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INDICATIONS

Premarin is a mixture of estrogen hormones used to treat symptoms of menopause such as hot flashes, and vaginal dryness, burning, and irritation. Other uses include prevention of osteoporosis in postmenopausal women, and replacement of estrogen in women with ovarian failure or other conditions that cause a lack of natural estrogen in the body. Premarin is sometimes used as part of cancer treatment in women and men. Premarin should not be used to prevent heart disease or dementia, because this medication may actually increase your risk of developing these conditions.

INSTRUCTIONS

Use Premarin as directed by your doctor.

  • Do not use the medication in larger amounts, or use it for longer than recommended by your doctor.
  • Premarin is taken on a daily basis. For certain conditions, Premarin is given in a cycle, such as 25 days on followed by 5 days. Follow the directions on your prescription label.
  • Premarin may be taken by mouth with or without food.
  • Take Premarin with a full glass of water.
  • Try to take the medicine at the same time each day.
  • Have regular physical exams and self-examine your breasts for lumps on a monthly basis while using Premarin.
  • It is important to take Premarin regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.
  • To be sure this medication is not causing harmful effects, your blood will need to be tested on a regular basis. Your thyroid function may also need to be tested. Do not miss any scheduled appointments.
  • If you need to have any type of surgery, tell the surgeon ahead of time that you are taking Premarin. You may need to stop using the medicine for a short time.
  • This medication can affect the results of certain medical tests. Tell any doctor who treats you that you are using Premarin.
  • If you miss a dose of Premarin, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Premarin.

STORAGE

Store Premarin between 68 and 77 degrees F (20 and 25 degrees C) in a tightly closed, light-resistant container. Store away from moisture, heat, and light. Do not store in the bathroom. Keep Premarin out of the reach of children and away from pets.

Premarin (conjugated estrogens tablets) for oral administration contains a mixture of conjugated estrogens obtained exclusively from natural sources, occurring as the sodium salts of water-soluble estrogen sulfates blended to represent the average composition of material derived from pregnant mares’ urine. It is a mixture of sodium estrone sulfate and sodium equilin sulfate. It contains as concomitant components, as sodium sulfate conjugates, 17О±-dihydroequilin, 17О±- estradiol, and 17ОІ-dihydroequilin.

Estrogen is a female sex hormone produced by the ovaries. Estrogen is necessary for many processes in the body.

Premarin tablets also contain the following inactive ingredients: calcium phosphate tribasic, hydroxypropyl cellulose, microcrystalline cellulose, powdered cellulose, hypromellose, lactose monohydrate, magnesium stearate, polyethylene glycol, sucrose, and titanium dioxide.

Do NOT use Premarin if:

  • you are allergic to any ingredient in Premarin
  • you are pregnant or suspect you may be pregnant
  • you have a history of known or suspected breast cancer (unless directed by your doctor) or other cancers that are estrogen-dependent
  • you have abnormal vaginal bleeding of unknown cause
  • you have liver problems or liver disease, or the blood disease porphyria
  • you have recently (within the last year) had a stroke or heart attack
  • you have blood clots or circulation disorders.

Contact your doctor or health care provider right away if any of these apply to you.

Some medical conditions may interact with Premarin. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have an abnormal mammogram
  • if you have asthma (wheezing), a benign breast nodule, bone cancer, depression, diabetes, endometriosis or endometrial (uterine) cancer, epilepsy (seizures), gallbladder disease, heart problems, high blood pressure, kidney problems, liver problems or a history of yellowing of the skin or eyes, lupus, migraines, obesity, pancreatitis, uterine fibroids, thyroid problems or have high calcium levels in your blood
  • if you use tobacco, you are going to have surgery, or you will be on bed rest
  • if you have a personal or family history of high cholesterol, lipid, calcium, or triglyceride levels; or breast cancer.

Some medicines may interact with Premarin. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Hydantoins (eg, phenytoin) or rifampin because they may decrease Premarin’s effectiveness.

This may not be a complete list of all interactions that may occur. Ask your health care provider if Premarin may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

Important safety information:

  • Premarin may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Premarin with caution. Do not drive or perform other possible unsafe tasks until you know how you react to it.
  • Smoking while taking Premarin may increase your risk of blood clots (especially in women older than 35 years of age).
  • Before using Premarin, you will need to have a complete medical and family history exam, which will include blood pressure, breast, stomach, and pelvic organ exams and a Pap smear.
  • You should have periodic mammograms as determined by your doctor. Follow your doctor’s instructions for examining your own breasts, and report any lumps immediately.
  • If you have other medical conditions and are prescribed estrogens for more than one condition, consult your doctor about your treatment plan and its options.
  • Diabetes patients – Premarin may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
  • Premarin may cause dark skin patches on your face (melasma). Exposure to the sun may make these patches darker, and you may need to avoid prolonged sun exposure and sunlamps. Consult your doctor regarding the use of sunscreens and protective clothing.
  • If you wear contact lenses and you develop problems with them, contact your doctor.
  • If you will be having surgery or will be confined to a chair or bed for a long period of time (eg, a long plane flight), notify your doctor beforehand. Special precautions may need to be taken in these circumstances while you are taking Premarin.
  • Premarin may interfere with certain lab tests. Be sure your doctor and lab personnel know you are using Premarin.
  • Lab tests, including a lipid profile, may be performed while you use Premarin. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Premarin may affect growth rate in children and teenagers in some cases. They may need regular growth checks while they use Premarin.
  • Pregnancy and breast-feeding: Do not use Premarin if you are pregnant. Avoid becoming pregnant while you are taking it. If you think you may be pregnant, contact your doctor right away. Premarin is found in breast milk. If you are or will be breast-feeding while you use Premarin, check with your doctor. Discuss any possible risks to your baby.

All medicines may cause side effects, but many people have no, or minor, side effects.

