Generic Medication guide:
What is the medication marketed as Premarin?
Premarin is Pfizer’s brand registered to market conjugated estrogens. The same medication is also available from other manufacturers but under different names, for instance, Conjugate, Conjurin, Espauz, Morestin, Premphase, Prempro, and others. If you want to buy Premarin cheap, you should look for a generic medication, i.e. the same drug sold under another trademark.
Short drug info
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Active ingredients |
Estrone sulfate, Equilin sulfate, 17α-Dihydro-equilin sulfate |
Trade names |
Cenestin, Enjuvia, Congest, C.E.S., Premarin, Prempro (with MPA), Premphase (with MPA), others |
Other names |
CEs; Conjugated equine estrogens; CEEs; Pregnant mares' urine; Premarin; Estrogens, conjugated |
Pregnancy category |
X (contraindicated) |
Routes of administration |
By mouth, topical, vaginal, intravenous injection, intramuscular injection |
Drug class |
Estrogen |
Legal status |
In general: Rx (Prescription only) |
Bioavailability |
Variable |
Protein binding |
High (to albumin and SHBG) |
Metabolism |
Liver |
Elimination half-life |
Estrone: 26.7 hours
Estrone (BA): 14.8 hours
Equilin: 11.4 hours
|
Excretion |
Urine |
It is a hormonal medication used for different conditions including:
- Hormone-replacement therapy in menopause and postmenopause;
- Hypofunction of ovaries (menstrual disorders);
- Sexual infantilism;
- Hypogonadism;
- Secondary estrogen deficiency (including after ovariectomy for non-malignant diseases or after radiation castration);
- Breast carcinoma (some inoperable forms);
- Androgen-dependent prostate carcinoma.
- Menopausal syndrome ("flushing" of blood to the skin of the upper half of the body, increased sweating, sleep disturbances, irritability, depression, atrophic urethritis and vaginitis);
- Postmenopausal osteoporosis,
- Prevention of atherosclerosis and cardiovascular diseases in menopause.
If you are diagnosed with one of the listed conditions but your doctor hadn’t prescribed you Premarin, please consult him or her before you buy generic Premarin to be sure that the medication is suitable for you. It is a hormonal medication that requires hormone tests before the therapy is started.
How does Premarin act?
The medication is based on estrogens, female sex hormones, which regulate the development and maintenance of female reproductive function. When the medication penetrates into the blood, it forms a complex with a specific receptor (in the fallopian tubes, cervix, excretory ducts of the mammary glands, vagina, urethra, breast, liver, hypothalamus, pituitary gland), stimulates the synthesis of DNA and proteins. At the same time, proliferation of the epithelium is noted; the sensitivity of the muscles of the uterus and tubes to the drugs that excite them is increased.
The formulation lowers the destruction of bone tissue in menopause, normalizes cholesterol level, and improves sensitivity to insulin including improved utilization of glucose.
Premarin and its analogs eliminate the menopausal syndrome symptoms such as heat flushes, sweating, dizziness irritability, depressive mood, etc. In fertile women, it contributes to the normalization of menstrual cycle.
In men, lowers the level of testosterone.
When shouldn’t you buy Premarin?
The medication is contraindicated in:
- Intolerance of the medication;
- Pregnancy;
- Estrogen-dependent cancerous tumors (including suspected ones);
- Uterine bleeding of unknown cause;
- Thrombophlebitis or thromboembolic diseases in the active phase (with the exception of the therapy for breast and prostate cancer).
The treatment is possible but with caution in:
- Thrombophlebitis, thrombosis or thromboembolism;
- Familial hyperlipoproteinemia;
- Pancreas diseases;
- Endometriosis;
- A history of gallbladder disease (especially cholelithiasis);
- Severe liver failure;
- Jaundice;
- Hepatic porphyria;
- Leiomyoma;
- Hypercalcemia in bone metastases of mammary gland cancer.
Only for the therapy of breast and prostate cancer: coronary or cerebral vessels disorders, active thrombophlebitis or thromboembolic diseases.
How is generic Premarin used?
Before you buy Estrogens, make sure that the medication is not contraindicated for you and that it is suitable for your condition. Here you can find the recommendations on the formulation use but it is preferable to consult a doctor who prescribes you the treatment.
The pills are taken orally. The average dosage for the cyclic use is from either 0.625 mg or 1.25 mg a day for 21 days with a break of 7 days between the courses. This is suitable for almost all indications except for breast carcinoma, prostate carcinoma and prevention of lactostasis.
