Brand
name: Premia (Premphase, Prempro)
Generic name: Conjugated estrogens
Other brand names: Cenestin, Premphase, Prempro
Why is Premia (Premphase, Prempro) rx prescribed?
Premia (Premphase, Prempro) rx is an estrogen replacement drug. The tablets are used to
reduce moderate to severe symptoms of menopause, including feelings
of warmth in the face, neck, and chest, and the sudden intense episodes
of heat and sweating known as "hot flashes." Cenestin tablets,
containing a synthetic form of conjugated estrogens, may also be prescribed
for these symptoms.
In addition to the symptoms of menopause, Premia (Premphase, Prempro) rx tablets are prescribed
for teenagers who fail to mature at the usual rate, and to relieve
the symptoms of certain types of cancer, including some forms of breast
and prostate cancer.
In addition, either the tablets or Premia (Premphase, Prempro) rx vaginal cream can be used
for other conditions caused by lack of estrogen, such as dry, itchy
external genitals and vaginal irritation.
Along with diet, calcium supplements, and exercise, Premia (Premphase, Prempro) rx tablets
are also prescribed to prevent postmenopausal osteoporosis, a condition
in which the bones become brittle and easily broken. Before taking
Premia (Premphase, Prempro) rx solely for this purpose, you should carefully consider using
alternative, nonestrogen therapies.
The addition of progesterone to estrogen-replacement therapy has been
shown to reduce the risk of uterine cancer. Prempro combines estrogen
and progesterone in a single tablet taken once daily. Premphase is
a 28-day supply of tablets. The first 14 contain only estrogen. The
second 14 supply both estrogen and progesterone. Both Prempro and Premphase
are prescribed to reduce the symptoms of menopause, including vaginal
problems, and to prevent osteoporosis.
Most important fact about Premia (Premphase, Prempro) rx without prescriptions
Because estrogens have been linked with an increased risk of uterine
and endometrial cancer (cancer in the lining of the uterus), it is
essential to have regular checkups and to report any unusual vaginal
bleeding to your doctor immediately.
Premia (Premphase, Prempro) rx and other estrogen drugs, with or without progesterone, should
not be used to prevent heart disease. Recent studies have confirmed
an increased rate of heart attack, stroke, and dangerous blood clots
among women taking estrogen or estrogen combinations for 5 years. Blood
clots can lead to phlebitis, stroke, heart attack, a loss of blood
supply to the lungs, a blockage in the blood vessels serving the eye,
and other serious disorders.
How should you take Premia (Premphase, Prempro) rx?
Take Premia (Premphase, Prempro) rx exactly as prescribed. Do not share it with anyone else.If
you are taking calcium supplements as a part of the treatment to help
prevent brittle bones, check with your doctor about how much to
take.
You should take a few moments to read the patient package insert provided
with your prescription.If you are using Premia (Premphase, Prempro) rx vaginal cream, apply
it as follows:
1. Remove cap from tube.
2. Screw nozzle end of applicator onto tube.
3. Gently squeeze tube from the bottom to force sufficient cream into
the barrel to provide the prescribed dose. Use the marked stopping
points on the applicator as a guide.
4. Unscrew applicator from tube.
5. Lie on back with knees drawn up. Gently insert applicator deeply
into the vagina and press plunger downward to its original position.
To cleanse the applicator, pull the plunger to remove it from the
barrel, then wash with mild soap and warm water. Do not boil or use
hot water.
If you miss a dose Premia (Premphase, Prempro) rx (Conjugated Estrogen)
Take the forgotten dose as soon as you remember. If it is almost time
for the next dose, skip the one you missed and go back to your regular
schedule. Never try to "catch up" by doubling the dose.
Storage instructions Premia (Premphase, Prempro) rx (Conjugated Estrogen)
Store at room temperature.
Premia (Premphase, Prempro) rx side effects
Side effects cannot be anticipated. If any develop or change in intensity,
inform your doctor immediately. Only your doctor can determine whether
it is safe to continue taking Premia (Premphase, Prempro) rx.
* Side effects of conjugated estrogens may include:
Abdominal/stomach cramps, bloating, breast pain, enlargement of benign tumors
of the uterus (also called fibroids), fluid retention, hair loss, headache,
high blood pressure, high blood sugar, irregular vaginal bleeding or spotting,
liver problems, nausea and vomiting, vaginal yeast infections
* Other possible side effects of Cenestin may include:
Constipation, increased heartbeat, joint pain, skin tingling
Why should Premia (Premphase, Prempro) rx not be prescribed?
Do not take Premia (Premphase, Prempro) rx if you have ever had a bad reaction to it, or
have undiagnosed abnormal vaginal bleeding.
Except in certain special circumstances, you should not be given Premia (Premphase, Prempro) rx
if you have ever had breast cancer, uterine cancer, or any other "estrogen-dependent" cancer.
Do not take Premia (Premphase, Prempro) rx if you have had any circulation problem involving
blood clots, or have had a stroke or heart attack in the past year.
Do not take Premia (Premphase, Prempro) rx if you have liver disease or your liver is not
working properly.
Do not use Premia (Premphase, Prempro) rx if you are pregnant or trying to become pregnant.
