Premarin (Conjugated Estrogens)

        Premarin is a mixture of estrogen hormones which regulates the development and functions of the female reproductive system, the formation of female secondary sex characteristics. On entering into the bloodstream it forms a complex with a specific receptor (in the fallopian tubes, cervix, excretory ducts of the mammary glands, vagina, urethra, breast, liver, hypothalamus, hypophysis), stimulates the synthesis of DNA and proteins. It results in proliferation of the epithelium, increased sensitivity of the uterus and tubes muscles of to medications stimulating their motility. This medication decreases bone resorption of Ca2 + in menopause, prevents involution of the genitals. Premarin is used to treat symptoms of menopause which include hot flashes, vaginal dryness, vaginal irritation and dryness, to prevent osteoporosis in postmenopausal women. Replacement therapy in peri- and postmenopausal women, ovarian hypofunction (primary and secondary amenorrhea, oligomenorrhea, dysmenorrhea) and other conditions.

        Take this medication once daily as prescribed with a full glass of water with or without food. Premarin may be administered for a cyclic treatment which consists of 25 days on followed by 5 days. Do not take in larger amounts than prescribed. Individual dosage depends on your condition (for hypogonadism 0.3 mg or 0.625 mg daily, for preventing postmenopausal osteoporosis is 0.3 mg/day). Try your best to take it regularly to get the best benefit from it. Do not take with grapefruit juice, it increases levels of estrogen.

        Long-term treatment with Premarin may increase the risk of breast cancer, endometrial hyperplasia, heart attack, or stroke so monitoring of the patient’s state should be done on a regular basis. This medication can be harmful to an unborn baby, do not use it during pregnancy. Do not use Premarin to prevent heart disease or dementia. To avoid endometrial hyperplasia you may be prescribed to take a progestin together with Premarin. Do not use this drug if you are under 18 y.o..

        Hypersensitivity, pregnancy, breastfeeding, estrogen depending malignant tumours, undiagnosed genital or uterine bleeding, thrombophlebitis or thromboembolic disease in active phase (excluding treatment of breast and prostate cancers). Cautiousness should be exercised in patients with thrombophlebitis, thrombosis or thromboembolism (while taking estrogens in history); family hyperlipoproteinemia, pancreatitis, endometriosis, gallbladder disease in history (especially cholelithiasis), severe liver failure, jaundice (including one during pregnancy in history), hepatic porphyria, leiomyoma, hypercalcemia associated with bone metastases caused by breast cancer, an underactive thyroid, porphyria, endometriosis, asthma.

        You may experience symptoms of allergy (hives, rash, swelling face and tongue) and also chest pain or heavy feeling, sudden numbness or weakness, abnormal vaginal bleeding, migraine headache, confusion, jaundice, swelling in hands, ankles, or feet. If such symptoms are severe stop taking this medication and notify your doctor at once.

        Estrogens stimulate the liver’s ability to produce factors that promote the clotting of blood. Thus, concomitant administration of Premarin and warfarin (blood thinner) may cause a decrease in their effects. Barbiturates, Rifampin (Rifadin), phenytoin (Dilantin), carbamazepine (Tegretol), griseofulvin (Grifulvin), St. John’s wort and primidone increase metabolism of estrogens. Erythromycin, ketoconazole (Nizoral), itraconazole (Sporanox), and ritonavir (Norvir) act oppositely.

        Take the missed dose as soon as you remember about it. If it is almost time of your next dose just skip it and return to your regular schedule.

        Immediate medical attention in needed in case you overdosed intake of the medicine. Symptoms may include vomiting, nausea, and vaginal bleeding.

        Premarin should be stored at room temperature, between 15-30 C (59-86 F). The right temperature to store the injection is between 2-8 C (36-46 F).