In the presence of menstrual bleeding, treatment begins from the 5th day of the menstrual cycle, and from 15 to 21 days any progestogen is additionally prescribed. With a prolonged absence of menstruation, treatment begins on any day. If necessary, on the 5-7th day of treatment, the daily dose can be increased to 3.75 mg, then it is reduced to 1.25 mg.
- With intermenstrual bleeding during estrogen therapy, the dose of the latter is increased. In the next cycle, the dose that was required to stop the bleeding in the previous cycle is prescribed. In subsequent cycles, the dose of estrogen is gradually reduced to a maintenance dose.
- In menopausal syndrome, 1.25 mg of the medication is prescribed daily. Doses decrease or increase is based on the severity of the symptoms and the reaction to the therapy.
- In postmenopausal women, as replacement therapy for conditions caused by estrogen deficiency, 0.3-1.25 mg is used daily in cycles.
- After oophorectomy (ovaries removal) and primary ovarian dysfunction - 1.25 mg / day continuously or in cycles.
- For dysfunctional uterine bleeding - 3.75-7.5 mg / day (in several doses). It is believed that bleeding can be stopped in 2-5 days. If it does not stop, it is recommended to raise the dose of the medication by 50% or more. In the last 5-10 days of estrogen therapy, progestin is prescribed orally. Bleeding should stop 2-5 days after the end of therapy.
- For hypogonadism - 2.5-7.5 mg daily for 20 days, followed by a break for 10 days. If bleeding does not occur at the end of this period, similar therapy is repeated. If bleeding occurs at the end of the 10th day of the period, a 20-day estrogen-progestogen cycle begins according to the scheme described below (for amenorrhea).
- For amenorrhea - 2.5-7.5 mg daily in several doses for twenty days. For the last 5 days of Premarin therapy, progestogen is prescribed orally. If bleeding occurs at the end of the treatment cycle, treatment stops and resumes on the 5th day of bleeding.
- For breast carcinoma in women in postmenopausal women and inoperable breast cancer in men - 10 mg 3 times a day for 3 months. With prostate carcinoma - 1.25-2.5 mg 3 times a day.
- In postmenopausal osteoporosis - 0.625 mg / day cyclically, for a long time.
- For the prevention of cardiovascular diseases - 0.625-1.25 mg / day.
- Elderly patients are given the minimum dose causing the effect.
- Premarin: for osteoporosis, vasomotor disorders, atrophic vaginitis and urethritis, female hypogonadism and primary ovarian dysfunction - 0.625-1.25 mg / day, for the prevention of CVD diseases - 0.625 mg / day.
What adverse effects can generic Premarin cause?
When you buy generic Estrogens, you should be ready that the medication can cause certain negative effects such as:
- In women: soreness, sensitivity and increased volume of breasts, amenorrhea, abundant bleeding, heavy menstrual bleeding, intermenstrual bloodlike vaginal discharge, breast tumor, enhanced sex drive.
- In men, soreness, sensitivity and increased volume of breasts, lowered sex drive. - For both sexes: Peripheral edema, gallbladder obstruction, hepatitis, pancreas dysfunction, bloating, anorexia, nausea, diarrhea, dizziness, headache, intolerance of contact lenses, vomiting.
