PREMPRO

Who is Prempro for ?

The combination of conjugated estrogens and medroxyprogesterone is a hormone medication used to treat certain symptoms of menopause in women who have not had surgical removal of the uterus (a hysterectomy). It works by replacing estrogen hormone that is no longer being made by the body. this medication reduces feelings of warmth in the upper body and periods of sweating and heat (hot flashes), vaginal symptoms (itching, burning, and dryness) and difficulty with urination but does not help with the other symptoms of menopause, such as nervousness or depression. This medication also prevents thinning of the bones (osteoporosis) in menopausal women. this medication is sometimes prescribed for other uses; ask your doctor or pharmacist for information.

Conjugated estrogens and medroxyprogesterone is a form of hormone replacement therapy (HRT). It contains an estrogen hormone and a progesterone hormone and is often used to treat symptoms of menopause. During menopause, a woman's levels of estrogen and progesterone are diminished, and thus taking HRT can replace her own hormones and help relieve symptoms of menopause. Exogenous (meaning coming from outside the body) hormones work in the same way that endogenous (produced inside the body) hormones do.

When should I be careful taking Prempro ?

• Estrogens with progestins should not be used for the prevention of cardiovascular disease.
• Estrogens with progestins should be prescribed at the lowest effective doses and for the shortest duration consistent with treatment goals and risks for the individual woman.
• For use in the treatment of moderate to severe symptoms of vulvar and vaginal atrophy associated with the menopause, topical vaginal products should be considered (e.g. Premarin cream, Estrace, Vagifem).
• For use in the prevention of postmenopausal osteoporosis, therapy should only be considered for women at significant risk of osteoporosis and non-estrogen medications should be carefully considered.

Do not take estrogens if you are pregnant or breast-feeding. If you become pregnant, call your doctor immediately. Discuss with your doctor the risks associated with the use of estrogens and the development of endometrial cancer. Progesterone-like drugs (medroxyprogesterone) have been used to prevent miscarriage in the first few months of pregnancy. No adequate evidence is available to show that they are effective for this purpose. Therefore, the use of medroxyprogesterone during the first 4 months of pregnancy is not recommended.

Before taking conjugated estrogens and medroxyprogesterone,

• ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.
• tell your doctor and pharmacist if you are allergic to estrogen, medroxyprogesterone, tartrazine (a yellow dye in some processed foods and drugs), or any other drugs.
• tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially anticoagulants ("blood thinners") such as warfarin (Coumadin), carbamazepine (Tegretol), phenobarbital, phenylbutazone, phenytoin (Dilantin), primidone (Mysoline), and rifampin; and any other antibiotics or anti-infectives, steroids (Decadron, Medrol, Prednisone), and vitamins.
• tell your doctor if you have or have ever had breast lumps or cancer; high blood pressure; high blood levels of cholesterol or fats; diabetes; asthma; a history of stroke, blood clots, toxemia (high blood pressure during pregnancy), a history of depression or heart attack; epilepsy (seizures); migraine headaches; liver, heart, gallbladder, or kidney disease; jaundice (yellowing of the skin or eyes); genital bleeding; and excessive weight gain and fluid retention (bloating) during the menstrual cycle.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking this medication, call your doctor immediately.
• if you are having surgery, including dental surgery, tell the doctor or dentist you are taking conjugated estrogens and medroxyprogesterone.
• tell your doctor if you smoke cigarettes. Smoking while taking this medication may increase your risk of cardiovascular side effects such as blood clots and stroke. Smoking also may decrease the effectiveness of this medication.
• tell your doctor and pharmacist if you wear contact lenses.

Side Effects

Although side effects from conjugated estrogens and medroxyprogesterone are not common, they can occur. Tell your doctor if any of these symptoms are severe or do not go away:

• upset stomach
• stomach cramps
• bloating
• diarrhea
• appetite and weight changes
• increased blood pressure
• glucose intolerance (increased blood sugar)
• brown or black skin patches
• acne
• swelling of hands, feet, or lower legs (fluid retention or edema)
• bleeding or spotting between menstrual periods
• changes in menstrual flow
• painful or missed periods
• breast tenderness, enlargement, or discharge
• intolerance to contact lenses

If you experience any of the following symptoms, call your doctor immediately:

• sudden, severe headache
• sudden, severe vomiting
• sudden partial or complete loss of vision
• speech problems
• dizziness or faintness
• weakness or numbness of an arm or leg
• crushing chest pain or chest heaviness
• coughing up blood
• sudden shortness of breath
• calf pain
• severe abdominal pain
• yellowing of the skin or eyes
• severe mental depression
• unusual bleeding
• loss of appetite
• rash