Conjugated Estrogens
Conjugated estrogens are a mixture of estrogen hormones used to treat symptoms of menopause, such as hot flashes and vaginal dryness. They are also used to prevent osteoporosis in postmenopausal women and to replace estrogen in women with ovarian failure or other conditions that cause a lack of natural estrogen.-Menopausal symptoms (e.g., hot flashes, vaginal atrophy) -Hypoestrogenism due to hypogonadism, castration, or primary ovarian failure -Prevention of postmenopausal osteoporosis -Palliative treatment of breast cancer and prostate cancer
-Menopausal symptoms: 0.3 mg to 1.25 mg daily, adjusted based on patient response. -Osteoporosis prevention: 0.3 mg to 0.625 mg daily. -Hypoestrogenism: 0.3 mg to 1.25 mg daily, depending on severity. -Breast/prostate cancer: 10 mg three times daily for at least three months.
-Known or suspected breast cancer (except in appropriately selected patients being treated for metastatic disease) -Estrogen-dependent neoplasia -Active or history of venous thromboembolism or arterial thromboembolism (e.g., stroke, myocardial infarction) -Liver dysfunction or disease -Pregnancy -Undiagnosed abnormal genital bleeding -Hypersensitivity to the drug or any of its ingredients
-Evaluate risks and benefits in patients with risk factors for cardiovascular disease or cancer. -Monitor blood pressure regularly. -Use with caution in patients with a history of hormone-dependent tumors. -Regularly evaluate for signs of thrombosis. -Periodically reassess the need for continued therapy. -Women with intact uterus should consider concurrent progestin therapy to reduce the risk of endometrial hyperplasia.
-Headache -Breast pain -Irregular vaginal bleeding or spotting -Stomach or abdominal cramps/bloating -Nausea and vomiting -Hair loss -Fluid retention (edema) -Risk of blood clots -Increased risk of certain cancers (e.g., endometrial, breast) -Mood changes
-CYP3A4 inhibitors (e.g., ketoconazole, erythromycin): May increase estrogen levels. -CYP3A4 inducers (e.g., rifampin, St. John's Wort): May decrease estrogen levels. -Anticoagulants: Estrogens may reduce the efficacy of anticoagulants. -Thyroid hormones: Estrogens can affect thyroid-binding globulin, requiring dose adjustments of thyroid hormone therapy. -Corticosteroids: May increase the pharmacologic effects of corticosteroids.
