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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.

It may also make it more difficult to breastfeed because it decreases the production of breast milk.

In the absence of comparable data.these risks should be assumed to be similar for other doses of CE and other dosage forms of estrogens.

Treatment Of Moderate To Severe Symptoms Of Vulvar And Vaginal Atrophy Due To Menopause.

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A 2to 4-fold increase in the risk of gallbladder disease requiring surgery in postmenopausal women receiving estrogens has been reported.

Treatment Of Moderate To Severe DyspareuniaA Symptom Of Vulvar And Vaginal AtrophyDue To Menopause.

Do not smoke or use tobaccoEstrogens combined with smoking further increases your risk of strokeblood clotshigh blood pressureand heart attackespecially in women older than 35.

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There is no evidence from randomised controlled trials of protection against myocardial infarction in women with or without existing CAD who received combined estrogen-progestogen or estrogen-only HRTRandomised controlled data found no increased risk of CAD in hysterectomised women using estrogen-only therapy.

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If any of the following conditions are presenthave occurred previouslyand/or have been aggravated during pregnancy or previous hormone treatmentthe patient should be closely supervisedIt should be taken into account that these conditions may recur or be aggravated during treatment with Premarinin particular:

In postmenopausal womenestrogens can increase the risk of cancer of the ovariesstrokedementiaand serious blood clots in the legsEstrogens alone do not appear to increase the risk of breast cancer when used for up to 7 yearsEstrogenwhen used with a progestincan increase the risk of heart diseasesuch as heart attacksstrokeserious blood clots in the lungs/legsdementiaand cancer of the breast/ovaries.

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In the WHI estrogen-alone substudya statistically significant increased risk of stroke was reported in women 50 to 79 years of age receiving daily CE0.625 mgalone compared to women in the same age group receiving placebo45 versus 33 per 10,000 women-yearsThe increase in risk was demonstrated in year 1 and persistedsee Clinical StudiesShould a stroke occur or be suspectedestrogen-alone therapy should be discontinued immediately.

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If VTE develops after initiating therapythe drug should be discontinuedPatients should be told to contact their doctors immediately when they are aware of potential thromboembolic symptomse.gpainful swelling of a legsudden pain in the chestdyspnoea

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