Premarin IV Injection
Conjugated Estrogens
25mg
Ayerst Wyeth PharmaceuticalsInc.,
| Pack size | 1 amp |
|---|---|
| Dispensing mode | |
| Source | |
| Agent | |
| Retail Price | 173.50 AED |
Available as:
Indications
Premarin IV Injection is used for:
Osteoporosis, Fungal infections, Itching, Burning, Hot flashes, Vaginal dryness, Vaginal atrophy, Menopausal symptoms, Female hypogonadism, Metastatic breast carcinoma, Ovarian failure, Prostate carcinoma, Primary ovarian failure, Hormone replacement therapy, Oral contraceptives
Adult Dose
Menopausal Vasomotor Symptoms, Atrophic Vaginitis/Kraurosis Vulvae
0.3 mg PO once daily in either continuous daily regimen or cyclic regimen (25 days on, 5 days off); adjusted PRN; use lowest dose that control symptoms; may be given daily if medical assessment warrants it
Female Hypogonadism
0.3-0.625 mg PO once daily in cyclic regimen (3 weeks on, 1 week off); may be titrated every 6-12 months; adjusted PRN; add progestin treatment should be added to maintain bone mineral density once skeletal maturity achieved
Osteoporosis
Prophylaxis
0.3 mg PO once daily in cyclic regimen (25 days on, 5 days off); adjusted PRN based on clinical response; may be given daily if medical assessment warrants it; administer lowest effective dose
May also be used in combination with medroxyprogesterone acetate
Prostate Cancer
Palliation only
1.25-2.5 mg PO q8hr
Female Castration/Primary Ovarian Failure
1.25 mg PO once daily in cyclic regimen (25 days on, 5 days off); adjusted PRN; administer lowest effective dose
Breast Cancer Palliation
Metastatic disease in selected patients (males and females):10 mg PO q8hr for >3 months
Abnormal Uterine Bleeding
25 mg IV/IM; repeated in 6-12 hours PRN or 25 mg IV repeated q4hr for 24 hr; if no response after 2 doses, re-evaluate therapy
Alternative regimen: 10-20 mg/day PO divided q4hr
May administer low dose medroxyprogesterone acetate with therapy or following therapy
Cyclic therapy: 25 days on, 5 days off; either 3 weeks on, 1 week off
Child Dose
Renal Dose
Administration
IV Preparation
Reconstitute with 5 mL of diluent provided
First withdraw air from vial, then add diluent slowly and aseptically with gentle agitation
Stable at 2-8°C for 60 days
Do not use if agent darkens or precipitates
IV/IM Administration
IM: Acceptable
IV: Administer slowly to avoid flushing reaction
Infusion not recommended; injection into running infusion can be performed
Contra Indications
Undiagnosed abnormal genital bleeding
Known, suspected, or history of breast cancer, except in appropriately selected patients being treated for metastatic diseases
Known or suspected estrogen-dependent neoplasia
Active DVT, PE, or a history of these conditions
Active arterial thromboembolic disease (for example, stroke and MI), or a history of these conditions
Known anaphylactic reaction or angioedema with Conjugated Estrogens
Known liver impairment or disease
Known protein C, protein S, or antithrombin deficiency, or other known thrombophilic disorders
Known or suspected pregnancy
Precautions
Estrogen-Alone Therapy
There is an increased risk of endometrial cancer in a woman with a uterus that uses unopposed estrogens
Estrogen-alone therapy should not be used for the prevention of cardiovascular disease or dementia
Women's Health Initiative (WHI) estrogen-alone substudy reported increased risks of stroke and deep vein thrombosis (DVT)
The WHI Memory Study (WHIMS) estrogen-alone ancillary study of WHI reported an increased risk of probable dementia in postmenopausal women 65 years of age and older
Estrogen Plus Progestin Therapy
Estrogen plus progestin therapy should not be used for the prevention of cardiovascular disease or dementia
The WHI estrogen plus progestin substudy reported increased risks of stroke, DVT, pulmonary embolism (PE), and myocardial infarction (MI)
The WHI estrogen plus progestin substudy reported increased risks of invasive breast cancer
The WHIMS estrogen plus progestin ancillary study of WHI reported an increased risk of probable dementia in postmenopausal women 65 years of age and older
Estrogens increase the risk of gallbladder disease
Discontinue estrogen if severe hypercalcemia, loss of vision, severe hypertriglyceridemia or cholestatic jaundice occurs
Use caution in diabetes mellitus, hyperlipidemias, hypertension, hypothyroidism, advanced age, hepatic or renal impairment, uterine leiomyomata, porphyria, patients with defects of lipoprotein metabolism, hypertriglyceridemia, ovarian cancer, systemic lupus erhythematosus, exacerbation of endometriosis or other conditions, smoking, diseases exacerbated by fluid retention
Monitor thyroid function in women on thyroid replacement therapy
Pregnancy-Lactation
Pregnancy
Not for use during pregnancy (contraindicated)
Lactation
Not for use during lactation; estrogen administration to nursing mothers has been shown to decrease quantity and quality of milk; detectable amounts of estrogens and progestins have been identified in milk of mothers receiving this drug; exercise caution when administering this drug to a nursing mother
Interactions
Rifampicin, and barbiturates increase the rate of metabolism.
Potentially Fatal: May reduce the efficacy of anticoagulants.
Contraindicated (2)
fezolinetant
ospemifene
Serious (36)
anastrozole
antithrombin alfa
antithrombin III
apalutamide
argatroban
bemiparin
bivalirudin
carbamazepine
cimetidine
clarithromycin
dabrafenib
dalteparin
darunavir
enoxaparin
enzalutamide
erythromycin base
erythromycin ethylsuccinate
erythromycin lactobionate
erythromycin stearate
fexinidazole
fondaparinux
givosiran
heparin
idelalisib
itraconazole
lorlatinib
mitotane
nefazodone
pacritinib
phenindione
protamine
quinidine
rifabutin
rifampin
St John's Wort
tucatinib
Adverse Effects
Side effects of Conjugated Estrogens :
>10%
Abdominal pain (15-17%),Back pain (13-14%),Breast enlargement,Breast tenderness (7-12%),Headache (26-32%),Arthralgia (7-14%),Pharyngitis (10-12%),Sinusitis (6-11%),Diarrhea (6-7%)
1-10%
Depression (5-8%),Dizziness (4-6%),Nervousness (2-5%),Flatulence (6-7%),Vaginitis (5-7%),Leukorrhea (4-7%),Leg cramps (3-7%),Increased cough (4-7%),Pruritus (4-5%)
Frequency Not Defined
Amenorrhea,Breakthrough bleeding,Corneal curvation change,Melasma,Spotting,Vaginal moniliasis,Weight changes
Potentially Fatal: Unopposed replacement therapy in postmenopausal women associated with increased risk of endometrial and breast cancer.
Potentially Fatal: Unopposed replacement therapy in postmenopausal women associated with increased risk of endometrial and breast cancer.
Mechanism of Action
Estrogens modulate pituitary secretion of gonadotropins, leutinising hormones and follicle-stimulating hormones through -ve feedback mechanism, thus reducing elevated levels of hormones in postmenopausal women during oestrogen replacement therapy.
Note
Premarin IV 25mg Injection manufactured by Ayerst Wyeth PharmaceuticalsInc.,. Its generic name is Conjugated Estrogens. Premarin IV is availble in Bangladesh.
Farmaco BD drug index information on Premarin IV Injection is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.