IMPORTANT NOTE: The following information is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist or other healthcare professional. It should not be construed to indicate that use of the drug is safe, appropriate, or effective for you. Consult your healthcare professional before using this drug.

ESTROGENS - ORAL (ESS-trow-jens, conjugated)

COMMON BRAND NAME(S) Cenestin, Estinyl, Estrace, Menest, Ogen, Premarin, Tace

WARNING: This drug has been reported to increase the chance of womb (endometrial) cancer in women who have been through menopause. This risk appears to depend on the length of time this drug is used and the amount of estrogen per dose. If you use this drug for an extended period, you should be evaluated at least every 6 months. If you experience abnormal vaginal bleeding, notify your doctor promptly. This medication is not effective in preventing or treating a tendency toward miscarriages (natural habitual abortion) nor the threat of miscarriage. This drug must not be used during pregnancy because its use may result in birth defects or cancer later in the child's life. If you become pregnant or think you may be pregnant, consult your doctor immediately to discuss the risk to the fetus.

USES: This medication is a hormone and is given to women who no longer produce the proper amount. It is used to reduce menopause symptoms (e.g., hot flashes), for brittle bones (osteoporosis), and treats certain cancers in both men and women.

HOW TO USE: May be taken with food or immediately after a meal to prevent stomach upset. Take this medication as prescribed. Follow the dosing schedule carefully. Be sure to ask your doctor if you have any questions.

SIDE EFFECTS: May cause dizziness, lightheadedness, headache, stomach upset, bloating, or nausea. These effects should disappear as your body adjusts to the medication. Notify your doctor if you experience: severe depression, calf pain, sudden severe headache, chest pain, shortness of breath, lumps in the breast, weakness or tingling in the arms or legs, yellowing of the eyes or skin, changes in vaginal bleeding (spotting, breakthrough bleeding, prolonged or complete stoppage of bleeding), stomach pain, skin rash. If you notice other effects not listed above, contact your doctor or pharmacist.

PRECAUTIONS: Before you take this medication, tell your doctor your entire medical history, including: family medical history (especially breast lumps and cancer), high blood pressure, diabetes, asthma, epilepsy (seizures), migraine headaches, liver disease, heart disease, kidney disease, depression, toxemia (high blood pressure during pregnancy), jaundice (yellowing skin/eyes) during pregnancy, excessive weight gain and fluid retention (bloating) during menstrual cycle, uterine fibroid tumor, abnormal vaginal bleeding, blood clots or stroke, cholesterol or lipid problems, gallbladder disease. Before having surgery, tell the doctor that you take this drug. Depending on strength, this drug may cause a patchy, darkening of the skin on the face (melasma). Higher strengths are more likely to cause melasma. Sunlight may intensify this darkening and you may need to avoid prolonged sun exposure and sunlamps. Consult your doctor regarding use of sunscreens and protective clothing. Cigarette smoking can increase the chance of blood-clots while taking this medication (especially in women past the age of 35). This drug should not be used during pregnancy. If you become pregnant or think you may be pregnant, inform your doctor immediately. This drug may be excreted into breast milk and its use is not recommended while breast-feeding. Consult your doctor before breast-feeding.

DRUG INTERACTIONS: Tell your doctor of all prescription and nonprescription drugs you may use, especially of: hydantoins (e.g., phenytoin), barbiturates (e.g., phenobarbital), corticosteroids (e.g., prednisone). This product can affect the results of certain lab tests. Make sure laboratory personnel and your doctors know you use this drug. Do not start or stop any medicine without doctor or pharmacist approval.

OVERDOSE: If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include nausea/vomiting or stoppage of periods.

NOTES: Do not share this medication with others.

MISSED DOSE: If you miss a dose, take as soon as remembered; do not take if it is almost time for the next dose, instead, skip the missed dose and resume your usual dosing schedule. Do not "double-up" the dose to catch up.

STORAGE : Store at room temperature between 59 and 86 degrees F (between 15 and 30 degrees C) away from moisture and sunlight. Do not store in the bathroom.