Periodontal diseases are a threat to women of all ages
Two new studies in the June issue of the Journal of Periodontology (JOP) suggest that periodontal diseases are a threat to women of all ages due to hormonal fluctuations that occur at various stages of their lives.
One study looked at 50 women who were between the ages of 20 to 35 with varying forms of periodontitis. The study found that women who currently were taking oral contraceptive pills had more gingival bleeding upon probing and deeper periodontal pockets (signs of periodontitis) than those who were not taking oral contraceptive pills.
"Younger women often think that periodontal disease is a condition associated with old age," explained study author Brian Mullally, PhD. "Our study shows that it is very possible for younger women to experience periodontal disease. It is important for women to alert their dental practitioners of any medications they are taking, such as oral contraceptive pills, because it is possible that their oral health may be affected. It might also be prudent where possible for young women to ensure that their periodontal health has been checked before commencing oral contraceptive therapy."
Another study in this month's issue of the JOP examined 1,256 postmenopausal women and looked for a potential association between periodontal bacteria and bone loss in the oral cavity. The study results showed that women with periodontal bacteria in their mouths were also more likely to have bone loss in the oral cavity, which can lead to tooth loss if not treated.
"Our study's findings are important for postmenopausal women because they suggest that good periodontal health is extremely important in the postmenopausal years," said study author Renee Brennan, PhD. "We found that oral bone loss was associated with presence of oral bacteria. In fact, 62% of the women in our study had at least one species of subgingival bacteria present, and the women with these bacteria had more evidence of oral bone loss. Interestingly, women who had a Body Mass Index in the overweight range were much more likely to have oral bone loss associated with presence of oral bacteria. Oral bone loss has been associated with osteoporosis in this group as well. This association has been difficult to study because many risk factors for periodontal disease and osteoporosis, including smoking, age, medications, and overall general health are similar. It should be noted that our study was limited in that it included a relatively healthy group of mostly Caucasian women and that future studies are needed to determine the effects of periodontal bacteria on bone loss in other groups of postmenopausal women."
"Taking care of your teeth and gums is a lifelong commitment," explained Preston D. Miller, Jr., DDS, President of the American Academy of Periodontology. "Women should pay special attention to their oral health as they enter different stages of their lives because additional periodontal care may be needed during different points such as the reproductive years or menopause. Knowing your ,pocket size, depth can be a good way for women to keep track of their periodontal health; periodontal pockets of one to two millimeters with no bleeding are not a concern but pockets of three and four millimeters may need a more in depth cleaning called scaling and root planing."
source : www.news-medical.net
Showing posts with label contraception. Show all posts
Showing posts with label contraception. Show all posts
Saturday, June 23, 2007
Monday, May 28, 2007
FDA Approves 'No-Period' Contraceptive Pill
Lybrel, a birth-control pill that does away with a woman's monthly period, was approved Tuesday by the U.S. Food and Drug Administration.
The estrogen-progestin hormonal pill differs from traditional birth-control pills in that it does not include the "week off" of placebo pills that leads to a cessation of artificial hormones and bleeding.
Lybrel is described as "continual contraception" but it "works the same way as the 21-days on, seven-days off [pill] cycle -- it stops the body's monthly preparation for pregnancy by lowering the production of hormones that make pregnancy possible," Dr. Daniel Shames, deputy director of the FDA's Office of Drug Evaluation III, at the Center for Drug Evaluation and Research, explained at a press conference late Tuesday.
A majority of women who decide to take Lybrel will encounter unscheduled bleeding, or spotting, that in most cases tapers off over the first year of use, Shames said. In the primary clinical trial leading up to approval, 59 percent of women who took Lybrel for one year reported no bleeding or spotting during the last month of the trial.
In terms of safety, two one-year clinical trials involving more than 2,400 18-to-49-year-old women showed no increased risk of endometrial cancer among those taking Lybrel. The risks of other side effects linked to the birth-control pill -- primarily blood clots -- were similar to those seen in other contraception regimens, Shames said.
"We don't expect any surprises in terms of long-term use of this product," he added, although he noted that the FDA has requested that the drug's maker, Wyeth Pharmaceuticals, conduct post-marketing studies to keep tabs on Lybrel's long-term safety.
Despite some women's reticence to do away completely with their monthly period, gynecologic experts agreed that there was no physiological "downside" to a period-free life. In fact, one expert noted that, for decades, many American women have been pharmaceutically ending their periods with more traditional birth-control pills with no resulting problems.
