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Enjuvia Side Effects

Generic Name: conjugated estrogens

Please note - some side effects for Enjuvia may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

Side Effects of Enjuvia - for the Consumer

Enjuvia

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 when using Enjuvia:

Bloating; diarrhea; dizziness; gas; headache; increased/decreased interest in sex; lightheadedness; nausea; stomach pain; weight changes.

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

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); abnormal bleeding from the vagina; breast lumps; breast pain; changes in vision or speech; chest pain; depression; fainting; mental/mood changes; pain in the calves; severe headache; severe or persistent stomach pain; sudden shortness of breath; swelling of the hands or feet; unusual vaginal discharge/itching/odor; vomiting; weakness or numbness of an arm or leg; yellowing of the skin or eyes.

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.

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Enjuvia Side Effects - for the Professional

Enjuvia

See BOXED WARNINGS, WARNINGS and PRECAUTIONS.

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. The adverse reaction information from clinical trials does, however, provide a basis for identifying the adverse events that appear to be related to drug use and for approximating rates.

In a 12-week clinical trial, 209 postmenopausal women with vasomotor symptoms were treated with Enjuvia. Adverse events that occurred in the study at a rate greater than or equal to 5% and greater than placebo, regardless of relationship to study drug, are summarized in Table 8.

Table 8. Enjuvia Tablets – Number (%) of Patients Reporting Aderse Events* with ≥ 5% Occurrence Rate by Body System
*Treatment-emergent adverse events, regardless of relationship to study drug
Body System/Adverse Event*

0.3 mg

n=68

0.625 mg

n=72

1.25 mg

n=69

Placebo

n=72
Number of Patients in Safety Sample (%) 68 (100) 72 (100) 69 (100) 72 (100)
Number of Patients with Adverse Events (%) 49 (72) 55 (76) 56 (81) 51 (71)
Number of Patients without Adverse Events (%) 19 (28) 17 (24) 13 (19) 21 (29)
Body as a Whole
   Abdominal Pain 3 (4) 11 (15) 3 (4) 7 (10)
   Accidental Injury 6 (8) 2 (3) 3 (4) 5 (7)
   Flu Syndrome 4 (6) 3 (4) 5 (7) 3 (4)
   Headache 10 (15) 18 (25) 11 (16) 15 (21)
   Pain 10 (15) 14 (19) 7 (10) 6 (8)
Digestive System
   Flatulence 3 (4) 5 (7) 3 (4) 2 (3)
   Nausea 5 (7) 7 (10) 8 (12) 6 (8)
Nervous System
   Dizziness 5 (7) 3 (4) 1 (1) 3 (4)
   Paresthesia 0 4 (6) 1 (1) 0
Respiratory System
   Bronchitis 0 3 (4) 5 (7) 3 (4)
   Rhinitis 3 (4) 4 (6) 5 (7) 4 (6)
   Sinusitis 2 (3) 3 (4) 5 (7) 2 (3)
Urogenital System
   Breast Pain 0 9 (12) 10 (14) 3 (4)
   Dysmenorrhea 1 (2) 6 (8) 1 (1) 2 (3)
   Vaginitis 1 (2) 5 (7) 2 (3) 3 (4)

 

In a second 12-week clinical trial, 310 women with symptoms of vulvar and vaginal atrophy were treated (154 women with Enjuvia 0.3 mg tablets and 156 women with placebo). The only adverse event that occurred at a rate of >5% was headache; seven patients (4.55%) with Enjuvia and twelve patients (7.69%) with placebo.

The following additional adverse reactions have been reported with estrogen and/or progestin therapy:

