Conjugated
Estrogens (Premarin)
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Category:
Description:
Indications:
-
Menopausal
vasomotor symptoms (hot flashes, etc.)
-
Atrophic
vaginitis and kraurosis vulvae
-
Female
hypogonadism
-
Female
castration and primary ovarian failure
-
Breast
cancer (palliation only)
-
Prostatic
carcinoma
-
Osteoporosis
prophylaxis
-
Postpartum
breast engorgement
-
Abnormal
uterine bleeding due to hormonal imbalance
Contraindications:
-
Known
or suspected breast cancer (except those being treated for metastatic
disease)
-
Known
or suspected estrogen-dependent neoplasia
-
Known
or suspected pregnancy
-
Undiagnosed
abnormal genital bleeding
-
Current
or history of thrombophlebitis, thrombosis, thromboembolic disorders
(except when used in breast or prostatic cancer treatment).
Precautions:
-
Pregnancy
category X
-
Use
with caution in nursing mothers and patients with hypertension,
diabetes, asthma, epilepsy, migraine, cardiac or renal dysfunction,
history of depression, pre-existing uterine leiomyotoma, history of
jaundice during pregnancy, impaired liver function, metabolic bone
disorders and in young women (and men).
-
Take
with food to avoid GI side effects.
-
May
decrease glucose intolerance in diabetic patients.
-
Discontinue
therapy and contact health care provider if pregnancy is suspected.
Adverse
Reactions (Side Effects):
-
Rash,
acne, alopecia, hirsutism
-
Abnormal
menstrual bleeding, changes in cervical secretions
-
Edema,
weight change
-
Depression,
insomnia, somnolence
-
Nausea
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Dosage:
-
Administered
orally, vaginally and IV injection
-
Menopausal
vasomotor symptoms: 1.25mg per day
-
Atrophic
vaginitis and kraurosis vulvae: 0.3-1.25mg orally, intravaginally and
topically per day depending on tissue response
-
Female
hypogonadism: 2.5-7.5mg per day in divided doses for 20 days, then
rest for ten days, then repeat schedule until bleeding occurs
-
Female
castration and primary ovarian failure: 1.25mg per day cyclically,
adjusted to lowest dose for individual
-
Breast
cancer (palliation only): 10mg tid for at least three months
-
Prostatic
carcinoma: 1.25-2.5mg tid
-
Osteoporosis
prophylaxis: 1.25mg per day, cyclically
-
Postpartum
breast engorgement: 3.75mg q4h for 5 doses or 1.25mg q4h for 5 days
-
Abnormal
uterine bleeding due to hormonal imbalance: 25mg IM or IV injection,
repeat in 6-12 hours if needed
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Source:
Operational Medicine 2001, Health
Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau
of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington,
D.C., 20372-5300
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