"There were other products, such as the long-acting progestin, Depo-Provera, that was given by injection," said Dr. Michael Petriella, vice chairman of obstetrics and gynecology at Hackensack University Medical Center, in Hackensack, N.J. "Women who were using that for contraception wouldn't get their period at all while on that product."
And for years, "some physicians have been allowing some women to take the Pill off-label -- allowing them to take two packages continuously, for example," Petriella said.
Another expert noted that the "period" women get while on conventional birth-control pills isn't connected to a natural cycle of egg production, anyway.
"It's not a natural period. It's an artificially induced period that happens because she stops taking the hormones for seven days. So, she gets some vaginal bleeding," explained Dr. Camelia Davtyan, an internist specializing in women's health and an associate professor of medicine at the University of California, Los Angeles.
In fact, a no-period pill like Lybrel could have been a contraceptive norm for women from the get-go, Davtyan said. However, the doctors and pharmaceutical companies who developed the birth-control pill back in the 1960s assumed that women would want a regimen that mimicked the monthly cycle.
"I guess they were trying to make it seem as 'real' as possible and cause as little change as possible in a woman's life," Davtyan said.
But times have changed, and newer contraceptive products such as Seasonale -- a contraceptive pill that cuts the number of periods to just four a year -- have already been readily embraced by some American women over the past decade.
Davtyan said she has recently noticed a big shift in her patients' attitudes toward their period.
"They want convenience, and they tell me that they'd just rather not have the bleeding altogether so that they don't have any limitations with sports, with having to use pads, tampons," she said. "And the younger the woman, the more likely that she will want her periods stopped. It's very possible that this will be the wave of the future."
But Petriella said many women still feel a strong psychological attachment to their period and do not want to give it up, however inconvenient it may be.
"Sometimes [ending periods] is just emotionally uncomfortable for women," he said. "They don't feel right about not having their period. For those women, obviously Lybrel and other such products are not good products for them."
Petriella believes that, at least in the short-term, Lybrel will appeal to only a minority of women. They include those with menstruation-linked conditions such as endometriosis and menstrual migraine, or those who have already tried -- and liked -- period-limiting products such as Seasonale, he said.
As with any pharmaceutical contraceptives, women who decide to go on Lybrel may experience random breakthrough bleeding, Davtyan said.
So, for the 59 percent of women who have no bleeding or spotting after one year, "I think Lybrel is a great deal," Davtyan said. "For the remainder, if they have the patience to hang in there for a few months, the spotting might abate. There will be an occasional patient that will continue to spot, and then, clearly, it's a better deal to have a scheduled period than to start spotting at an unknown time and maybe in an uncomfortable circumstance."
Women who decide to resume their monthly cycle -- for example, those who wish to become pregnant -- can typically expect to resume their normal cycle within days of stopping Lybrel, Shames said. He said that short timespan to resumption of ovulation could leave women who skip or miss pills open to unplanned pregnancy, so the FDA is advising that women consider a second form of birth control while on Lybrel, as a safeguard.
Both Davtyan and Petriella stressed that young women who are considering a pharmaceutical end to their period should not be concerned that doing so will harm their health.
"Remember, there's no real physiological value to hold on to the period that a woman has while she is taking the Pill, unless it is a psychological value, which I respect," Davtyan said.
source : health.yahoo.com
The estrogen-progestin hormonal pill differs from traditional birth-control pills in that it does not include the "week off" of placebo pills that leads to a cessation of artificial hormones and bleeding.
Lybrel is described as "continual contraception" but it "works the same way as the 21-days on, seven-days off [pill] cycle -- it stops the body's monthly preparation for pregnancy by lowering the production of hormones that make pregnancy possible," Dr. Daniel Shames, deputy director of the FDA's Office of Drug Evaluation III, at the Center for Drug Evaluation and Research, explained at a press conference late Tuesday.
A majority of women who decide to take Lybrel will encounter unscheduled bleeding, or spotting, that in most cases tapers off over the first year of use, Shames said. In the primary clinical trial leading up to approval, 59 percent of women who took Lybrel for one year reported no bleeding or spotting during the last month of the trial.
