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Conjugated Estrogens Medroxyprogesterone Brand Names
Premphase | Prempro
What is Conjugated Estrogens Medroxyprogesterone
Conjugated estrogens and medroxyprogesterone are used together in an oral preparation to treat vasomotor and genitourinary symptoms associated with menopause, and for the prevention of osteoporosis.
Conjugated estrogens are a mixture of the water soluble sodium salts of sulfate esters from estrone, equilin, and 17 alpha-dihydroequilin; other related steroids are also present.
The mixture is traditionally derived from pregnant equine urine.
The exact composition of the mixture is uncertain; and precisely how each of these various estrogens contribute to the drug’s overall effectiveness is not known.
Conjugated estrogens may also be synthesized from estrone and equilin, but the composition of the mixtures may not be equivalent to the naturally occurring sources.
However, there is no evidence that ‘natural’ estrogens are more or less efficacious or safe than synthetic estrogens.
Medroxyprogesterone is a synthetic progestin that is 15 times more potent than progesterone; the addition of medroxyprogesterone reduces the risk for endometrial hyperplasia.
Oral combination conjugated estrogens-medroxyprogesterone products can enhance patient compliance with hormone replacement therapy (HRT) in women with an intact uterus.
These products were first FDA-approved in November 1995
Indications
- atrophic vaginitis
- dyspareunia
- hot flashes
- menopause
- osteoporosis prophylaxis
For treatment of moderate to severe vasomotor symptoms (hot flashes) associated with menopause and/or related genitourinary symptoms including atrophic vaginitis, vulvar atrophy (kraurosis vulvae), or dyspareunia in women with an intact uterus
Side Effects
- abdominal pain
- acne vulgaris
- alopecia
- amenorrhea
- anaphylactoid reactions
- angioedema
- anxiety
- arthralgia
- biliary obstruction
- bowel ischemia
- breakthrough bleeding
- breast cancer
- breast discharge
- breast enlargement
- candidiasis
- cervicitis
- cholecystitis
- cholelithiasis
- cholestasis
- colitis
- cystitis
- dementia
- depression
- diarrhea
- diplopia
- dizziness
- dysmenorrhea
- dyspepsia
- edema
- elevated hepatic enzymes
- emotional lability
- endometrial cancer
- endometrial hyperplasia
- erythema multiforme
- erythema nodosum
- fatigue
- flatulence
- fluid retention
- galactorrhea
- gynecomastia
- headache
- hepatitis
- hirsutism
- hypercalcemia
- hyperglycemia
- hypertension
- hypocalcemia
- impaired cognition
- insomnia
- jaundice
- leukorrhea
- libido decrease
- libido increase
- mastalgia
- melasma
- migraine
- muscle cramps
- myocardial infarction
- nausea
- new primary malignancy
- ovarian cancer
- pancreatitis
- papilledema
- peliosis hepatis
- pelvic pain
- peripheral edema
- pruritus
- pulmonary embolism
- rash
- retinal thrombosis
- stroke
- teratogenesis
- thromboembolism
- thrombosis
- urinary incontinence
- urticaria
- vaginal bleeding
- vaginal discharge
- vaginitis
- visual impairment
- vomiting
- weight gain
Monitoring Parameters
- pap smear
- pelvic exam
Contraindications
- asthma
- breast cancer
- breast-feeding
- cardiac disease
- cerebrovascular disease
- cervical cancer
- children
- contact lenses
- coronary artery disease
- dementia
- depression
- diabetes mellitus
- endometrial cancer
- endometrial hyperplasia
- endometriosis
- gallbladder disease
- geriatric
- hepatic disease
- hepatocellular cancer
- hereditary angioedema
- history of angioedema
- hypercalcemia
- hypercholesterolemia
- hypertension
- hypertriglyceridemia
- hypocalcemia
- hypoparathyroidism
- hypothyroidism
- infants
- jaundice
- migraine
- myocardial infarction
- new primary malignancy
- obesity
- ovarian cancer
- pancreatitis
- porphyria
- pregnancy
- protein C deficiency
- protein S deficiency
- renal disease
- seizure disorder
- stroke
- surgery
- systemic lupus erythematosus (SLE)
- thromboembolic disease
- thromboembolism
- thrombophlebitis
- thyroid disease
- tobacco smoking
- uterine cancer
- uterine leiomyomata
- vaginal bleeding
- vaginal cancer
- visual disturbance
Interactions
- Acarbose
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Propoxyphene
- Acetohexamide
- Acitretin
- Albiglutide
- Alogliptin
- Alogliptin; Metformin
- Alogliptin; Pioglitazone
- Alpha-glucosidase Inhibitors
- Amiodarone
