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Premarin, Conjugated Estrogens


Premarin (conjugated estrogens tablets) contains a mixture of conjugated estrogens obtained exclusively from natural sources, occurring as the sodium salts of water-soluble estrogen sulfates blended to represent the average composition of material derived from pregnant maresÕ urine.


synthetic estrogens


atrophic vaginitis, breast carcinoma, dysfunctional uterine bleeding, hot flashes, hypogonadism, menopausal symptoms, oophorectomy, osteoporosis, ovarian failure, prostate carcinoma, vulvar squamous hyperplasia,

Side Effects

bleeding, edema, endometrial carcinoma, gynecomastia, headache, hypertension, libido decrease, libido increase, pancreatitis, peripheral edema (swelling of feet and lower legs), rapid weight gain
Menstrual irregularities: amenorrhea, breakthrough bleeding (heavier vaginal bleeding between regular menses), menorrhagia (prolonged or heavier menses), spotting (lighter vaginal bleeding between regular menses)
Breast symptoms: mastalgia (breast pain or tenderness), breast enlargement (gynecomastia), breast tumors (breast lumps), breast discharge, breast carcinoma
Skin symptoms: acne vulgaris, skin irritation and redness (with transdermal system), erythema nodosum, melasma
Abdominal symptoms: abdominal pain, abdominal cramping or bloating, anorexia (loss of appetite), nausea, nausea/vomiting, diarrhea
Liver and gallblader symptoms: cholecystitis, cholelithiasis (gallstones), elevated hepatic enzymes, hepatitis, hepatoma
Eye symptoms: intolerance to contact lenses, keratoconus (conical protrusion of the cornea)
Thromboembolism or thrombus formation: severe or sudden headache; sudden loss of coordination; pains in chest, groin, or leg, especially calf; sudden and unexplained shortness of breath; sudden slurred speech; sudden vision changes; weakness or numbness in arm or leg.

Drug-Vitamin-Herb Interactions

Negative interactions:

Androstenedione increases estrogen levels, which may increase the adverse effects of estrogen therapy.

Boron may increase estrogen levels, which may increase the adverse effects of estrogen therapy.

Dong quai
Dong quai contains beta-sitosterol, a phytoestrogen, which may increase the adverse effects of estrogen therapy. Studies, however, do not support this.

Grapefruit juice
Grapefruit juice slows breakdown of estrogen.

Mixed interactions:

Ipriflavone protects bone, but may increase estrogen effect on the uterus.

Positive interactions:

Calcium and Vitamin D
Calcium and Vitamin D aid in bone growth.

Magnesium metabolism is enhanced by estrogen, which may result in a deficiency.




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