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What should I discuss with my healthcare provider before using vaginal conjugated estrogens (Premarin Vaginal, Synthetic Conjugated Estrogens, A)?

Do not use vaginal conjugated estrogens if you are pregnant, or if you have:

• a history of heart attack, stroke, or blood clot (especially in your lung or your lower body);
• abnormal vaginal bleeding that a doctor has not checked;
• liver disease; or
• any type of breast, uterine, or hormone-dependent cancer.

Before using vaginal conjugated estrogens, tell your doctor if you are allergic to any drugs, or if you have:

• high blood pressure, heart disease, or circulation problems;
• a personal or family history of stroke;
• endometriosis;
• liver or kidney disease;
• asthma;
• epilepsy or other seizure disorder;
• migraines;
• diabetes;
• underactive thyroid;
• high cholesterol or triglycerides;
• high or low levels of calcium in your blood;
• porphyria;
• systemic lupus erythematosus (SLE);
• gallbladder disease; or
• if you have had your uterus removed (hysterectomy).

Vaginal conjugated estrogens increase your risk of developing endometrial hyperplasia, a condition that may lead to cancer of the uterus. Taking progestins while using conjugated estrogens may lower this risk. If your uterus has not been removed, your doctor may prescribe a progestin for you to take while you are using vaginal conjugated estrogens.

Long-term conjugated estrogens treatment may increase your risk of stroke or blood clots. Talk with your doctor about your individual risks before using vaginal conjugated estrogens long term, especially if you smoke or are overweight. Your doctor should check your progress on a regular basis (every 3 to 6 months) to determine whether you should continue this treatment.

FDA pregnancy category X. This medication can cause birth defects. Do not use vaginal conjugated estrogens if you are pregnant. Tell your doctor right away if you become pregnant during treatment. Use an effective form of birth control while you are using this medication. You should know that conjugated estrogens vaginal cream can weaken the latex of a condom, diaphragm, or cervical cap. Talk to your doctor about the best contraceptive methods to use.

Conjugated estrogens can pass into breast milk and may harm a nursing baby. This medication may also slow breast milk production. Do not use if you are breast-feeding a baby.

Do not use this medication in anyone under 18 years old without the advice of a doctor.

How should I use vaginal conjugated estrogens (Premarin Vaginal, Synthetic Conjugated Estrogens, A)?

Use this medication exactly as it was prescribed for you. Do not use the medication in larger amounts, or use it for longer than recommended by your doctor. Follow the directions on your prescription label.

Vaginal conjugated estrogens are usually prescribed for only a short time and are most often used in a cycle, such as 3 weeks on followed by 1 week off. Some conditions require daily use and others require use only twice a week during the treatment period. Follow the directions on your prescription label.

To apply this medication, use only the vaginal applicator provided. After each use, take the applicator apart and clean it with mild soap and warm water. Do not use hot or boiling water.

Have regular physical exams and self-examine your breasts for lumps on a monthly basis if you are using vaginal conjugated estrogens long term.

If you need to have any type of surgery, tell the surgeon ahead of time that you are using conjugated estrogens. You may need to stop using the medicine for a short time.

This medication can affect the results of certain medical tests. Tell any doctor who treats you that you are using conjugated estrogens.

Store this medication at room temperature away from moisture and heat.

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