Monday, September 19, 2016

conjugated estrogens and medroxyprogesterone


Generic Name: conjugated estrogens and medroxyprogesterone (KON joo GAY ted ES troe jenz and me DOX ee proe JES ter one)

Brand Names: Premphase, Prempro


What are conjugated estrogens and medroxyprogesterone?

Conjugated estrogens are a mixture of estrogen hormones. Estrogen is a female sex hormone produced by the ovaries that is necessary for many processes in the body.


Medroxyprogesterone is also a female hormone, usually called "progesterone." It is important for the regulation of ovulation and menstruation.


Together, conjugated estrogens and medroxyprogesterone are used to treat the symptoms of menopause such as hot flashes, and vaginal dryness, burning, and irritation, and to prevent thinning of the bones (osteoporosis).


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

Conjugated estrogens and medroxyprogesterone 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 and medroxyprogesterone?


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 harm an unborn baby or cause birth defects. Do not use conjugated estrogens and medroxyprogesterone if you are pregnant.

Long-term treatment with conjugated estrogens and medroxyprogesterone may increase your risk of breast cancer, heart attack, or stroke. Talk with your doctor about your individual risks before using this medication 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 and medroxyprogesterone.


Conjugated estrogens and medroxyprogesterone 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 and medroxyprogesterone?


Do not use this medication 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.



If you have any of these other conditions, you may need a dose adjustment or special tests:



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




  • a personal or family history of stroke;




  • endometriosis;



  • liver or 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 and medroxyprogesterone.


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 and medroxyprogesterone 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 and medroxyprogesterone 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 and medroxyprogesterone?


Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.


This medication comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.


The 28-day Premphase treatment consists of two differently colored pills, 14 of each color. Carefully follow the patient instructions about which pills to take on days 1 through 14 and which pills to take on days 15 through 28.


You may take this medication 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 and medroxyprogesterone.


Use this medication regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.


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

This medication can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using conjugated estrogens and medroxyprogesterone.


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

See also: Conjugated estrogens and medroxyprogesterone dosage (in more detail)

What happens if I miss a dose?


Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.


What happens if I overdose?


Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include nausea, vomiting, or vaginal bleeding.

What should I avoid while taking conjugated estrogens and medroxyprogesterone?


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

Conjugated estrogens and medroxyprogesterone 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 pain;




  • breast pain, tenderness, or swelling;




  • freckles or darkening of facial skin;




  • acne, 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 and medroxyprogesterone Dosing Information


Usual Adult Dose for Osteoporosis:

Regimen 1 (Cyclic Combined Estrogen-Progestin Therapy): Conjugated estrogens 0.625 mg orally once a day AND Medroxyprogesterone acetate 5 mg orally once a day for 14 days per month.

-or-

Regimen 2 (Continuous Combined Estrogen-Progestin Therapy): Conjugated estrogens 0.3 mg orally once a day AND Medroxyprogesterone acetate 1.5 mg orally once a day or conjugated estrogens 0.625 mg orally once a day AND Medroxyprogesterone acetate 2.5 mg or 5 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.

Usual Adult Dose for Postmenopausal Symptoms:

Regimen 1 (Cyclic Combined Estrogen-Progestin Therapy): Conjugated estrogens 0.625 mg orally once a day AND Medroxyprogesterone acetate 5 mg orally once a day for 14 days per month.

-or-

Regimen 2 (Continuous Combined Estrogen-Progestin Therapy): : Conjugated estrogens 0.3 mg or 0.45 mg orally once a day AND Medroxyprogesterone acetate 1.5 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.

Usual Adult Dose for Atrophic Urethritis:

Regimen 1 (Cyclic Combined Estrogen-Progestin Therapy): Conjugated estrogens 0.625 mg orally once a day AND Medroxyprogesterone acetate 5 mg orally once a day for 14 days per month.

-or-

Regimen 2 (Continuous Combined Estrogen-Progestin Therapy): Conjugated estrogens 0.45 mg orally once a day AND Medroxyprogesterone acetate 1.5 mg orally once a day or conjugated estrogens 0.625 mg orally once a day AND Medroxyprogesterone acetate 2.5 mg or 5 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.

Usual Adult Dose for Atrophic Vaginitis:

Regimen 1 (Cyclic Combined Estrogen-Progestin Therapy): Conjugated estrogens 0.625 mg orally once a day AND Medroxyprogesterone acetate 5 mg orally once a day for 14 days per month.

-or-

Regimen 2 (Continuous Combined Estrogen-Progestin Therapy): Conjugated estrogens 0.45 mg orally once a day AND Medroxyprogesterone acetate 1.5 mg orally once a day or conjugated estrogens 0.625 mg orally once a day AND Medroxyprogesterone acetate 2.5 mg or 5 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.

Usual Adult Dose for Oophorectomy:

Regimen 1 (Cyclic Combined Estrogen-Progestin Therapy): Conjugated estrogens 0.625 mg orally once a day AND Medroxyprogesterone acetate 5 mg orally once a day for 14 days per month.

-or-

Regimen 2 (Continuous Combined Estrogen-Progestin Therapy): Conjugated estrogens 0.45 mg orally once a day AND Medroxyprogesterone acetate 1.5 mg orally once a day or conjugated estrogens 0.625 mg orally once a day AND Medroxyprogesterone acetate 2.5 mg or 5 mg orally once a day.

Usual Adult Dose for Primary Ovarian Failure:

Regimen 1 (Cyclic Combined Estrogen-Progestin Therapy): Conjugated estrogens 0.625 mg orally once a day AND Medroxyprogesterone acetate 5 mg orally once a day for 14 days per month.

-or-

Regimen 2 (Continuous Combined Estrogen-Progestin Therapy): Conjugated estrogens 0.45 mg orally once a day AND Medroxyprogesterone acetate 1.5 mg orally once a day or conjugated estrogens 0.625 mg orally once a day AND Medroxyprogesterone acetate 2.5 mg or 5 mg orally once a day.


What other drugs will affect conjugated estrogens and medroxyprogesterone?


The following drugs can interact with conjugated estrogens and medroxyprogesterone. Tell your doctor if you are using any of these:



  • St. John's wort;




  • carbamazepine (Carbatrol, Tegretol);




  • phenobarbital (Luminal, Solfoton);




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




  • ritonavir (Norvir);




  • ketoconazole (Nizoral) or itraconazole (Sporanox); or




  • an antibiotic such as clarithromycin (Biaxin), erythromycin (E.E.S., Ery-Tab, Erythrocin, E-Mycin), itraconazole (Sporanox) or ketoconazole (Nizoral).



This list is not complete and other drugs may interact with conjugated estrogens and medroxyprogesterone. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.



More conjugated estrogens and medroxyprogesterone resources


  • Conjugated estrogens and medroxyprogesterone Side Effects (in more detail)
  • Conjugated estrogens and medroxyprogesterone Dosage
  • Conjugated estrogens and medroxyprogesterone Use in Pregnancy & Breastfeeding
  • Conjugated estrogens and medroxyprogesterone Drug Interactions
  • Conjugated estrogens and medroxyprogesterone Support Group
  • 6 Reviews for Conjugated estrogens and medroxyprogesterone - Add your own review/rating


Compare conjugated estrogens and medroxyprogesterone with other medications


  • Atrophic Urethritis
  • Atrophic Vaginitis
  • Oophorectomy
  • Osteoporosis
  • Postmenopausal Symptoms
  • Primary Ovarian Failure


Where can I get more information?


  • Your pharmacist can provide more information about conjugated estrogens and medroxyprogesterone.

See also: conjugated estrogens and medroxyprogesterone side effects (in more detail)


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