What is Conjugated Estrogens?

Conjugated Estrogens as the name suggest is a medication that contains a mixture of estrogen hormones. Estrogen is a female sex hormone produced by the ovaries and is required for several functions in the body. Conjugated estrogens medication is prescribed for the treatment of vaginal symptoms of menopause like dryness, burning, irritation, and painful sexual intercourse.
Conjugated estrogens medication is sold as various brands, one of which is Premarin (made by Wyeth Pharmaceuticals). It comes in two forms, tablets and vaginal cream.

Important Information about Conjugate Estrogens

Taking Conjugated Estrogens (Premarin) for a long time may increase the risk of breast, ovarian, or uterine cancer. Discuss this with your doctor about your specific risks. You may be required to have regular physical checkups and mammograms while taking this medication. Do not forget to also self examine your breasts regularly for lumps. You may be monitored for your progress and condition every 3 to 6 months to ensure that Conjugated Estrogens medication is functioning properly in you. This medication also increases the risk of endometrial hyperplasia, a condition that may lead to uterine cancer. Taking progestin while taking Conjugated Estrogens medication may decrease your risk of uterine cancer. If you have not had a hysterectomy (uterus removal surgery), you may be prescribed progestin along with Conjugated Estrogens.
Do not take Conjugated Estrogens if you have unusual and abnormal vaginal bleeding, liver disease, breast or uterine cancer, hormone related cancer, an incident of heart attack or stroke in the recent past, if you are allergic to it, if you are pregnant, or if you have ever had a blood clot. Hormonal medications can increase risk of blood clots, stroke, or a heart attack, especially if you are suffering from diabetes, high blood pressure, high cholesterol or triglycerides, if you are overweight, or if you smoke.
Conjugated Estrogens is classified as FDA pregnancy category X drug which means this medication can harm an unborn baby or cause birth defects in the newborn if the mother takes it during her pregnancy. Conjugated Estrogens is strictly not recommended for pregnant women. Notify your doctor in advance if you are pregnant or become pregnant while taking Conjugated Estrogens. Use of an effective birth control measure is recommended while taking this medication. You must also know that this medication can weaken the latex of condom, diaphragm, or cervical cap. Ask your doctor about the proper contraception to use while taking Conjugated estrogens. Conjugated Estrogens can pass into breast milk and harm a nursing baby. It may also slow breast milk production. Hence this medication is also not recommended if you are breastfeeding.

Before taking Conjugated Estrogens

Before taking Conjugated Estrogens (Premarin), take all precautions as mentioned above and discuss about them with your doctor. Inform your doctor in advance if you have any of these conditions: lupus, porphyria, endometriosis, gallbladder disease, hypothyroidism, asthma, migraines, epilepsy, calcium deficiency, or if you have had a hysterectomy. Your doctor will decide if it is safe for you to take this medication on top of these conditions.

How should I take Conjugated Estrogens?

You should take Conjugated Estrogens (Premarin) exactly as directed by your doctor. All medications come with a patient leaflet with complete instructions and details. Refer it for any doubts. Do not alter the course of the medication in any way (do not take more or less than the prescribed dosage). Also do not take it after the period for which the medication was prescribed is over. You may be prescribed a course of progestin along with Conjugated Estrogens. Always follow your doctor’s directions and advice.
Conjugated Estrogens is usually advised for only a short duration, mostly in a cycle (3 weeks of usage followed by a week off). Some conditions may require daily usage and others only twice in a week during the treatment period. Remember to always follow your doctor’s advice or instructions on the medication label.
To apply the Conjugated Estrogens vaginal cream, employ only the vaginal applicator provided along with the cream. After every application, clean the applicator thoroughly. Take the oral tablets as prescribed by your doctor. Always store medications in a cool and dry place.

What if I miss a dose?

If you forget to take a dose of Conjugated Estrogens for some reasons, take it as soon as you remember it. However, skip the missed dose if the time to take the next dose is almost up or near. Do not take two doses closer to each other to make up for the missed dose.

What if I overdose?

In case of an overdose of Conjugated Estrogens, get urgent medical attention or call the Doctor immediately. Overdose can result in nausea, vomiting, or vaginal bleeding.

Restrictions regarding to diet and activities while taking Conjugated Estrogens

Smoking is not recommended while taking Conjugated Estrogens. Smoking while taking this medication can increase the likelihood of blood clots, or heart attack due to Conjugated Estrogens.

Side Effects due to Conjugated Estrogens

Some common and less serious side effects of Conjugated Estrogens (Premarin) are stomach upset, nausea, vomiting, bloating, breast tenderness, headache, or weight changes. Get medical attention right away if any of these effects do not go away or deteriorate. Also inform your doctor if you see the tablet in your stool.
Some serious side effects of Conjugated Estrogens are mental or mood changes (depression, memory loss); breast lumps; unusual vaginal bleeding; vaginal irritation, itching, odor, or discharge; severe stomach or abdominal pain; persistent nausea or vomiting; yellowing eyes or skin; dark urine; increase thirst or urination; or swelling in limbs. Some rarely occurring serious problems due to Conjugated Estrogens are blood clots which may result in heart attack, stroke, deep vein thrombosis, or pulmonary embolism. Get emergency medical attention if you experience any serious side effects due to Conjugated Estrogens.
The side effects mentioned above are not the only ones caused by Conjugated Estrogens. There may be others.

Conjugated Estrogens Dosing Information

Conjugated Estrogens dosage for you will be decided by your doctor after examining you thoroughly. Dosage may depend on several factors like age, seriousness of the conditions, other conditions, and allergies among several others.

Interaction with other drugs

Some interacting drugs which can interact or interfere with functioning of Conjugated Estrogens (Premarin) are warfarin (blood thinner), cimetidine, rifampin, ritonavir (anti retroviral), some antibiotics like clarithromycin, erythromycin, or antifungal medicines like ketoconazole. These are not all the drugs which can interact with Conjugated Estrogens. There may be other drugs. Let your doctor know about all your present medications in advance. Do not start a new medication without proper medical attention and advice.