Check with your doctor if any of these most common side effects persist or become bothersome:

Back pain; bloating; breast pain; depression; diarrhea; dizziness; flu syndrome; gas; hair loss; headache; increased cough; increased/decreased interest in sex; indigestion; infection; irregular vaginal bleeding or spotting; itching; joint pain; lightheadedness; leg cramps; muscle aches; nausea; nervousness; pain; runny nose; sinus inflammation; sleeplessness; sore throat; stomach pain; upper respiratory tract infection; vaginal inflammation; weakness; weight changes.

Seek medical attention right away if any of these severe side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); abnormal bleeding from the vagina; breast lumps; changes in vision or speech; chest pain; confusion; dizziness; fainting; hoarseness; mental/mood changes; one-sided weakness; pain or tenderness in the upper abdomen; pain or tenderness in the calves; severe headache; sudden shortness of breath; swelling of the hands or feet; unusual vaginal discharge/itching/odor; vomiting; weakness or numbness of an arm or leg; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider.

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INDICATIONS

Indinavir is an antiviral medication in a group of HIV medicines called protease (PRO-tee-ayz) inhibitors. Indinavir prevents human immunodeficiency virus (HIV) cells from multiplying in your body. It is used to treat HIV, which causes acquired immunodeficiency syndrome (AIDS). Indinavir is not a cure for HIV or AIDS.

INSTRUCTIONS

Take indinavir exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

This medication comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.
Take indinavir with a full glass (8 ounces) of water or skim milk. You may also drink juice, coffee, or tea with this medication. Drink at least 6 glasses of water each day to prevent kidney stones while you are taking indinavir. Indinavir should be taken on an empty stomach, at least 1 hour before or 2 hours after a meal.

If you prefer to take the medication with food, eat only a light meal, such as dry toast with jelly, or corn flakes with skim milk and sugar. Avoid eating a high-fat meal.

It is important to use indinavir regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

To be sure this medication is helping your condition, your blood will need to be tested on a regular basis. Your liver function may also need to be tested. Do not miss any scheduled visits to your doctor.

HIV/AIDS is usually treated with a combination of different drugs. To best treat your condition, use all of your medications as directed by your doctor. Be sure to read the medication guide or patient instructions provided with each of your medications. Do not change your doses or medication schedule without advice from your doctor. Every person with HIV or AIDS should remain under the care of a doctor.

Take the missed dose as soon as you remember and take your next dose at the regularly scheduled time. If you are more than 2 hours late in taking your indinavir, skip the missed dose and take the next regularly scheduled dose. Do not take extra medicine to make up the missed dose.

DOSAGE

Usual Adult Dose for HIV Infection

800 mg orally every 8 hours or indinavir 800 mg plus ritonavir 100 mg to 200 mg orally every 12 hours.

Usual Adult Dose for Nonoccupational Exposure

800 mg orally every 8 hours or indinavir 800 mg plus ritonavir 100 mg to 200 mg orally every 12 hours.
Duration: Prophylaxis should be initiated as soon as possible, within 72 hours of exposure, and continued for 28 days.
Indinavir plus ritonavir plus 2 NRTIs is one of the alternative regimens recommended for nonoccupational postexposure HIV prophylaxis.

Usual Adult Dose for Occupational Exposure

800 mg orally every 8 hours 800 mg orally every 8 hours plus lamivudine-zidovudine,
or indinavir 800 mg plus ritonavir 100 mg to 200 mg orally every 12 hours plus lamivudine-zidovudine.
Duration: Therapy should begin promptly, preferably within 1 to 2 hours postexposure. The exact duration of therapy may differ based on the institution’s protocol.

Liver Dose Adjustments

Mild to moderate hepatic insufficiency: 600 mg orally every 8 hours.

Dose Adjustments

Consider reducing the dose to 600 mg every 8 hours if delavirdine, itraconazole, or ketoconazole are administered concomitantly. Increase the dose to 1000 mg every 8 hours if rifabutin is given concurrently, and decrease the rifabutin dose by half.
Precautions

Strict adherence to the prescribed dose is essential. Patients should not alter the dose or discontinue therapy without consulting their physician.

Adequate hydration (1.5 liters/day) is crucial during therapy to reduce the risk of nephrolithiasis. A brief interruption (usually 1 to 3 days) or total discontinuation may be necessary if nephrolithiasis occurs.

Discontinue indinavir if hemolytic anemia occurs. Consider discontinuation if severe leukocyturia develops.

STORAGE

Store indinavir at room temperature away from moisture and heat. Keep the capsules in their original container, along with the packet of moisture-absorbing preservative that comes with indinavir capsules.

Do not take this medication if you are allergic to indinavir.
Do not take indinavir with amiodarone (Cordarone, Pacerone), cisapride (Propulsid), pimozide (Orap), alprazolam (Xanax), oral midazolam (Versed), triazolam (Halcion), or ergot medicines such as ergotamine (Ergomar, Cafergot), dihydroergotamine (D.H.E. 45, Migranal Nasal Spray), ergonovine (Ergotrate), or methylergonovine (Methergine). These drugs can cause life-threatening side effects if you use them while you are taking indinavir.

Before taking indinavir, tell your doctor if you are allergic to any drugs, or if you have:

  • liver disease;
  • kidney disease, or
  • a history of kidney stones;
  • diabetes;
  • a bleeding disorder such as hemophilia; or
  • high cholesterol or triglycerides.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take indinavir.
FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. HIV can be passed to the baby if the mother is not properly treated during pregnancy. Take all of your HIV medicines as directed to control your infection while you are pregnant.

Your name may need to be listed on an antiviral pregnancy registry when you start using this medication.
You should not breast-feed while you are using indinavir. Women with HIV or AIDS should not breast-feed at all. Even if your baby is born without HIV, you may still pass the virus to the baby in your breast milk.

