Conjugated estrogens

Conjugated estrogens
(Oestrogens & Progesterones & Related Synthetic Drugs)

Dosage form	Brand	Strength
Tablet	Premarin®	0.625mg ,0.3 mg

Indication : Estrogen deficiency women without a uterus, Menopause, Vulvar atrophy, Osteoporosis.

Mechanism of action : Estrogens modulate pituitary secretion of gonadotropins, leutinising hormones and follicle-stimulating hormones through -ve feedback mechanism, thus reducing elevated levels of hormones in postmenopausal women during estrogen replacement therapy.

Pregnancy Category X

Contraindication : Genital or uterine bleeding, thrombophlebitis, neoplasia.

Precautions: Asthma, epilepsy, migraine; heart or kidney dysfunction; CV disease; cerebrovascular disorders; diabetes, hypercalcaemia; gall bladder disease; porphyria. Childn. Lactation

Drug Interaction : Bromocriptine, Ca²⁺ supplement ,Corticosteroids, glucocorticoid

Side Effect : Breasts pain, wt gain, fluid retention; headache, depression.  Males: Gynecomastia, impotence.

Monitoring parameters : BP, Bone age, Breast examination, Endometrial evaluation, Lipid profile.

Usual Dose :         - Osteoporosis 0.625 mg a day.       

- Primary ovarian failure oral 1.25 mg a day.

                                - Vulvaratrophy 0.3-1.25 mg a day.

Patient Education : Carcinogenicity : increase risk of endometrial cancer for patients with intact uteri placed on unopposed estrogen therapy.