Chemical Name: CONJUGATED ESTROGENS (ESS-troe-jenz) and MEDROXYPROGESTERONE (me-DROX-ee-proe-JESS-te-rone)
This medicine is a combination of hormones (estrogen and progestin) used to treat menopausal symptoms (e.g., hot flashes, vaginal dryness). It is also used to prevent bone loss (osteoporosis) in people at high risk. If you are only being treated for vaginal menopause symptoms, products applied locally such as vaginal creams, tablets, or rings should be considered before products taken by mouth or absorbed through the skin. There are several medicines (e.g. raloxifene or bisphosphonates) that are safe and effective to prevent or treat bone loss. These medicines should be considered for use before estrogen/progestin HRT for osteoporosis. If you have other medical conditions as well and are prescribed estrogen/progestin HRT for more than one condition, consult your doctor about your treatment plan and its options.
WARNING: Combination hormone replacement therapy (estrogen and progestin HRT) should not be used to treat heart disease. Estrogen and progestin taken together can increase the risk of heart disease (including heart attack), stroke, dementia, serious blood clots in the lung (pulmonary embolism) or leg (deep venous thrombosis), or cancer of the breast. It is not known whether estrogen alone increases dementia risk. Estrogen may also increase the risk of cancer of the ovary and the womb (endometrial cancer). These risks appear to depend on the length of time this combination is used and the amount of estrogen per dose. Therefore, two-drug HRT should be used for the shortest possible length of time at the lowest effective dose, so you obtain the benefits and minimize the chance of serious side effects from long-term treatment. Discuss the risks and benefits with your doctor. If you use this medicine for an extended period, you should be evaluated at least once a year (see CAUTIONS section). INFORM YOUR DOCTOR OR PHARMACIST of all prescription and over-the-counter medicine that you are taking. ADDITIONAL MONITORING OF YOUR DOSE OR CONDITION may be needed if you are also taking aminoglutethimide, corticosteroids (e.g., prednisone), hydantoins (e.g., phenytoin), warfarin, drugs which affect certain liver enzymes (CYP450-3A4 enzymes) such as azole antifungals (e.g., ketoconazole, itraconazole), carbamazepine, macrolide antibiotics (e.g., clarithromycin, erythromycin), phenobarbital, rifamycins, (e.g., rifampin), ritonavir, cimetidine, or St. John's wort. DO NOT START OR STOP any medicine without doctor or pharmacist approval. Inform your doctor of any other medical conditions including a family medical history (especially for breast lumps or cancer), asthma, diabetes, seizures, migraine headaches, heart disease (e.g., high blood pressure, heart attacks, congestive heart failure), kidney disease, low thyroid hormone (hypothyroidism), abnormal calcium level in the blood, depression, high blood pressure during pregnancy (toxemia), yellowing of the eyes and skin (cholestatic jaundice) during pregnancy or with past estrogen use, womb problems (e.g., uterine fibroids, endometriosis), cholesterol or lipid problems, gallbladder disease, excessive weight gain, certain blood disorders (porphyria), allergies, pregnancy, or breast-feeding. USE OF THIS MEDICINE IS NOT RECOMMENDED if you have undiagnosed abnormal vaginal bleeding, cancer (e.g., of the breast or ovary), blood clots, active/recent stroke or heart attack, or liver disease. Contact your doctor or pharmacist if you have any questions or concerns about taking this medicine.
Follow the directions for using this medicine provided by your doctor. THIS MEDICINE COMES with a patient information leaflet. Read it carefully. Ask your doctor, nurse, or pharmacist any questions that you may have before using this medicine. This medicine is usually taken once daily. This medicine may be taken with food or immediately after a meal to prevent stomach upset. TRY TO TAKE THIS MEDICINE at the same time every day. STORE THIS MEDICINE at room temperature between 68 and 77 degrees F (20 and 25 degrees C), away from heat, moisture, and light. Brief storage between 59 and 86 degrees F (15 and 30 degrees C) is permitted. IF YOU MISS A DOSE OF THIS MEDICINE, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. DO NOT take 2 doses at once.
KEEP ALL DOCTOR AND LABORATORY APPOINTMENTS while you are using this medicine. You should have a complete physical examination, including blood pressure measurements, breast and pelvic examinations, and a PAP test (for vaginal cancer), at least once a year. You should also have periodic mammograms as determined by your doctor. Follow your doctor's instructions for examining your own breasts, and report any lumps immediately. DO NOT INCREASE YOUR DOSE, take this medicine more often than prescribed, or stop taking this medicine without checking with your doctor. BEFORE YOU HAVE SURGERY, or will be confined to a chair or bed for a long period of time (e.g., a long plane flight), tell the doctor that you are using this medicine. Special precautions may need to be taken in these circumstances while you are taking this medicine. THIS MEDICINE MAY AFFECT CERTAIN LAB TEST RESULTS. Make sure your doctors and laboratory personnel know you are using this medicine. THIS MEDICINE MAY CAUSE DIZZINESS. DO NOT DRIVE, OPERATE MACHINERY, OR DO ANYTHING ELSE THAT COULD BE DANGEROUS until you know how you react to this medicine. Limit alcoholic beverages. THIS MEDICINE MAY CAUSE dark skin patches on your face (melasma). Exposure to the sun may make these patches darker. If patches develop, consult your doctor about the use of sunscreen or protective clothing when exposed to the sun, sunlamps, or tanning booths. SMOKING WHILE USING THIS MEDICINE may increase your risk of blood clots (especially in women over the age of 35). DO NOT USE THIS MEDICINE if you are pregnant. IF YOU SUSPECT THAT YOU COULD BE PREGNANT, contact your doctor immediately. IT IS UNKNOWN IF THIS MEDICINE IS EXCRETED IN BREAST MILK. DO NOT BREAST-FEED while using this medicine.
Possible side effects
SIDE EFFECTS that may go away during treatment, include dizziness, lightheadedness, headache, stomach upset, bloating, irritability, changes in sleep patterns, fatigue, nausea, weight changes, increased or decreased interest in sex, or breast tenderness. If they continue or are bothersome, check with your doctor. CHECK WITH YOUR DOCTOR IMMEDIATELY if you experience mental or mood changes (e.g., severe depression, memory loss); calf pain or swelling; sudden severe headache; chest pain; trouble breathing; one-sided weakness; slurred speech; vision changes (e.g., change in contact lens fit, loss of vision); breast lumps; swelling of hands and feet; changes in vaginal bleeding (e.g., spotting, breakthrough bleeding, or prolonged bleeding); unusual vaginal discharge, itching, or odor; or yellowing of eyes or skin. AN ALLERGIC REACTION to this medicine is unlikely, but seek immediate medical attention if it occurs. Symptoms of an allergic reaction include rash, itching, swelling, severe dizziness, or trouble breathing. If you notice other effects not listed above, contact your doctor, nurse, or pharmacist.
If you take too much
If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include severe nausea and vomiting, and excessive vaginal bleeding.
Non-drug therapy to help prevent bone loss includes a weight-bearing exercise plan and adequate daily calcium and vitamin D. Consult your doctor or pharmacist for more details. DO NOT SHARE THIS MEDICINE with others for whom it was not prescribed. DO NOT USE THIS MEDICINE for other health conditions. KEEP THIS MEDICINE out of the reach of children and pets. IF USING THIS MEDICINE FOR AN EXTENDED PERIOD OF TIME, obtain refills before your supply runs out.