Conjugated Estrogens and Medroxyprogesterone For Ovarian Hormone Therapy (OHT) (Systemic)

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For conjugated estrogens and medroxyprogesterone, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to estrogens or progestins. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy - Conjugated estrogens and medroxyprogesterone are not recommended for use during pregnancy. Becoming pregnant or maintaining a pregnancy is not likely to occur around the time of menopause. Tell your doctor right away if you suspect you are pregnant.

Breast-feeding - Conjugated estrogens and medroxyprogesterone pass into the breast milk. This medicine is not recommended for use during breast-feeding.

Older adults - Conjugated estrogens and medroxyprogesterone may increase your chance of having a stroke, memory problems, or breast cancer that spreads to other parts of your body.

Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking conjugated estrogens and medroxyprogesterone, it is especially important that your health care professional know if you are taking any of the following:

• Acetaminophen (e.g., Tylenol) (with long-term, high-dose use) or
• Amiodarone (e.g., Cordarone) or
• Anabolic steroids (nandrolone [e.g., Anabolin], oxandrolone [e.g., Anavar], oxymetholone [e.g., Anadrol], stanozolol [e.g., Winstrol]) or
• Androgens (male hormones) or
• Anti-infectives by mouth or by injection (medicine for infection) or
• Antithyroid agents (medicine for overactive thyroid) or
• Carmustine (e.g., BiCNU) or
• Chloroquine (e.g., Aralen) or
• Dantrolene (e.g., Dantrium) or
• Daunorubicin (e.g., Cerubidine) or
• Disulfiram (e.g., Antabuse) or
• Divalproex (e.g., Depakote) or
• Etretinate (e.g., Tegison) or
• Gold salts (medicine for arthritis) or
• Hydroxychloroquine (e.g., Plaquenil) or
• Isoniazid or
• Mercaptopurine (e.g., Purinethol) or
• Methotrexate (e.g., Mexate) or
• Methyldopa (e.g., Aldomet) or
• Naltrexone (e.g., Trexan) (with long-term, high-dose use) or
• Phenothiazines (acetophenazine [e.g., Tindal], chlorpromazine [e.g., Thorazine], fluphenazine [e.g., Prolixin], mesoridazine [e.g., Serentil], perphenazine [e.g., Trilafon], prochlorperazine [e.g., Compazine], promazine [e.g., Sparine], promethazine [e.g., Phenergan], thioridazine [e.g., Mellaril], trifluoperazine [e.g., Stelazine], triflupromazine [e.g., Vesprin], trimeprazine [e.g., Temaril]) or
• Plicamycin (e.g., Mithracin) - Use of these medicines with conjugated estrogens and medroxyprogesterone may increase the chance of problems occurring that affect the liver

• Aminoglutethimide (e.g., Cytadren) or
• Barbiturates, especially phenobarbital or
• Carbamazepine (e.g., Tegretol) or
• Phenytoin (e.g., Dilantin) or
• Rifampin (e.g., Rifadin) or
• St. John's wort (Hypericum perforatum - These medicines may decrease the effect of conjugated estrogens or medroxyprogesterone

• Cyclosporine (e.g., Sandimmune) - Conjugated estrogens can prevent cyclosporine's removal from the body; this can lead to cyclosporine causing kidney or liver problems

Other medical problems - The presence of other medical problems may affect the use of conjugated estrogens and medroxyprogesterone. Make sure you tell your doctor if you have any other medical problems, especially:

• Asthma or
• Heart problems or
• Epilepsy or
• High blood pressure or
• Kidney problems, severe or
• Migraine headaches - Rarely, water retention caused by conjugated estrogens or medroxyprogesterone may worsen these conditions; on the other hand, blood pressure and some heart or blood vessel problems can improve for most patients

• Blood clotting problems (or history of during previous estrogen therapy) - Estrogens usually are not used until blood clotting problems stop; using estrogens is usually not a problem for most patients without a history of blood clotting problems due to estrogen use

• Bone cancer or
• Breast cancer or
• Cancer of the uterus (active or suspected) or
• Fibroid tumors of the uterus - Estrogens may interfere with the treatment of breast or bone cancer, worsen cancer of the uterus, or increase the size of fibroid tumors

• Changes in genital or vaginal bleeding of unknown causes - Estrogens may make these conditions worse; some irregular vaginal bleeding may be a sign that the lining of the uterus may be growing too much or is a sign of cancer of the uterus lining

• Changes in vision - This medicine may make cause changes in vision; your medicine may need to be stopped if these conditions become worse

• Diabetes mellitus (sugar diabetes) - Conjugated estrogens or medroxyprogesterone may slightly change the amount of blood sugar for some patients, but for most patients with sugar diabetes, there is no change in blood sugar

• Endometriosis or
• Gallbladder disease or gallstones (or history of) or
• High cholesterol or triglycerides (or family history of) or
• Jaundice (yellow skin) or
• Liver disease, including jaundice (or history of) or
• Pancreatitis (inflammation of pancreas) or
• Porphyria (liver problem) - Conjugated estrogens or medroxyprogesterone may worsen these conditions; using estrogens can lower blood cholesterol in many patients with high cholesterol

• Low blood calcium, severe - Estrogens should be used with caution in patients with this condition

• Underactive thyroid - A change in dose of thyroid medication may be needed. Your doctor will watch for this.