Generic Premarin i.e. Conjugated Estrogens are one of the two major classes of female hormones. Progestins comprise the second major class. Estrogens are used primarily to treat the symptoms of menopause and states in which there is a deficiency of estrogen, for example in women who have had their ovaries removed.

Conjugated estrogens are a mixture of several different estrogens estrogen salts that are derived from natural sources and blended to the approximate composition of estrogens in the urine of pregnant mares. The main components are sodium estrone sulphate and sodium equilin sulfate. Estrogens have widespread effects on many tissues in the body. Estrogens cause growth and development of the female sexual organs and maintain female sexual characteristics such as the growth of underarm and pubic hair body contours and skeleton. Estrogens also increase secretions from the cervix and growth of the inner lining of the uterus endometrium.

However, before taking Conjugated Estrogens i.e. Premarin medication, ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient and read it carefully. Talk to your doctor about all the possible risks of taking Premarin medication. However, Premarin may also be used for purposes other than those listed in this medication guide. Hence, for more information, consult your doctor and your medical pharmacist.

Follow the directions given by the doctor exactly for the usage of the Premarin i.e. Conjugated Estrogens medication and also read the prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand.

To minimize side effects, the lowest effective oral dose of conjugated estrogens is used. The usual starting dose for treating symptoms associated with menopause and for preventing postmenopausal osteoporosis is 0.3 mg/day. The dose should be increased based on response. Conjugated estrogens may be administered in a continuous or cyclical interval i.e. 25 days on treatment then 5 days off treatment.

Hypogonadism is treated with doses of 0.3 mg or 0.625 mg daily with a cyclical interval of 25 days on treatment followed by 5 days off treatment. The dose for women who have been castrated or have ovarian failure is 1.25 mg daily in a cyclical interval of three weeks on treatment and one week off treatment. In reality most women take estrogens continuously since during the week off treatment symptoms return because of the lack of estrogen. For treatment of breast cancer the recommended dose is 10 mg daily for three months.

Abnormal uterine bleeding due to hormonal imbalance is treated with one 25 mg intravenous or intramuscular injection. Another injection may be given in 6-12 hours if needed.

The vaginal cream is used for treating vulvar and vaginal atrophy and the recommended dose is ½ to 2 g daily.

If you wish to use the medication for your children, please contact your pediatrician for the dosage.

If you notice any of the symptoms, which seem severe or persistent to you, please contact your doctor immediately. However, your doctor may need to monitor you carefully for side effects and alter the doses if necessary.

Common side effects of conjugated estrogens include headache, abdominal pain, nervousness, nausea, back pain, joint pain and vaginal bleeding. Patients may also experience vaginal spotting loss of periods or excessively prolonged periods, breast pain, breast enlargement and an increase or decrease in sexual drive. Effects of estrogen on the skin include rashes and melasma i.e. tan or brown patches, that may develop on the forehead cheeks or temples and may persist even after estrogens are stopped. In the eyes conjugated estrogens may cause an increase in the curvature of the cornea and as a result patients with contact lenses may develop intolerance to their lenses. Estrogens may increase calcium levels in the blood hypercalcemia in patients with breast and bone cancer. Some patients may experience increased blood pressure and triglyceride levels.

Inform your doctor if you experience any of these side effects or some new side effects occur which appear too bothersome to you.

Inform your doctor if you are allergic to the formulation of this medication or any other medication in any other form and also inform your doctor about any other medication you may be taking in any other form, as they may affect the way your medicine works.

Estrogens increase the livers ability to manufacture factors that promote the clotting of blood. Because of this patients receiving warfarin, Coumadin a drug that thins the blood and prevents clotting by reducing clotting factors need to be monitored for loss of the blood thinning effect if treatment with an estrogen is begun.

Rifampin i.e. Rifadin, barbiturates, carbamazepine i.e. Tegretol, Griseofulvin i.e. Grifulvin, phenytoin i.e. Dilantin, St. John’s wort and primi all increase the elimination of estrogen by enhancing the livers ability to eliminate estrogens. Use of any of these medications with estrogens may result in a reduction of the beneficial effects of estrogens. Conversely drugs such as erythromycin, ketoconazole i.e. Nizoral, itraconazole i.e. Sporanox and ritonavir i.e. Norvir may reduce the elimination of estrogens by the liver as and lead to increased levels of estrogens in the blood.

Grapefruit juice also may increase levels of estrogen by increasing the absorption of estrogens from the intestine. Increased levels of estrogens in the blood may result in more estrogen-related side effects. However, Estrogens should not be given to pregnant women due to the risk of harm to the fetus.

Moreover, Premarin i.e. Conjugated Estrogens may also interact with some kind of foods, varied medications, herbal products, nutritional supplements, vitamins, other OTC medicines etc. Acquire more information about the interactions of the Premarin medication from your doctor and the medical pharmacists.

In case of overdose call your local poison control center at 1-800-222-1222.
If the suffering patient has collapsed or is not breathing call local emergency services at 911. Canadian residents should call their local poison control center directly.

