Premarin/Conjugated estrogens IS USED FOR:

Treating symptoms of advanced breast cancer in selected men and women; treating or preventing a variety of symptoms due to menopause (hot flashes, vaginal itching, burning, dryness); preventing osteoporosis (brittle bones) after menopause; replacing estrogen after failure of the ovaries; and treating advanced prostate cancer in men. Premarin/Conjugated Estrogens may be used for certain conditions, as determined by your doctor, which may not be listed in the professional package insert. If you have questions about how Premarin/Conjugated Estrogens is being used, contact your doctor.

Premarin/Conjugated Estrogens is a mixture of female estrogen hormones. It works by replacing natural estrogens in a woman who can no longer produce enough estrogen.It works for advanced prostate cancer by antagonizing male hormones.

DO NOT USE Premarin/Conjugated estrogens IF:

• you have abnormal vaginal bleeding of unknown cause
• you are allergic to any ingredient in Premarin/Conjugated Estrogens
• you have impaired liver function or liver disease, or the blood disease porphyria
• you have known, suspected, or a history of breast cancer (unless directed by your doctor) or other cancers that are estrogen-dependent
• you have recently (within the last year) had a stroke or heart attack
• you are pregnant or suspect you may be pregnant
• you have blood clots or circulation disorders

Contact your doctor or health care provider right away if any of these apply to you.

POSSIBLE SIDE EFFECTS OF Premarin/Conjugated estrogens:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Back pain; bloating; breast pain; depression; diarrhea; dizziness; flu syndrome; gas; hair loss; headache; increased cough; increased/decreased interest in sex; indigestion; infection; irregular vaginal bleeding or spotting; itching; joint pain; lightheadedness; leg cramps; muscle aches; nausea; nervousness; pain; runny nose; sinus inflammation; sleeplessness; sore throat; stomach pain; upper respiratory tract infection; vaginal inflammation; weakness; weight changes.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); abnormal bleeding from the vagina; breast lumps; changes in vision or speech; chest pain; dizziness; fainting; mental/mood changes; pain or tenderness in the upper abdomen; pain in the calves; severe headache; sudden shortness of breath; swelling of the hands or feet; unusual vaginal discharge/itching/odor; vomiting; weakness or numbness of an arm or leg; yellowing of the skin or eyes.

IMPORTANT SAFETY INFORMATION:

• Premarin/Conjugated Estrogens may cause dizziness. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Premarin/Conjugated Estrogens. Using Premarin/Conjugated Estrogens alone, with certain other medicines, or with alcohol may lessen your ability to drive or perform other potentially dangerous tasks.
• 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. If you have other medical conditions and are prescribed estrogens for more than one condition, consult your doctor about your treatment plan and its options.
• If you will be having surgery or will be confined to a chair or bed for a long period of time (eg, a long plane flight), notify your doctor beforehand. Special precautions may need to be taken in these circumstances while you are taking Premarin/Conjugated Estrogens.
• Before using Premarin/Conjugated Estrogens, you will need to have a complete medical and family history exam, which will include blood pressure, breast, stomach, and pelvic organ exams and a Pap smear.
• PREGNANCY and LACTATION: Do not use Premarin/Conjugated Estrogens if you are pregnant. If you suspect that you could be pregnant, contact your doctor immediately. Premarin/Conjugated Estrogens is excreted in breast milk. If you are or will be breast-feeding while you are taking Premarin/Conjugated Estrogens, check with your doctor or pharmacist to discuss the risks to your baby.
• Non-drug therapy to help prevent bone loss includes a weight-bearing exercise plan, as well as adequate daily Phoslo/calcium and vitamin D intake. Consult your doctor of pharmacist for more details.
• If you wear contact lenses and you develop problems with them, contact your doctor.
• Smoking while taking Premarin/Conjugated Estrogens may increase your risk of blood clots (especially in women older than 35 years of age).
• Use Premarin/Conjugated Estrogens with caution in CHILDREN. Their growth pattern should be monitored as Premarin/Conjugated Estrogens might stunt their growth.
• LAB TESTS, including a lipid profile, may be performed to monitor your progress. Be sure to keep all doctor and lab appointments.
• Premarin/Conjugated Estrogens may affect certain lab test results. Make sure laboratory personnel and your doctors know you use Premarin/Conjugated Estrogens.
• Premarin/Conjugated Estrogens may cause dark skin patches on your face (melasma). Exposure to the sun may make these patches darker, and you may need to avoid prolonged sun exposure and sunlamps. Consult your doctor regarding the use of sunscreens and protective clothing.
• You should have periodic mammograms as determined by your doctor. Follow your doctor´s instructions for examining your own breasts, and report any lumps immediately.
• Diabetes patients - Premarin/Conjugated Estrogens may affect your blood sugar. Check blood sugar levels closely and ask your doctor before adjusting the dose of your diabetes medicine.
• Your doctor should reevaluate you every 3 to 6 months to determine whether or not you need to continue taking Premarin/Conjugated Estrogens.

BEFORE USING Premarin/Conjugated estrogens:

Some medical conditions may interact with Premarin/Conjugated Estrogens. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, plan to become pregnant, or are breast-feeding
• if you have an abnormal mammogram
• if you have a family history of high cholesterol, lipid, Phoslo/calcium, or triglyceride levels; or breast cancer
• if you have allergies to medicines or other substances
• if you use tobacco, you are going to have surgery, or you will be on bed rest
• if you have asthma (wheezing), a benign breast nodule, bone cancer, depression, diabetes, endometriosis or endometrial (uterine) cancer, epilepsy (seizures), gallbladder disease, heart problems, high blood pressure, kidney problems, liver problems or a history of yellowing of the skin or eyes, lupus, migraines, obesity, pancreatitis, uterine fibroids, thyroid problems or have high Phoslo/calcium levels in your blood
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement

Some MEDICINES MAY INTERACT with Premarin/Conjugated Estrogens. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Hydantoins (eg, Phenytek er/phenytoin) and rifampin because the effectiveness of this medication may be decreased

This may not be a complete list of all interactions that may occur. Ask your health care provider if Premarin/Conjugated Estrogens may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

HOW TO USE Premarin/Conjugated estrogens:

Use Premarin/Conjugated Estrogens as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Take Premarin/Conjugated Estrogens with food or immediately after a meal to prevent stomach upset.
• Take Premarin/Conjugated Estrogens at the same time each day.
• Premarin/Conjugated Estrogens comes with an additional patient leaflet. Read it carefully.
• If you miss a dose of Premarin/Conjugated Estrogens, take it as soon as possible. If it is almost time for the next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
• Discuss with your doctor stopping Premarin/Conjugated Estrogens 4 to 6 weeks before surgery.

Ask your health care provider any questions you may have about how to use Premarin/Conjugated Estrogens.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.