Conjugated estrogens creamPronunciation
Generic Name: conjugated estrogens (KON-joo-GAY-ted ES-troe-jenz)
Brand Name: Premarin
Conjugated estrogens cream should not be used to prevent heart disease, heart attacks, strokes, or dementia. Estrogens may increase the risk of heart disease (including heart attack), stroke, dementia, serious blood clots (eg, in the lungs or legs), cancer of the uterus, and breast cancer in some women. Tell your doctor right away if you have unusual vaginal bleeding while you use conjugated estrogens cream. Talk with your doctor if you have questions about the benefits and risks of using conjugated estrogens cream.
Conjugated estrogens cream should be used for the shortest possible time at the lowest effective dose to minimize the risk of these side effects. Talk with your doctor regularly about your need to use conjugated estrogens cream.
Conjugated estrogens cream is used for:
Treating certain menopausal changes of the vagina (eg, vaginal dryness) and other vaginal conditions. It is also used to treat painful intercourse caused by those vaginal changes. It may also be used for certain conditions as determined by your doctor.
Conjugated estrogens cream is a mixture of female estrogen hormones. It works by replacing natural estrogens in a woman who can no longer produce enough estrogen.
Do NOT use conjugated estrogens cream if:
- you are allergic to any ingredient in conjugated estrogens cream
- you have had a severe reaction (eg, swelling of the hands, face, lips, eyes, throat, or tongue; trouble swallowing or breathing; hoarseness) after taking conjugated estrogens cream
- you are pregnant or think you may be pregnant
- you have known or suspected breast cancer or another estrogen-dependent cancer, or you have a history of breast cancer
- you have liver problems or liver disease
- you have abnormal vaginal bleeding of unknown cause
- you have active blood clots (eg, of the legs or lungs), a history of blood clots, or a condition which may increase your risk of blood clots
- you have had a stroke or a heart attack
Contact your doctor or health care provider right away if any of these apply to you.
Before using conjugated estrogens cream:
Some medical conditions may interact with conjugated estrogens cream. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have a condition called hereditary angioedema
- if you have a history of breast lumps, breast disease, or an abnormal mammogram, or if a member of your family has had breast cancer
- if you have a vaginal infection or a history of uterus problems (eg, fibroids, endometriosis, abnormal vaginal bleeding, cancer), or you have had your uterus removed (hysterectomy)
- if you have a history of asthma, depression, memory problems, diabetes, seizures, gallbladder disease, pancreatitis, heart problems, high blood cholesterol or triglyceride levels, high blood calcium levels, high blood pressure, low blood levels of parathyroid hormone, or porphyria
- if you have a history of kidney or liver problems, yellowing of the skin or eyes, cancer, lupus, migraines, thyroid problems, or chorea (jerky, involuntary movements of the face, arms, or legs)
- if you smoke, use tobacco, are very overweight, will be having surgery, or will be confined to a bed or chair for a period of time
- if a member of your family has had high cholesterol or triglyceride levels, blood clots (eg, in the leg or lung), or lupus, or has been very overweight
Some MEDICINES MAY INTERACT with conjugated estrogens cream. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Azole antifungals (eg, ketoconazole), macrolide antibiotics (eg, erythromycin), or protease inhibitors (eg, ritonavir) because they may increase the risk of conjugated estrogens cream's side effects
- Carbamazepine, hydantoins (eg, phenytoin), phenobarbital, rifamycins (eg, rifampin), or St. John's wort because they may decrease conjugated estrogens cream's effectiveness
- Thyroid hormones (eg, levothyroxine) because their effectiveness may be decreased by conjugated estrogens cream
This may not be a complete list of all interactions that may occur. Ask your health care provider if conjugated estrogens cream may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
How to use conjugated estrogens cream:
Use conjugated estrogens cream as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- An extra patient leaflet is available with conjugated estrogens cream. Talk to your pharmacist if you have questions about this information.
- Closely follow the dosing schedule provided by your doctor. On days that you are using conjugated estrogens cream, use it at the same time each day.
- Wash your hands before and after using conjugated estrogens cream.
- Fill the applicator with conjugated estrogens cream according to the directions provided. Lie on your back with your knees drawn up. Insert the applicator high into the vagina and press the plunger to release the medicine.
- To clean the applicator, pull the plunger to remove it from the barrel. Wash with mild soap and warm water and rinse well. Do not boil or use hot water.
- Eating grapefruit or drinking grapefruit juice may increase the risk of conjugated estrogens cream's side effects. Check with your doctor before including grapefruit or grapefruit juice in your diet.
