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Conjugated Estrogen

Premarin Vaginal Cream 14gm

TAH Drug Code EPRE1
Indications Atrophic vaginitis. Post-menopausal atrophic urethritis.
Dosing Intravaginally or topically, 0.5-2 g daily depending on severity of condition. the maximum dose: 4 g/day. Cyclic administration (3 weeks on and 1 week off) should be used.
Hepatic Impairment Dose adjustment not necessary
Renal Impairment Dose adjustment not necessary
Contraindications Known or suspected breast cancer, estrogen-dependent neoplasia, active thromboembolic disease, undiagnosed abnormal genital bleeding. Pregnancy.
Adverse Effects Rarely nausea, vomiting. Breakthrough bleeding, spotting, change in menstrual flow, amenorrhea. Breast tenderness, enlargement, secretion. GI effects, cholestatic jaundice. Chloasma or melasma. Steepening of the corneal curvature; intolerance to contact lenses. Headache, migraine, dizziness; chorea. Wt changes; edema; changes in libido. Cardiovascular: Edema, Vasodilatation (vaginal cream, 21 days on/7 off regimen, 3.5%; 2 times/wk regimen, 5% ) Dermatologic: Chloasma, Hirsutism, Injection site reaction, Pruritus (5% ) Endocrine metabolic: Weight change finding Gastrointestinal: Abdominal pain (vaginal cream, 21 days on/7 off regimen, 7.7%; 2 times/wk regimen, 6.4% ), Bloating symptom, Diarrhea (vaginal cream, 21 days on/7 off regimen, 2.8%; 2 times/wk regimen, 7.1% ), Flatulence (7% ), Nausea (oral, 9% ; vaginal cream, 21 days on/7 off regimen, 3.5%; 2 times/wk regimen, 2.1% ), Stomach cramps, Vomiting Musculoskeletal: Backache (vaginal cream, 21 days on/7 off regimen, 4.9%; 2 times/wk regimen, 9.3% ), Leg cramp Neurologic: Asthenia (vaginal cream, 21 days on/7 off regimen, 5.6%; 2 times/wk regimen, 1.4% ), Headache (vaginal cream, 21 days on/7 off regimen, 11.2%; 2 times/wk regimen, 17.9% ), Migraine Psychiatric: Depression, Disturbance in mood Reproductive: Disorder of menstruation, Pain of breast (oral, 12% ; vaginal cream, 21 days on/7 off regimen, 5.6%; 2 times/wk regimen, 2.9% ), Swelling of breast, Vaginitis (vaginal cream, 21 days on/7 off regimen, 5.6%; 2 times/wk regimen, 5% ), Withdrawal bleeding Respiratory: Increasing frequency of cough (vaginal cream, 21 days on/7 off regimen, 0%; 2 times/wk regimen, 5% ), Pharyngitis (vaginal cream, 21 days on/7 off regimen, 2.1%; 2 times/wk regimen, 5% ) Other: Accidental injury (vaginal cream, 21 days on/7 off regimen, 2.8%; 2 times/wk regimen, 6.4% ), Disorder of skin appendage (vaginal cream, 21 days on/7 off regimen, 8.4%; 2 times/wk regimen, 11.4% ), Infectious disease (vaginal cream, 21 days on/7 off regimen, 4.9%; 2 times/wk regimen, 11.4% ), Pain (vaginal cream, 21 days on/7 off regimen, 7%; 2 times/wk regimen, 2.9% )
Pregnancy Contraindicated
Lactation No (Limited) Human Data - Probably Compatible
More Info UpToDate