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Conjugated estrogens

Pronunciation

Generic Name: conjugated estrogens (KON-joo-GAY-ted ES-troe-jenz)
Brand Name: Premarin

Conjugated estrogens 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. Talk with your doctor if you have questions about the benefits and risks of using conjugated estrogens.

Conjugated estrogens 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.


Conjugated estrogens is used for:

Short-term treatment of abnormal bleeding of the uterus caused by certain hormonal imbalances. It may also be used for other conditions as determined by your doctor.

Conjugated estrogens is a mixture of estrogen hormones. It works by replacing natural estrogens in a woman who can no longer produce enough estrogen.

Do NOT use conjugated estrogens if:

  • you are allergic to any ingredient in conjugated estrogens
  • 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
  • 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 a history of liver problems or liver disease
  • you have abnormal vaginal bleeding of an unknown cause
  • you have active blood clots (eg, of the legs or lungs), a history of blood clots, or a condition that may increase your risk of blood clots
  • you have had a stroke or heart attack

Contact your doctor or health care provider right away if any of these apply to you.

Slideshow: 2014 Update: First Time Brand-to-Generic Switches

Before using conjugated estrogens:

Some medical conditions may interact with conjugated estrogens. 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, diabetes, memory problems, 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. 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's side effects
  • Barbiturates (eg, phenobarbital), carbamazepine, hydantoins (eg, phenytoin), rifamycins (eg, rifampin), or St. John's wort because they may decrease conjugated estrogens's effectiveness
  • Thyroid hormones (eg, levothyroxine) because their effectiveness may be decreased by conjugated estrogens

This may not be a complete list of all interactions that may occur. Ask your health care provider if conjugated estrogens 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:

Use conjugated estrogens as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • An extra patient leaflet is available with conjugated estrogens. Talk to your pharmacist if you have questions about this information.
  • Conjugated estrogens is usually given as an injection at your doctor's office, hospital, or clinic. If you will be using conjugated estrogens at home, a health care provider will teach you how to use it. Be sure you understand how to use conjugated estrogens. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.
  • Do not use conjugated estrogens if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.
  • Eating grapefruit or drinking grapefruit juice may increase the risk of conjugated estrogens's side effects. Check with your doctor before including grapefruit or grapefruit juice in your diet.
  • Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.
  • If you miss a dose of conjugated estrogens, contact your doctor right away.

Ask your health care provider any questions you may have about how to use conjugated estrogens.

Important safety information:

  • Conjugated estrogens may increase the risk of stroke, heart attack, blood clots, high blood pressure, or similar problems. The risk may be greater if you smoke.
  • 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.
  • Diabetes patients - Conjugated estrogens may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
  • Conjugated estrogens 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 take conjugated estrogens 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 taking conjugated estrogens or take other special precautions for a period of time.
  • Conjugated estrogens may interfere with certain lab tests. Be sure your doctor and lab personnel know you are using conjugated estrogens.
  • Lab tests, including physical exams, cholesterol levels, and blood pressure, may be performed while you use conjugated estrogens. 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.
  • Use conjugated estrogens with caution in ELDERLY women; they may be more sensitive to its effects.
  • Use conjugated estrogens with caution in CHILDREN; they may need regular growth and/or development checks while they use conjugated estrogens.
  • PREGNANCY and BREAST-FEEDING: Do not use conjugated estrogens if you are pregnant. If you think you may be pregnant, contact your doctor right away. Conjugated estrogens is found in breast milk. If you are or will be breast-feeding while you use conjugated estrogens, check with your doctor. Discuss any possible risks to your baby.

Possible side effects of conjugated estrogens:

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:

Breast pain or tenderness; gas; hair loss; headache; leg cramps; mild fluid retention; mild nausea or vomiting; nervousness; pain, swelling, or redness at the injection site; spotting or breakthrough bleeding; stomach cramps or bloating.

Seek medical attention right away if any of these SEVERE side effects occur:

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:

Conjugated estrogens is usually handled and stored by a health care provider. If you are using conjugated estrogens at home, store conjugated estrogens as directed by your pharmacist or health care provider. Keep conjugated estrogens out of the reach of children and away from pets.

General information:

  • If you have any questions about conjugated estrogens, please talk with your doctor, pharmacist, or other health care provider.
  • Conjugated estrogens 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 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. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to conjugated estrogens. 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.

Issue Date: July 2, 2014
Database Edition 14.3.1.001
Copyright © 2014 Wolters Kluwer Health, Inc.

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.

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