Description and Brand Names

Drug information provided by: Merative, Micromedex®

US Brand Name

  1. Premphase
  2. Prempro
  3. Prempro Low Dose

Descriptions


Conjugated estrogens and medroxyprogesterone acetate combination is used to treat moderate to severe hot flashes, dryness in and around the vagina, and other symptoms of menopause. This medicine is also used to prevent osteoporosis (thinning of the bones) after menopause.

This medicine is available only with your doctor's prescription.

This product is available in the following dosage forms:

  • Tablet

Before Using

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Conjugated estrogens and medroxyprogesterone acetate combination is not recommended for children.

Geriatric

Although appropriate studies on the relationship of age to the effects of conjugated estrogens and medroxyprogesterone combination have not been performed in the geriatric population, no geriatric-specific problems have been documented to date. However, elderly patients are more likely to have certain unwanted effects (eg, breast cancer, stroke, or dementia), which may require caution in patients receiving this medicine.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Tranexamic Acid

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Amifampridine
  • Apalutamide
  • Aprepitant
  • Armodafinil
  • Artemether
  • Belzutifan
  • Bexarotene
  • Bosentan
  • Bupropion
  • Carbamazepine
  • Cenobamate
  • Clobazam
  • Cosyntropin
  • Dabrafenib
  • Darunavir
  • Dexamethasone
  • Donepezil
  • Efavirenz
  • Elagolix
  • Elvitegravir
  • Enasidenib
  • Encorafenib
  • Enzalutamide
  • Eslicarbazepine Acetate
  • Etravirine
  • Fosaprepitant
  • Fosphenytoin
  • Griseofulvin
  • Isotretinoin
  • Ivosidenib
  • Lesinurad
  • Lorlatinib
  • Lumacaftor
  • Mavacamten
  • Meropenem
  • Mitapivat
  • Mitotane
  • Mobocertinib
  • Modafinil
  • Mycophenolic Acid
  • Nafcillin
  • Nevirapine
  • Oxcarbazepine
  • Phenobarbital
  • Phenylbutazone
  • Phenytoin
  • Pitolisant
  • Prednisone
  • Primidone
  • Red Clover
  • Repotrectinib
  • Rifabutin
  • Rifampin
  • Rifapentine
  • Ritonavir
  • Rufinamide
  • Secobarbital
  • St John's Wort
  • Sugammadex
  • Tazemetostat
  • Telaprevir
  • Theophylline
  • Topiramate
  • Ulipristal

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Etoricoxib
  • Ginseng
  • Levothyroxine
  • Licorice
  • Tipranavir

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

  • Caffeine

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Abnormal vaginal bleeding or
  • Antithrombin deficiency (blood clotting disorder) or
  • Blood clots, or history of or
  • Breast cancer, or history of or
  • Deep vein thrombosis (blood clot in the leg), or history of or
  • Heart attack, or history of or
  • Hysterectomy (removal of the uterus), history of or
  • Liver disease or
  • Protein C deficiency (blood clotting disorder) or
  • Protein S deficiency (blood clotting disorder) or
  • Pulmonary embolism (blood clot in the lung), or history of or
  • Stroke, or history of or
  • Tumor (estrogen-dependent)—Should not be used in patients with these conditions.
  • Asthma or
  • Congestive heart failure or
  • Diabetes or
  • Edema (fluid retention or body swelling) or
  • Epilepsy (seizures) or
  • Gallbladder disease or
  • Hereditary angioedema (swelling of the face, mouth, or throat) or
  • Hypertension (high blood pressure) or
  • Hypertriglyceridemia (high fats in the blood) or
  • Hypothyroidism (an underactive thyroid) or
  • Migraine headache or
  • Porphyria (an enzyme problem) or
  • Systemic lupus erythematosus (SLE)—Use with caution. May make these conditions worse.

Proper Use

It is very important that you use this medicine only as directed by your doctor. Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered. To do so may cause unwanted side effects.

This medicine comes with a patient information leaflet. Read and follow the instructions in the leaflet carefully. Ask your doctor if you have any questions.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For treatment of menopause symptoms and prevention of osteoporosis:
      • Adults—
        • Premphase®: One tablet once a day for 28 days, then repeat the cycle. The maroon colored tablet is taken on days 1 to 14, and the light blue tablet is taken on days 15 to 28.
        • Prempro®: One tablet once a day for 28 days, then repeat the cycle.
      • Children—Use is not recommended.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly and does not cause unwanted effects.

It is unlikely that a postmenopausal woman may become pregnant. But you should know that using this medicine while you are pregnant can harm your unborn baby. If you think you have become pregnant while using the medicine, tell your doctor right away.

Using this medicine may increase your risk of heart attack, stroke, blood clots, dementia, breast cancer, or uterine cancer. Talk with your doctor about these risks.

Your risk of heart disease or stroke from this medicine is higher if you smoke. Your risk is also increased if you have diabetes or high cholesterol, or if you are overweight. Talk with your doctor about ways to stop smoking. Keep your diabetes under control. Ask your doctor about diet and exercise to control your weight and blood cholesterol level.

