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Drugs reference index «conjugated estrogens»

conjugated estrogens


conjugated estrogens

Generic Name: conjugated estrogens (oral) (KON joo gay ted ES troe jenz)Brand names: Cenestin, Enjuvia, Premarin, Premarin Intravenous

What are conjugated estrogens?

Estrogen is a female sex hormone produced by the ovaries. Estrogen is necessary for many processes in the body.

Conjugated estrogens are a mixture of estrogen hormones used to treat symptoms of menopause such as hot flashes, and vaginal dryness, burning, and irritation. Other uses include prevention of osteoporosis in postmenopausal women, and replacement of estrogen in women with ovarian failure or other conditions that cause a lack of natural estrogen in the body. Conjugated estrogens are sometimes used as part of cancer treatment in women and men.

Conjugated estrogens should not be used to prevent heart disease or dementia, because this medication may actually increase your risk of developing these conditions.

Conjugated estrogens may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about conjugated estrogens?

Do not use this medication if you have any of the following conditions: a history of heart attack, stroke, or blood clot (especially in your lung or your lower body), liver disease, abnormal vaginal bleeding, or a hormone-related cancer such as breast or uterine cancer. This medication can cause birth defects in an unborn baby. Do not use conjugated estrogens if you are pregnant.

Long-term treatment with conjugated estrogens may increase your risk of breast cancer, heart attack, or stroke. Talk with your doctor about your individual risks before using conjugated estrogens long term, especially if you smoke or are overweight. Your doctor should check your progress on a regular basis (every 3 to 6 months) to determine whether you should continue this treatment.

Have regular physical exams and self-examine your breasts for lumps on a monthly basis while using conjugated estrogens.

Conjugated estrogens should not be used to prevent heart disease or dementia, because this medication may actually increase your risk of developing these conditions.What should I discuss with my healthcare provider before taking conjugated estrogens?Do not use conjugated estrogens if you have:
  • a history of heart attack, stroke, or blood clot (especially in your lung or your lower body);

  • abnormal vaginal bleeding that a doctor has not checked;

  • liver disease; or

  • any type of breast, uterine, or hormone-dependent cancer.

Before using conjugated estrogens, tell your doctor if you are allergic to any drugs, or if you have:

  • high blood pressure, heart disease, or circulation problems;

  • a personal or family history of stroke;

  • endometriosis;

  • kidney disease;
  • asthma;

  • epilepsy or other seizure disorder;

  • migraines;

  • diabetes;

  • underactive thyroid;

  • high cholesterol or triglycerides;

  • high or low levels of calcium in your blood;

  • porphyria;

  • systemic lupus erythematosus (SLE);

  • gallbladder disease; or

  • if you have had your uterus removed (hysterectomy).

Conjugated estrogens increase your risk of developing endometrial hyperplasia, a condition that may lead to cancer of the uterus. Taking progestins while using conjugated estrogens may lower this risk. If your uterus has not been removed, your doctor may prescribe a progestin for you to take while you are using conjugated estrogens.

Long-term conjugated estrogens treatment may increase your risk of stroke or blood clots. Talk with your doctor about your individual risks before using conjugated estrogens long term, especially if you smoke or are overweight. Your doctor should check your progress on a regular basis (every 3 to 6 months) to determine whether you should continue this treatment.

FDA pregnancy category X. This medication can cause birth defects. Do not use conjugated estrogens if you are pregnant. Tell your doctor right away if you become pregnant during treatment. Use an effective form of birth control while you are using this medication. Conjugated estrogens can pass into breast milk and may harm a nursing baby. This medication may also slow breast milk production. Do not use if you are breast-feeding a baby. Do not give this medication to anyone under 18 years old without the advice of a doctor.

How should I take conjugated estrogens?

Take this medication exactly as it was prescribed for you. Do not use the medication in larger amounts, or use it for longer than recommended by your doctor.

Conjugated estrogens are sometimes taken on a daily basis. For certain conditions, the medication is given in a cycle, such as 3 weeks on followed by 1 week off. Follow the directions on your prescription label.

Take this medication with a full glass of water.

You may take conjugated estrogens with or without food. Try to take the medicine at the same time each day.

Have regular physical exams and self-examine your breasts for lumps on a monthly basis while using conjugated estrogens.

It is important to take conjugated estrogens regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

To be sure this medication is not causing harmful effects, your blood will need to be tested on a regular basis. Your thyroid function may also need to be tested. Do not miss any scheduled appointments.