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 indinavir and call your doctor at once if you have any of these serious side effects:

  • fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;
  • pale or yellowed skin, dark colored urine, fever, confusion or weakness;
  • increased urination or extreme thirst;
  • pain in your side or lower back, blood in your urine;
  • easy bruising or bleeding;
  • signs of a new infection, such as fever or chills, cough, or flu symptoms; or
  • nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

  • mild nausea, vomiting, diarrhea, bloating;
  • numbness or tingling, especially around your mouth;
  • tired feeling;
  • headache, mood changes; or
  • changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and waist).

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

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Premarin is a mixture of estrogen hormones used to treat symptoms of menopause such as hot flashes, and vaginal dryness, burning, and irritation. Other uses include prevention of osteoporosis in postmenopausal women, and replacement of estrogen in women with ovarian failure or other conditions that cause a lack of natural estrogen in the body. Premarin is sometimes used as part of cancer treatment in women and men. Premarin should not be used to prevent heart disease or dementia, because this medication may actually increase your risk of developing these conditions.

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Use Premarin as directed by your doctor.

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Premarin (conjugated estrogens tablets) for oral administration contains a mixture of conjugated estrogens obtained exclusively from natural sources, occurring as the sodium salts of water-soluble estrogen sulfates blended to represent the average composition of material derived from pregnant mares’ urine. It is a mixture of sodium estrone sulfate and sodium equilin sulfate. It contains as concomitant components, as sodium sulfate conjugates, 17О±-dihydroequilin, 17О±- estradiol, and 17ОІ-dihydroequilin.

Estrogen is a female sex hormone produced by the ovaries. Estrogen is necessary for many processes in the body.

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  • if you have allergies to medicines, foods, or other substances
  • if you have an abnormal mammogram
  • if you have asthma (wheezing), a benign breast nodule, bone cancer, depression, diabetes, endometriosis or endometrial (uterine) cancer, epilepsy (seizures), gallbladder disease, heart problems, high blood pressure, kidney problems, liver problems or a history of yellowing of the skin or eyes, lupus, migraines, obesity, pancreatitis, uterine fibroids, thyroid problems or have high calcium levels in your blood
  • if you use tobacco, you are going to have surgery, or you will be on bed rest
  • if you have a personal or family history of high cholesterol, lipid, calcium, or triglyceride levels; or breast cancer.

Some medicines may interact with Premarin. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Hydantoins (eg, phenytoin) or rifampin because they may decrease Premarin’s effectiveness.

This may not be a complete list of all interactions that may occur. Ask your health care provider if Premarin may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

Important safety information:

  • Premarin may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Premarin with caution. Do not drive or perform other possible unsafe tasks until you know how you react to it.
  • Smoking while taking Premarin may increase your risk of blood clots (especially in women older than 35 years of age).
  • Before using Premarin, you will need to have a complete medical and family history exam, which will include blood pressure, breast, stomach, and pelvic organ exams and a Pap smear.
  • You should have periodic mammograms as determined by your doctor. Follow your doctor’s instructions for examining your own breasts, and report any lumps immediately.
  • If you have other medical conditions and are prescribed estrogens for more than one condition, consult your doctor about your treatment plan and its options.
  • Diabetes patients – Premarin may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
  • Premarin may cause dark skin patches on your face (melasma). Exposure to the sun may make these patches darker, and you may need to avoid prolonged sun exposure and sunlamps. Consult your doctor regarding the use of sunscreens and protective clothing.
  • If you wear contact lenses and you develop problems with them, contact your doctor.
  • If you will be having surgery or will be confined to a chair or bed for a long period of time (eg, a long plane flight), notify your doctor beforehand. Special precautions may need to be taken in these circumstances while you are taking Premarin.
  • Premarin may interfere with certain lab tests. Be sure your doctor and lab personnel know you are using Premarin.
  • Lab tests, including a lipid profile, may be performed while you use Premarin. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Premarin may affect growth rate in children and teenagers in some cases. They may need regular growth checks while they use Premarin.
  • Pregnancy and breast-feeding: Do not use Premarin if you are pregnant. Avoid becoming pregnant while you are taking it. If you think you may be pregnant, contact your doctor right away. Premarin is found in breast milk. If you are or will be breast-feeding while you use Premarin, check with your doctor. Discuss any possible risks to your baby.

All medicines may cause side effects, but many people have no, or minor, side effects.

Check with your doctor if any of these most common side effects persist or become bothersome:

Back pain; bloating; breast pain; depression; diarrhea; dizziness; flu syndrome; gas; hair loss; headache; increased cough; increased/decreased interest in sex; indigestion; infection; irregular vaginal bleeding or spotting; itching; joint pain; lightheadedness; leg cramps; muscle aches; nausea; nervousness; pain; runny nose; sinus inflammation; sleeplessness; sore throat; stomach pain; upper respiratory tract infection; vaginal inflammation; weakness; weight changes.

Seek medical attention right away if any of these severe side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); abnormal bleeding from the vagina; breast lumps; changes in vision or speech; chest pain; confusion; dizziness; fainting; hoarseness; mental/mood changes; one-sided weakness; pain or tenderness in the upper abdomen; pain or tenderness in the calves; severe headache; sudden shortness of breath; swelling of the hands or feet; unusual vaginal discharge/itching/odor; vomiting; weakness or numbness of an arm or leg; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider.

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INDICATIONS

Indinavir is an antiviral medication in a group of HIV medicines called protease (PRO-tee-ayz) inhibitors. Indinavir prevents human immunodeficiency virus (HIV) cells from multiplying in your body. It is used to treat HIV, which causes acquired immunodeficiency syndrome (AIDS). Indinavir is not a cure for HIV or AIDS.

INSTRUCTIONS

Take indinavir exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

This medication comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.
Take indinavir with a full glass (8 ounces) of water or skim milk. You may also drink juice, coffee, or tea with this medication. Drink at least 6 glasses of water each day to prevent kidney stones while you are taking indinavir. Indinavir should be taken on an empty stomach, at least 1 hour before or 2 hours after a meal.