Incidence of Premarin adverse effects compared to placebo
Adverse Reactions
|
PREMARIN 0.625 mg
(n=348) %
|
Placebo
(n=332) %
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Pain in the abdomen
|
38 (11)
|
21 (6)
|
Physical weakness
|
16 (5)
|
3 (1)
|
Back pain
|
18 (5)
|
4 (1)
|
Chest pain
|
2 (1)
|
2 (1)
|
Swelling
|
7 (2)
|
8 (2)
|
Headache
|
45 (13)
|
46 (14)
|
Fungal infection
|
5 (1)
|
1 (0)
|
Pain
|
17 (5)
|
14 (4)
|
Pelvic pain
|
10 (3)
|
4 (1)
|
Elevated blood tension
|
4 (1)
|
5 (2)
|
Migraine
|
7 (2)
|
3 (1)
|
Palpitation
|
3 (1)
|
4 (1)
|
Blood vessels dilation
|
2 (1)
|
5 (2)
|
Constipation
|
7 (2)
|
3 (1)
|
Diarrhea
|
4 (1)
|
8 (2)
|
Indigestion
|
7 (2)
|
14 (4)
|
Indigestion
|
7 (2)
|
14 (4)
|
Burping
|
1 (0)
|
1 (0)
|
Bloating
|
22 (6)
|
8 (2)
|
Increased appetite
|
4 (1)
|
2 (1)
|
Nausea
|
16 (5)
|
16 (5)
|
Elevated levels of lipids
|
2 (1)
|
2 (1)
|
Peripheral edema
|
5 (1)
|
3 (1)
|
Weight gain
|
11 (3)
|
14 (4)
|
Join pain
|
6 (2)
|
5 (2)
|
Leg cramps
|
10 (3)
|
4 (1)
|
Muscle pain
|
2 (1)
|
1 (0)
|
Anxiety
|
6 (2)
|
4 (1)
|
Depression
|
17 (5)
|
17 (5)
|
Dizziness
|
9 (3)
|
5 (2)
|
Emotional lability
|
3 (1)
|
8 (2)
|
Hypertonia
|
1 (0)
|
3 (1)
|
Insomnia
|
16 (5)
|
14 (4)
|
Nervousness
|
9 (3)
|
6 (2)
|
Acne
|
3 (1)
|
3 (1)
|
Alopecia
|
6 (2)
|
2 (1)
|
Hirsutism (increased body hair growth) 0
|
4 (1)
|
0
|
Pruritus
|
11 (3)
|
3 (1)
|
Rash
|
6 (2)
|
2 (1)
|
Skin discoloration
|
4 (1)
|
1 (0)
|
Sweating
|
4 (1)
|
4 (1)
|
Breast disorder
|
6 (2)
|
6 (2)
|
Breast enlargement
|
3 (1)
|
3 (1)
|
Breast cysts, tumors
|
4 (1)
|
7 (2)
|
Breast pain
|
37 (11)
|
26 (8)
|
Cervix disorder 0
|
8 (2)
|
0
|
Painful periods
|
12 (3)
|
2 (1)
|
Endometrial disorder
|
4 (1)
|
0
|
Endometrial hyperplasia
|
16 (5)
|
0
|
Leukorrhea
|
17 (5)
|
6 (2)
|
Metrorrhagia
|
11 (3)
|
1 (0)
|
Urinary tract infection
|
1 (0)
|
4 (1)
|
Uterine fibroids enlarged
|
6 (2)
|
2 (1)
|
Uterine spasm
|
11 (3)
|
2 (1)
|
Vaginal dryness
|
1 (0)
|
6 (2)
|
Vaginal hemorrhage
|
46 (13)
|
0
|
Vaginal moniliasis
|
14 (4)
|
5 (2)
|
Vaginitis
|
18 (5)
|
1 (0)
|
Overdose Symptoms:
nausea, vomiting, withdrawal bleeding. Treatment: gastric lavage, symptomatic therapy.
Special instructions
- During treatment, it is necessary to remember the risk of developing endometrial cancer in postmenopausal women.
- Before a patient orders Premarin and starts the course, a thorough general medical and gynecological examination should be carried out, including the examination of the mammary glands and the performance of a vaginal smear according to Papanicolaou to detect malignant cells. Similar studies should be carried out every 6 months of treatment.
- In order to reduce the risk of hyperplasia or endometrial cancer, patients with an intact uterus are prescribed in combination with progestogens from 10 to 14 days of the menstrual cycle. If gestagen therapy is not performed, a gynecological examination with a mandatory endometrial biopsy is indicated.
- Information about the risk of developing breast cancer in postmenopausal women during estrogen treatment is debatable. It is believed that the use of high doses or long-term therapy for more than 10 years increase the risk of developing breast cancer. However, at present, most researchers consider this fact unproven. Women receiving estrogen replacement therapy should be regularly examined for mammary glands, and should also be trained in self-examination skills.
- During therapy, an increase in existing uterine leiomyoma is possible.
Where can you buy Premarin?
To get the medication cheap and without Rx, you should order generic Premarin from our online drugstore. We offer only high-quality generics identical to the branded drugs. These drugs are cheaper because they are not as promoted as the branded medicines.
Free prescription
Our doctor prescribes online for free, and there is no doctor’s consultation fee.
Discrete packaging
All orders arrive in discrete unmarked parcels. We leave the shipment description blank.
For more answers see the FAQ section
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