Premarin

What is Premarin?

Premarin tablets contain conjugated estrogens, a mixture of estrogens obtained from natural sources. Estrogen is a female sex hormone produced by the ovaries. Estrogen is necessary for many processes in the body.

Premarin is used to treat symptoms of menopause such as hot flashes, and vaginal dryness, burning, and irritation. Other uses include prevention of osteoporosis in postmenopausal women, and replacement of estrogen in women with ovarian failure or other conditions that cause a lack of natural estrogen in the body. Premarin is sometimes used as part of cancer treatment in women and men.

Premarin should not be used to prevent heart disease or dementia, because this medicine may actually increase your risk of developing these conditions.

Premarin may also be used for purposes not listed in this medication guide.

Important information

Do not use Premarin if you have any of the following conditions: a history of heart attack, stroke, or blood clot (especially in your lung or your lower body), liver disease, abnormal vaginal bleeding, or a hormone-related cancer such as breast or uterine cancer. Premarin can harm an unborn baby or cause birth defects. Do not use if you are pregnant.

Long-term use of Premarin may increase your risk of breast cancer, heart attack, stroke, or blood clot. Talk with your doctor about your individual risks before using conjugated estrogens long term.

Have regular physical exams and self-examine your breasts for lumps on a monthly basis while using Premarin.

Premarin should not be used to prevent heart disease, strokes, or dementia, because this medicine may actually increase your risk of developing these conditions.

Before taking this medicine

Do not use Premarin if you have:

• a history of heart attack, stroke, or blood clot (especially in your lung or your lower body);

• abnormal vaginal bleeding that a doctor has not checked;

• a bleeding or blood-clotting disorder;

• liver disease; or

• any type of breast, uterine, or hormone-dependent cancer.

To make sure you can safely take Premarin, tell your doctor if you have any of these other conditions:

• high blood pressure, heart disease, or circulation problems;

• a personal or family history of stroke;

• endometriosis;

• kidney disease;

• asthma;

• hereditary angioedema;

• epilepsy or other seizure disorder;

• migraines;

• diabetes;

• underactive thyroid;

• high cholesterol or triglycerides;

• high or low levels of calcium in your blood;

• porphyria;

• systemic lupus erythematosus (SLE); or

• gallbladder disease.

Premarin increase your risk of developing endometrial hyperplasia, a condition that may lead to cancer of the uterus. Taking progestins while using Premarin may lower this risk. If your uterus has not been removed, your doctor may prescribe a progestin for you to take while you are using Premarin.

Long-term use of Premarin may increase your risk of breast cancer, heart attack, stroke, or blood clot. Talk with your doctor about your individual risks before using conjugated estrogens long term, especially if you smoke or are overweight. Your doctor should check your progress on a regular basis (every 3 to 6 months) to determine whether you should continue this treatment.

FDA pregnancy category X. Premarin can harm an unborn baby or cause birth defects. Do not use Premarin if you are pregnant. Tell your doctor right away if you become pregnant during treatment. Use effective birth control while you are using this medication. Conjugated estrogens can pass into breast milk and may harm a nursing baby. Premarin may also slow breast milk production. Do not use if you are breast-feeding a baby. Do not give this medication to anyone under 18 years old without the advice of a doctor.

See also: Pregnancy and breastfeeding warnings (in more detail)

How should I take Premarin?

Take Premarin exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Premarin are sometimes taken on a daily basis. For certain conditions, the medication is given in a cycle, such as 3 weeks on followed by 1 week off. Follow your doctor's instructions.

If you see what looks like part of a Premarin tablet in your stool, talk with your doctor.

Have regular physical exams and self-examine your breasts for lumps on a monthly basis while using Premarin.

Use Premarin regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

To be sure this medication is helping your condition and not causing harmful effects, your blood will need to be tested often. Your thyroid function may also need to be tested. Visit your doctor regularly.

If you need surgery or medical tests or if you will be on bed rest, you may need to stop using this medication for a short time. Any doctor or surgeon who treats you should know that you are taking Premarin.

Store Premarin at room temperature away from moisture and heat. Keep the medicine container tightly closed.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at . Overdose symptoms may include nausea, vomiting, or vaginal bleeding.

What should I avoid?

Do not smoke while using Premarin. Smoking can increase your risk of blood clots, stroke, or heart attack caused by this medication.

Premarin side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Premarin: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using Premarin and call your doctor at once if you have a serious side effect such as:

• chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;

• sudden numbness or weakness, especially on one side of the body;

• sudden severe headache, confusion, problems with vision, speech, or balance;

• pain, swelling, warmth, or redness in one or both legs;

• abnormal vaginal bleeding;

• migraine headache;

• pain, swelling, or tenderness in your stomach;

• confusion, problems with memory or concentration;

• jaundice (yellowing of the skin or eyes);

• swelling in your hands, ankles, or feet; or

• a breast lump.

Less serious Premarin side effects may include:

• mild nausea, vomiting, bloating, stomach cramps;

• breast pain, tenderness, or swelling;

• freckles or darkening of facial skin;

• increased hair growth, loss of scalp hair;

• changes in weight or appetite;

• problems with contact lenses;

• vaginal itching or discharge;

• changes in your menstrual periods, decreased sex drive; or

• mild headache, nervousness, dizziness, tired feeling.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at .

See also: Side effects (in more detail)

What other drugs will affect Premarin?

Tell your doctor about all other medicines you use, especially:

• a blood thinner such as warfarin (Coumadin, Jantoven);

• a thyroid medication such as levothyroxine (Synthroid, Levoxyl, Levothroid and others);

• insulin or diabetes medicine taken by mouth;

• rifampin (Rifadin, Rifater, Rifamate, Rimactane);

• ketoconazole (Nizoral) or itraconazole (Sporanox);

• seizure medicines such as phenytoin (Dilantin), carbamazepine (Carbatrol, Equetro, Tegretol), felbamate (Felbatol), oxcarbazepine (Trileptal), or primidone (Mysoline);

• a barbiturate such as amobarbital (Amytal), butabarbital (Butisol), mephobarbital (Mebaral), secobarbital (Seconal), or phenobarbital (Luminal, Solfoton); or

• antidepressants such as amitriptyline (Elavil, Etrafon), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), imipramine (Janimine, Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil), or trimipramine (Surmontil).

This list is not complete and other drugs may interact with Premarin. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.