If you need to have any type of surgery, tell the surgeon ahead of time that you are taking conjugated estrogens. You may need to stop using the medicine for a short time.

This medication can affect the results of certain medical tests. Tell any doctor who treats you that you are using conjugated estrogens.

Store conjugated estrogens at room temperature away from moisture and heat. Keep the medicine container tightly closed.

See also: Conjugated estrogens dosage in more detail

What happens if I miss a dose?

Take the medication as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include nausea, vomiting, or vaginal bleeding.

What should I avoid while taking conjugated estrogens?

Do not smoke while using this medication. Smoking can increase your risk of blood clots, stroke, or heart attack caused by conjugated estrogens.

Conjugated estrogens side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop taking this medication and call your doctor at once if you have any of these serious side effects:
  • chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;

  • sudden numbness or weakness, especially on one side of the body;

  • sudden headache, confusion, problems with vision, speech, or balance;

  • pain or swelling in your lower leg;

  • abnormal vaginal bleeding;

  • migraine headache;

  • pain, swelling, or tenderness in your stomach;

  • confusion, problems with memory or concentration;

  • jaundice (yellowing of the skin or eyes);

  • swelling in your hands, ankles, or feet; or

  • a breast lump.

Less serious side effects may include:

  • mild nausea, vomiting, bloating, stomach cramps;

  • breast pain, tenderness, or swelling;

  • freckles or darkening of facial skin;

  • increased hair growth, loss of scalp hair;

  • changes in weight or appetite;

  • problems with contact lenses;

  • vaginal itching or discharge;

  • changes in your menstrual periods, decreased sex drive; or

  • headache, nervousness, dizziness, tired feeling.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Conjugated estrogens Dosing Information

Usual Adult Dose for Osteoporosis:

0.3 mg to 1.25 mg orally once a day.Long-term therapy (for more than 5 years) is generally necessary in order to obtain substantive benefits in reducing the risk of bone fracture. Maximal benefits are obtained if estrogen therapy is initiated as soon after menopause as possible. The optimal duration of therapy has not been definitively determined.In addition to hormonal therapy, adequate calcium intake is important for postmenopausal women who require treatment or prevention of osteoporosis. The average diet of older American women contains 400 to 600 mg of calcium per day. 1500 mg per day has been suggested as optimal intake. If dietary intake is insufficient to achieve 1500 mg per day, dietary supplementation may be useful in women who have no contraindication to calcium supplementation.When used solely for the prevention of postmenopausal osteoporosis, approved non-estrogen treatments should carefully be considered, and estrogen and combined estrogen-progestin products should only be considered for women with significant risk of osteoporosis that outweighs the risks of the drug.

Usual Adult Dose for Postmenopausal Symptoms:

0.3 mg to 1.25 mg orally once a day.In general, the duration of hormone therapy for the treatment of postmenopausal symptoms should be limited. Treatment for one to five years is generally sufficient. However, long-term therapy (for the treatment/prophylaxis of osteoporosis and for risk reduction of cardiovascular disease) may be considered during the time in which the patient is being treated for postmenopausal symptoms.Because of the potential increased risks of cardiovascular events, breast cancer and venous thromboembolic events, use should be limited to the shortest duration consistent with treatment goals and risks for the individual woman, and should be periodically reevaluated. When used solely for the treatment of symptoms of vulvar and vaginal atrophy, topical vaginal products should be considered.

Usual Adult Dose for Atrophic Urethritis:

1/2 to 1 applicatorful (2 to 4 g) vaginally once a day. -or- 0.3 mg to 1.25 mg orally once a day.In general, the duration of hormone therapy for the treatment of postmenopausal symptoms like atrophic vaginitis, kraurosis vulvae, or atrophic urethritis should be limited. Treatment for one to five years is generally sufficient. Long-term therapy with conjugated estrogen vaginal cream is not recommended. Attempts to discontinue or taper use should be made at three to six month intervals. Conjugated estrogens administered by vaginal application are systemically absorbed (although systemic absorption is variable and unreliable). For the treatment of atrophic vaginitis/urethritis, vaginal creams offer no advantage over oral formulations of conjugated estrogens but the potentially favorable systemic effects of oral therapy are less reliably obtained.Because of the potential increased risks of cardiovascular events, breast cancer and venous thromboembolic events, use should be limited to the shortest duration consistent with treatment goals and risks for the individual woman, and should be periodically reevaluated. When used solely for the treatment of symptoms of vulvar and vaginal atrophy, topical vaginal products should be considered.