- If you miss a dose of conjugated estrogens cream, use it as soon as possible. If it is almost time for the next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.
Ask your health care provider any questions you may have about how to use conjugated estrogens cream.
Important safety information:
- Conjugated estrogens cream may increase the risk of a stroke, heart attack, blood clots, high blood pressure, or similar problems. The risk may be greater if you smoke.
- If you are only being treated for vaginal menopause symptoms, products applied locally, such as vaginal creams, tablets, or rings, should be considered before products taken by mouth or absorbed through the skin. If you have other medical conditions and are prescribed estrogens for more than one condition, consult your doctor about your treatment plan and its options.
- Conjugated estrogens cream may weaken and increase the failure of condoms, diaphragms, or cervical caps made of latex or rubber. To avoid pregnancy, use another form of birth control. Check with your doctor if you have questions about effective birth control.
- Diabetes patients - Conjugated estrogens cream may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
- Conjugated estrogens cream may cause dark skin patches on your face (melasma). Exposure to the sun may make these patches darker, and you may need to avoid prolonged sun exposure and sunlamps. Consult your doctor regarding the use of sunscreens and protective clothing.
- If you wear contact lenses and you develop problems with them, contact your doctor.
- Tell your doctor or dentist that you use conjugated estrogens cream before you receive any medical or dental care, emergency care, or surgery. If you will be having surgery or will be confined to a chair or bed for a long period of time (eg, a long plane flight), notify your doctor at least 4 to 6 weeks beforehand. You may need to stop using conjugated estrogens cream or take other special precautions for a period of time.
- Conjugated estrogens cream may interfere with certain lab tests. Be sure your doctor and lab personnel know you are using conjugated estrogens cream.
- Lab tests, including physical exams, cholesterol levels, and blood pressure, may be performed while you use conjugated estrogens cream. You should have breast and pelvic exams, and a Pap test at least once a year. You should also have periodic mammograms as determined by your doctor. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
- Follow your doctor's instructions for examining your own breasts. Report any lumps immediately.
- Talk with your doctor regularly (eg, every 3 to 6 months) about whether you need to continue taking conjugated estrogens cream.
- Use conjugated estrogens cream with caution in ELDERLY women; they may be more sensitive to its effects.
- Conjugated estrogens cream is not approved for use in CHILDREN; safety and effectiveness in children have not been confirmed.
- PREGNANCY and BREAST-FEEDING: Do not use conjugated estrogens cream if you are pregnant. If you think you may be pregnant, contact your doctor right away. Conjugated estrogens cream is found in breast milk. If you are or will be breast-feeding while you use conjugated estrogens cream, check with your doctor. Discuss any possible risks to your baby.
Possible side effects of conjugated estrogens cream:
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Seek medical attention right away if any of these SEVERE side effects occur:
Breast pain or tenderness; gas; hair loss; headache; leg cramps; mild fluid retention; mild nausea or vomiting; mild vaginal burning, itching, or irritation; nervousness; spotting or breakthrough bleeding; stomach cramps or bloating.
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness); abnormal vaginal bleeding; breast lumps or pain; bulging eyes; calf pain, swelling, or tenderness; chest pain; coughing up blood; fainting; mental or mood changes (eg, depression); migraine headache; new or worsening memory problems; pelvic pain; severe or persistent dizziness or headache; severe or persistent stomach or back pain (with or without nausea or vomiting); shortness of breath; swelling of the hands or feet; symptoms of heart attack (eg, chest, jaw, or arm pain; sudden severe nausea or vomiting; shortness of breath; sudden unusual sweating); symptoms of liver problems (eg, dark urine, pale stools, yellowing of the skin or eyes); symptoms of stroke (eg, one-sided weakness, slurred speech, confusion); unusual vaginal discharge/itching/odor; vision loss or other vision changes; vomiting.
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.
If OVERDOSE is suspected:
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include abnormal vaginal bleeding; breast tenderness; drowsiness or fatigue; nausea and vomiting; stomach pain.Proper storage of conjugated estrogens cream:
Store conjugated estrogens cream at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep conjugated estrogens cream out of the reach of children and away from pets.
- If you have any questions about conjugated estrogens cream, please talk with your doctor, pharmacist, or other health care provider.
- Conjugated estrogens cream is to be used only by the patient for whom it is prescribed. Do not share it with other people.
- If your symptoms do not improve or if they become worse, check with your doctor.
- Check with your pharmacist about how to dispose of unused medicine.
This information should not be used to decide whether or not to take conjugated estrogens cream or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about conjugated estrogens cream. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to conjugated estrogens cream. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using conjugated estrogens cream.
Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.