Conjugated estrogens vaginal

Estrogen is a female sex hormone produced by the ovaries. Estrogen is necessary for many processes in the body.

Vaginal conjugated estrogens are a mixture of estrogen hormones used to treat the vaginal symptoms of menopause such as dryness, burning, irritation, and painful sexual intercourse.

Vaginal conjugated estrogens should not be used to prevent heart disease or dementia, because this medication may actually increase your risk of developing these conditions.

Vaginal conjugated estrogens may also be used for purposes not listed in this medication guide.

Usual Adult Dose for Atrophic Vaginitis:

Initial dose: 0.5 grams intravaginally in a cyclic regimen: daily for 21 days, then off for 7 days
Maintenance dose: 0.5 to 2 grams intravaginally in a cyclic regimen: daily for 21 days, then off for 7 days

Comments:
-Adjust dose based on individual response

Uses: Treatment of atrophic vaginitis and kraurosis vulvae

Usual Adult Dose for Postmenopausal Symptoms:

0.5 grams intravaginally twice weekly (e.g. Monday and Thursday)
OR
0.5 grams intravaginally in a cyclic regimen: daily for 21 days, then off for 7 days

Uses: Treatment of moderate to severe dyspareunia, a symptom of vulvar and vaginal atrophy, due to menopause

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 there may be other drugs that can interact with vaginal conjugated estrogens. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

In the U.S.

• Premarin
• Premarin Vaginal

Available Dosage Forms:

• Cream

Therapeutic Class: Female Reproductive Agent

Pharmacologic Class: Estrogen

This medication is a female hormone. It is used by women to help reduce vaginal symptoms of menopause (such as vaginal dryness/burning/itching). These symptoms are caused by the body making less estrogen. When treating only vaginal symptoms of menopause, products applied directly inside the vagina (such as this medication) should be used first. Estrogens that are taken by mouth, absorbed through the skin, or injected may have greater risks of side effects due to more estrogen being absorbed.

How to use Conjugated Estrogens Cream

Read the Patient Information Leaflet if available from your pharmacist before you start using this medication and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Use this medication as directed by your doctor. Fill the applicator with the medication according to the directions. Insert the applicator high into the vagina and press the plunger to release the medication. Clean the applicator with warm soapy water and rinse well. Do not boil or use hot water to clean the applicator.

The dosage is based on your medical condition and response to treatment.

Use this medication regularly to get the most benefit from it. Follow your dosing schedule carefully. Do not increase your dose or use this medication more often or for a longer time than directed.

Tell your doctor if your condition does not improve or if it worsens.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this drug include: aromatase inhibitors (such as anastrozole, exemestane, letrozole), fulvestrant, ospemifene, raloxifene, tamoxifen, toremifene, tranexamic acid.

This medication may interfere with certain laboratory tests (including metyrapone test), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

This medicine may be harmful if swallowed. If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe nausea/vomiting, unusual vaginal bleeding.

Notes

Do not share this medication with others.

Keep all regular medical and laboratory appointments. You should have regular complete physical exams (for example, once a year) which include laboratory and medical tests (such as blood pressure, breast exam/mammogram, pelvic exam, pap smear) to monitor your progress and check for side effects. Follow your doctor's instructions for examining your own breasts, and report any lumps right away. Consult your doctor for more details.

Preventing or controlling high blood pressure, high cholesterol, and diabetes can help to reduce your chances of heart disease and stroke. Lifestyle changes that can help to control or prevent these diseases include reducing stress, eating a low fat/salt diet, losing weight if overweight, exercising regularly, and stopping smoking. Keep your mind active with mental exercises (such as reading, solving crossword puzzles) to help prevent dementia. Talk to your doctor about lifestyle changes that might benefit you.

Missed Dose

If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Storage

Store at room temperature. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.Information last revised November 2016. Copyright(c) 2016 First Databank, Inc.

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