Premarin Tablets (0.3mg, 0.625mg, & 1.25mg)

What is Premarin & what is it used for?

Premarin tablets are a form of hormone replacement therapy (HRT), used to treat symptoms of the menopause. Premarin contains conjugated oestrogens, which emulate the female sex hormone oestrogen.

Premarin tablets are available in 0.3mg, 0.625mg & 1.25mg strengths to suit the severity of your symptoms. Your doctor will tell you which strength you need to take depending on your symptoms and risks.

Premarin will provide relief from menopausal symptoms within a few weeks of daily use. As your body adjusts to Premarin, you may notice breakthrough bleeding or spotting. Talk to your GP if this continues after more than a few months of treatment. HRT should only be necessary as a relatively short-term treatment as your body adjusts to the menopause. You should review your HRT with your GP at least once each year and have regular gynaecological checkups.

HRT will not prevent pregnancy in women who are otherwise fertile. Women under 50 are considered fertile until two years after their final menstrual cycle (for women over 50, this is reduced to one year). Do not use a hormonal contraceptive while undergoing HRT.

What is the menopause?

During the menopause, the production of oestrogen in a woman’s ovaries gradually stops. This deficiency can lead to a number of symptoms that can have a significant impact on day-to-day life, including:

• hot flushes
• depression
• sleep problems
• dryness
• osteoporosis
• stopping the menstrual cycle

Experiences with menopausal symptoms vary significantly depending on the individual. They can begin multiple years prior to the menopause itself and remain for many years. Women will, on average, experience symptoms for about four years.

How does HRT work?

Hormone Replacement Therapy eases the symptoms of menopause by supplementing the levels of hormones that the body can produce naturally. Premarin tablets contain conjugated oestrogens, which are natural forms of oestrogen. If you have had a hysterectomy (an operation to remove the uterus), oestrogen is the only hormone you will be required to replace.

If you have not had your uterus removed, you will be prescribed a progestogen medicine alongside Premarin. This is because when oestrogen levels alone are increased, the lining of the uterus (the endometrium) will grow excessively. This will substantially increase your risk of complications such as endometrial cancer. If you have not had a hysterectomy, you may instead be prescribed another medicine that provides combined HRT.

Non-medicinal alternatives for the symptoms of menopause

For Night Sweats and Hot Flushes

• Using A fan
• Cool Showers
• Wearing light clothing

Vaginal Dryness

• Lubricants

Other Alternatives

• A healthy diet and regular exercise
• Stopping Smoking

Sources

• Premarin Tablets, Patient Information Leaflet: https://www.medicines.org.uk/e...
• https://www.nhs.uk/conditions/hormone-replacement-therapy-hrt/types/
• https://www.nhs.uk/conditions/blood-clots
• https://www.nhs.uk/conditions/stroke/symptoms/

Premarin warnings

Reading the following warnings carefully will help to ensure you are selecting an appropriate product.

Premarin is unsuitable for you if you:

• Have ever had breast cancer
• May have a cancer which is sensitive to oestrogen (including uterine cancer)
• Have untreated endometrial hyperplasia (an excessively thick womb lining)
• Suffer from a blood clotting disorder, or have ever had a blood clot
• Have recently had a heart attack or stroke
• Have a history of liver disease
• Suffer from porphyria (a rare hereditary blood disease)
• Are allergic to any of the ingredients in Premarin.

Inform your GP if you plan on taking Premarin and have ever had any of the following health complications:

• Fibroids
• Impaired liver function
• Uterine problems including endometriosis or endometrial hyperplasia
• Circulation problems (e.g. angina, heart attack)
• High risk of blood clots
• Kidney disease
• Diabetes
• Migraine
• Gallstones
• An autoimmune disorder
• Asthma
• Epilepsy
• Fluid retention
• High blood pressure
• Heart disease
• High fat levels in the blood
• Low calcium levels in the blood
• Otosclerosis (a hereditary ear disorder)
• A family history of breast cancer or another oestrogen-sensitive cancer.

Tell your GP or pharmacist if you have taken or plan to take any of the following medicines:

• Epilepsy medicines (e.g. phenytoin, carbamazepine)
• Tuberculosis medicines (e.g. rifampicin)
• HIV medicines (e.g. nevirapine, ritonavir, nelfinavir)
• Certain antibiotics
• Antifungal medicines (e.g. ketoconazole)
• St John’s Wort
• Metyrapone
• Cimetidine
• Dexamethasone.

Avoid drinking grapefruit juice as it may impact the effectiveness of Premarin.

As your body adjusts to Premarin, you may notice breakthrough bleeding or spotting. Talk to your GP if this continues after more than a few months of treatment.

If you have not had your uterus removed, you will be prescribed a progestogen medicine alongside Premarin. This is because when oestrogen levels alone are increased, the lining of the uterus (the endometrium) will grow excessively. This will substantially increase your risk of complications such as endometrial cancer.

HRT may increase your risk of breast cancer. The extent of this risk will vary depending on the length of your HRT treatment and whether you are taking combined or oestrogen-only HRT. Check your breasts regularly for changes to the skin or nipple, or for any noticeable lump. For women who use HRT for more than five years, there may also be a slight increase in the risk of ovarian cancer.

Stop taking Premarin and seek medical attention immediately if you notice early signs of any of the following:

• Blood clots – pain and swelling of the legs, difficulty breathing
• Stroke – sudden migraines, blurred vision
• Heart disease – chest pain which extends to the neck or arm
• Liver disease – yellow colouration of the skin or eyes.

Discuss with your doctor whether the personal benefits of HRT outweigh the risks mentioned above.

Please read all packaging and the Product Information Leaflet before taking any new medicine and inform your doctor of medicines you are taking or intend to take.

Premarin directions

Premarin should be taken at a similar time each day, according to the directions on the pack. Swallow the tablet whole with a sip of water. This can be done with or without food.

HRT should only be necessary as a relatively short-term treatment as your body adjusts to the menopause. You should review your HRT with your GP at least once each year and have regular gynaecological checkups.

If, for any reason, you forget to take a tablet, take it as soon as possible. However, if it is almost time for your next tablet, skip the dose that you missed. Never double your dose to compensate for a dose that you have missed.

Premarin ingredients

The active ingredients contained in Premarin are conjugated oestrogens.

Premarin also contains the following inactive ingredients to make up the complete product: Lactose monohydrate, microcrystalline cellulose, magnesium stearate, sucrose, hypromellose, hydroxylpropyl cellulose, macrogol, carnauba wax, titanium dioxide (E171)

The edible ink contains propylene glycol and either titanium dioxide (E171) or iron oxide black (E172).

The green tablets also contain quinolone yellow (E104), indigo carmine (E132) and polysorbate 80.

The maroon tablets also contain red aluminium lake (E129) and indigo carmine (E132).

The yellow tablets also contain quinolone yellow (E104), sunset yellow (E110) and polysorbate 80.

Premarin side effects

Not everyone will experience side effects when they take Premarin, however if you do they may include:

• breakthrough bleeding
• thrush
• migraine
• vaginal discharge
• mood swings
• dizziness
• change in libido
• change in weight
• leg cramps
• breast pain or tenderness
• joint pain

If you are concerned about these effects, or if the product affects you in any other way, stop using it and talk to your doctor or pharmacist.