estrogens conjugated, Premarin (cont.)

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Medical and Pharmacy Editor:

Conversely, drugs such as erythromycin, ketoconazole (Nizoral), itraconazole (Sporanox), and ritonavir (Norvir) may reduce the elimination of estrogens by the liver and lead to increased levels of estrogens in the blood.

Grapefruit juice also may increase levels of estrogen by increasing the absorption of estrogens from the intestine. Increased levels of estrogens in the blood may result in more estrogen-related side effects.

PREGNANCY: Estrogens should not be given to pregnant women due to the risk of harm to the fetus.

NURSING MOTHERS: Estrogens are secreted in breast milk and may cause unpredictable effects in the infant. Estrogens may also reduce the quality of breast milk. They should not be taken by women who are breastfeeding.

SIDE EFFECTS: Common side effects of conjugated estrogens include headache, abdominal pain, nervousness, nausea, back pain, joint pain and vaginal bleeding. Patients also may experience vaginal spotting, loss of periods or excessively prolonged periods, breast pain, breast enlargement and an increase or decrease in sexual drive.

Effects of estrogen on the skin include rash, and melasma (tan or brown patches) that may develop on the forehead, cheeks, or temples and may persist even after estrogens are stopped.

In the eyes, conjugated estrogens may cause an increase in the curvature of the cornea, and, as a result, patients with contact lenses may develop intolerance to their lenses.



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