  1. Genitourinary system
    Changes in vaginal bleeding pattern and abnormal withdrawal bleeding or flow; breakthrough bleeding; spotting; dysmenorrhea; increase in size of uterine leiomyomata; vaginitis, including vaginal candidiasis; change in amount of cervical secretion; changes in cervical ectropion; ovarian cancer; endometrial hyperplasia; endometrial cancer.
  2. Breasts
    Tenderness, enlargement, pain, nipple discharge, galactorrhea; fibrocystic breast changes; breast cancer.
  3. Cardiovascular
    Deep and superficial venous thrombosis; pulmonary embolism; thrombophlebitis; myocardial infarction; stroke; increase in blood pressure.
  4. Gastrointestinal
    Nausea, vomiting; abdominal cramps, bloating; cholestatic jaundice; increased incidence of gallbladder disease; pancreatitis, enlargement of hepatic hemangiomas.
  5. Skin
    Chloasma or melasma that may persist when drug is discontinued; erythema multiforme; erythema nodosum; hemorrhagic eruption; loss of scalp hair; hirsutism; pruritus, rash.
  6. Eyes
    Retinal vascular thrombosis, intolerance to contact lenses.
  7. Central Nervous System
    Headache; migraine; dizziness; mental depression; chorea; nervousness; mood disturbances; irritability; exacerbation of epilepsy, dementia.
  8. Miscellaneous
    Increase or decrease in weight; reduced carbohydrate tolerance; aggravation of porphyria; edema; arthralgias; leg cramps; changes in libido; urticaria, angioedema, anaphylactoid/anaphylactic reactions; hypocalcemia; exacerbation of asthma; increased triglycerides.
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Side Effects by Body System - for Healthcare Professionals

Oncologic

Oncologic side effects have included increased risks of endometrial carcinoma, ovarian cancer, and breast cancer.

Cardiovascular

The manufacturer recommends close observation if conjugated estrogens must be used in patients who may be particularly sensitive to fluid retention because of underlying asthma, epilepsy, migraine, heart disease, and renal dysfunction.

Cardiovascular side effects have included deep and superficial venous thrombosis, pulmonary embolism, thrombophlebitis, increase in blood pressure, and myocardial infarction.

Genitourinary

Genitourinary side effects have included breakthrough bleeding, spotting, changes in vaginal bleeding pattern, abnormal withdrawal bleeding or flow, dysmenorrhea, increase the size of preexisting uterine leiomyomata, vaginitis, including vaginal candidiasis, change in cervical erosion and in degree of cervical secretion, cystitis-like syndrome, application site reactions of vulvovaginal discomfort including burning and irritation, genital pruritus, ovarian cancer, endometrial hyperplasia, and precocious puberty.

Metabolic

Metabolic side effects have included increased serum triglyceride levels and reduced carbohydrate tolerance. Aggravation of porphyria has been reported.

General

General side effects have included reports of fluid retention and increase or decrease in weight.

Gastrointestinal

Cases of oral pigmentation and ischemic colitis have been reported rarely.

Gastrointestinal side effects have included nausea, vomiting, abdominal cramps, bloating, cholestatic jaundice, pancreatitis, ischemic colitis, and increased incidence of gallbladder disease.

Hematologic

Hematologic side effects have included hypercoagulability. Several cases of the hemolytic uremic syndrome have also been associated with conjugated estrogen therapy.

Hepatic

Hepatic side effects have also included many reports of hepatic tumors in women taking long-term oral contraceptives. However, some tumors have been reported in women taking isolated estrogen therapy.

Hepatic side effects have included enlargement of hepatic hemangiomas and rare cases of focal nodular hyperplasia, liver cell adenomas, hepatic hemangiomas and well-differentiated hepatocellular carcinomas.

Nervous system

Nervous system side effects have included headache, migraine, dizziness, stroke, chorea, nervousness, exacerbation of epilepsy, dementia, and mental depression. Possible growth potentiation of benign meningioma has been reported.

Other

Other side effects have included breast tenderness, pain, enlargement, secretion, and fibrocystic breast changes.

Psychiatric

Psychiatric side effects have included case reports of rapid mood cycling in patients with severe depression.

Respiratory

Respiratory side effects have included pulmonary embolism, exacerbation of asthma, and rare cases of exacerbations of pulmonary lymphangioleiomyomatosis. In addition, combinations of high-dose conjugated estrogens and progestin have been reported to increase ventilation and increase the hypoxic ventilatory response.

Dermatologic

Dermatologic side effects have included chloasma or melasma, which did not always resolve following discontinuation of estrogen therapy, scalp hair loss, hirsutism, rash, erythema multiforme, erythema nodosum, and hemorrhagic eruptions.

Hypersensitivity

Hypersensitivity side effects have included anaphylactoid/anaphylaxis reactions including urticaria and angioedema.

Endocrine

Endocrine side effects have included reports of increased levels of thyroxin-binding globulin, leading to an increase in total thyroid serum levels and a decrease in resin uptake of T3. Free thyroid hormone levels remained unchanged. Other endocrine effects have included decreased fasting plasma glucose.

Ocular

Ocular side effects have included retinal vascular thrombosis and intolerance to contact lenses.

Local

Local side effects have included phlebitis at the injection site and injection site pain and edema.

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