Conjugated estrogens synthetic a (oral route)

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.

Cenestin® is not indicated for use in children.

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of Cenestin® in the elderly. However, elderly patients are more likely to have breast cancer, dementia, or stroke, which may require caution in patients receiving this medicine.

Studies suggest that this medication may alter milk production or composition. If an alternative to this medication is not prescribed, you should monitor the infant for side effects and adequate milk intake.

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 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.

• Cosyntropin
• Fosphenytoin
• Insulin Aspart, Recombinant
• Phenytoin

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.

• Levothyroxine

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. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

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 or unusual vaginal bleeding or
• Blood clots (eg, deep vein thrombosis, pulmonary embolism), active or history of or
• Breast cancer, known or suspected, or a history of or
• Heart attack, active or history of or
• Liver disease or
• Protein C, protein S, or other known blood clotting disorders or
• Stroke, active or history of or
• Surgery with a long period of inactivity or
• Tumors (estrogen-dependent), known or suspected—Should not be used in patients with these conditions.

• Asthma or
• Cancer, history of or
• Diabetes or
• Edema (fluid retention or body swelling) or
• Endometriosis or
• Epilepsy (seizures) or
• Gallbladder disease or
• Hereditary angioedema (swelling of the face, lips, tongue, or throat) or
• Hypercalcemia (high calcium in the blood) or
• Hypertension (high blood pressure) or
• Hypertriglyceridemia (high triglycerides or fats in the blood) or
• Hypocalcemia (low calcium in the blood) or
• Hypothyroidism (an underactive thyroid) or
• Jaundice during pregnancy or from using hormonal therapy in the past or
• Liver tumors or
• Migraine headache or
• Porphyria (an enzyme problem) or
• Systemic lupus erythematosus (SLE)—Use with caution. May make these conditions worse.

More common

• Bloating or swelling of the face, arms, hands, lower legs, or feet
• cough
• cramps
• difficulty with swallowing
• dizziness
• fast heartbeat
• heavy bleeding
• hives, itching, or skin rash
• itching of the vagina or genital area
• normal menstrual bleeding occurring earlier, possibly lasting longer than expected
• pain during sexual intercourse
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• rapid weight gain
• thick, white vaginal discharge with no odor or with a mild odor
• tightness in the chest
• tingling of the hands or feet
• unusual tiredness or weakness
• unusual weight gain or loss

Incidence not known

• Acid or sour stomach
• backache
• belching
• change in vaginal discharge
• clear or bloody discharge from the nipple
• confusion
• decrease in the amount of urine
• difficulty with speaking
• dimpling of the breast skin
• double vision
• headache
• heartburn
• inability to move the arms, legs, or facial muscles
• inability to speak
• indigestion
• inverted nipple
• loss of appetite
• lump in the breast or under the arm
• noisy, rattling breathing
• pain or feeling of pressure in the pelvis
• pain, redness, or swelling in the arm or leg
• persistent crusting or scaling of the nipple
• redness or swelling of the breast
• slow speech
• sore on the skin of the breast that does not heal
• stomach discomfort, upset, or pain
• swelling of the abdominal or stomach area
• swelling of the fingers, hands, feet, or lower legs
• troubled breathing at rest
• vaginal bleeding

More common

• Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
• excess air or gas in the stomach or intestines
• fear or nervousness
• heartburn
• increased clear or white vaginal discharge
• indigestion
• lack or loss of strength
• loss of bladder control
• nausea
• passing gas
• runny nose
• sneezing
• stuffy nose
• vomiting

Less common

• Back pain
• increased appetite

Incidence not known

• Breast pain, swelling, or tenderness
• discouragement
• enlarged breasts
• feeling sad or empty
• hair loss or thinning of the hair
• irritability
• lack of appetite
• loss of interest or pleasure
• sleepiness or unusual drowsiness
• tiredness
• trouble concentrating
• trouble sleeping