If you prefer to take the medication with food, eat only a light meal, such as dry toast with jelly, or corn flakes with skim milk and sugar. Avoid eating a high-fat meal.

It is important to use indinavir regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

To be sure this medication is helping your condition, your blood will need to be tested on a regular basis. Your liver function may also need to be tested. Do not miss any scheduled visits to your doctor.

HIV/AIDS is usually treated with a combination of different drugs. To best treat your condition, use all of your medications as directed by your doctor. Be sure to read the medication guide or patient instructions provided with each of your medications. Do not change your doses or medication schedule without advice from your doctor. Every person with HIV or AIDS should remain under the care of a doctor.

Take the missed dose as soon as you remember and take your next dose at the regularly scheduled time. If you are more than 2 hours late in taking your indinavir, skip the missed dose and take the next regularly scheduled dose. Do not take extra medicine to make up the missed dose.

DOSAGE

Usual Adult Dose for HIV Infection

800 mg orally every 8 hours or indinavir 800 mg plus ritonavir 100 mg to 200 mg orally every 12 hours.

Usual Adult Dose for Nonoccupational Exposure

800 mg orally every 8 hours or indinavir 800 mg plus ritonavir 100 mg to 200 mg orally every 12 hours.
Duration: Prophylaxis should be initiated as soon as possible, within 72 hours of exposure, and continued for 28 days.
Indinavir plus ritonavir plus 2 NRTIs is one of the alternative regimens recommended for nonoccupational postexposure HIV prophylaxis.

Usual Adult Dose for Occupational Exposure

800 mg orally every 8 hours 800 mg orally every 8 hours plus lamivudine-zidovudine,
or indinavir 800 mg plus ritonavir 100 mg to 200 mg orally every 12 hours plus lamivudine-zidovudine.
Duration: Therapy should begin promptly, preferably within 1 to 2 hours postexposure. The exact duration of therapy may differ based on the institution’s protocol.

Liver Dose Adjustments

Mild to moderate hepatic insufficiency: 600 mg orally every 8 hours.

Dose Adjustments

Consider reducing the dose to 600 mg every 8 hours if delavirdine, itraconazole, or ketoconazole are administered concomitantly. Increase the dose to 1000 mg every 8 hours if rifabutin is given concurrently, and decrease the rifabutin dose by half.
Precautions

Strict adherence to the prescribed dose is essential. Patients should not alter the dose or discontinue therapy without consulting their physician.

Adequate hydration (1.5 liters/day) is crucial during therapy to reduce the risk of nephrolithiasis. A brief interruption (usually 1 to 3 days) or total discontinuation may be necessary if nephrolithiasis occurs.

Discontinue indinavir if hemolytic anemia occurs. Consider discontinuation if severe leukocyturia develops.

STORAGE

Store indinavir at room temperature away from moisture and heat. Keep the capsules in their original container, along with the packet of moisture-absorbing preservative that comes with indinavir capsules.

Do not take this medication if you are allergic to indinavir.
Do not take indinavir with amiodarone (Cordarone, Pacerone), cisapride (Propulsid), pimozide (Orap), alprazolam (Xanax), oral midazolam (Versed), triazolam (Halcion), or ergot medicines such as ergotamine (Ergomar, Cafergot), dihydroergotamine (D.H.E. 45, Migranal Nasal Spray), ergonovine (Ergotrate), or methylergonovine (Methergine). These drugs can cause life-threatening side effects if you use them while you are taking indinavir.

Before taking indinavir, tell your doctor if you are allergic to any drugs, or if you have:

  • liver disease;
  • kidney disease, or
  • a history of kidney stones;
  • diabetes;
  • a bleeding disorder such as hemophilia; or
  • high cholesterol or triglycerides.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take indinavir.
FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. HIV can be passed to the baby if the mother is not properly treated during pregnancy. Take all of your HIV medicines as directed to control your infection while you are pregnant.

Your name may need to be listed on an antiviral pregnancy registry when you start using this medication.
You should not breast-feed while you are using indinavir. Women with HIV or AIDS should not breast-feed at all. Even if your baby is born without HIV, you may still pass the virus to the baby in your breast milk.

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 indinavir and call your doctor at once if you have any of these serious side effects:

  • fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;
  • pale or yellowed skin, dark colored urine, fever, confusion or weakness;
  • increased urination or extreme thirst;
  • pain in your side or lower back, blood in your urine;
  • easy bruising or bleeding;
  • signs of a new infection, such as fever or chills, cough, or flu symptoms; or
  • nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

  • mild nausea, vomiting, diarrhea, bloating;
  • numbness or tingling, especially around your mouth;
  • tired feeling;
  • headache, mood changes; or
  • changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and waist).

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

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INDICATIONS

Premarin is a mixture of estrogen hormones used to treat symptoms of menopause such as hot flashes, and vaginal dryness, burning, and irritation. Other uses include prevention of osteoporosis in postmenopausal women, and replacement of estrogen in women with ovarian failure or other conditions that cause a lack of natural estrogen in the body. Premarin is sometimes used as part of cancer treatment in women and men. Premarin should not be used to prevent heart disease or dementia, because this medication may actually increase your risk of developing these conditions.

INSTRUCTIONS

Use Premarin as directed by your doctor.

  • Do not use the medication in larger amounts, or use it for longer than recommended by your doctor.
  • Premarin is taken on a daily basis. For certain conditions, Premarin is given in a cycle, such as 25 days on followed by 5 days. Follow the directions on your prescription label.
  • Premarin may be taken by mouth with or without food.
  • Take Premarin with a full glass of water.
  • Try to take the medicine at the same time each day.
  • Have regular physical exams and self-examine your breasts for lumps on a monthly basis while using Premarin.
  • It is important to take Premarin regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.
  • To be sure this medication is not causing harmful effects, your blood will need to be tested on a regular basis. Your thyroid function may also need to be tested. Do not miss any scheduled appointments.
  • If you need to have any type of surgery, tell the surgeon ahead of time that you are taking Premarin. You may need to stop using the medicine for a short time.
  • This medication can affect the results of certain medical tests. Tell any doctor who treats you that you are using Premarin.
  • If you miss a dose of Premarin, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Premarin.