In terms of safety, two one-year clinical trials involving more than 2,400 18-to-49-year-old women showed no increased risk of endometrial cancer among those taking Lybrel. The risks of other side effects linked to the birth-control pill -- primarily blood clots -- were similar to those seen in other contraception regimens, Shames said.
"We don't expect any surprises in terms of long-term use of this product," he added, although he noted that the FDA has requested that the drug's maker, Wyeth Pharmaceuticals, conduct post-marketing studies to keep tabs on Lybrel's long-term safety.
Despite some women's reticence to do away completely with their monthly period, gynecologic experts agreed that there was no physiological "downside" to a period-free life. In fact, one expert noted that, for decades, many American women have been pharmaceutically ending their periods with more traditional birth-control pills with no resulting problems.
"There were other products, such as the long-acting progestin, Depo-Provera, that was given by injection," said Dr. Michael Petriella, vice chairman of obstetrics and gynecology at Hackensack University Medical Center, in Hackensack, N.J. "Women who were using that for contraception wouldn't get their period at all while on that product."
And for years, "some physicians have been allowing some women to take the Pill off-label -- allowing them to take two packages continuously, for example," Petriella said.
Another expert noted that the "period" women get while on conventional birth-control pills isn't connected to a natural cycle of egg production, anyway.
"It's not a natural period. It's an artificially induced period that happens because she stops taking the hormones for seven days. So, she gets some vaginal bleeding," explained Dr. Camelia Davtyan, an internist specializing in women's health and an associate professor of medicine at the University of California, Los Angeles.
In fact, a no-period pill like Lybrel could have been a contraceptive norm for women from the get-go, Davtyan said. However, the doctors and pharmaceutical companies who developed the birth-control pill back in the 1960s assumed that women would want a regimen that mimicked the monthly cycle.
"I guess they were trying to make it seem as 'real' as possible and cause as little change as possible in a woman's life," Davtyan said.
But times have changed, and newer contraceptive products such as Seasonale -- a contraceptive pill that cuts the number of periods to just four a year -- have already been readily embraced by some American women over the past decade.
Davtyan said she has recently noticed a big shift in her patients' attitudes toward their period.
"They want convenience, and they tell me that they'd just rather not have the bleeding altogether so that they don't have any limitations with sports, with having to use pads, tampons," she said. "And the younger the woman, the more likely that she will want her periods stopped. It's very possible that this will be the wave of the future."
But Petriella said many women still feel a strong psychological attachment to their period and do not want to give it up, however inconvenient it may be.
"Sometimes [ending periods] is just emotionally uncomfortable for women," he said. "They don't feel right about not having their period. For those women, obviously Lybrel and other such products are not good products for them."
Petriella believes that, at least in the short-term, Lybrel will appeal to only a minority of women. They include those with menstruation-linked conditions such as endometriosis and menstrual migraine, or those who have already tried -- and liked -- period-limiting products such as Seasonale, he said.
As with any pharmaceutical contraceptives, women who decide to go on Lybrel may experience random breakthrough bleeding, Davtyan said.
So, for the 59 percent of women who have no bleeding or spotting after one year, "I think Lybrel is a great deal," Davtyan said. "For the remainder, if they have the patience to hang in there for a few months, the spotting might abate. There will be an occasional patient that will continue to spot, and then, clearly, it's a better deal to have a scheduled period than to start spotting at an unknown time and maybe in an uncomfortable circumstance."
Women who decide to resume their monthly cycle -- for example, those who wish to become pregnant -- can typically expect to resume their normal cycle within days of stopping Lybrel, Shames said. He said that short timespan to resumption of ovulation could leave women who skip or miss pills open to unplanned pregnancy, so the FDA is advising that women consider a second form of birth control while on Lybrel, as a safeguard.
Both Davtyan and Petriella stressed that young women who are considering a pharmaceutical end to their period should not be concerned that doing so will harm their health.
"Remember, there's no real physiological value to hold on to the period that a woman has while she is taking the Pill, unless it is a psychological value, which I respect," Davtyan said.
source : health.yahoo.com
Thursday, May 17, 2007
Conjugated estrogen and medroxyprogesterone combinations
What is the most important information I should know about conjugated estrogens and medroxyprogesterone?
Conjugated estrogens increase the risk of developing endometrial hyperplasia, a condition that may lead to cancer of the lining of the uterus. Taking a progestin, such as medroxyprogesterone, with conjugated estrogens lowers the risk of developing this condition. Visit your doctor regularly and report any unusual vaginal bleeding right away.
