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Generic Premarin contains a mixture of estrogen hormones. Estrogen is a female sex hormone produced by the ovaries. Estrogen is necessary for many processes in the body. Generic Premarin is used to treat the vaginal symptoms of menopause such as dryness, burning, irritation, and painful sexual intercourse.
How to take
Your doctor will start therapy with Generic Premarin at a low dose and adjust the dosage according to your response. He or she will want to check you periodically at 3- to 6-month intervals to determine the need for continued therapy.
The usual starting dosage is 0.3 milligrams daily, taken continuously or in cycles such as 25 days on Generic Premarin and 5 days off.
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 rash, and melasma (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.
Estrogen therapy can worsen endometriosis (uterine tissue growing outside the uterus). If you have ever had endometriosis, make sure the doctor is aware of it. If you have had a hysterectomy but still have residual endometriosis, your doctor may want you to use an estrogen/progesterone combination.
Certain studies have shown that women taking estrogen for prolonged periods of time (4 years or more) face an increased risk of breast cancer, and a study by the National Heart, Lung and Blood Institute (NHLBI) has confirmed an increased risk among women taking estrogen/progesterone combinations.
Use combination products (and estrogen-only preparations, too) with special caution if you have a family history of breast cancer or have ever had an abnormal mammogram. Be sure to get an annual breast exam from your doctor, and do your own self-examination each month.
Estrogens such as Generic Premair have been known to make certain conditions worse, including asthma, diabetes, epilepsy, migraine, porphyria (a genetic enzyme deficiency), lupus, and liver tumors.
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.
Estrogens increase the liver's 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.
Inform your doctor if you are taking any of the following:
- Rifampin (Rifadin), barbiturates, carbamazepine (Tegretol), griseofulvin (Grifulvin), phenytoin (Dilantin), St. John's wort and primidone all increase the elimination of estrogen by enhancing the liver's ability to eliminate estrogens.
Conversely, drugs such as erythromycin, ketoconazole (Nizoral), itraconazole (Sporanox), and ritonavir (Norvir) may reduce the elimination of estrogens by the liver as and lead to increased levels of estrogens in the blood.
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