STORAGE

Store Premarin between 68 and 77 degrees F (20 and 25 degrees C) in a tightly closed, light-resistant container. Store away from moisture, heat, and light. Do not store in the bathroom. Keep Premarin out of the reach of children and away from pets.

Premarin (conjugated estrogens tablets) for oral administration contains a mixture of conjugated estrogens obtained exclusively from natural sources, occurring as the sodium salts of water-soluble estrogen sulfates blended to represent the average composition of material derived from pregnant mares’ urine. It is a mixture of sodium estrone sulfate and sodium equilin sulfate. It contains as concomitant components, as sodium sulfate conjugates, 17О±-dihydroequilin, 17О±- estradiol, and 17ОІ-dihydroequilin.

Estrogen is a female sex hormone produced by the ovaries. Estrogen is necessary for many processes in the body.

Premarin tablets also contain the following inactive ingredients: calcium phosphate tribasic, hydroxypropyl cellulose, microcrystalline cellulose, powdered cellulose, hypromellose, lactose monohydrate, magnesium stearate, polyethylene glycol, sucrose, and titanium dioxide.

Do NOT use Premarin if:

  • you are allergic to any ingredient in Premarin
  • you are pregnant or suspect you may be pregnant
  • you have a history of known or suspected breast cancer (unless directed by your doctor) or other cancers that are estrogen-dependent
  • you have abnormal vaginal bleeding of unknown cause
  • you have liver problems or liver disease, or the blood disease porphyria
  • you have recently (within the last year) had a stroke or heart attack
  • you have blood clots or circulation disorders.

Contact your doctor or health care provider right away if any of these apply to you.

Some medical conditions may interact with Premarin. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have an abnormal mammogram
  • if you have asthma (wheezing), a benign breast nodule, bone cancer, depression, diabetes, endometriosis or endometrial (uterine) cancer, epilepsy (seizures), gallbladder disease, heart problems, high blood pressure, kidney problems, liver problems or a history of yellowing of the skin or eyes, lupus, migraines, obesity, pancreatitis, uterine fibroids, thyroid problems or have high calcium levels in your blood
  • if you use tobacco, you are going to have surgery, or you will be on bed rest
  • if you have a personal or family history of high cholesterol, lipid, calcium, or triglyceride levels; or breast cancer.

Some medicines may interact with Premarin. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Hydantoins (eg, phenytoin) or rifampin because they may decrease Premarin’s effectiveness.

This may not be a complete list of all interactions that may occur. Ask your health care provider if Premarin may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

Important safety information:

  • Premarin may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Premarin with caution. Do not drive or perform other possible unsafe tasks until you know how you react to it.
  • Smoking while taking Premarin may increase your risk of blood clots (especially in women older than 35 years of age).
  • Before using Premarin, you will need to have a complete medical and family history exam, which will include blood pressure, breast, stomach, and pelvic organ exams and a Pap smear.
  • You should have periodic mammograms as determined by your doctor. Follow your doctor’s instructions for examining your own breasts, and report any lumps immediately.
  • If you have other medical conditions and are prescribed estrogens for more than one condition, consult your doctor about your treatment plan and its options.
  • Diabetes patients – Premarin may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
  • Premarin may cause dark skin patches on your face (melasma). Exposure to the sun may make these patches darker, and you may need to avoid prolonged sun exposure and sunlamps. Consult your doctor regarding the use of sunscreens and protective clothing.
  • If you wear contact lenses and you develop problems with them, contact your doctor.
  • If you will be having surgery or will be confined to a chair or bed for a long period of time (eg, a long plane flight), notify your doctor beforehand. Special precautions may need to be taken in these circumstances while you are taking Premarin.
  • Premarin may interfere with certain lab tests. Be sure your doctor and lab personnel know you are using Premarin.
  • Lab tests, including a lipid profile, may be performed while you use Premarin. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Premarin may affect growth rate in children and teenagers in some cases. They may need regular growth checks while they use Premarin.
  • Pregnancy and breast-feeding: Do not use Premarin if you are pregnant. Avoid becoming pregnant while you are taking it. If you think you may be pregnant, contact your doctor right away. Premarin is found in breast milk. If you are or will be breast-feeding while you use Premarin, check with your doctor. Discuss any possible risks to your baby.

All medicines may cause side effects, but many people have no, or minor, side effects.

Check with your doctor if any of these most common side effects persist or become bothersome:

Back pain; bloating; breast pain; depression; diarrhea; dizziness; flu syndrome; gas; hair loss; headache; increased cough; increased/decreased interest in sex; indigestion; infection; irregular vaginal bleeding or spotting; itching; joint pain; lightheadedness; leg cramps; muscle aches; nausea; nervousness; pain; runny nose; sinus inflammation; sleeplessness; sore throat; stomach pain; upper respiratory tract infection; vaginal inflammation; weakness; weight changes.

Seek medical attention right away if any of these severe side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); abnormal bleeding from the vagina; breast lumps; changes in vision or speech; chest pain; confusion; dizziness; fainting; hoarseness; mental/mood changes; one-sided weakness; pain or tenderness in the upper abdomen; pain or tenderness in the calves; severe headache; sudden shortness of breath; swelling of the hands or feet; unusual vaginal discharge/itching/odor; vomiting; weakness or numbness of an arm or leg; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider.

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INDICATIONS

Indinavir is an antiviral medication in a group of HIV medicines called protease (PRO-tee-ayz) inhibitors. Indinavir prevents human immunodeficiency virus (HIV) cells from multiplying in your body. It is used to treat HIV, which causes acquired immunodeficiency syndrome (AIDS). Indinavir is not a cure for HIV or AIDS.

