Conjugated Estrogens Medroxyprogesterone

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

  1. atrophic vaginitis
  2. dyspareunia
  3. hot flashes
  4. menopause
  5. 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

  1. abdominal pain
  2. acne vulgaris
  3. alopecia
  4. amenorrhea
  5. anaphylactoid reactions
  6. angioedema
  7. anxiety
  8. arthralgia
  9. biliary obstruction
  10. bowel ischemia
  11. breakthrough bleeding
  12. breast cancer
  13. breast discharge
  14. breast enlargement
  15. candidiasis
  16. cervicitis
  17. cholecystitis
  18. cholelithiasis
  19. cholestasis
  20. colitis
  21. cystitis
  22. dementia
  23. depression
  24. diarrhea
  25. diplopia
  26. dizziness
  27. dysmenorrhea
  28. dyspepsia
  29. edema
  30. elevated hepatic enzymes
  31. emotional lability
  32. endometrial cancer
  33. endometrial hyperplasia
  34. erythema multiforme
  35. erythema nodosum
  36. fatigue
  37. flatulence
  38. fluid retention
  39. galactorrhea
  40. gynecomastia
  41. headache
  42. hepatitis
  43. hirsutism
  44. hypercalcemia
  45. hyperglycemia
  46. hypertension
  47. hypocalcemia
  48. impaired cognition
  49. insomnia
  50. jaundice
  51. leukorrhea
  52. libido decrease
  53. libido increase
  54. mastalgia
  55. melasma
  56. migraine
  57. muscle cramps
  58. myocardial infarction
  59. nausea
  60. new primary malignancy
  61. ovarian cancer
  62. pancreatitis
  63. papilledema
  64. peliosis hepatis
  65. pelvic pain
  66. peripheral edema
  67. pruritus
  68. pulmonary embolism
  69. rash
  70. retinal thrombosis
  71. stroke
  72. teratogenesis
  73. thromboembolism
  74. thrombosis
  75. urinary incontinence
  76. urticaria
  77. vaginal bleeding
  78. vaginal discharge
  79. vaginitis
  80. visual impairment
  81. vomiting
  82. 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
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