Estrogens, Conjugated(ess’ troe jenz)
Oral, topical vaginal cream: C.E.S. (CAN), Premarin
Parenteral: Premarin Intravenous
Synthetic: Cenestin, Enjuvia
PREGNANCY CATEGORY X
Drug Classes
Estrogen
Hormone
Therapeutic Actions
Estrogens are endogenous female sex hormones important in the development of the female reproductive system and secondary sex characteristics. They affect the release of pituitary gonadotropins; cause capillary dilation, fluid retention, protein anabolism, and thin cervical mucus; conserve calcium and phosphorus; encourage bone formation; inhibit ovulation and prevent postpartum breast discomfort. They are responsible for the proliferation of the endometrium; absence or decline of estrogen produces signs and symptoms of menopause on the uterus, vagina, breasts, cervix. Their efficacy as palliation in male patients with androgen-dependent prostatic carcinoma is attributable to their competition with androgens for receptor sites, thus decreasing the influence of androgens.
Indications
Oral
-
Palliation of moderate to severe vasomotor symptoms, atrophic vaginitis, or kraurosis vulvae associated with menopause
-
Treatment of female hypogonadism; female castration; primary ovarian failure
-
Osteoporosis: To retard progression
-
Palliation of inoperable prostatic cancer
-
Palliation of metastatic breast cancer
-
Cenestin, Enjuvia: Treatment of moderate to severe vasomotor symptoms associated with menopause
Parenteral
-
Treatment of uterine bleeding due to hormonal imbalance in the absence of organic pathology
Vaginal cream
-
Treatment of atrophic vaginitis and kraurosis vulvae associated with menopause
Contraindications and Cautions
-
Contraindicated with allergy to estrogens, breast cancer (with exceptions), estrogen-dependent neoplasm, undiagnosed abnormal genital bleeding, active or past thrombophlebitis or thromboembolic disorders from previous estrogen use, pregnancy (serious fetal defects; women of childbearing age should be advised of risks and birth control measures suggested).
-
Use cautiously with metabolic bone disease, renal or hepatic insufficiency, heart failure, lactation.
Available Forms
Tablets—0.3, 0.45, 0.625, 0.9, 1.25 mg; injection—25 mg; vaginal cream—0.625 mg/g
Dosages
Oral drug should be given cyclically (3 wk on/1 wk off) except in selected cases of carcinoma and prevention of postpartum breast engorgement.
Adults
-
Moderate to severe vasomotor symptoms associated with menopause: 0.3–0.625 mg/day PO.
-
Atrophic vaginitis, kraurosis vulvae associated with menopause: 0.5–2 g vaginal cream daily intravaginally or topically, depending on severity of condition. Taper or discontinue at 3- to 6-mo intervals. Or, 0.3 mg/day PO continually.
-
Female hypogonadism: 0.3–0.625 mg/day PO for 3 wk followed by 1 wk of rest. Adjust dose depending on severity of symptoms and responsiveness of endometrium.
-
Female castration, primary ovarian failure: 1.25 mg/day PO. Adjust dosage by patient response to lowest effective dose.
-
Prostatic cancer (inoperable): 1.25–2.5 mg tid PO. Judge effectiveness by phosphatase determinations and by symptomatic improvement.
-
Osteoporosis: Start with lowest dose, 0.3 mg/day PO given continuously or cyclically (25 days on/5 days off). Adjust dosage based on individual response.
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