INSTRUCTIONS

Take indinavir exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

This medication comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.
Take indinavir with a full glass (8 ounces) of water or skim milk. You may also drink juice, coffee, or tea with this medication. Drink at least 6 glasses of water each day to prevent kidney stones while you are taking indinavir. Indinavir should be taken on an empty stomach, at least 1 hour before or 2 hours after a meal.

If you prefer to take the medication with food, eat only a light meal, such as dry toast with jelly, or corn flakes with skim milk and sugar. Avoid eating a high-fat meal.

It is important to use indinavir regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

To be sure this medication is helping your condition, your blood will need to be tested on a regular basis. Your liver function may also need to be tested. Do not miss any scheduled visits to your doctor.

HIV/AIDS is usually treated with a combination of different drugs. To best treat your condition, use all of your medications as directed by your doctor. Be sure to read the medication guide or patient instructions provided with each of your medications. Do not change your doses or medication schedule without advice from your doctor. Every person with HIV or AIDS should remain under the care of a doctor.

Take the missed dose as soon as you remember and take your next dose at the regularly scheduled time. If you are more than 2 hours late in taking your indinavir, skip the missed dose and take the next regularly scheduled dose. Do not take extra medicine to make up the missed dose.

DOSAGE

Usual Adult Dose for HIV Infection

800 mg orally every 8 hours or indinavir 800 mg plus ritonavir 100 mg to 200 mg orally every 12 hours.

Usual Adult Dose for Nonoccupational Exposure

800 mg orally every 8 hours or indinavir 800 mg plus ritonavir 100 mg to 200 mg orally every 12 hours.
Duration: Prophylaxis should be initiated as soon as possible, within 72 hours of exposure, and continued for 28 days.
Indinavir plus ritonavir plus 2 NRTIs is one of the alternative regimens recommended for nonoccupational postexposure HIV prophylaxis.

Usual Adult Dose for Occupational Exposure

800 mg orally every 8 hours 800 mg orally every 8 hours plus lamivudine-zidovudine,
or indinavir 800 mg plus ritonavir 100 mg to 200 mg orally every 12 hours plus lamivudine-zidovudine.
Duration: Therapy should begin promptly, preferably within 1 to 2 hours postexposure. The exact duration of therapy may differ based on the institution’s protocol.

Liver Dose Adjustments

Mild to moderate hepatic insufficiency: 600 mg orally every 8 hours.

Dose Adjustments

Consider reducing the dose to 600 mg every 8 hours if delavirdine, itraconazole, or ketoconazole are administered concomitantly. Increase the dose to 1000 mg every 8 hours if rifabutin is given concurrently, and decrease the rifabutin dose by half.
Precautions

Strict adherence to the prescribed dose is essential. Patients should not alter the dose or discontinue therapy without consulting their physician.

Adequate hydration (1.5 liters/day) is crucial during therapy to reduce the risk of nephrolithiasis. A brief interruption (usually 1 to 3 days) or total discontinuation may be necessary if nephrolithiasis occurs.

Discontinue indinavir if hemolytic anemia occurs. Consider discontinuation if severe leukocyturia develops.

STORAGE

Store indinavir at room temperature away from moisture and heat. Keep the capsules in their original container, along with the packet of moisture-absorbing preservative that comes with indinavir capsules.

Do not take this medication if you are allergic to indinavir.
Do not take indinavir with amiodarone (Cordarone, Pacerone), cisapride (Propulsid), pimozide (Orap), alprazolam (Xanax), oral midazolam (Versed), triazolam (Halcion), or ergot medicines such as ergotamine (Ergomar, Cafergot), dihydroergotamine (D.H.E. 45, Migranal Nasal Spray), ergonovine (Ergotrate), or methylergonovine (Methergine). These drugs can cause life-threatening side effects if you use them while you are taking indinavir.

Before taking indinavir, tell your doctor if you are allergic to any drugs, or if you have:

  • liver disease;
  • kidney disease, or
  • a history of kidney stones;
  • diabetes;
  • a bleeding disorder such as hemophilia; or
  • high cholesterol or triglycerides.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take indinavir.
FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. HIV can be passed to the baby if the mother is not properly treated during pregnancy. Take all of your HIV medicines as directed to control your infection while you are pregnant.

Your name may need to be listed on an antiviral pregnancy registry when you start using this medication.
You should not breast-feed while you are using indinavir. Women with HIV or AIDS should not breast-feed at all. Even if your baby is born without HIV, you may still pass the virus to the baby in your breast milk.

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 indinavir and call your doctor at once if you have any of these serious side effects:

  • fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;
  • pale or yellowed skin, dark colored urine, fever, confusion or weakness;
  • increased urination or extreme thirst;
  • pain in your side or lower back, blood in your urine;
  • easy bruising or bleeding;
  • signs of a new infection, such as fever or chills, cough, or flu symptoms; or
  • nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

  • mild nausea, vomiting, diarrhea, bloating;
  • numbness or tingling, especially around your mouth;
  • tired feeling;
  • headache, mood changes; or
  • changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and waist).

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

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INDICATIONS

Indinavir is an antiviral medication in a group of HIV medicines called protease (PRO-tee-ayz) inhibitors. Indinavir prevents human immunodeficiency virus (HIV) cells from multiplying in your body. It is used to treat HIV, which causes acquired immunodeficiency syndrome (AIDS). Indinavir is not a cure for HIV or AIDS.

INSTRUCTIONS

Take indinavir exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

This medication comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.
Take indinavir with a full glass (8 ounces) of water or skim milk. You may also drink juice, coffee, or tea with this medication. Drink at least 6 glasses of water each day to prevent kidney stones while you are taking indinavir. Indinavir should be taken on an empty stomach, at least 1 hour before or 2 hours after a meal.

If you prefer to take the medication with food, eat only a light meal, such as dry toast with jelly, or corn flakes with skim milk and sugar. Avoid eating a high-fat meal.

