Estrogens (Conjugated)
- Atc Codes:G03CA57
- CAS Codes:438-67-5
- PHARMGKB ID:438-67-5
Table of contents
- Brand Names
- Drug Combinations
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Substrate of
- Inhibits
- Induces
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Germany: Climopax, Presomen; Greece: Premarin; Ireland: Cathate, Premarin; Luxembourg: Premarin; Poland: Oestrofeminal, Premarin; Spain: Equin; UK: Premarin.
North America
Canada: Cenestin; USA: Cenestin.
Latin America
Argentina: Belestar, Premarin; Brazil: Estrinolon, Estrogenon, Estroplus, Gestrocon, Menoprin, Prem, Premarin; Mexico: C. E. S., DNA-EC, Equifan, Fahifem, Neradin, Premarin, Six Din, Sultrona.
Drug combinations
Estrogens (Conjugated) and Medrogeston
Estrogens (Conjugated) and Medroxyprogesterone
Estrogens (Conjugated) and Norgestrel
Chemistry
Estrogens (Conjugated): C~18~H~21~NaO~5~S. Mw average: 372.411. (1) Estrone Hydrogen Sulfate; (2) Sodium Estrone Sulfate. CAS-438-67-5.
Pharmacologic Category
Estrogens and Estrogen Agonist-Antagonists; Estrogen Bone Resorption Inhibitors. Estrogen Derivative. (ATC-Code: G03CA57).
Mechanism of action
Estrogens modulate the pituitary secretion of gonadotropins, luteinizing hormone, and FSH through a negative feedback system. Estrogen replacement reduces elevated levels of these hormones in postmenopausal women.
Therapeutic use
Treatment of moderate-to-severe vasomotor symptoms of menopause. Treatment of vulvar and vaginal atrophy.
Pregnancy and lactiation implications
Use during pregnancy contraindicated. Estrogen has been shown to decrease quantity and quality of human milk. Use during lactation only if clearly needed.
Unlabeled use
Contraindications
Hypersensitivity to estrogens or any component of the formulation. Undiagnosed abnormal vaginal bleeding. History of or current thrombophlebitis or venous thromboembolic disorders. Active or recent (within 1 year) arterial thromboembolic disease (e.g. stroke, MI). Breast carcinoma. Estrogen-dependent tumor. Hepatic dysfunction or disease. Pregnancy.
Warnings and precautions
Estrogens may increase the risk of breast cancer. Hypercalcemia might occur in breast cancer and bone metastases. Risk of dementia may be increased in postmenopausal women. Unopposed estrogens may increase risk of endometrial carcinoma in postmenopausal women. Lipid effects such as increased HDL-C, decreased LDL-C, and increased triglycerides (use with caution in familial defects of lipoprotein metabolism). Estrogens may cause retinal vascular thrombosis. Estrogens with or without progestin should not be used to prevent coronary heart disease (use caution with cardiovascular disease or dysfunction). Use caution in history of cholestatic jaundice associated with past estrogen use or pregnancy. Use with caution in diseases which may be exacerbated by fluid retention (asthma, epilepsy, migraine, diabetes or renal dysfunction). Use with caution in gallbladder disease, hepatic hemangiomas, severe hypocalcemia, porphyria, or systemic lupus erythematosus. Whenever possible, estrogens should be discontinued at least 4 weeks prior to and 2 weeks following elective surgery associated with increased risk of thromboembolism or during periods of prolonged immobilization.