (tan or copper patches) that may develop on the forehead, cheeks, or temples as well as may persist even after estrogens are stopped. In the eyes, conjugated estrogens may cause an increase in the curvature of the cornea, as well as patients with contact lenses may develop intolerance to their lenses.

There is an increased risk of cholesterol gallstones among men as well as women using estrogens. Estrogens can inhibit the flow of bile from the liver (cholestasis) as well as uncommonly cause jaundice.

More Information

• Conjugated estrogens increase the risk of developing a condition (endometrial hyperplasia) that may lead to cancer of the lining of the uterus. Using progestins, another hormone drug, with conjugated estrogens lowers the risk of developing this condition. Therefore, incase your uterus has not been removed, your doctor may prescribe a progestin for you to take together with the estrogen. Visit your doctor regularly as well as report any unusual vaginal bleeding fair away.
• Treatment with conjugated estrogens may increase the risk of heart attack, stroke, breast cancer, as well as blood clots in the lungs or legs. Because of these risks, conjugated estrogens should be prescribed at the lowest effective dose, for the shortest amount of time essential.
• Incase you experience any of the following humorless side effects, halt using conjugated estrogens as well as seek emergency health examination attention:
  • an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);
  • shortness or breath or pain in the chest;
  • a painful, red, or swollen leg;
  • abnormal vaginal bleeding;
  • pain, swelling, or tenderness in the abdomen;
  • very bad headache or vomiting, dizziness, faintness or changes in vision or speech;
  • yellowing of the skin or eyes; or
  • a lump in a breast.
• Other, less humorless side effects may be more likely to occur. Continue to take conjugated estrogens as well as talk to your doctor incase you experience
  • decreased appetite, nausea, or vomiting;
  • swollen or tender breasts;
  • acne or skin color changes;
  • decreased sex drive;
  • migraine headaches or dizziness;
  • water retention (swollen hands, feet, or ankles);
  • problems with wearing contact lenses;
  • depression; or
  • changes in menstrual cycle or breakthrough bleeding.
• Side effects other than those listed here may as well as occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.