Symptoms of overdose may include nausea, vomiting and vaginal bleeding etc.

Do not allow any other person to use your medication without getting doctor’s prescription themselves and also avoid using this medicine for other health conditions on your own. Keep the medicine away from the children and pets.

Also inform your doctor, if you are pregnant or are breast feeding. If you conceive during the course, inform your doctor immediately. Do not share your medicines with anyone, even if they have the same symptoms, for it may harm them. Do not begin, increase, decrease, or stop using this medicine on your own.

Remember, it is very important to keep regular appointments with your doctor to study the way your body is responding to the course. And if you are going to have a surgery, tell your health care professional that you are taking Premarin medication.

However, the medication should be administered with the lowest possible dose and for the possible short term. Your heath care provider may prescribe progestin with Premarin to reduce the chances of serious side effects. You may need to perform a physical examination periodically to monitor your progress and to check side effects. And you may also need to undergo some blood tests regularly. Avoid sunlight exposure. And Premarin drug should not be used to treat heart disease or dementia.

And in case, if you wish to use the medicine in children, please contact your pediatrician for sure before its use.

If you missed the dose, do take the medicine immediately provided that there is ample of time in between the next dose. However, if it is almost time for the next dose skip the missed dose and continue your regular dosing schedule. Never double your doses to cope up with the missed. And in case, if you miss your one or two consecutive doses consult to your doctor or physician for guidance and continue further.

The generic Premarin i.e. Conjugated Estrogens are used for treating the symptoms of menopause including hot flashes, vaginal dryness and vaginal atrophy. They also are used as therapy when the body does not produce enough estrogen due to castration i.e. removal of the ovaries, ovarian failure or underdevelopment of hormone-secreting organs i.e. hypogonadism. Conjugated estrogens also may be beneficial in treating advanced prostate and breast cancer. Although estrogens are approved for preventing osteoporosis, other drugs are more commonly prescribed for this purpose. Intravenous conjugated estrogens are used for treating abnormal uterine bleeding due to hormonal imbalance.

However, it may also be used to treat some other medical conditions which may be determined by your doctor accordingly and consult a pediatrician for the use of this medication in children.

The generic Premarin i.e. Conjugated Estrogens medication may be prescribed for other uses also, so ask your doctor or pharmacist for more information about the Premarin i.e. Conjugated Estrogens medication.

Generic Premarin i.e. Conjugated Estrogens tablets should be stored at room temperature in between 15-30°C 59-86°F. The injection should be stored between 2°-8°C and 36°-46°F in a cool and dry place. Keep the medicine in the container, it came in and always keep it tightly closed. Check Expiry date without fail. Keep all medicines away from women, newborns, children and pets. Do not freeze in any case. Also, keep it away from heat, dampness and direct light. Heat or moisture may cause the medicine to break down. When the medicine is not in use or outdated it should be discarded. Take help of your pharmacist in disposing this medicine properly. In any case, do not store the Premarin tablets in the bathroom.

Following precautions must be taken during consuming generic Premarin i.e. Conjugated Estrogens:

1. Inform your doctor if you have or have ever had: kidney disease, lung disease, liver disease, heart disease, diabetes, low or high blood pressure, asthma, heart attack and strokes or any other severe disease etc. Also inform, if you drink alcoholic beverages or smoke.

2. Also acknowledge your doctor if you need to undergo any kind of surgery, including dental surgery or need an x-ray procedure that uses contrast agents. So, inform your doctors immediately about it, so that the doctor can decide whether to continue taking Premarin medication or stop it during the surgery.

3. Let the doctor also know, if you are in-taking or are planning to take any prescribed or non prescribed medicines, health supplements or any other OTC medications, vitamins etc.

4. Do not use the Premarin i.e. Conjugated Estrogens medication, if you have any kind of allergy to it or to any ingredients of it and tell your doctor or pharmacist about the allergy and get treated.

5. Tell your doctor if you are pregnant or breast feeding before taking Premarin medication. Hence also, inform your doctor immediately when you plan to conceive, or become pregnant during the course.

6. Do not share the drug with others unless they are prescribed by the doctor themselves. And if your symptoms of side effects do not improve in few weeks or if they become worse and bothersome, check these conditions immediately with your doctor.

7. Please, use the Premarin medicine in the prescribed amount and do not overdose it or use it for the longer period of time. Do not discontinue on your own and consult your doctor before doing so to avoid further problems.

8. Regularly, keep your appointments with your doctor and keep an eye on the progress or side effects that has been noticed during the complete course.

9. Also, avoid smoking and consuming alcohol and alcohol containing beverages during the complete course.

10. Do not use Conjugated Estrogens in pregnancy as it may have adverse effects on an unborn baby and nursing mothers also should avoid taking this medication as it passes into breast milk.

11. Consult with your doctor, if you wish to use this medication for anyone under the age of 18.

12. For more information, contact your doctor and your pharmacists and also discuss the risks and benefits of the generic Premarin.