PREMARIN
(conjugated estrogens)
Premarin is a brand-name for the essential Estrogen tablets produced from natural sources. Estrogen is also a very important female hormone. It was first introduced into market in 1941 and 1942 by a manufacturer called Wyeth.
Brand Names
Cenestin, Enjuvia, Mannest, DNA-EC, Equifan, Esonovag, Fahifem, Neradin, Six Din, Sultrona, Terapova.
Mechanism of action (MOA)
Estrogen mainly binds with nuclear receptors in estrogen responding tissues. They stimulate pituitary secretion in Gonadotropins through negative feedback mechanism in Luteinizing hormone (LH), Follicle stimulating hormone (FSH) lowers elevated levels of these hormones.
Uses of Premarin
Premarin is an estrogen therefore it is mostly used to treat female problems like
1) Menopause
2) Hot flashes
3) Vaginal dryness
4) Burning
5) Irritation
6) Osteoporosis in post menopausal
7) Breast cancer
8) Hormonal Replacement Therapy (HRT)
It is used in HRT because natural estrogen levels are reduced. It compensates the estrogen in the body.
9) Hypoestrogenism
10) Vaginal atrophy
Dosage and Administration
Premarin can be taken as orally, Intravenously and in the form of vaginal creams. The oral dose consist of 0.3mg, 0.625mg, 0.9mg, 1.25mg or 2.5mg pills. It can be taken as with or without the regard to meals. Patient should be treated with lowest dose first and then gradually the dose should be increased. If the treatment is interrupted then she should consult her doctor for continuation of her drugs.
Side-Effects of Premarin
Common side-effects
1) Nausea
2) Vomiting
3) Bloating
4) Headache
5) Weight changes
6) Cramping
7) Bleeding
8) Painful menses
9) Infection
10) Vaginal spotting
Serious side-effects
1) Mood changes
2) Depression
3) Memory loss
4) Vaginal discharge
5) Extreme irritation
6) Abdominal pain
7) Stomach pain
8) Dark urine
9) Swelling of hands and feet
10) Strokes
11) Heart attack
12) Blurred vision
13) Breast lumps
14) Confusion
15) Coughing up of blood
16) Dizziness
17) Breathing problems
18) Rash
19) Tingling or numbness
20) Weakness on any side of the body.
Precautions and Warning
Before taking this medication tell your doctor of any allergic reaction. Also give your family and personal history thoroughly as the drug may interact with other conditions and can be harmful.
Patient should not smoke if she is taking this medicine as estrogen medicine tends to riskier if combined with smoking it will cause blood clots and stroke. Also if you had a surgery or planning on a surgery do inform your doctor . As prolong bed-rest may increase risk of blood clots.
Pregnancy and Breast feeding
Studies suggest that there are little to no risk of teratogenic or toxic effect on the fetus. Progestins and Estrogen exposure during pregnancy is not frown upon. But during breast feeding it should be avoided as it gets mixed with milk and it effects the milk secreting properties of mother. The milk decreases in quantity therefore it should be stopped during pregnancy.
Drug Interaction
Some drug interaction may change the course of drug and its effect. Therefore drugs like aromatase inhibitors, fulvestrant, raloxifene, tamoxifene, letrozole etc.
Product Information
Drug Uses
The drug is known to be effective against advanced breast cancer and also in preventing and treating vaginal itching, burning, hot flashes and dryness.
How Taken
The drug should always be taken with food. Premarin should be taken at the same time every day.
Missed Dose
Do not go for double dosage. If a dose is missed and if you remember it in time, you can take it. Well, if it is time for the next dosage, better leave the missed one and continue with the regular schedule.
More Information
Premarin is known to cause dizziness. This can worsen if the medicine is taken along with alcohol and certain other drugs. It is better not to drive and do hard jobs after taking the drug. The drug should not be given to others for whom it has not been prescribed.
Warnings/Precautions
When consulting the doctor, it is better to inform him if you have any allergies to any particular food and medicines. Tell the doctor if you have a benign breast nodule, heart problems, depression, diabetes, endometrial cancer, bone cancer, epilepsy, high blood pressure, gallbladder disease, kidney and liver problems.
The other health conditions that have to be intimated are history of yellowing of the skin or eyes, pancreatitis, lupus, uterine fibroids and thyroid problems. If you are having abnormal mammogram; a family history of cholesterol; high levels of cholesterol, calcium and triglyceride levels, you have to tell the doctor.
Premarin should not be used when pregnant or if you feel to conceive soon or when breast feeding. As the drug is excretes into breast milk, it is not safe to breast feed when taking the drug.
You should also consul your doctor when taking other medicines along with Premarin as some medicines are known to interact with it. Always take care not to take the drug if you have known, suspected, or a history of breast cancer and other other cancers which are estrogen–dependent. If you have vaginal bleeding, porphyria, circulation disorders, the drug should be avoided.
You should have to quit smoking when taking the drug. Smoking increases the risk of blood clots, especially in women above 35 years of age. You should have to go for regular check ups, usually in three to six months so that the doctor could evaluate your health conditions.
The drug causes dark patches on the face and so it is better to use some sunscreen lotion of cream when going out.