Premarin for Vaginal Bleeding: Indications, Usage, Dosage and Administration of Premarin

Reproductive Health
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Vaginal bleeding that occurs at the wrong time in a month and in appropriate amounts is considered abnormal vaginal bleeding. During consultation with a doctor, the patient will be asked if she is pregnant or if she is ovulating, as well as the pattern of bleeding that is experienced. These questions are necessary for the doctor to validate if the bleeding is indeed abnormal.

Premarin is a medication that is composed of conjugated estrogen. Several different estrogens (estrogen salts) make up this product. Its main components are sodium estrone sulphate and sodium equilin sulfate. It comes in tablet, vaginal cream, and injection form. Conjugated estrogens are used to treat menopause symptoms (hot flashes, vaginal dryness and vaginal atrophy), hypogonadism or the uderdevelopment of hormone-secreting organs, advanced prostate and breast cancer, and as preventive treatment for osteoporosis. Abnormal uterine bleeding that is caused by hormonal imbalance is also treated with intravenous Premarin.

Learn more about the indications, usage, dosage and administration of Premarin in treating abnormal vaginal bleeding.

Indications and Usage of Premarin

Conjugated estrogens are among the medications used in hormone replacement therapy (HRT). Premarin, the brand name of this medication, is used to prevent or treat osteoporosis, manage menopause symptoms (hot flashes, abnormal vaginal bleeding or spotting, night sweats and chills), treat vaginal atrophy, and it essential for women who had hysterectomy (removal of the uterus).

Dosage and Administration

Premarin tablets come in 0.3 mg, 0.625 mg, 0.9 mg, and 1.25 mg. It may be taken daily or in a cycle (e.g., 25 days cycle, with 5 days off), depending on the doctor’s prescription. Taking a double dose is not recommended.

Injected Premarin, or Premarin Intravenous, is effective in the treatment of abnormal uterine bleeding caused by hormonal imbalance. However, its usage is intended for short-term duration only, since the medication provides a rapid and temporary increase of estrogen.

To minimize side effects, doctors prescribe the lowest effective dosage of conjugated estrogens. For abnormal uterine bleeding that is caused by hormonal imbalance, a patient is treated by giving 25 mg of intravenous or intermuscular injection. This form of Premarin is preferred because of the rapid positive response of the body with this mode of administration.The same amount of dosage is given in 6 to 12 hours, if it is still needed.

Precautions

In using intravenous conjugated estrogens, one should observe the precautionary measures for this means of administration. To prevent the occurence of flushes, injections should be done in a slow and precise manner.

Premarin intravenous is compatible with some agents such as normal saline, dextrose and invert sugar solutions. It is found incompatible with ascorbic acid, protein hydrolysate, and any solution with an acid pH. The compatibility of solutions must be considered when infusion with other agents has already been started.

Women should discuss with their doctor any medical conditions they have before taking Premarin tablets, or any form of Premarin. Among these health issues are the following:

  • Endometrial cancer
  • Breast cancer
  • Heart disease
  • High cholesterol
  • Diabetes
  • Hypocalcemia
  • Kidney disease
  • High blood pressure
  • Gall bladder disease
  • Fibroids

Aside from these conditions, pregnant and breastfeeding women are not advised to take Premarin.

There are medications that should not be taken with Premarin. These drugs can affect how estrogen works, and they can increase the risks of side effects. Among these medications are: barbiturates, rifampin, St. John’s wort, meprobamate, phenytoin, protease inhibitors, topiramate, blood pressure lowering agents, antidiabetic agents (insulin, glyburide), corticosteroids and warfarin. The doctor will advise whether taking the medication should be stopped or not.

Abnormal vaginal bleeding may result from hormonal imbalance, and can arise during menopause or any period in a woman’s life. This condition can be treated using certain medications, such as Premarin. However, the patient must take precautionary measures when taking this drug in order to prevent serious side effects. Present medical conditions, current medications taken, and other health issues must be discussed thoroughly with the doctor. Adhering to the doctor’s prescription and recommendations must be done as well to achieve success of treatment.

Resources

Marks, Jay, MD, “Estrogens Conjugated (Premarin)”, https://www.medicinenet.com/estrogens_conjugated/article.htm

Stoppler, Melissa Conrad, MD, “Vaginal Bleeding,” https://www.medicinenet.com/vaginal_bleeding/article.htm