The Women's Health Initiative (WHI) study found an increased risk of breast cancer, heart disease, nonfatal heart attacks, and blood clots in women taking estrogen and medroxyprogesterone combinations long-term. You should contact your doctor or healthcare provider to discuss your individual risks and benefits before taking a conjugated estrogen and medroxyprogesterone combination long-term. You should also talk to your doctor or healthcare provider on a regular basis (for example, every 3-6 months) about whether you should continue this treatment.
Have yearly physical exams and examine your breasts for lumps on a monthly basis while taking conjugated estrogen and medroxyprogesterone combinations.
nopreg Do not take conjugated estrogen and medroxyprogesterone combinations if you are pregnant or planning to become pregnant. It could affect the development of the baby.
What is conjugated estrogens and medroxyprogesterone?
Conjugated estrogens are naturally occurring female sex hormones that are involved in the development and maintenance of the female reproductive system.
Medroxyprogesterone is a female hormone, usually called "progesterone." It is important for the regulation of ovulation and menstruation.
Together, conjugated estrogen and progesterone are used to treat the symptoms of menopause such as feelings of warmth in the face, neck and chest, or sudden intense spells of heat and sweating ("hot flashes" or "hot flushes"); to treat vulvar and vaginal changes caused by menopause (itching, burning, dryness in or around the vagina, difficulty or burning with urination); and to prevent thinning of the bones (osteoporosis).
Conjugated estrogen and medroxyprogesterone combinations may also be used for purposes other than those listed in this medication guide.
What should I discuss with my healthcare provider before taking conjugated estrogens and medroxyprogesterone?
donot Do not take conjugated estrogen and medroxyprogesterone combinations without first talking to your doctor if you have
* had an allergic reaction to another estrogen or progesterone product;
* a circulation, bleeding, or blood-clotting disorder;
* a history of blood clots in the leg or lung;
* liver disease;
* undiagnosed, abnormal vaginal bleeding; or
* any type of breast, uterine, or hormone-dependent cancer.
Taking conjugated estrogen and medroxyprogesterone combinations may be dangerous in some cases if you have any of the conditions listed above.
Before taking conjugated estrogen and medroxyprogesterone combinations, tell your doctor if you have
* high blood pressure, angina, or heart disease;
* a history of heart attack or stroke;
* high levels of cholesterol or triglycerides in the blood;
* kidney disease;
* thyroid problems;
* asthma;
* epilepsy;
* migraines;
* depression;
* diabetes;
* gallbladder disease;
* uterine fibroids; or
* had a hysterectomy (uterus removed).
You may not be able to take conjugated estrogen and medroxyprogesterone combinations, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.
The Women's Health Initiative (WHI) study found an increased risk of breast cancer, heart disease, nonfatal heart attacks, and blood clots in women taking estrogen and medroxyprogesterone combinations long-term. You should contact your doctor or healthcare provider to discuss your individual risks and benefits before taking a conjugated estrogen and medroxyprogesterone combination long-term. You should also talk to your doctor or healthcare provider on a regular basis (for example, every 3-6 months) about whether you should continue this treatment.
nopreg Conjugated estrogen and medroxyprogesterone combinations are in the FDA pregnancy category X. This means that these medications are known cause birth defects in an unborn baby. Do not take conjugated estrogen and medroxyprogesterone combinations if you are pregnant or if you could become pregnant during treatment.
nobrfeed Conjugated estrogen and medroxyprogesterone combinations pass into breast milk, and the effects on a nursing infant are unknown. Do not take this medication without first talking to your doctor if you are breast-feeding a baby.
How should I take conjugated estrogens and medroxyprogesterone?
Take conjugated estrogen and medroxyprogesterone combinations exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.
water Take each dose with a full glass of water.
food Take conjugated estrogen and medroxyprogesterone combinations with food or milk to lessen stomach upset. Try to take doses at the same time each day. You may be taking the medication on a cycle, such as every day for 3 weeks with 1 week off each month to mimic the body's natural cycle. Follow the directions on the prescription label.
Have yearly physical exams and examine your breasts for lumps on a monthly basis while taking a conjugated estrogen and medroxyprogesterone combination.
It is important to take conjugated estrogen and medroxyprogesterone combinations regularly to get the most benefit.
