Enjuvia (other name Premarin)

What should I tell my health care provider before I take this medicine?

Before starting this medication, inform your healthcare provider about all your medical conditions, allergies, and medications you are currently taking. It is crucial to disclose if you have or have had any of the following:

• Abnormal vaginal bleeding
• Blood vessel disease or blood clots
• Breast, cervical, endometrial, ovarian, liver, or uterine cancer
• Dementia
• Diabetes
• Endometriosis
• Fibroids
• Gallbladder disease
• Heart disease or recent heart attack
• High blood pressure
• High cholesterol
• High level of calcium in the blood
• Kidney disease
• Liver disease
• Mental depression
• Migraine headaches
• Stroke
• Tobacco smoker
• An unusual or allergic reaction to estrogens, other medicines, foods, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breast-feeding

Disclose all medications, including prescription, over-the-counter, herbal remedies, and supplements, you are currently taking. Certain medical conditions or medications can affect how this medicine works.

How should I use this medicine?

Take this medicine orally with a glass of water. Follow the directions provided on the prescription label. Take your medicine at regular intervals, at the same time each day. Do not take your medicine more often than directed. Consistency is key for optimal results.

A patient information sheet for the product will be given with each prescription and refill. Read this sheet carefully each time. The sheet may change frequently.

This medicine is not approved for use in children. Consult your pediatrician for alternative treatments for children.

Overdosage: If you suspect an overdose, contact a poison control center or emergency room immediately.

What if I miss a dose?

If you miss a dose, take it as soon as you remember. However, if it is less than four hours until your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double or extra dose to compensate for the missed one.

What may interact with this medicine?

Do not take this medicine with any of the following medications:

• Aromatase inhibitors like aminoglutethimide, anastrozole, exemestane, letrozole, testolactone
• Metyrapone

This medicine may also interact with the following medications:

• Barbiturates, such as phenobarbital
• Carbamazepine
• Clarithromycin
• Erythromycin
• Grapefruit juice
• Medicines for fungal infections like ketoconazole and itraconazole
• Phenytoin
• Rifampin
• Ritonavir
• St. John's Wort
• Thyroid hormones

This list may not include all possible drug interactions. Provide your health care provider with a comprehensive list of all the medicines, herbs, non-prescription drugs, and dietary supplements you use. Inform them if you smoke, drink alcohol, or use illegal drugs, as these may interact with your medicine.

What should I watch for while using this medicine?

Visit your health care professional for regular check-ups to monitor your progress. Regular breast and pelvic exams, as well as Pap smears, are necessary while taking this medicine. Discuss the need for regular mammograms with your healthcare professional and adhere to their guidelines for these tests. This medicine may cause fluid retention, leading to swelling in your fingers, hands, or ankles. Your blood pressure may also increase. Contact your doctor if you experience fluid retention. If you suspect you are pregnant, discontinue the medicine immediately and contact your doctor or health care professional. Smoking increases the risk of blood clots or stroke while taking this medicine, particularly if you are over 35 years old. Abstaining from smoking is strongly advised. If you wear contact lenses and notice visual changes or discomfort, consult your eye care specialist. This medicine can increase the risk of developing endometrial hyperplasia, which may lead to uterine cancer. Taking progestins with this medicine reduces this risk. If your uterus has not been removed (hysterectomy), your doctor may prescribe a progestin to take alongside your estrogen. However, taking estrogens with progestins may pose additional health risks. Discuss the benefits and risks of estrogens and progestins with your health care professional to determine the best approach for you. If you are scheduled for surgery, you may need to stop taking this medicine. Consult your health care professional for guidance before scheduling the surgery.

What side effects may I notice from receiving this medicine?

Side effects that require immediate medical attention:

• Allergic reactions (skin rash, itching or hives, swelling of the face, lips, or tongue)
• Breast tissue changes or discharge
• Changes in vision
• Chest pain
• Confusion, trouble speaking or understanding
• Dark urine
• General ill feeling or flu-like symptoms
• Light-colored stools
• Nausea, vomiting
• Pain, swelling, warmth in the leg
• Right upper belly pain
• Severe headaches
• Shortness of breath
• Sudden numbness or weakness of the face, arm or leg
• Trouble walking, dizziness, loss of balance or coordination
• Unusual vaginal bleeding
• Yellowing of the eyes or skin

Side effects that usually do not require medical attention (but report if they persist or are bothersome):

• Hair loss
• Increased hunger or thirst
• Increased urination
• Symptoms of vaginal infection (itching, irritation or unusual discharge)
• Unusually weak or tired

Where should I keep my medicine?

Keep out of the reach of children. Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Discard any unused medicine after the expiration date.

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