- Vulvovaginal atrophy:
- Initially intravaginally 0.5-2g OD *2/52 OR PO 0.3-1.25mg OD *3/52, off *1/52, repeat
- Taper dose gradually to maintain dose
- Consider adding progestin for 10-14 days/4 week cycle if intact uterus
- Initially intravaginally 0.5-2g OD *2/52 OR PO 0.3-1.25mg OD *3/52, off *1/52, repeat
- Moderate-severe dyspareunia; treats symptoms of vulvar and vaginal atrophy due to menopause:
- 5g intravaginally twice/week OR 0.3-1.25mg*3/52, off 1 week, repeat OR
- Dosing is cyclic i.e. 4 weeks on, 1 week off
- Post-menopausal osteoporosis prevention:
- PO 0.3-0.625mg OD *3/52, off *1/52, repeat
- Consider adding progestin for 10-14 days/4 week cycle if intact uterus
- PO 0.3-0.625mg OD *3/52, off *1/52, repeat
- Hypoestrogenism associated with hypogonadism:
- PO 0.3-1.25mg OD *3/52, off *1/52, repeat
- Consider adding progestin for 10-14 days/4 week cycle if intact uterus
- Reasses treatment in 3-6 months
- PO 0.3-1.25mg OD *3/52, off *1/52, repeat
- Palliative treatment in metastatic breast cancer:
- PO 10mg TDS *3/12
- PO 10mg TDS *3/12
- Palliative treatment in advanced prostrate cancer:
- PO 12.5-2.5mg TDS
- PO 12.5-2.5mg TDS
- Fusion of labis in children (Off-label):
- >1 month: Apply BD for up to 6 weeks
- Cream:
- 0.625mg/g
- Tablet:
- 0.3mg
- 0.625mg
- 1.25mg
- In postmenopausal women with a uterus, a progestin should also be considered to reduce risk of endometrial cancer
- Women without a uterus do not need a progestin unless they have a history of endometriosis
- The plastic applicator is calibrated in 0.5g increments to a maximum of 2g
Estrogen derivative
It binds to estrogen receptors, developing and maintaining female sex characteristics and reproductive systems
- Vaginal bleeding
- Vaginal spotting
- Abdominal cramps
- Abdominal distension
- Nausea
- Vomiting
- Breast changes
- Breast pain
- Cervical secretion changes
- Headache
- Migraine
- Pain
- Asthenia
- Fluid retention
- Elevated BP
- Mood changes
- Vulvovaginal candidiasis
- Glucose intolerance
- Weight changes
- Libido changes
- Contact lens intolerance
- Vision changes
- Rash
- Melasma
- Chloasma
- Alopecia
- Hirsutism
- Acne
- Breast development (vaginal cream form in peds patients)
- Hypersensitivity to class/components
- Hepatic disease or impairment
- Undiagnosed vaginal bleeding
- Breast cancer or history
- Estrogen-dependent cancer or history
- Venous thromboembolism or history
- Arterial thromboembolism within 12 months
- Protein C deficiency
- Protein S deficiency
- Thrombophilic disorder
- Pregnancy
WARNING
- Using conjugated estrogens in combination with medroxyprogesterone increases risk of invasive breast cancer
- Estrogens with progestins increased risks of myocardial infarction (MI), stroke, invasive breast cancer, pulmonary embolism (PE) and deep vein thrombosis (DVT) in postmenopausal women
- Estrogens increase risk of endometrial cancer in a woman with a uterus who uses unopposed estrogens
None restricted
Drug Status
Availability | Prescription only |
Pregnancy | Category X |
Breastfeeding | Contraindicated |
Schedule | Not controlled |
BRAND NAME | STRENGTH | FORMULATION | PACK SIZE | MANUFACTURER | DISTRIBUTOR |
---|---|---|---|---|---|
Premarin | 0.3mg | Tablet | 28’s | Pfizer Labs | Pfizer Labs |
Premarin | 0.625mg | Tablet | 28’s | Pfizer Labs | Pfizer Labs |
Premarin | 1.25mg | Tablet | 28’s | Pfizer Labs | Pfizer Labs |
Premarin V | 0.625mg/g | Cream | 14g | Pfizer Labs | Pfizer Labs |