Your doctor may want you to have blood tests or other medical evaluations during treatment with a conjugated estrogen and medroxyprogesterone combination to monitor progress and side effects.
rt Store conjugated estrogen and medroxyprogesterone combinations at room temperature away from moisture and heat.
What happens if I miss a dose?
Take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and return to the regular dosing schedule. Do not take a double dose of this medication unless otherwise directed by your doctor.
What happens if I overdose?
emt An overdose of a conjugated estrogen and medroxyprogesterone combination is unlikely to threaten life. Call an emergency room or poison control center for advice if an overdose is suspected.
Symptoms of a conjugated estrogen and medroxyprogesterone combination overdose might include nausea, vomiting, and vaginal bleeding.
What should I avoid while taking conjugated estrogens and medroxyprogesterone?
There are no restrictions on food, beverages, or activity while taking a conjugated estrogen and medroxyprogesterone combination unless your doctor directs otherwise.
What are the possible side effects of conjugated estrogens and medroxyprogesterone?
Conjugated estrogens increase the risk of developing endometrial hyperplasia, a condition that may lead to cancer of the lining of the uterus. Taking a progestin, such as medroxyprogesterone, with conjugated estrogens lowers the risk of developing this condition. Visit your doctor regularly and report any unusual vaginal bleeding right away.
The Women's Health Initiative (WHI) study found an increased risk of breast cancer, heart disease, nonfatal heart attacks, and blood clots in women taking estrogen and medroxyprogesterone combinations long-term. You should contact your doctor or healthcare provider to discuss your individual risks and benefits before taking a conjugated estrogen and medroxyprogesterone combination long-term. You should also talk to your doctor or healthcare provider on a regular basis (for example, every 3-6 months) about whether you should continue this treatment.
emt Stop taking the conjugated estrogen and medroxyprogesterone combination and seek emergency medical attention or call your doctor immediately if you experience any of the following serious side effects:
* an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);
* a blood clot (pain, redness, and swelling in an arm or leg; shortness of breath; coughing blood; chest pain; headache; blurred vision; confusion; loss of speech, or dizziness);
* unusual or abnormal vaginal bleeding;
* gallbladder disease (pain, swelling, or tenderness in the abdomen);
* liver damage (yellowing of the skin or eyes, nausea, abdominal pain or discomfort, unusual bleeding or bruising, severe fatigue); or
* a lump in a breast.
Other, less serious side effects may be more likely to occur. Continue to take conjugated estrogen and medroxyprogesterone combinations and talk to your doctor if you experience
* changes in appetite or weight,
* changes in blood sugar levels;
* swelling of the hands or feet,
* tiredness or weakness,
* irregular bleeding or spotting,
* depression,
* an increase in body or facial hair or hair loss,
* swollen or tender breasts,
* nausea,
* headache or insomnia,
* changes in your voice, or
* areas of darker skin.
Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.
What other drugs will affect conjugated estrogens and medroxyprogesterone?
Before taking a conjugated estrogen and medroxyprogesterone combination, tell your doctor if you are taking any of the following medicines:
* an anticoagulant (blood thinner) such as warfarin (Coumadin);
* insulin or an oral diabetes medicine such as glipizide (Glucotrol), glyburide (Diabeta, Micronase), and others; or
* tamoxifen (Nolvadex);
A dosage adjustment or special monitoring may be required during treatment if you are taking any of the medicines listed above.
Drugs other than those listed here may also interact with conjugated estrogen and medroxyprogesterone combinations. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products.
Where can I get more information?
Your pharmacist has additional information about conjugated estrogen and medroxyprogesterone combinations written for health professionals that you may read.
What does my medication look like?
Conjugated estrogen and medroxyprogesterone combinations are available with a prescription under the brand names Prempro and Premphase. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.
* Prempro 0.625 mg of conjugated estrogens and 2.5 mg of medroxyprogesterone--two blister cards, each containing 14 oval, peach-colored tablets
* Premphase--one blister card of 14 oval, maroon tablets, each containing 0.625 mg of conjugated estrogens, to be taken on days 1 through 14; and a second blister card of 14 oval, light-blue tablets, each containing 0.625 mg of conjugated estrogens and 5 mg of medroxyprogesterone, to be taken on days 15 through 28.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Conjugated estrogens increase the risk of developing endometrial hyperplasia, a condition that may lead to cancer of the lining of the uterus. Taking a progestin, such as medroxyprogesterone, with conjugated estrogens lowers the risk of developing this condition. Visit your doctor regularly and report any unusual vaginal bleeding right away.
