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The only differences between generics and their brand-name counterparts is that generics are less expensive and may look slightly different (eg. different shape or color), as trademarks laws prevent a generic from looking exactly like the brand-name drug.
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PREMARIN cream (conjugated estrogens) is a medication prescribed to treat atrophic vaginitis (thinning, drying, and inflammation of the vaginal walls) and kraurosis vulvae (shrinkage of the skin of the vagina and vulva). PREMARIN cream may also be prescribed to treat dyspareunia (pain or difficulty during intercourse).
After menopause, the levels of circulating estrogen decreases. Additionally, different types of estrogens are present than pre-menopause. PREMARIN works by increasing levels of the levels of certain estrogens and decreasing circulating luteinizing hormone (LH) and follicle-stimulating hormone (FSH). Increasing levels of estrogen help to maintain secondary sexual characteristics.
When treating atrophic vaginitis or kraurosis vulvae, the typical dosage of PREMARIN is 0.5 g once daily intravaginally for 7 days on and 21 days off. Use the included applicator to measure the appropriate dose.
When treating dyspareunia, the typical dose is 0.5 g twice weekly.
The active ingredients in PREMARIN cream are conjugated estrogens - sodium estrone sulfate, sodium equilin sulfate, 17-alpha-dihydroequilin, 17-alpha-estradiol, and 17-beta-dihydroequilin.
The inactive ingredients include benzyl alcohol, cetyl alcohol, cetyl esters wax, glycerin, glyceryl monostearate, mineral oil, methyl stearate, and white wax.
Fact Table |
|
Formula |
C22H19N3O4 |
License |
US FDA |
Bioavailability |
Varies |
Legal status |
US: RX Only |
Chemical Name |
Conjugated Estrogens |
Elimination half-life |
Estrone: 26.7 hours, Estrone (BA): 14.8 hours, Equilin: 11.4 hours |
Dosage (Strength) |
0.625mg/g x 14 grams (1/3 tubes), 0.625mg/g x 30 grams (1 tube) |
Pregnancy |
Consult a doctor |
Brands |
Premarin Cream |
Protein binding |
High |
PubChem CID |
656613 |
MedlinePlus |
- |
ChEBI |
- |
ATC code |
G03CA57 |
DrugBank |
DB00286 |
KEGG |
D04070 |
Routes of administration |
Topical |
Estrogens have been shown to increase the risk of stroke and deep vein thrombosis (DVT) in postmenopausal women. The increased risk has been shown with daily oral estrogen supplements, and the risk is probably lower for topical formulations.
Daily oral estrogens have also been shown to increase the risk of myocardial infarction (heart attack), invasive breast cancer, pulmonary emboli, and uterine cancer. This risk is probably not as great for topical formulations.
Due to the increased risk of the above-listed health conditions, PREMARIN cream should be used for the shortest amount of time at the lowest possible dose.
Speak to your doctor for a full list of cautions before using PREMARIN cream.
The most common side effects of PREMARIN cream include:
Speak with your doctor for a full list of possible side effects. Systemic side effects may also occur.
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Hormonal levels for certain hormones drop as a woman becomes menopausal. Vaginal atrophy and dyspareunia occur because the lack of sufficient levels for one those hormones – estrogen – promotes less natural lubrication of the vaginal walls as the body no longer foresees the possibility of a pregnancy. Vaginal walls become thinner over time too. Premarin provides a mixture of estrogen hormones to replenish those levels and promote better lubrication so that a woman is able to enjoy intimacy with her partner.
The can be used for temporary relief from painful sex during menopause, but using a prescription menopause treatment medication like Premarin is a better choice for women who find sex painful during menopause. Providing conjugated estrogens provides more long-term dyspareunia relief and treatment for vaginal dryness, something which can continue for women after they’ve finished menopause. Women may also find that their symptoms are more severe periodically.
The dosage frequency for Premarin Cream will be indicated in your prescription and based on your doctor’s recommendation depending on the severity of these menopause symptoms. Treatment objectives will also determine how often to apply Premarin:
For dyspareunia or painful sex treatment:
Apply 2x per week or in a cyclic regimen of 21 days of therapy with 0.5mg dose followed by 7 days off therapy and not applying the cream until the next week begins to start the 28-day cycle again. This will be explained in your prescription
For vaginal atrophy treatment (VVA):
Apply in a cyclic regimen of 21 days of therapy (starting at 0.5mg dose with dosage adjustments made on level of effectiveness and response according to doctor and prescription) followed by 7 days off therapy and not applying the cream until the next week begins to start the 28-day cycle again. This will be explained in your prescription.
As with all medicated creams, dosage strength and frequency of application will determine how long one tube of the medication will last for the user. Using standard Premarin cream dosage and treatment regimen most women will find one tube of Premarin Cream lasts them around 6 months. You can discuss this with your dispensing pharmacist if you would like to know more.
Most women will begin to see results from using Premarin Cream and less vaginal dryness or pain during sex at around the 12 week (3 month) point from beginning treatment. It is important to take your medication exactly as directed and consistently in order to have these expectations.
Premarin Cream is not available in a generic equivalent at this time, but a generic conjugated estrogens cream may be available in the future. You can order Premarin Cream online from Canada Pharmacy and pay less for branded Premarin and likely pay significantly less than you would at your local pharmacy.
No, it is not. Women who have a history of unusual vaginal bleeding, cancer, heart attack or stroke, or blood clots will not be suitable for using Premarin cream. Women who have or at risk of gallbladder disease or who are taking thyroid medication may also not be suitable for this medication. All of this will be determined based on your doctor’s professional opinion.
Common Premarin Cream side effects include headache, pelvic or breast pain, vaginitis or vaginal bleeding. Most women only have mild side effects if any when using Premarin for menopause symptoms relief.
Dr. Sheehy (BSc Molecular Biology, PharmD) works a clinical pharmacist specializing in cardiology, oncology, and ambulatory care. He’s a board-certified pharmacotherapy specialist (BCPS), and his experience working one-on-one with patients to fine tune their medication and therapy plans for optimal results makes him a valuable subject matter expert for our pharmacy. Read More....