conjugated equine estrogens and medroxyprogesterone acetate, Prempro, Premphase (cont.)

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Medical Editor:

PRESCRIPTION: Yes

GENERIC AVAILABLE: No

PREPARATIONS:

  • Prempro: Tablets 0.3/1.5, 0.45/1.5, 0.625/2.5, and 0.625/5 (mg conjugated estrogen/mg medroxyprogesterone).
  • Premphase: Tablets, 28 day pack containing 14 tablets of 0.625 mg conjugated estrogens and 14 tablets of 0.625 mg/5 mg (conjugated estrogen/medroxyprogesterone).

STORAGE: Prempro and Premphase should be stored at room temperature between 15-30 C (59-86 F).

PRESCRIBED FOR: Prempro and Premphase are prescribed for women with a uterus who are experiencing hot flashes, vaginal dryness, vaginal atrophy, uterine bleeding and other symptoms associated with menopause. They also are approved for treating osteoporosis; however, other drugs usually are prescribed for this purpose.

DOSING: One tablet of Prempro should be taken daily. The lowest effective dose should be used. For either hot flashes or osteoporosis, patients are most often started at a dose of 0.3 mg/1.5 mg. For women with hot flashes, the dose is adjusted depending on the response of the hot flashes.

Patients should take one tablet of Premphase daily starting with the 0.625 mg conjugated estrogen tablets for 14 days (days 1 to 14) followed by one tablet daily of the 0.625/5 mg conjugated estrogen/medroxyprogesterone tablets for 14 days (days 14 to 28).

DRUG INTERACTIONS: Drugs such as St. John's Wort (Hypericum perforatum), phenobarbital, carbamazepine (Tegretol, Tegretol XR, Equetro, Carbatrol), and rifampin may increase break-down of estrogens in the liver, reducing blood levels of estrogens and possibly reducing the effect of estrogens. Erythromycin, clarithromycin (Biaxin, Biaxin XL), ketoconazole (Nizoral, Extina, Xolegel, Kuric), itraconazole (sporanox), ritonavir (Norvir) and grapefruit juice may reduce break-down of estrogens in the liver, increasing blood concentrations of estrogens and possibly increasing side effects of estrogens.



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