- Amobarbital
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Amprenavir
- Anastrozole
- Apalutamide
- Aprepitant, Fosaprepitant
- Armodafinil
- Artemether; Lumefantrine
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Atazanavir
- Atazanavir; Cobicistat
- Atracurium
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Azelastine; Fluticasone
- Barbiturates
- Beclomethasone
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Betamethasone
- Bexarotene
- Bosentan
- Brigatinib
- Bromocriptine
- Budesonide
- Budesonide; Formoterol
- Butabarbital
- Calcium
- Canagliflozin
- Canagliflozin; Metformin
- Carbamazepine
- Cenobamate
- Ceritinib
- Chenodiol
- Chloramphenicol
- Chlorpropamide
- Ciclesonide
- Cimetidine
- Cisatracurium
- Clarithromycin
- Clobazam
- Cobicistat
- Conivaptan
- Corticosteroids
- Corticotropin, ACTH
- Cortisone
- Cosyntropin
- Cyclosporine
- Dalfopristin; Quinupristin
- Danazol
- Dantrolene
- Dapagliflozin
- Dapagliflozin; Metformin
- Dapagliflozin; Saxagliptin
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Deflazacort
- Delavirdine
- Dexamethasone
- Diltiazem
- Dipeptidyl Peptidase-4 Inhibitors
- Doxacurium
- Dulaglutide
- Duloxetine
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elbasvir; Grazoprevir
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Empagliflozin
- Empagliflozin; Linagliptin
- Empagliflozin; Linagliptin; Metformin
- Empagliflozin; Metformin
- Enzalutamide
- Ertugliflozin
- Ertugliflozin; Metformin
- Ertugliflozin; Sitagliptin
- Erythromycin
- Erythromycin; Sulfisoxazole
- Exemestane
- Exenatide
- Fedratinib
- Felbamate
- Fludrocortisone
- Flunisolide
- Fluoxetine
- Fluoxetine; Olanzapine
- Fluticasone
- Fluticasone; Salmeterol
- Fluticasone; Umeclidinium; Vilanterol
- Fluticasone; Vilanterol
- Fluvoxamine
- Formoterol; Mometasone
- Fosamprenavir
- Glimepiride
- Glimepiride; Pioglitazone
- Glimepiride; Rosiglitazone
- Glipizide
- Glipizide; Metformin
- Glyburide
- Glyburide; Metformin
- grapefruit juice
- Griseofulvin
- Hemin
- Hyaluronidase
- Hyaluronidase, Recombinant; Immune Globulin
- Hydantoins
- Hydralazine
- Hydralazine; Hydrochlorothiazide, HCTZ
- Hydralazine; Isosorbide Dinitrate, ISDN
- Hydrocortisone
- Icosapent ethyl
- Idelalisib
- Imatinib
- Incretin Mimetics
- Indinavir
- Insulin Degludec; Liraglutide
- Insulin Glargine; Lixisenatide
- Insulins
- Isotretinoin
- Itraconazole
- Ivosidenib
- Ketoconazole
- Lefamulin
- Lenalidomide
- Lesinurad
- Lesinurad; Allopurinol
- Letermovir
- Letrozole
- Levothyroxine
- Levothyroxine; Liothyronine (Porcine)
- Levothyroxine; Liothyronine (Synthetic)
- Linagliptin
- Linagliptin; Metformin
- Liothyronine
- Liraglutide
- Lixisenatide
- Lopinavir; Ritonavir
- Lorlatinib
- Lumacaftor; Ivacaftor
- Meglitinides
- Mephobarbital
- Metformin
- Metformin; Pioglitazone
- Metformin; Repaglinide
- Metformin; Rosiglitazone
- Metformin; Saxagliptin
- Metformin; Sitagliptin
- Methohexital
- Methylprednisolone
- Metreleptin
- Metyrapone
- Mifepristone
- Miglitol
- Mineral Oil
- Minoxidil
- Mitotane
- Mivacurium
- Modafinil
- Mometasone
- Nefazodone
- Nelfinavir
- Neuromuscular blockers
- Nevirapine
- Nitroprusside
- Ombitasvir; Paritaprevir; Ritonavir
- Ospemifene
- Oxcarbazepine
- Pancuronium
- Pegvaliase
- Pentobarbital
- Phenobarbital
- Phentermine; Topiramate
- Posaconazole
- Pramlintide
- Prasterone, Dehydroepiandrosterone, DHEA (Dietary Supplements)
- Prasterone, Dehydroepiandrosterone, DHEA (FDA-approved)
- Prednisolone
- Prednisone
- Primidone
- Propoxyphene
- Raloxifene
- Rapacuronium
- Ribociclib
- Ribociclib; Letrozole
- Rifamycins
- Ritonavir
- Rituximab; Hyaluronidase
- Rocuronium
- Ropinirole
- Saquinavir
- Saxagliptin
- Secobarbital
- Semaglutide
- SGLT2 Inhibitors
- Simvastatin; Sitagliptin
- Sitagliptin
- Somatropin, rh-GH
- St. John’s Wort, Hypericum perforatum
- Streptogramins
- Succinylcholine
- Sugammadex
- Sulfonylureas
- Tacrine
- Tamoxifen
- Tazemetostat
- Telaprevir
- Telithromycin
- Telotristat Ethyl
- Testolactone
- Thiazolidinediones
- Thiopental
- Thyroid hormones
- Tipranavir
- Tolazamide
- Tolbutamide
- Topiramate
- Toremifene
- Trandolapril; Verapamil
- Tranexamic Acid
- Trastuzumab; Hyaluronidase
- Triamcinolone
- Tricyclic antidepressants
- Tubocurarine
- Ulipristal
- Ursodeoxycholic Acid, Ursodiol
- Valproic Acid, Divalproex Sodium
- Vecuronium
- Verapamil
- Voriconazole
- Warfarin
- Zafirlukast