The Women's Health Initiative (WHI) study found an increased risk of breast cancer, heart disease, nonfatal heart attacks, and blood clots in women taking estrogen and medroxyprogesterone combinations long-term. You should contact your doctor or healthcare provider to discuss your individual risks and benefits before taking a conjugated estrogen and medroxyprogesterone combination long-term. You should also talk to your doctor or healthcare provider on a regular basis (for example, every 3-6 months) about whether you should continue this treatment.
Have yearly physical exams and examine your breasts for lumps on a monthly basis while taking conjugated estrogen and medroxyprogesterone combinations.
nopreg Do not take conjugated estrogen and medroxyprogesterone combinations if you are pregnant or planning to become pregnant. It could affect the development of the baby.
What is conjugated estrogens and medroxyprogesterone?
Conjugated estrogens are naturally occurring female sex hormones that are involved in the development and maintenance of the female reproductive system.
Medroxyprogesterone is a female hormone, usually called "progesterone." It is important for the regulation of ovulation and menstruation.
Together, conjugated estrogen and progesterone are used to treat the symptoms of menopause such as feelings of warmth in the face, neck and chest, or sudden intense spells of heat and sweating ("hot flashes" or "hot flushes"); to treat vulvar and vaginal changes caused by menopause (itching, burning, dryness in or around the vagina, difficulty or burning with urination); and to prevent thinning of the bones (osteoporosis).
Conjugated estrogen and medroxyprogesterone combinations may also be used for purposes other than those listed in this medication guide.
What should I discuss with my healthcare provider before taking conjugated estrogens and medroxyprogesterone?
donot Do not take conjugated estrogen and medroxyprogesterone combinations without first talking to your doctor if you have
* had an allergic reaction to another estrogen or progesterone product;
* a circulation, bleeding, or blood-clotting disorder;
* a history of blood clots in the leg or lung;
* liver disease;
* undiagnosed, abnormal vaginal bleeding; or
* any type of breast, uterine, or hormone-dependent cancer.
Taking conjugated estrogen and medroxyprogesterone combinations may be dangerous in some cases if you have any of the conditions listed above.
Before taking conjugated estrogen and medroxyprogesterone combinations, tell your doctor if you have
* high blood pressure, angina, or heart disease;
* a history of heart attack or stroke;
* high levels of cholesterol or triglycerides in the blood;
* kidney disease;
* thyroid problems;
* asthma;
* epilepsy;
* migraines;
* depression;
* diabetes;
* gallbladder disease;
* uterine fibroids; or
* had a hysterectomy (uterus removed).
You may not be able to take conjugated estrogen and medroxyprogesterone combinations, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.
The Women's Health Initiative (WHI) study found an increased risk of breast cancer, heart disease, nonfatal heart attacks, and blood clots in women taking estrogen and medroxyprogesterone combinations long-term. You should contact your doctor or healthcare provider to discuss your individual risks and benefits before taking a conjugated estrogen and medroxyprogesterone combination long-term. You should also talk to your doctor or healthcare provider on a regular basis (for example, every 3-6 months) about whether you should continue this treatment.
nopreg Conjugated estrogen and medroxyprogesterone combinations are in the FDA pregnancy category X. This means that these medications are known cause birth defects in an unborn baby. Do not take conjugated estrogen and medroxyprogesterone combinations if you are pregnant or if you could become pregnant during treatment.
nobrfeed Conjugated estrogen and medroxyprogesterone combinations pass into breast milk, and the effects on a nursing infant are unknown. Do not take this medication without first talking to your doctor if you are breast-feeding a baby.
How should I take conjugated estrogens and medroxyprogesterone?
Take conjugated estrogen and medroxyprogesterone combinations exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.
water Take each dose with a full glass of water.
food Take conjugated estrogen and medroxyprogesterone combinations with food or milk to lessen stomach upset. Try to take doses at the same time each day. You may be taking the medication on a cycle, such as every day for 3 weeks with 1 week off each month to mimic the body's natural cycle. Follow the directions on the prescription label.
Have yearly physical exams and examine your breasts for lumps on a monthly basis while taking a conjugated estrogen and medroxyprogesterone combination.
