Estrogen+ Progestin ( Hormone replacement therapy )

CAUTION:
Hormone replacement therapy may increase the risk of heart attack, stroke, breast cancer, and blood clots in the lungs and legs. Inform your doctor if you smoke and if you have or have ever had breast lumps or cancer; a heart attack; a stroke; blood clots; high blood pressure; high blood levels of cholesterol or fats; or diabetes. If you are having surgery or will be on bedrest, talk to your doctor about stopping estrogen and progestin at least 4-6 weeks before the surgery or bedrest.If you experience any of the following side effects, call your doctor without delay: sudden, severe headache; sudden, severe vomiting; sudden partial or complete loss of vision; speech problems; dizziness or faintness; weakness or numbness of an arm or a leg; crushing chest pain or chest heaviness; coughing up blood; sudden shortness of breath; or calf pain.Talk to your doctor about the risks and benefits of taking estrogen and progestin.

General Information and Indications:

Combinations of estrogen and progestin are used to treat certain symptoms of menopause. Estrogen and progestin are two female sex hormones. Hormone replacement therapy works by replacing estrogen hormone that is no longer being made by the body. Estrogen reduces feelings of warmth in the upper body and periods of sweating and heat (hot flashes), vaginal symptoms (itching, burning, and dryness) and difficulty with urination, but it does not relieve other symptoms of menopause such as nervousness or depression. Estrogen also prevents thinning of the bones (osteoporosis) in menopausal women. Progestin is added to estrogen in hormone replacement therapy to reduce the risk of uterine cancer in women who still have their uterus.

Information For Users:

Hormone replacement therapy comes as a tablet to take by mouth. It is usually taken once a day. To help you remember to take hormone replacement therapy, take it around the same time every day. Follow the directions on your prescription label, ask your doctor or pharmacist If you have any questions. Take this medication exactly as directed. Do not take more or less of it or take it more often than prescribed by your health care provider. Do not discontinue taking this medication without informing your doctor.

Activella, femhrt, and Prempro come as tablets containing estrogen and progestin. Take one tablet every day.

Ortho-Prefest comes in a blister card containing 30 tablets. Take one pink tablet (containing only estrogen) once daily for 3 days, then take one white tablet (containing estrogen and progestin) once daily for 3 days. Repeat this process until you finish all the tablets on the card. Begin a new blister card the day after you finish the last one.

Premphase comes in a dispenser containing 28 tablets. Take one maroon tablet (containing only estrogen) once daily on days 1 to 14, and take one light-blue tablet (containing estrogen and progestin) once daily on days 15 to 28. Begin a new dispenser the day after you finish the last one.

Before taking hormone replacement therapy, ask your pharmacist or doctor for a copy of the manufacturer's information for the patient and read it carefully.

Special precautions:

o Inform your doctor or pharmacist if you have allergy to estrogen, progestin, or any other medications.
o Inform your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: acetaminophen (Tylenol); anticoagulants ('blood thinners') such as warfarin (Coumadin); cyclosporine (Neoral, Sandimmune); medications for seizures such as carbamazepine (Tegretol), phenobarbital (Luminal, Solfoton), and phenytoin (Dilantin); morphine (Kadian, MS Contin, MSIR, others); oral steroids such as dexamethasone (Decadron, Dexone), methylprednisolone (Medrol), prednisone (Deltasone) and prednisolone (Prelone); rifampin (Rifadin, Rimactane); salicylic acid; temazepam (Restoril); theophylline (Theobid, Theo-Dur); and thyroid medication such as levothyroxine (Levothroid, Levoxyl, Synthroid). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
o in addition to the conditions listed in the CAUTION section, Inform your doctor if you have had a hysterectomy and if you have or have ever had asthma; toxemia (high blood pressure during pregnancy); depression; epilepsy (seizures); migraine headaches; liver, heart, gallbladder, or kidney disease; jaundice (yellowing of the skin or eyes, jaundice); vaginal bleeding between menstrual periods; and excessive weight gain and fluid retention (bloating) during the menstrual cycle.
o Inform your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking this medication, call your doctor without delay. Estrogen and progestin may harm the fetus.
o if you are having surgery, including dental surgery, tell the doctor or dentist you are taking hormone replacement therapy.
o Inform your doctor if you smoke cigarettes. Smoking while taking this medication may increase your risk of serious side effects such as blood clots and stroke. Smoking also may decrease the effectiveness of this medication.
o Inform your doctor and pharmacist if you wear contact lenses. If you notice changes in vision or ability to wear your lenses while taking hormone replacement therapy, see an eye doctor.

Possible Adverse Effects:

Hormone replacement therapy may cause adverse effects. Inform your doctor if any of the following symptoms are severe or do not go away:

o headache
o upset stomach
o vomiting
o stomach cramps or bloating
o diarrhea
o appetite and weight changes
o changes in sex drive or ability, impotence
o nervousness
o brown or black skin patches
o acne
o swelling of hands, feet, or lower legs (fluid retention)
o bleeding or spotting between menstrual periods
o changes in menstrual flow
o breast tenderness, enlargement, or discharge
o difficulty wearing contact lenses

Some adverse effects could be serious. The following symptoms are uncommon, but if you experience any of them or those listed in the CAUTION section, call your doctor without delay:

o double vision (diplopia)
o severe abdominal pain
o yellowing of the skin or eyes, jaundice
o severe mental depression
o unusual bleeding
o loss of appetite (anorexia)
o rash
o extreme tiredness, weakness, or lack of energy
o fever
o dark-colored urine
o light-colored stool

Hormone replacement therapy may increase the risk of developing endometrial cancer and gallbladder disease. Talk to your doctor about the risks of taking this medication.

Possible Symptoms of Overdose:

o upset stomach
o vomiting

Brand Name(s):

o Activella®
o femhrt®
o Ortho-Prefest®
o Premphase®
o Prempro®

Other Name(s):

o conjugated estrogens and medroxyprogesterone
o estradiol and norgestimate
o estradiol and norethindrone
o ethinyl estradiol and norethindrone