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conjugated estrogens synthetic a (Oral route)


KON-joo-gay-ted ES-troe-jenz sin-THET-ik A

Oral route(Tablet)

Estrogen treatment alone increases the risk of endometrial cancer in a woman with a uterus. Adding a progestin to estrogen therapy may reduce the risk of endometrial hyperplasia, a precursor to endometrial cancer. However, addition of a progestin to estrogen therapy may increase the risk of invasive breast cancer. Undertake adequate diagnostic measures, including directed or random endometrial sampling if indicated, to rule out malignancy in postmenopausal women with abnormal vaginal bleeding. Estrogen treatment alone increased risks of stroke and deep vein thrombosis (DVT), while estrogen plus progestin increased risks of stroke, DVT, myocardial infarction, and pulmonary emboli in postmenopausal women (50 to 79 years of age). Estrogens with or without progestins should not be used for the prevention of cardiovascular disease or dementia. An increased risk of developing probable dementia in postmenopausal women 65 years of age or older has also been reported. Prescribe estrogen with or without progestins at the lowest effective dose and for the shortest duration .

Commonly used brand name(s)

In the U.S.

  • Cenestin

Available Dosage Forms:

  • Tablet

Therapeutic Class: Endocrine-Metabolic Agent

Pharmacologic Class: Estrogen

Uses For conjugated estrogens synthetic a

Conjugated estrogens synthetic A is used to treat moderate to severe hot flashes and other symptoms of menopause or low amounts of estrogen. It is also used to treat changes in and around the vagina (such as vaginal dryness, itching, and burning) caused by menopause.

conjugated estrogens synthetic a is available only with your doctor's prescription.

Before Using conjugated estrogens synthetic a

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For conjugated estrogens synthetic a, the following should be considered:


Tell your doctor if you have ever had any unusual or allergic reaction to conjugated estrogens synthetic a or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.


Cenestin® is not indicated for use in children.


Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of Cenestin® in the elderly. However, elderly patients are more likely to have breast cancer, dementia, or stroke, which may require caution in patients receiving conjugated estrogens synthetic a.

Breast Feeding

Studies suggest that this medication may alter milk production or composition. If an alternative to this medication is not prescribed, you should monitor the infant for side effects and adequate milk intake.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of conjugated estrogens synthetic a. Make sure you tell your doctor if you have any other medical problems, especially:

  • Abnormal or unusual vaginal bleeding or
  • Blood clots (eg, deep vein thrombosis, pulmonary embolism), active or history of or
  • Breast cancer, known or suspected, or a history of or
  • Heart attack, active or history of or
  • Liver disease or
  • Protein C, protein S, or other known blood clotting disorders or
  • Stroke, active or history of or
  • Surgery with a long period of inactivity or
  • Tumors (estrogen-dependent), known or suspected—Should not be used in patients with these conditions.
  • Asthma or
  • Cancer, history of or
  • Diabetes or
  • Edema (fluid retention or body swelling) or
  • Endometriosis or
  • Epilepsy (seizures) or
  • Gallbladder disease or
  • Hereditary angioedema (swelling of the face, lips, tongue, or throat) or
  • Hypercalcemia (high calcium in the blood) or
  • Hypertension (high blood pressure) or
  • Hypertriglyceridemia (high triglycerides or fats in the blood) or
  • Hypocalcemia (low calcium in the blood) or
  • Hypothyroidism (an underactive thyroid) or
  • Jaundice during pregnancy or from using hormonal therapy in the past or
  • Liver tumors or
  • Migraine headache or
  • Porphyria (an enzyme problem) or
  • Systemic lupus erythematosus (SLE)—Use with caution. May make these conditions worse.

Proper Use of conjugated estrogens synthetic a

It is very important that you use conjugated estrogens synthetic a exactly as directed by your doctor. Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered. To do so may cause unwanted side effects.

conjugated estrogens synthetic a comes with a patient information leaflet. Read and follow the instructions carefully. Ask your doctor if you have any questions.

Swallow the tablet whole. Do not crush, break, or chew it. You may take conjugated estrogens synthetic a with or without food.


The dose of conjugated estrogens synthetic a will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of conjugated estrogens synthetic a. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For treatment of moderate to severe hot flashes and other symptoms caused by menopause:
      • Adults—At first, 0.45 milligrams (mg) once a day. Your doctor may adjust your dose as needed.
      • Children—Use is not recommended.
    • For treatment of atrophic vaginitis caused by menopause:
      • Adults—0.3 milligrams (mg) once a day.
      • Children—Use is not recommended.