It is important to take conjugated estrogen and medroxyprogesterone combinations regularly to get the most benefit.
Your doctor may want you to have blood tests or other medical evaluations during treatment with a conjugated estrogen and medroxyprogesterone combination to monitor progress and side effects.
rt Store conjugated estrogen and medroxyprogesterone combinations at room temperature away from moisture and heat.
What happens if I miss a dose?
Take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and return to the regular dosing schedule. Do not take a double dose of this medication unless otherwise directed by your doctor.
What happens if I overdose?
emt An overdose of a conjugated estrogen and medroxyprogesterone combination is unlikely to threaten life. Call an emergency room or poison control center for advice if an overdose is suspected.
Symptoms of a conjugated estrogen and medroxyprogesterone combination overdose might include nausea, vomiting, and vaginal bleeding.
What should I avoid while taking conjugated estrogens and medroxyprogesterone?
There are no restrictions on food, beverages, or activity while taking a conjugated estrogen and medroxyprogesterone combination unless your doctor directs otherwise.
What are the possible side effects of conjugated estrogens and medroxyprogesterone?
Conjugated estrogens increase the risk of developing endometrial hyperplasia, a condition that may lead to cancer of the lining of the uterus. Taking a progestin, such as medroxyprogesterone, with conjugated estrogens lowers the risk of developing this condition. Visit your doctor regularly and report any unusual vaginal bleeding right away.
The Women's Health Initiative (WHI) study found an increased risk of breast cancer, heart disease, nonfatal heart attacks, and blood clots in women taking estrogen and medroxyprogesterone combinations long-term. You should contact your doctor or healthcare provider to discuss your individual risks and benefits before taking a conjugated estrogen and medroxyprogesterone combination long-term. You should also talk to your doctor or healthcare provider on a regular basis (for example, every 3-6 months) about whether you should continue this treatment.
emt Stop taking the conjugated estrogen and medroxyprogesterone combination and seek emergency medical attention or call your doctor immediately if you experience any of the following serious side effects:
* an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);
* a blood clot (pain, redness, and swelling in an arm or leg; shortness of breath; coughing blood; chest pain; headache; blurred vision; confusion; loss of speech, or dizziness);
* unusual or abnormal vaginal bleeding;
* gallbladder disease (pain, swelling, or tenderness in the abdomen);
* liver damage (yellowing of the skin or eyes, nausea, abdominal pain or discomfort, unusual bleeding or bruising, severe fatigue); or
* a lump in a breast.
Other, less serious side effects may be more likely to occur. Continue to take conjugated estrogen and medroxyprogesterone combinations and talk to your doctor if you experience
* changes in appetite or weight,
* changes in blood sugar levels;
* swelling of the hands or feet,
* tiredness or weakness,
* irregular bleeding or spotting,
* depression,
* an increase in body or facial hair or hair loss,
* swollen or tender breasts,
* nausea,
* headache or insomnia,
* changes in your voice, or
* areas of darker skin.
Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.
What other drugs will affect conjugated estrogens and medroxyprogesterone?
Before taking a conjugated estrogen and medroxyprogesterone combination, tell your doctor if you are taking any of the following medicines:
* an anticoagulant (blood thinner) such as warfarin (Coumadin);
* insulin or an oral diabetes medicine such as glipizide (Glucotrol), glyburide (Diabeta, Micronase), and others; or
* tamoxifen (Nolvadex);
A dosage adjustment or special monitoring may be required during treatment if you are taking any of the medicines listed above.
Drugs other than those listed here may also interact with conjugated estrogen and medroxyprogesterone combinations. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products.
Where can I get more information?
Your pharmacist has additional information about conjugated estrogen and medroxyprogesterone combinations written for health professionals that you may read.
What does my medication look like?
Conjugated estrogen and medroxyprogesterone combinations are available with a prescription under the brand names Prempro and Premphase. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.
* Prempro 0.625 mg of conjugated estrogens and 2.5 mg of medroxyprogesterone--two blister cards, each containing 14 oval, peach-colored tablets
* Premphase--one blister card of 14 oval, maroon tablets, each containing 0.625 mg of conjugated estrogens, to be taken on days 1 through 14; and a second blister card of 14 oval, light-blue tablets, each containing 0.625 mg of conjugated estrogens and 5 mg of medroxyprogesterone, to be taken on days 15 through 28.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
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