Premarin

Generic name: Conjugated estrogens

What is Premarin?

Premarin is a medicine that contains a mixture of estrogens. Premarin is used after menopause to reduce moderate to severe symptoms of menopause, including feelings of warmth in the face, neck, and chest, and the sudden intense episodes of heat and sweating known as "hot flashes."

Premarin is also used to treat moderate to severe menopausal changes, such as dryness, itching, and burning, in and around the vagina, or painful intercourse caused by menopausal changes; help reduce your chances of getting osteoporosis (thin, weak bones) after menopause; treat certain conditions in women before menopause if their ovaries do not make enough estrogen naturally; and ease symptoms of certain cancers that have spread through the body, in men and women.

What is the most important information I should know about Premarin?

Estrogens increase your risk of developing cancer of the uterus. Report any unusual bleeding immediately to your healthcare provider while you are taking Premarin. Vaginal bleeding after menopause may be a warning sign of uterine cancer.

Do not use estrogens with or without progestins to prevent heart disease, heart attacks, strokes, or dementia. Using estrogens with or without progestins may increase your chances of getting heart attacks, strokes, breast cancer, and blood clots. It may also increase your risk of dementia, based on a study of women age 65 years or older. Talk regularly with your doctor about whether you still need treatment with Premarin.

Premarin vaginal cream can weaken latex condoms, diaphragms, and cervical caps.

Who should not take Premarin?

Do not take Premarin if you currently have or have had stroke or heart attack in the last year, blood clots, liver problems, unusual vaginal bleeding, or certain cancers, including cancer of the breast and uterine. Do not take Premarin if you are hypersensitive to it.

What should I tell my doctor before I take the first dose of Premarin?

Tell your doctor about all prescription, over-the-counter, and herbal medication you are taking before beginning treatment with Premarin. Also, talk to your doctor about your complete medical history, especially if you have asthma (wheezing), epilepsy (seizures), migraine, endometriosis, lupus, problems with your heart, liver, thyroid, kidneys, or have high calcium levels in your blood. Also, tell your doctor if you are going to have surgery or will be on bedrest.

What is the usual dosage?

The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.

Adults: Your doctor will start therapy with Premarin at a low dose and adjust the dosage according to your response. He or she will want to check you periodically at 3- to 6-month intervals to determine the need for continued therapy.

PREMARIN TABLETS

The usual starting dosage is 0.3 milligrams daily. However, this may vary depending upon the condition being treated. Your doctor will prescribe the correct regimen for your treatment needs.

PREMARIN VAGINAL CREAM

Given cyclically for short-term use only.

Degeneration of genital tissue or severe itching in the genital area

Adults: The recommended dosage is one-half to 2 grams daily, inserted into the vagina, depending on the severity of the condition. You will use the cream for 3 weeks, then stop for 1 week. Tell your doctor if you notice any unusual bleeding.

How should I take Premarin?

Take one Premarin tablet at the same time each day.

Estrogens should be used at the lowest dose possible for your treatment only as long as needed. You and your healthcare provider should talk regularly (for example, every 3 to 6 months) about the dose you are taking and whether you still need treatment with Premarin.

If you are using Premarin vaginal cream, apply it as follows:

1. Remove cap from tube.

2. Screw nozzle end of applicator onto tube.

3. Gently squeeze tube from the bottom to force sufficient cream into the barrel to provide the prescribed dose. Use the marked stopping points on the applicator as a guide.

4. Unscrew applicator from tube.

5. Lie on back with knees drawn up. Gently insert applicator deeply into the vagina and press plunger downward to its original position.

To cleanse the applicator, pull the plunger to remove it from the barrel, then wash with mild soap and warm water. Do not boil or use hot water.

What should I avoid while taking Premarin?

Do not smoke while using this medication. Smoking can increase your risk of blood clots, stroke, or heart attack caused by conjugated estrogens. Avoid taking estrogen along with grapefruit juice.

What are possible food and drug interactions associated with Premarin?

If Premarin is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Premarin with the following: barbiturates such as phenobarbital; blood thinners such as warfarin; carbamazepine; clarithromycin; drugs used for epilepsy; erythromycin; itraconazole; ketoconazole; major tranquilizers; oral diabetes drugs; rifampin; ritonavir; St. John's wort; steroid medications; thyroid preparations; tricyclic antidepressants; and vitamin C.

What are the possible side effects of Premarin?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

Side effects may include: headache, breast pain, irregular vaginal bleeding or spotting, stomach/abdominal cramps, bloating, nausea and vomiting, hair loss, high blood pressure, liver problems, high blood sugar, fluid retention, enlargement of benign tumors of the uterus (fibroids), vaginal yeast infections

Serious side effects may include: breast cancer, cancer of the uterus, stroke, heart attack, blood clots, dementia, gallbladder disease, ovarian cancer

Warning signs of serious side effects include: breast lumps, unusual vaginal bleeding, dizziness and faintness, changes in speech, severe headaches, chest pain, shortness of breath, pains in your legs, changes in vision, vomiting

Call your doctor right away if you get any of these warning signs or any other unusual symptom that concerns you.

Can I receive Premarin if I am pregnant or breastfeeding?

If you are pregnant or plan to become pregnant, notify your doctor immediately. Premarin and conjugated estrogens should not be taken during pregnancy because of the possibility of harm to the fetus.

If you are breastfeeding, the hormones in Premarin can pass into your milk. Your doctor may advise you not to breastfeed while you are taking Premarin.

What should I do if I miss a dose of Premarin?

If you miss a dose, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your normal schedule. Do not take 2 doses at the same time.

How should I store Premarin?

Store at room temperature.