Special warnings about Premia (Premphase, Prempro) rx
For women who have not had a hysterectomy, the risk of endometrial
and uterine cancer increases when estrogen-only drugs are used for
a long time or taken in large doses. Estrogen therapy can also worsen
endometriosis (uterine tissue growing outside the uterus). If you've
ever had endometriosis, make sure the doctor is aware of it. If you've
had a hysterectomy but still have residual endometriosis, your doctor
may want you to use an estrogen/progesterone combination.
Certain studies have shown that women taking estrogen for prolonged
periods of time (4 years or more) face an increased risk of breast
cancer, and a study by the National Heart, Lung and Blood Institute
(NHLBI) has confirmed an increased risk among women taking estrogen/progesterone
combinations. Use combination products (and estrogen-only preparations,
too) with special caution if you have a family history of breast cancer
or have ever had an abnormal mammogram. Be sure to get an annual breast
exam from your doctor, and do your own self-examination each month.
The NHLBI study also found an increased risk of dementia for women
taking estrogen or estrogen/progesterone combinations.
Because Premia (Premphase, Prempro) rx can increase the risk of heart attack, stroke, blood
clots, and certain estrogen-dependent cancers, contact your doctor
right away if you notice any of the following:
Abdominal pain, tenderness, or swelling
Abnormal bleeding from the vagina
Breast lumps
Coughing up blood
Pain in your chest or calves
Severe headache, dizziness, or faintness
Sudden shortness of breath
Vision changes
Women who take Premia (Premphase, Prempro) rx after menopause are more likely to develop
gallbladder disease.
Estrogens such as Premia (Premphase, Prempro) rx can cause hypercalcemia, a severe increase
of calcium levels in the blood. Women with breast or bone cancer are
especially at risk and should stop taking Premia (Premphase, Prempro) rx immediately if they
develop hypercalcemia. In addition, women with the opposite problem--hypocalcemia,
or a severe decrease of calcium in the blood--should use Premia (Premphase, Prempro) rx with
caution.
Women who have not had a hysterectomy and take estrogen along with
progesterone have a lower risk of precancerous endometrial changes.
However, you should be aware that estrogen/progesterone combinations
could increase "bad" LDL cholesterol and blood sugar levels
as well as increase the risk of breast cancer.
There is a slight chance that estrogen therapy could cause an increase
in blood pressure. Ask your doctor to check your blood pressure regularly.
If you have high levels of fat in your blood, specifically a high
triglyceride level, conjugated estrogens such as Premia (Premphase, Prempro) rx are likely
to cause side effects in the pancreas.
Use Premia (Premphase, Prempro) rx with caution if you have a history of liver problems,
including jaundice. Call your doctor right away if you develop abdominal
pain or yellowing of the skin.
Premia (Premphase, Prempro) rx can alter thyroid function. If you're taking thyroid medication,
you may need your dosage adjusted.
Premia (Premphase, Prempro) rx can also cause fluid retention. Use the drug with caution
if you have heart or kidney problems, or any other condition that's
affected by excess fluid in the body.
Some studies have shown that using estrogen-only drugs, especially
for 10 years or more, could increase the risk of ovarian cancer. It's
unknown whether this also applies to estrogen/progesterone combinations.
Estrogens such as Premia (Premphase, Prempro) rx have been known to make certain conditions
worse, including asthma, diabetes, epilepsy, migraine, porphyria (a
genetic enzyme deficiency), lupus, and liver tumors.
If you are using Premia (Premphase, Prempro) rx vaginal cream, you should be aware that
this product can weaken latex condoms, diaphragms, and cervical caps.
Possible food and drug interactions when taking Premia (Premphase, Prempro) rx
If Premia (Premphase, Prempro) rx is taken with certain other drugs, the effects of either
could be increased, decreased, or altered. It is especially important
to check with your doctor before combining Premia (Premphase, Prempro) rx with the following:
Barbiturates such as phenobarbital
Blood thinners such as Coumadin
Carbamazepine (Tegretol)
Clarithromycin (Biaxin)
Drugs used for epilepsy, such as Dilantin
Erythromycin
Grapefruit juice
Itraconazole (Sporanox)
Ketoconazole (Nizoral)
Major tranquilizers such as Thorazine
Oral diabetes drugs such as Micronase
Rifampin (Rifadin)
Ritonavir (Norvir)
St. John's wort
Steroid medications such as Deltasone
Thyroid preparations such as Synthroid
Tricyclic antidepressants such as Elavil and Tofranil
Vitamin C
Special information if you are pregnant or breastfeeding
If you are pregnant or plan to become pregnant, notify your doctor
immediately. Premia (Premphase, Prempro) rx and conjugated estrogens should not be taken
during pregnancy because of the possibility of harm to the unborn child.
Premia (Premphase, Prempro) rx cannot prevent a miscarriage. Estrogens can decrease the quantity
and quality of breast milk, and progestins appear in breast milk. Your
doctor may advise you not to breastfeed while you are taking Premia (Premphase, Prempro) rx.
Recommended dosage for Premia (Premphase, Prempro) rx
Your doctor will start therapy with Premia (Premphase, Prempro) rx at a low dose and adjust
the dosage according to your response. He or she will want to check
you periodically at 3- to 6-month intervals to determine the need for
continued therapy.
Premia (Premphase, Prempro) rx TABLETS
Overdosage
Any medication taken in excess can have serious consequences. If you
suspect an overdose of Premia (Premphase, Prempro) rx, seek medical attention immediately.
