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 medicine may actually increase your risk of developing these conditions.
Conjugated estrogens may also be used for purposes not listed in this medication guide.
What is the most important information I should know about conjugated estrogens?
Do not use this medicine 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. Conjugated estrogens can harm an unborn baby or cause birth defects. Do not use if you are pregnant. Long-term use of 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, strokes, or dementia, because this medicine 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;
a bleeding or blood-clotting disorder;
liver disease; or
any type of breast, uterine, or hormone-dependent cancer.
To make sure you can safely take conjugated estrogens, tell your doctor if you have any of these other conditions:
high blood pressure, heart disease, or circulation problems;
a personal or family history of stroke;
endometriosis;
kidney disease;
asthma;
hereditary angioedema;
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 harm an unborn baby or cause birth defects. Do not use conjugated estrogens if you are pregnant. Tell your doctor right away if you become pregnant during treatment. Use effective birth control while you are using this medication. Conjugated estrogens can pass into breast milk and may harm a nursing baby. This medicine 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 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.
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 your doctor's instructions.
If you see what looks like part of a conjugated estrogen tablet in your stool, talk with your doctor.
Have regular physical exams and self-examine your breasts for lumps on a monthly basis while using conjugated estrogens.
Use 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 helping your condition and not causing harmful effects, your blood will need to be tested often. Your thyroid function may also need to be tested. Visit your doctor regularly.
If you need surgery or medical tests or if you will be on bed rest, you may need to stop using this medication for a short time. Any doctor or surgeon who treats you should know that you are taking conjugated estrogens. Store 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 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?
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; difficult breathing; swelling of your face, lips, tongue, or throat. Stop using conjugated estrogens and call your doctor at once if you have a serious side effect such as:
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 severe headache, confusion, problems with vision, speech, or balance;
pain, swelling, warmth, or redness in one or both legs;
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
mild 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?
Tell your doctor about all other medicines you use, especially:
a blood thinner such as warfarin (Coumadin, Jantoven);
a thyroid medication such as levothyroxine (Synthroid, Levoxyl, Levothroid and others);
insulin or diabetes medicine taken by mouth;
rifampin (Rifadin, Rifater, Rifamate, Rimactane);
ketoconazole (Nizoral) or itraconazole (Sporanox);
seizure medicines such as phenytoin (Dilantin), carbamazepine (Carbatrol, Equetro, 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 other drugs may interact with conjugated estrogens. 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 resources
- Conjugated estrogens Dosage
- Conjugated estrogens Use in Pregnancy & Breastfeeding
- Conjugated estrogens Drug Interactions
- Conjugated estrogens Support Group
- 16 Reviews for Conjugated estrogens - Add your own review/rating
- conjugated estrogens Advanced Consumer (Micromedex) - Includes Dosage Information
- Conjugated Estrogens MedFacts Consumer Leaflet (Wolters Kluwer)
- Cenestin Advanced Consumer (Micromedex) - Includes Dosage Information
- Cenestin Prescribing Information (FDA)
- Cenestin MedFacts Consumer Leaflet (Wolters Kluwer)
- Enjuvia Prescribing Information (FDA)
- Enjuvia MedFacts Consumer Leaflet (Wolters Kluwer)
- Enjuvia Consumer Overview
- Premarin Prescribing Information (FDA)
- Premarin Consumer Overview
Compare conjugated estrogens with other medications
- Abnormal Uterine Bleeding
- Atrophic Urethritis
- Atrophic Vaginitis
- Breast Cancer, Palliative
- Hypoestrogenism
- Oophorectomy
- Osteoporosis
- Postmenopausal Symptoms
- Primary Ovarian Failure
- Prostate Cancer
Where can I get more information?
- Your pharmacist can provide more information about conjugated estrogens.
No comments:
Post a Comment