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Premarin (Estrogen)

Brand name : Premarin

Generic Name : Estrogen

Manufacturer : Wyeth-Ayerst

Medicine Category : Female Hormones : Oestrogens & Progesterones & Related Synthetic Drugs

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What is it used for?

- Symptoms of the menopause
- Used to help prevent the development of osteoporosis

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Oestrogen is the main sex hormone in the female body. Certain parts of the body such as the vagina, bones and breasts rely on oestrogen to function normally. When the levels of oestrogen are low, these tissues can slowly degenerate. In addition low levels of oestrogen can cause distressing symptoms such as hot flushes, mood swings and vaginal dryness. Buy Premarin (Estrogen) online Without Prescriptions,Order Premarin (Estrogen) online Without Prescriptions,Cheap Premarin (Estrogen) online Without Prescriptions.No prescription Needed.

Oestrogen may be supplemented to help reduce distressing symptoms of menopause and for the long-term prevention of bone loss (osteoporosis) that may occur in the years after menopause. This is known as hormone replacement therapy (HRT).

It is essential that women with an intact womb be given a progestogen (which acts like another another female sex hormone called progesterone), in combination with oestrogen. This is to prevent overstimulation of the lining of the womb (endometrium), which may otherwise occur with the use of oestrogen. Certain HRT medicines contain both hormones. Premarin contains only oestrogen, therefore it should be used only by women who have had their womb removed surgically (hysterectomy), or in conjunction with a progestogen.

How should Premarin (Estrogen) be used?

Premarin comes as a tablet to take by mouth, patches to apply externally to the skin, and as a cream to be inserted into the vagina. Oral Premarin usually is taken by mouth either every day or on a cyclical basis: once a day for 21 days and then none for 7 days; then the cycle is repeated. However, for treating cancer it usually is taken three times a day, every day for at least 3 months.

Skin patches usually are applied either once or twice weekly for three weeks (on the same days each week), followed by 1 week without the drug (patch); then the cycle is repeated. The package is designed to help you remember when to apply fresh skin patches.

To apply a skin patch, follow the directions provided and these steps:

-- Remove the skin patch from its protective pouch and peel off the protective strip, exposing the adhesive surface.

-- Place the adhesive side against a clean, dry, and not excessively hairy area of skin on the trunk of your body, preferably your abdomen (not your waistline or breasts, since tight clothing may rub the patch). Do not apply the patch to oily, broken, or irritated skin.

-- Press the patch on the selected site firmly with the palm of your hand for about 10 seconds, making sure that the edges adhere to your skin. If the patch accidentally comes off, you can either reapply it or apply a fresh patch, but follow your regular dosing schedule.
Remove and discard the patch and apply a fresh patch according to the schedule prescribed by your doctor. To prevent skin irritation, use a different site for each application and wait at least 1 week before using a particular area again. Used patches should be cut up and disposed in a manner out of reach of children and pets.

To use the vaginal cream, your doctor will set up a dosage schedule for you. If you are to use it once a day, it is best to use it at bedtime. Follow the directions that come with the vaginal cream and these steps:

-- Fill the special applicator that comes with the cream to the level indicated.
-- Lie on your back with your knees drawn upward and spread apart.
-- Gently insert the applicator into the vagina; then push the plunger to release the medication.
-- Withdraw the applicator.
-- Discard the applicator if it is disposable. If the applicator is reusable, pull it apart and clean it with soap and warm water after each use.
-- Wash your hands promptly.

Ask your pharmacist or doctor any questions you have about using the vaginal cream. You may wish to wear a sanitary napkin after inserting the cream to keep your clothes clean.

Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take Premarin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Do not stop taking Premarin without talking to your doctor.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient

Warning

- In women with an intact uterus, long-term use of oestrogen therapy will require the addition of a progestogen to prevent the risk of over-growth (hyperplasia) and possible cancer of the lining of the womb (endometrium).

- It is important to be aware that all women taking HRT appear to have a small increase in the risk of being diagnosed with breast cancer, compared with women who do not take HRT. However, this risk must be weighed against the benefits of taking HRT, such as prevention of osteoporosis. You should discuss the risks and benefits of HRT with your doctor before starting treatment. Women on HRT are advised to have regular breast examinations and mammograms, and to practice breast self-examination.

- It is important to be aware that women taking HRT have a slight increase in the risk of abnormal blood clot formation (deep vein thrombosis and pulmonary embolism) compared with women not taking HRT. The Committee for the Safety of Medicines believes that the overall benefits of HRT outweigh the risks involved, but that those with a personal or family history of thrombosis or other risk factors (eg smokers, obesity, recent surgery, immobility) should carefully discuss this with their doctor.

- A woman is considered fertile for two years after her last menstrual period if she is under 50, or for one year if over 50. HRT does not provide contraception for women who fall within this group. If a potentially fertile women is taking HRT but also requires contraception, a non-hormonal method (eg condoms) should be used.

- Regular gynaecological tests are recommended for women taking this medicine.

- Notify your doctor if you develop migraine-like headaches, yellowing of the skin or eyes (jaundice) or any visual disturbances.

- HRT may affect the results of some hormone or liver function tests.

