Premarin Vaginal cream contains a mixture of estrogen hormones. Estrogen is a female sex hormone produced by the ovaries. Estrogen is necessary for many processes in the body.
Premarin Vaginal cream is used to treat the vaginal symptoms of menopause such as dryness, burning, irritation, and painful sexual intercourse.
Premarin Vaginal cream should not be used to prevent heart disease or dementia, because this medication may actually increase your risk of developing these conditions.
Premarin Vaginal may also be used for purposes not listed in this medication guide.
Important information
Premarin Vaginal cream can harm an unborn baby or cause birth defects. Do not use if you are pregnant. You should not use Premarin Vaginal if you have any of the following conditions: a history of heart attack, stroke, or blood clot (especially in your lung or your lower body), liver disease, abnormal vaginal bleeding, or a hormone-related cancer such as breast or uterine cancer.
Long-term treatment with conjugated estrogens may increase your risk of breast cancer, heart attack, or stroke. Talk with your doctor about your individual risks before using Premarin Vaginal 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.
Have regular physical exams and self-examine your breasts for lumps on a monthly basis while using Premarin Vaginal.
Premarin Vaginal should not be used to prevent heart disease or dementia, because this medication may actually increase your risk of developing these conditions.
Before using Premarin Vaginal
You should not use Premarin Vaginal if you are pregnant, or if you have:
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a history of heart attack, stroke, or blood clot (especially in your lung or your lower body);
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abnormal vaginal bleeding that a doctor has not checked;
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liver disease; or
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any type of breast, uterine, or hormone-dependent cancer.
To make sure you can safely use Premarin Vaginal, tell your doctor if you have any of these other conditions:
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high blood pressure, heart disease, or circulation problems;
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a personal or family history of stroke;
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endometriosis;
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liver or kidney disease;
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asthma;
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epilepsy or other seizure disorder;
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migraines;
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diabetes;
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underactive thyroid;
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high cholesterol or triglycerides;
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high or low levels of calcium in your blood;
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porphyria;
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systemic lupus erythematosus (SLE); or
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gallbladder disease.
Long-term treatment with conjugated estrogens may increase your risk of breast cancer, heart attack, or stroke. Talk with your doctor about your individual risks before using Premarin Vaginal 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.
Conjugated estrogens increase your risk of developing endometrial hyperplasia, a condition that may lead to cancer of the uterus. Taking progestins while using Premarin Vaginal 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 Premarin Vaginal.
FDA pregnancy category X. Premarin Vaginal can harm an unborn baby or cause birth defects. Do not use Premarin Vaginal if you are pregnant. Tell your doctor right away if you become pregnant during treatment. Use effective birth control while you are using this medication. You should know that Premarin 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. Premarin Vaginal 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.
See also: Pregnancy and breastfeeding warnings (in more detail)
How should I use Premarin Vaginal?
Use Premarin Vaginal cream exactly as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.
Premarin Vaginal cream is 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 Premarin Vaginal cream, 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 while using Premarin Vaginal.
If you need surgery or medical tests or if you will be on bed rest, you may need to stop using this medication for a short time. Any doctor or surgeon who treats you should know that you are using Premarin Vaginal.
This medication can affect the results of certain medical tests. Tell any doctor who treats you that you are using Premarin Vaginal.
Store Premarin Vaginal cream at room temperature away from moisture and heat.
What happens if I miss a dose?
Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include nausea, vomiting, or vaginal bleeding.
What should I avoid?
Do not smoke while using this medication. Smoking can increase your risk of blood clots, stroke, or heart attack caused by Premarin Vaginal.
Premarin Vaginal side effects
Get emergency medical help if you have any of these signs of an allergic reaction to Premarin Vaginal: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Stop using Premarin Vaginal and call your doctor at once if you have a serious side effect such as:
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chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;
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sudden numbness or weakness, especially on one side of the body;
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sudden severe headache, confusion, problems with vision, speech, or balance;
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pain, swelling, warmth, or redness in one or both legs;
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abnormal vaginal bleeding;
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migraine headache;
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pain, swelling, or tenderness in your stomach;
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confusion, problems with memory or concentration;
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jaundice (yellowing of the skin or eyes);
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swelling in your hands, ankles, or feet; or
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a breast lump.
Less serious Premarin Vaginal side effects may include:
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mild nausea, vomiting, bloating, stomach cramps;
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breast pain, tenderness, or swelling;
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freckles or darkening of facial skin;
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increased hair growth, loss of scalp hair;
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changes in weight or appetite;
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problems with contact lenses;
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vaginal itching or discharge;
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changes in your menstrual periods, decreased sex drive; or
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headache, nervousness, dizziness, tired feeling.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
What other drugs will affect Premarin Vaginal?
Tell your doctor about all other medicines you use, especially:
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a blood thinner such as warfarin (Coumadin, Jantoven);
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a thyroid medication such as levothyroxine (Synthroid, Levoxyl, Levothroid and others);
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insulin or diabetes medicine taken by mouth;
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rifampin (Rifadin, Rifater, Rifamate, Rimactane);
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ketoconazole (Nizoral) or itraconazole (Sporanox);
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seizure medicines such as phenytoin (Dilantin), carbamazepine (Carbatrol, Equetro, Tegretol), felbamate (Felbatol), oxcarbazepine (Trileptal), or primidone (Mysoline);
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a barbiturate such as amobarbital (Amytal), butabarbital (Butisol), mephobarbital (Mebaral), secobarbital (Seconal), or phenobarbital (Luminal, Solfoton); or
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antidepressants such as amitriptyline (Elavil, Etrafon), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), imipramine (Janimine, Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil), or trimipramine (Surmontil).
This list is not complete and there may be other drugs that can interact with Premarin Vaginal. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.