Enjuvia Treatment Report

Precautions

Instructions

Side Effects

Interactions

Do not use conjugated estrogens if you have:

• a history of heart attack, stroke, or blood clot (especially in your lung or your lower body);
• abnormal vaginal bleeding that a doctor has not checked;
• liver disease; or
• any type of breast, uterine, or hormone-dependent cancer.

Before using conjugated estrogens, tell your doctor if you are allergic to any drugs, or if you have:

• high blood pressure, heart disease, or circulation problems;
• a personal or family history of stroke;
• endometriosis;
• kidney disease;
• asthma;
• epilepsy or other seizure disorder;
• migraines;
• diabetes;
• underactive thyroid;
• high cholesterol or triglycerides;
• high or low levels of calcium in your blood;
• porphyria;
• systemic lupus erythematosus (SLE);
• gallbladder disease; or
• if you have had your uterus removed (hysterectomy).

Conjugated estrogens increase your risk of developing endometrial hyperplasia, a condition that may lead to cancer of the uterus. Taking progestins while using conjugated estrogens 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 conjugated estrogens.

Long-term conjugated estrogens treatment may increase your risk of stroke or blood clots. Talk with your doctor about your individual risks before using conjugated estrogens 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.

FDA pregnancy category X. This medication can cause birth defects. Do not use conjugated estrogens if you are pregnant. Tell your doctor right away if you become pregnant during treatment. Use an effective form of birth control while you are using this medication.

Conjugated estrogens can pass into breast milk and may harm a nursing baby. This medication may also slow breast milk production. Do not use if you are breast-feeding a baby.

Do not give this medication to anyone under 18 years old without the advice of a doctor.

Do not smoke while using this medication. Smoking can increase your risk of blood clots, stroke, or heart attack caused by conjugated estrogens.

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Take the medication as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

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Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop taking this medication and call your doctor at once if you have any of these serious side effects:

• chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;
• sudden numbness or weakness, especially on one side of the body;
• sudden headache, confusion, problems with vision, speech, or balance;
• pain or swelling in your lower leg;
• abnormal vaginal bleeding;
• migraine headache;
• pain, swelling, or tenderness in your stomach;
• confusion, problems with memory or concentration;
• jaundice (yellowing of the skin or eyes);
• swelling in your hands, ankles, or feet; or
• a breast lump.

Less serious side effects may include:

• mild nausea, vomiting, bloating, stomach cramps;
• breast pain, tenderness, or swelling;
• freckles or darkening of facial skin;
• increased hair growth, loss of scalp hair;
• changes in weight or appetite;
• problems with contact lenses;
• vaginal itching or discharge;
• changes in your menstrual periods, decreased sex drive; or
• 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. You may report side effects to FDA at 1-800-FDA-1088.

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Before taking conjugated estrogens, tell your doctor if you are taking any of the following medicines:

• a blood thinner such as warfarin (Coumadin);
• a thyroid medication such as levothyroxine (Synthroid);
• insulin or diabetes medicine taken by mouth;
• rifampin (Rifadin, Rifater, Rifamate, Rimactane);
• ketoconazole (Nizoral) or itraconazole (Sporanox);
• seizure medicines such as phenytoin (Dilantin), carbamazepine (Tegretol), felbamate (Felbatol), oxcarbazepine (Trileptal), or primidone (Mysoline);
• a barbiturate such as amobarbital (Amytal), butabarbital (Butisol), mephobarbital (Mebaral), secobarbital (Seconal), or phenobarbital (Luminal, Solfoton); or
• 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 conjugated estrogens. 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.

Cenestin, Enjuvia, Premarin, Premarin Intravenous, and conjugated estrogens

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