Premarin
Conjugated Estrogens
Drug Class and Mechanism of Action of Premarin
Estrogens are one of the two major hormone class of females, the other class is Progestins. Premarin is used mainly in treatment of symptoms of menopause and states in which there is a deficiency of estrogen (due to removal of ovaries etc.). Estrogens have many effects on many tissues in the body and they cause growth and development of the female sexual organs and maintain female sexual characteristics like the growth of underarm and pubic hair and the shape of body contours and skeleton. Estrogens also increase secretions from the cervix and growth of the inner lining of the uterus known as endometrium. Estrogens are derived from the urine of pregnant mares.
Therapeutic Uses of Premarin
Premarin (Conjugated Estrogens) is used in the treatment of menopausal symptoms like hot flashes, vaginal dryness, and vaginal atrophy. Premarin is also used in the treatment of medical conditions in which the body is unable to produce enough of estrogen like castration, ovarian failure or underdevelopment of hormone secreting organs (hypogonadism).
Premarin is also used in the treatment of advanced prostate and breast cancer. Estrogens are also approved for treating osteoporosis (but other drugs are used in the treatment of osteoporosis).
Direction of use of Premarin
Premarin tablet is taken orally with a glass of water on full stomach or on empty stomach. The lowest effective oral dose of conjugated estrogens is used for treatment to minimize side effects.
- The normal starting dose for treatment of symptoms associated with menopause and for preventing postmenopausal osteoporosis is 0.3 mg/day. The dose is then adjusted or increased based on the response of patient.
- Hypogonadism is treated (with Premarin) with doses of 0.3 mg or 0.625 daily with a cyclical interval of three weeks treatment which is followed by one week without treatment.
- The dose of Premarin for women who have ovarian failure is 1.25 mg daily. Estrogens should be taken continuously since symptoms return because of the lack of estrogen, if a cyclical interval of three weeks treatment which is followed by one week without treatment is maintained.
- In treatment of breast cancer the recommended dose is 10 mg daily for three months.
If You Miss a Dose of Premarin
If you miss a dose of Premarin, take it as soon as possible. If you miss for long you should skip the missed dose and go back to your regular dosing schedule. Do not take two doses at a time to make for the missed dose.
How to Store Premarin
Premarin should be stored at room temperature between 15-30 degrees C (59-77 degrees F). Store it in a dry place away from moisture, heat and direct light. Keep Premarin out of reach of children.
More Information About Premarin
- Premarin may increase the risk of development of endometrial hyperplasia which may lead to cancer of the lining of the uterus (endometrium). Taking progestins (another hormone), with Premarin lowers the risk of developing endometrial hyperplasia. Therefore, if your uterus has not been removed, your doctor may prescribe a progestin for you to take together with the estrogen (and you should take it regularly without missing it). Consult your doctor regularly and report any unusual vaginal bleeding right away.
- Treatment with Premarin may increase the risk of heart attack, stroke, breast cancer, and blood clots in the lungs or legs and because of these risks Premarin should be prescribed at the lowest effective dose, for the shortest period of time necessary.
- If you experience any of the serious side effects of Premarin, you should stop taking Premarin and get emergency medical attention. The serious side effects are a painful, red, and swollen leg; pain, swelling, and/or tenderness in the abdomen; abnormal vaginal bleeding and vaginal spotting; severe headache, severe vomiting, dizziness, faintness, changes in vision and/or speech; breast tumor, yellowing of the skin or eyes and an allergic reaction (manifested by difficulty in breathing, closing of the throat; swelling of the lips, tongue etc.).
- There may be less serious and common side effects of Premarin. If you experience any less serious side effects of Premarin, you should keep taking it and consult your doctor. The less serious and common side effects of Premarin are nausea, vomiting, migraine headaches, dizziness, loss of appetite; acne, skin color changes, swollen or tender breasts; decreased sex drive, problems with wearing contact lenses, water retention (edema of hands, feet, or ankles); depression, changes in menstrual cycle, breakthrough menstrual bleeding etc.
- There may also be some side effects which are not listed above. If you get any side effect that is not listed above, consult your doctor immediately.
Precautions to be Taken While Taking Premarin
- Do not take Premarin if you are pregnant. If you become pregnant, consult your doctor immediately.
- Do not breast feed your baby if you are taking Premarin, it may harm your baby or if you are breast feeding do not take Premarin.
- Usually there is no restriction on food, beverages, or activity while taking Premarin unless your doctor directs otherwise.
Possible Adverse Effects of Premarin
- The most common and mild side effects of Premarin are mild vomiting, headache, nausea, back pain, joint pain and vaginal bleeding.
- There may also be vaginal spotting, loss of menstrual periods or excessively prolonged menstrual periods, breast pain, breast enlargement and an increase or decrease in sexual drive.
- On the skin the side effects of Premarin include rash, and melasma (tan or brown patches) that may develop on the forehead, cheeks, or temples and can persist even after Premarin is stopped.
- There is an increased risk of cholesterol gallstones among men and women who are taking Premarin. Premarin can inhibit the flow of bile from the liver called cholestasis and cause jaundice although very rare.
- Premarin may cause an increase in the curvature of the cornea, and patients with contact lenses may develop intolerance to their lenses due to that. If you are taking Premarin, get your eyes check by Ophthalmologist regularly.