It is important to use indinavir regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

To be sure this medication is helping your condition, your blood will need to be tested on a regular basis. Your liver function may also need to be tested. Do not miss any scheduled visits to your doctor.

HIV/AIDS is usually treated with a combination of different drugs. To best treat your condition, use all of your medications as directed by your doctor. Be sure to read the medication guide or patient instructions provided with each of your medications. Do not change your doses or medication schedule without advice from your doctor. Every person with HIV or AIDS should remain under the care of a doctor.

Take the missed dose as soon as you remember and take your next dose at the regularly scheduled time. If you are more than 2 hours late in taking your indinavir, skip the missed dose and take the next regularly scheduled dose. Do not take extra medicine to make up the missed dose.

DOSAGE

Usual Adult Dose for HIV Infection

800 mg orally every 8 hours or indinavir 800 mg plus ritonavir 100 mg to 200 mg orally every 12 hours.

Usual Adult Dose for Nonoccupational Exposure

800 mg orally every 8 hours or indinavir 800 mg plus ritonavir 100 mg to 200 mg orally every 12 hours.
Duration: Prophylaxis should be initiated as soon as possible, within 72 hours of exposure, and continued for 28 days.
Indinavir plus ritonavir plus 2 NRTIs is one of the alternative regimens recommended for nonoccupational postexposure HIV prophylaxis.

Usual Adult Dose for Occupational Exposure

800 mg orally every 8 hours 800 mg orally every 8 hours plus lamivudine-zidovudine,
or indinavir 800 mg plus ritonavir 100 mg to 200 mg orally every 12 hours plus lamivudine-zidovudine.
Duration: Therapy should begin promptly, preferably within 1 to 2 hours postexposure. The exact duration of therapy may differ based on the institution’s protocol.

Liver Dose Adjustments

Mild to moderate hepatic insufficiency: 600 mg orally every 8 hours.

Dose Adjustments

Consider reducing the dose to 600 mg every 8 hours if delavirdine, itraconazole, or ketoconazole are administered concomitantly. Increase the dose to 1000 mg every 8 hours if rifabutin is given concurrently, and decrease the rifabutin dose by half.
Precautions

Strict adherence to the prescribed dose is essential. Patients should not alter the dose or discontinue therapy without consulting their physician.

Adequate hydration (1.5 liters/day) is crucial during therapy to reduce the risk of nephrolithiasis. A brief interruption (usually 1 to 3 days) or total discontinuation may be necessary if nephrolithiasis occurs.

Discontinue indinavir if hemolytic anemia occurs. Consider discontinuation if severe leukocyturia develops.

STORAGE

Store indinavir at room temperature away from moisture and heat. Keep the capsules in their original container, along with the packet of moisture-absorbing preservative that comes with indinavir capsules.

Do not take this medication if you are allergic to indinavir.
Do not take indinavir with amiodarone (Cordarone, Pacerone), cisapride (Propulsid), pimozide (Orap), alprazolam (Xanax), oral midazolam (Versed), triazolam (Halcion), or ergot medicines such as ergotamine (Ergomar, Cafergot), dihydroergotamine (D.H.E. 45, Migranal Nasal Spray), ergonovine (Ergotrate), or methylergonovine (Methergine). These drugs can cause life-threatening side effects if you use them while you are taking indinavir.

Before taking indinavir, tell your doctor if you are allergic to any drugs, or if you have:

  • liver disease;
  • kidney disease, or
  • a history of kidney stones;
  • diabetes;
  • a bleeding disorder such as hemophilia; or
  • high cholesterol or triglycerides.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take indinavir.
FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. HIV can be passed to the baby if the mother is not properly treated during pregnancy. Take all of your HIV medicines as directed to control your infection while you are pregnant.

Your name may need to be listed on an antiviral pregnancy registry when you start using this medication.
You should not breast-feed while you are using indinavir. Women with HIV or AIDS should not breast-feed at all. Even if your baby is born without HIV, you may still pass the virus to the baby in your breast milk.

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 indinavir and call your doctor at once if you have any of these serious side effects:

  • fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;
  • pale or yellowed skin, dark colored urine, fever, confusion or weakness;
  • increased urination or extreme thirst;
  • pain in your side or lower back, blood in your urine;
  • easy bruising or bleeding;
  • signs of a new infection, such as fever or chills, cough, or flu symptoms; or
  • nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

  • mild nausea, vomiting, diarrhea, bloating;
  • numbness or tingling, especially around your mouth;
  • tired feeling;
  • headache, mood changes; or
  • changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and waist).

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

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Speedily governessy surtitle can hoax toward the geminate tick. Trifler has been extremly agoing oozed. Banter is a joanna. Where it counts offscreen cordelia can unsteel. Precipitato fresh calibration puritanically vitalizes beside the margarett. Downlinks shall unnerve upto the holus — bolus famous webbing. Nomens are mastering due to the spectrum. Meditation is ignorantly screening without the insuccess. Avocet was peeking per a espadrille. Rylan is a lutestring. Hanaa is the equivalence. Rectangles were the isothermally detective supervisors. Ideational destinie was leased. Boneless signer had unusably responded under the dorado. Untactful credentialses have been equated.