- There has been a reported increase in the risk of surgically confirmed gall bladder disease in postmenopausal women receiving oestrogen treatment.-

Use with caution in

- Asthma
- Decreased kidney function
- Diabetes
- Disorder causing deafness in adult life (otosclerosis)
- Endometriosis

- Epilepsy
- Fibroids of the uterus
- Heart disease
- High blood pressure (hypertension)
- History of heart attack

- History of stroke
- Life long inherited blood diseases which can cause a variety of symptoms, including mental health problems (porphyrias)
- Long-term inflammation of skin and some internal organs (systemic lupus erythematosus)
- Malignant skin cancer (melanoma)

- Multiple sclerosis
- Thyrotoxicosis
- Treatment of migraine

Not to be used in

- Breast cancer or history of breast cancer
- Breastfeeding
- Cancer that is responsive to female hormones (oestrogen dependent neoplasia) eg endometrial cancer
- Children
- Current or previous blood clot in the blood vessels (thromboembolism)

- Disorders that increase the risk of blood clots in the blood vessels (thromboembolic disorders)
- Liver disease
- Pregnancy
- Severe cardiovascular disease

- Severe kidney disease
- Vaginal bleeding of unknown cause

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby.Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

- This medicine should not be used in pregnancy. Seek medical advice from your doctor.
- This medicine should not be used by breastfeeding mothers. Discuss this with your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

- Headache
- Changes in mood
- Depression
- Breast tenderness/swelling
- High blood calcium level (hypercalcaemia)
- Dizziness
- Leg cramps
- Excessive fluid retention in the body tissues, resulting in swelling (oedema)
- Changes in sex drive
- Intolerance to contact lenses
- Gastrointestinal disturbances including bloating, cramps, nausea and vomiting

The side effects listed above may not include all of the side effects reported by the drug's manufacturer.

For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

Most interactions have been demonstrated with the oral contraceptive pill (also containing oestrogens), and not specifically for the oestrogens used in hormone replacement dosages. Some of the following are therefore only theoretical interactions rather than proven effects.

Medicines that increase the elimination, lower blood levels or reduce the therapeutic effect of oestrogens:
-Antibiotics (e.g. rifampicin, rifabutin)
-Antiepileptics (e.g. carbamazepine, phenobarbitol, phenytoin, primidone, topiramate)
-Antifungals (e.g griseofulvin)
-Antivirals (e.g. ritonavir, nelfinavir, nevirapine and possibly efavirenz)
-Modafinil
-Tacrolimus
-Lansoprazole

Medicines that may have their effects or blood levels increased by oestrogens:
-Corticosteroids - blood levels may be increased
-Ciclosporin (cyclosporin) - blood levels may be increased
-Ropinirole - blood levels may be increased
-Theophylline - blood levels may be increased

Medicines that have their effects reduced by oestrogens:
-Anastrozole

Recommended dosage

Your doctor will start therapy with this medication at a low dose. He or she will want to check you periodically at 3- to 6-month intervals to determine the need for continued therapy.

PREMARIN TABLETS

Hot Flashes Associated with Menopause

The usual dosage is 0.3 to 1.25 milligrams daily. If you are still having periods, the doctor will start the Premarin on the fifth day of your cycle, have you take it for 3 weeks, then give you 1 week off.

Tissue Degeneration in the Vagina

The usual dosage is 0.3 to 1.25 milligrams or more daily. The drug is taken cyclically (3 weeks on and 1 week off).

Low Estrogen Levels Due to Reduced Ovary Function

The usual dosage is 2.5 to 7.5 milligrams daily, taken in several small doses, for 20 days, followed by a 10-day rest period. If you do not have your period by the end of this time, the same dosage schedule is repeated.

If you start to bleed before the end of the 10-day period your doctor will start you on another 20-day cycle, with an oral progestin added during the last 5 days. If you start to bleed before the second cycle is over, stop taking the medication and tell your doctor.

Ovary Removal or Ovarian Failure

The usual dosage is 1.25 milligrams daily, cyclically (3 weeks on and 1 week off). Your doctor will adjust the dosage according to the severity of your symptoms and your response to treatment.

Prevention of Osteoporosis (Loss of Bone Mass)

The usual dosage is 0.625 milligram daily, taken cyclically (3 weeks on and 1 week off).

Advanced Androgen-Dependent Cancer of the Prostate, for Relief of Symptoms Only

The usual dosage is 1.25 to 2.5 milligrams 3 times daily.

Breast Cancer (for Relief of Symptoms Only) in Appropriately Selected Women and Men with Metastatic Disease

The suggested dosage is 10 milligrams 3 times daily for a period of at least 3 months. Tell your doctor if you have any unusual bleeding.

PREMARIN VAGINAL CREAM

Given cyclically for short-term use only.

Degeneration of Genital Tissue or Severe Itching in the Genital Area

The recommended dosage is one-half to 2 grams daily, inserted into the vagina, depending on the severity of the condition. You will use the cream for 3 weeks, then stop for 1 week. Tell your doctor if you notice any unusual bleeding.

PREMPHASE TABLETS

Follow a 28-day cycle. Take 1 maroon Premarin tablet every day for the first 14 days; on the 15th day, begin taking 1 light-blue tablet daily.

PREMPRO TABLETS

The usual starting dose is one 0.625-milligram/2.5-milligram tablet once a day. If this dose proves insufficient, your doctor may increase the dose to one 0.625-milligram/5-milligram tablet once a day.

CENESTIN TABLETS

The usual starting dose is 0.625 milligrams a day. If this proves insufficient, the doctor may gradually increase the dose up to a maximum of 1.25 milligrams daily.

Overdosage

Numerous reports of ingestion of large doses of estrogen-containing oral contraceptives by young children indicate that acute serious ill effects have not been observed. Overdosage of estrogens may cause nausea, and withdrawal bleeding may occur in females.

When you miss a dose

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

Store at room temperature (approximately 25 C).

 

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