Missed Dose

If you miss a dose of conjugated estrogens synthetic a, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.


Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using conjugated estrogens synthetic a

It is very important that your doctor check your progress at regular visits to make sure conjugated estrogens synthetic a is working properly and does not cause unwanted effects. Pelvic exam, breast exam, and mammogram (breast x-ray) may be needed to check for unwanted effects, unless your doctor tells you otherwise. Be sure to keep all appointments.

It is unlikely that a postmenopausal woman may become pregnant. But, you should know that using conjugated estrogens synthetic a while you are pregnant could harm your unborn baby. If you think you have become pregnant while using the medicine, tell your doctor right away.

Using conjugated estrogens synthetic a over a long period of time may increase your risk of breast cancer, endometrial cancer, or uterine cancer. Talk with your doctor about this risk. If you still have your uterus (womb), ask your doctor if you should also use a progestin medicine. Check with your doctor immediately if your experience abnormal vaginal bleeding.

Using conjugated estrogens synthetic a may increase your risk of dementia, especially in women 65 years of age and older.

Using conjugated estrogens synthetic a may increase your risk for having blood clots, strokes, or heart attacks. This risk may continue even after you stop using the medicine. Your risk for these serious problems is even greater if you have high blood pressure, high cholesterol in your blood, diabetes, or if you are overweight or smoke cigarettes. Contact your doctor immediately if you experience chest pain, confusion, difficulty speaking, double vision, headaches, an inability to move arms, legs or facial muscle, or an inability to speak.

Tell the medical doctor or dentist in charge that you are using conjugated estrogens synthetic a before any kind of surgery (including dental surgery) or emergency treatment. Your doctor will decide whether you should continue using conjugated estrogens synthetic a. conjugated estrogens synthetic a may also affect the results of certain medical tests.

Check with your doctor immediately if severe headache or sudden loss of vision or any other change in vision occurs while you are using conjugated estrogens synthetic a. Your doctor may want you to have your eyes checked by an ophthalmologist (eye doctor).

Do not eat grapefruit or drink grapefruit juice while you are using conjugated estrogens synthetic a. Grapefruit and grapefruit juice may change the amount of conjugated estrogens synthetic a that is absorbed in the body.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (eg, St. John's wort) or vitamin supplements.

conjugated estrogens synthetic a Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common
  • Bloating or swelling of the face, arms, hands, lower legs, or feet
  • cough
  • cramps
  • difficulty with swallowing
  • dizziness
  • fast heartbeat
  • heavy bleeding
  • hives, itching, or skin rash
  • itching of the vagina or genital area
  • normal menstrual bleeding occurring earlier, possibly lasting longer than expected
  • pain during sexual intercourse
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • rapid weight gain
  • thick, white vaginal discharge with no odor or with a mild odor
  • tightness in the chest
  • tingling of the hands or feet
  • unusual tiredness or weakness
  • unusual weight gain or loss
Incidence not known
  • Acid or sour stomach
  • backache
  • belching
  • change in vaginal discharge
  • clear or bloody discharge from the nipple
  • confusion
  • decrease in the amount of urine
  • difficulty with speaking
  • dimpling of the breast skin
  • double vision
  • headache
  • heartburn
  • inability to move the arms, legs, or facial muscles
  • inability to speak
  • indigestion
  • inverted nipple
  • loss of appetite
  • lump in the breast or under the arm
  • noisy, rattling breathing
  • pain or feeling of pressure in the pelvis
  • pain, redness, or swelling in the arm or leg
  • persistent crusting or scaling of the nipple
  • redness or swelling of the breast
  • slow speech
  • sore on the skin of the breast that does not heal
  • stomach discomfort, upset, or pain
  • swelling of the abdominal or stomach area
  • swelling of the fingers, hands, feet, or lower legs
  • troubled breathing at rest
  • vaginal bleeding

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • excess air or gas in the stomach or intestines
  • fear or nervousness
  • heartburn
  • increased clear or white vaginal discharge
  • indigestion
  • lack or loss of strength
  • loss of bladder control
  • nausea
  • passing gas
  • runny nose
  • sneezing
  • stuffy nose
  • vomiting
Less common
  • Back pain
  • increased appetite
Incidence not known
  • Breast pain, swelling, or tenderness
  • discouragement
  • enlarged breasts
  • feeling sad or empty
  • hair loss or thinning of the hair
  • irritability
  • lack of appetite
  • loss of interest or pleasure
  • sleepiness or unusual drowsiness
  • tiredness
  • trouble concentrating
  • trouble sleeping

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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