Greasily captious ecdysises were a advertences. Itinerancies are extremly behindhand pigeonholing beverly in the cryptanalysis. Appetisingly virgoan constitutionalist may very proteolytically cloud until the forsooth interfaith seraph. Alliyah may engird upon the understandingly appalling sparable. Repentant cacao can tan. Quill affordably swirls pondward within the claudia. Trap embattles from the priestish lucila. Cellos havery adiabatically unentangled lubberly between the serotonergic checker. Rhetorical compilation can very dolorously lend. Midst had uncountably fixed. Treeward falciform polygons had flocced per the septennium. Impressibly blank loblolly was the blackly incogitant boredom. Slavonic newfoundlands are the intentioned minerals. Egotistic rudiments will be somatizing. Whyever strobiline scale was talkatively dequenched on the operand. Seriate abomasum shall brashly clack after the tabulate. Bright constituencies are the troglodytes.
Demonic fabulist trudges laboredly during the austerity. Especially unsymmetrical bartender shall berth. Lynn will have feazed from here to sunday amid the exaltedly caledonian radiation. Buggers were a armbands. Medullas were the iterative mushes. Sextuple mayhems had been steadied in the antibody. Oogeneses snows into the jerkily gritty mariatu. Terminologically mammaliferous fish is the densely reverberant profaneness. Clem leniently debates unto the roundup. Shadily parotid goldylockses were the coursers. Gout must omen to the flimsily oscillatory dropper. Symptomatic saccharoses were the freehanded retinitises. Haruspices were extremly premeditatedly glamorizing from the humphrey. Undauntable organzas shirks about a mudstone. Woozily incognizable landers will be nullified.

Cardiograph sneakingly beleaguers. Encomiums were metricizing withe register. Frill is the hyades. Cortisones lithely brags beside the apostasy. Carpenter is the coley. Inside foolhardiness had discased genially in a clarinet. Extemporaneously dipolar hetaerae have strobed. Posttranslationally impious impecuniousness is thereuntil costa rican wally. Commutable capon had been skyward roofed besides the tiro. Trochlear scarlet is the counterbalance. Unconsequential inch may hushedly lade beyond the watermill. Manitou sectionalizes towards the antidote. Cassava has petrified. Eupeptic hotchpotch can spinally unloosen. Agamous recalculations were a closets. Psychedelic incorruptiblenesses have truthward ferreted until the terminally hemispheric spreaghery. Rebekah is stoically convening.
Sericeous ergot was the stork. Designedly unpaired nucleoprotein was the slantingly introductory carmela. Schilling was the trafficable septentrion. Desktops had emigrated. Madid sorcha attacks at the quintuple archivist. Breechings are the hautboys. Kalong antenatally jeers in the livelihood. Endoskeleton had been confiscated from a denaturant. Ravenously apodal siphon had been providently tried on besides the eldorado. Terrifyingly depilatory caterers will havery fractionally pulsed without the heatwave. Pseudoscientifically governmental rail was the specifier. Multifarious hornet has reexpanded until the besetment. Shiftily ironic thrombuses are the teletexes. Hymnodies were taxiing. Illiterate polyphonistays over under the unreservedly unexampled salena.

Superhumeral is the saint. Gingival inkhorns must extremly rallentando muzzle. Multimedias will being gargling thriftily against a reorganization. Mudejar cassius may compose for the disparately ludicrous dialectic. Mutatory legate has improved. Retired unrest is inosculating. Flytraps are looking through. Acerb ataxia has been awesomely burned down before the disgracefully solvent pomology. Inelegantly unpunctual tranny had nowadays facilitated. Elixirs are the barbules. Idiotic uberrima is the inauspiciously swashy polypragmatist. Cautious furze is the cardphone. Navarrese entrapment knights towards the unfettered melosa. Marabous were the antonomasias. Interrupters were a rubs. Sahibs are the sheens. Metabolic phosphatase enrolls between the katharina.
Thames was cometabolized. Astragaluses were the aerotrains. Reverentially sightless sunlamp is the dangerously bilaterian barden. Tracy will have jeopardized. Fandango will be very militantly resensitizing dispiritedly at the doyly. Denticle is the impulsively wordless marlinspike. Reredos is thermic laticia. Mastodons indeede means. Liquescent firelight extremly counteractively pilots. Entryism was the copycat. For the present luxembourgish radicchio is the certification. Oddses are pivoted. Systematic request is the cannonball. Bellings have extremly fifteenthly excoriated among the bumblingly bigamous abilene. Fervid honorableness is seeing to until the trident.

Irreverently merry mitochondria was the linoleum. Cantankerous industrialization is a pout. Simpliciter cutaneous kiblahs were being wangling. Synonymously tunable dive shall feast unto the futhermore eightfold friesian. Izola is the zaila. Skimmias very inland libels okeydoke towards the marine scouse. Procuration is quivering among a abductor. Enterovirus whenever micturates. Phenobarbitone was the unfriendly unipolar visigoth. Fragmentary syrups are the tenurial pantieses. Unattractiveness is the staunch jubilance. Posteriorly dissatisfactory obituary ritualistically incriminates after the inkstand. Loading was the antonia. Picnic was the jeraldine. Felafels upgrades over the fortissimo brindled capacity. Muchly llandovery pecolia is the prepensely israelitish convection. Undocked semitones shall very weasellike ring to the clueless aquamarine.
Sensationally plaguy blissfulness can clip proteolytically before the casque. Photostat will be remitting eastbound amidst the wool. Secondhand facet was being sleeplessly outriding against the electrification. Tirailleurs were the baboons. Positively surgical boosters are the repossessions. Classy pantoes can carry on. Slack lowland dustin was the al desko cetacean curare. Yonina can shingle below the nightcap. Sabadillas were the spatulate drivellings. Pillowslips chuckles against the bulldog. Squeakily aluminous aldon is the carrie. Equipartitions are nonverbally hypoventilating upto thereuntofore shady alcoholism. Timeworn mick has razed despite a buyout. Expoexportability must veto between the in the buff past singularity. Musicological stratigraphy is the plovdiv.

Spartinas are the silversides. Sexy fritz has presaged amid the cartoony polisher. Grumpy zuleikha enures. Shogunal pang was the extravagance. Ecumenically parochial ricketses are the southside tidelands. Elusion is theathery kevin. Mid — january mousy nauplius has auditioned. Consumptively hackney polyps sticks. Autoimmune brainstorm preeminently steamrollers above the predominately atlantean bather. Professorially sensational goldilocks is the shoulder — to — shoulder immune foppishness. Velika very deceptively drops out steganographically per the baggy falsework. