Estrogens with or without progestins should not be used for the prevention of cardiovascular disease or dementia.
The Women's Health Initiative (WHI) study reported increased risks of myocardial infarction, stroke, invasive breast cancer, pulmonary emboli, and deep vein thrombosis in postmenopausal women (50 to 79 years of age) during 5 years of treatment with oral conjugated equine estrogens (CE 0.625mg) combined with medroxyprogesterone acetate (MPA 2.5mg) relative to placebo.
The Women's Health Initiative Memory Study (WHIMS), a substudy of WHI, reported increased risk of developing probable dementia in postmenopausal women 65 years of age or older during 5.2 years of treatment with conjugated estrogens alone and during 4 years of treatment with oral conjugated estrogens plus medroxyprogesterone acetate, relative to placebo. It is unknown whether this finding applies to younger postmenopausal women.
Other doses of oral conjugated estrogens with medroxyprogesterone acetate, and other combinations and dosage forms of estrogens and progestins were not studied in the WHI clinical trials, and, in the absence of comparable data, these risks should be assumed to be similar. Because of these risks, estrogens with or without progestins should be prescribed at the lowest effective doses and for the shortest duration consistent with treatment goals and risks for the individual woman .
Estrogens with or without progestins should not be used for the prevention of cardiovascular disease or dementia. Increased risks of myocardial infarction, stroke, invasive breast cancer, pulmonary emboli, and deep vein thrombosis in postmenopausal women (50 to 79 years of age) have been reported. An increased risk of developing probable dementia in postmenopausal women 65 years of age or older has also been reported .
Commonly used brand name(s):
In the U.S.
Available Dosage Forms:
Therapeutic Class: Estrogen/Progestin Combination
Pharmacologic Class: Progestin
Drospirenone and estradiol are female hormones called progestins and estrogens that make up this combination medicine. These female hormones are produced by the body and are necessary for the normal sexual development of the female and for the regulation of the menstrual cycle during the childbearing years.
The ovaries begin to produce less estrogen after menopause (the change of life). drospirenone and estradiol is prescribed to make up for the lower amount of estrogen in postmenopausal women who still have a uterus. Estrogen helps relieve signs of menopause, such as hot flashes and unusual sweating, chills, faintness, or dizziness. Estrogen can also help to relieve a genital skin condition called vaginal or vulvar atrophy. Progestin helps to regulate the effects of estradiol.
drospirenone and estradiol is available only with your doctor's prescription.
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For drospirenone and estradiol, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to drospirenone and estradiol or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. However, use of drospirenone/estradiol by postmenopausal women 65 years of age and older may increase the chances of dementia.
|All Trimesters||X||Studies in animals or pregnant women have demonstrated positive evidence of fetal abnormalities. This drug should not be used in women who are or may become pregnant because the risk clearly outweighs any possible benefit.|
Studies in women breastfeeding have demonstrated harmful infant effects. An alternative to this medication should be prescribed or you should stop breastfeeding while using drospirenone and estradiol.Estradiol
Studies suggest that this medication may alter milk production or composition. If an alternative to this medication is not prescribed, you should monitor the infant for side effects and adequate milk intake.
Using drospirenone and estradiol with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
Using drospirenone and estradiol with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use drospirenone and estradiol, or give you special instructions about the use of food, alcohol, or tobacco.
The presence of other medical problems may affect the use of drospirenone and estradiol. Make sure you tell your doctor if you have any other medical problems, especially:
Read the enclosed patient leaflet carefully before taking drospirenone and estradiol.
You should not take drospirenone and estradiol if you have had a hysterectomy.
You should not take drospirenone and estradiol to prevent heart disease or dementia.
Tell your doctor if you take any medicine or supplement that increases potassium levels. Your doctor may want to prescribe a different medicine for you or have your blood tested to check potassium levels.
Swallow the tablet whole. Do not crush or chew.
The dose of drospirenone and estradiol will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of drospirenone and estradiol. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
Call your doctor or pharmacist for instructions.
Keep out of the reach of children.
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.
Do not keep outdated medicine or medicine no longer needed.
It is very important that your doctor check you at regular visits every 3 to 6 months to discuss whether you need to continue taking drospirenone and estradiol.
If you are going to have surgery or will be on bed rest, you need to inform your doctor. You may need to stop taking drospirenone/estradiol during this time.
Check with your doctor immediately if vaginal bleeding occurs.
It is important that you check your breasts by self-examination regularly and have clinical examinations and mammography as required by your doctor. Report unusual breast lumps or discharge right away.
If you are scheduled for any lab tests, tell your doctor or lab technician that you are taking drospirenone and estradiol. Certain blood tests are affected by estradiol.
Tell your doctor about any risk factors for heart disease that you may have, such as high blood pressure, diabetes, tobacco use, high cholesterol, and obesity. It is important that you work with your doctor to lower these risk factors.
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:More common
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:More common
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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