Tell the medical doctor in charge that you are using this medicine before you have any kind of surgery. Your doctor will decide whether you should continue using this medicine.

Check with your doctor right away if a severe headache or a sudden loss of vision or any change in vision occurs while you are using this medicine. Your doctor may want you to have your eyes checked by an ophthalmologist (eye doctor).

Pancreatitis may occur while you are using this medicine. Check with your doctor right away if you have sudden and severe stomach pain, chills, constipation, nausea, vomiting, fever, or lightheadedness.

This medicine may cause serious types of allergic reactions, including anaphylaxis and angioedema. Anaphylaxis and angioedema can be life-threatening and require immediate medical attention. Call your doctor right away if you have a rash; itching; hoarseness; trouble breathing; trouble swallowing; or any swelling of your hands, face, mouth, or throat while you are using this medicine.

Before you have any medical tests, tell the medical doctor in charge that you are taking this medicine. The results of some tests may be affected by this medicine.

Do not eat grapefruit or drink grapefruit juice while you are using this medicine. Grapefruit and grapefruit juice may cause the amount of medicine in the blood to be too high.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (e.g., St. John's wort) or vitamin supplements.

Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common

  1. Bloating or swelling of the face, arms, hands, lower legs, or feet
  2. blood in the urine
  3. blurred vision
  4. chest pain
  5. clear or bloody discharge from the nipple
  6. cough or hoarseness
  7. dimpling of the breast skin
  8. dizziness
  9. fast, irregular, pounding, or racing heartbeat or pulse
  10. feeling faint, dizzy, or lightheaded
  11. feeling of warmth or heat
  12. fever or chills
  13. flushing or redness of the skin, especially on the face and neck
  14. headache
  15. inverted nipple
  16. lower back or side pain
  17. lump in the breast or under the arm
  18. nervousness
  19. pain during sexual intercourse
  20. painful or difficult urination
  21. persistent crusting or scaling of the nipple
  22. pounding in the ears
  23. redness or swelling of the breast
  24. severe cramping of the uterus
  25. sore on the skin of the breast that does not heal
  26. sweating
  27. thick, white vaginal discharge with no odor or with a mild odor
  28. tingling of the hands or feet
  29. unusual weight gain or loss
  30. vaginal bleeding that is unusual and heavy
  31. vaginal or genital itching
  32. vaginal yeast infection

Incidence not known

  1. Absent, missed, or irregular menstrual periods
  2. acid or sour stomach
  3. anxiety
  4. backache
  5. breast pain or tenderness
  6. confusion
  7. constipation
  8. darkened urine
  9. decreased vision or other changes in vision
  10. difficulty with speaking
  11. double vision
  12. fainting
  13. heartburn
  14. inability to move the arms, legs, or facial muscles
  15. inability to speak
  16. indigestion
  17. loss of appetite
  18. nausea
  19. pain or discomfort in the arms, jaw, back, or neck
  20. pain or feeling of pressure in the pelvis
  21. pain, redness, or swelling in the arm or leg
  22. painful or tender cysts in the breasts
  23. pains in the stomach, side, or abdomen, possibly radiating to the back
  24. slow speech
  25. sudden shortness of breath or troubled breathing
  26. unexpected or excess milk flow from the breasts
  27. vomiting
  28. yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  1. Back pain
  2. depression
  3. excess gas in the stomach or intestines
  4. lack or loss of strength

Less common

  1. Blemishes on the skin
  2. body aches or pain
  3. congestion
  4. depersonalization
  5. diarrhea
  6. difficulty with moving
  7. dry skin
  8. dryness of the vagina
  9. dysphoria
  10. euphoria
  11. excessive muscle tone
  12. feeling paranoid
  13. flu-like symptoms
  14. fullness or swelling of the breasts
  15. hair loss or thinning of the hair
  16. headache, severe and throbbing
  17. leg cramps
  18. loss of bladder control
  19. menstrual periods that are longer or heavier
  20. muscle pain or stiffness
  21. pain in the joints
  22. pain or tenderness around the eyes and cheekbones
  23. pimples or acne
  24. quick to react or overreact emotionally
  25. rapidly changing moods
  26. rash
  27. sleeplessness
  28. sore mouth or tongue
  29. stuffy or runny nose
  30. tender, swollen glands in the neck
  31. tightness of the chest or wheezing
  32. trouble with sleeping
  33. trouble with swallowing
  34. vaginal discharge that is clear or white
  35. voice changes
  36. white patches in the mouth or on the tongue

Incidence not known

  1. Changes in appetite
  2. hives or welts
  3. inability to have or keep an erection
  4. increased hair growth, especially on the face
  5. increased interest in sexual intercourse
  6. irritability
  7. loss in sexual ability, desire, drive, or performance
  8. loss of scalp hair
  9. pain in the ankles or knees
  10. painful, red lumps under the skin, mostly on the legs
  11. patchy brown or dark brown discoloration of the skin
  12. redness of the skin
  13. weight changes

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Portions of this document last updated: April 01, 2024

Original article: https://www.mayoclinic.org/drugs-supplements/conjugated-estrogens-and-medroxyprogesterone-oral-route/side-effects/DRG-20075469