Usual Adult Dose for Atrophic Vaginitis:

1/2 to 1 applicatorful (2 to 4 g) vaginally once a day. -or- 0.3 mg to 1.25 mg orally once a day.In general, the duration of hormone therapy for the treatment of postmenopausal symptoms like atrophic vaginitis, kraurosis vulvae, or atrophic urethritis should be limited. Treatment for one to five years is generally sufficient. Long-term therapy with conjugated estrogen vaginal cream is not recommended. Attempts to discontinue or taper use should be made at three to six month intervals. Conjugated estrogens administered by vaginal application are systemically absorbed (although systemic absorption is variable and unreliable). For the treatment of atrophic vaginitis/urethritis, vaginal creams offer no advantage over oral formulations of conjugated estrogens but the potentially favorable systemic effects of oral therapy are less reliably obtained.Because of the potential increased risks of cardiovascular events, breast cancer and venous thromboembolic events, use should be limited to the shortest duration consistent with treatment goals and risks for the individual woman, and should be periodically reevaluated. When used solely for the treatment of symptoms of vulvar and vaginal atrophy, topical vaginal products should be considered.

Usual Adult Dose for Hypoestrogenism:

2.5 to 7.5 mg orally once a day repeated for 20 days, then off 10 days until menses occur.Conjugated estrogens (and other exogenous estrogens) have been used for the treatment of hypoestrogenism due to ovarian disease or hypogonadotropic hypogonadism in young women who require development and maintenance of female secondary sexual characteristics. Treatment is usually initiated at the expected time of puberty and may continue for prolonged periods. Often a progestin, like medroxyprogesterone acetate, is added on the last several days of the monthly treatment.

Usual Adult Dose for Abnormal Uterine Bleeding:

5 to 25 mg IM or IV every 6 to 12 hours until bleeding stops.

Usual Adult Dose for Prostate Cancer:

1.25 to 2..5 mg orally 3 times a day.Conjugated estrogen therapy for prostate cancer should only be considered for palliation in the treatment of metastatic disease in select patients.

Usual Adult Dose for Oophorectomy:

0.3 mg to 1.25 mg orally once a day.

Usual Adult Dose for Primary Ovarian Failure:

0.3 mg to 1.25 mg orally once a day.

Usual Adult Dose for Breast Cancer--Palliative:

10 mg three times a day for at least three months. Conjugated estrogen therapy for breast cancer should only be considered for palliation in the treatment of metastatic disease in select patients.

What other drugs will affect conjugated estrogens?

Before taking conjugated estrogens, tell your doctor if you are taking any of the following medicines:

  • a blood thinner such as warfarin (Coumadin);

  • a thyroid medication such as levothyroxine (Synthroid);

  • insulin or diabetes medicine taken by mouth;

  • rifampin (Rifadin, Rifater, Rifamate, Rimactane);

  • ketoconazole (Nizoral) or itraconazole (Sporanox);

  • seizure medicines such as phenytoin (Dilantin), carbamazepine (Tegretol), felbamate (Felbatol), oxcarbazepine (Trileptal), or primidone (Mysoline);

  • a barbiturate such as amobarbital (Amytal), butabarbital (Butisol), mephobarbital (Mebaral), secobarbital (Seconal), or phenobarbital (Luminal, Solfoton); or

  • antidepressants such as amitriptyline (Elavil, Etrafon), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), imipramine (Janimine, Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil), or trimipramine (Surmontil).

This list is not complete and there may be other drugs that can interact with conjugated estrogens. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about conjugated estrogens.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2006 Cerner Multum, Inc. Version: 7.02. Revision Date: 11/19/2009 8:46:53 AM.
  • Conjugated estrogens Detailed Consumer Information (PDR)
  • Conjugated Estrogens MedFacts Consumer Leaflet (Wolters Kluwer)
  • Cenestin Advanced Consumer (Micromedex) - Includes Dosage Information
  • Cenestin MedFacts Consumer Leaflet (Wolters Kluwer)
  • Enjuvia MedFacts Consumer Leaflet (Wolters Kluwer)
  • Enjuvia Consumer Overview
  • Premarin Prescribing Information (FDA)
  • Premarin Consumer Overview

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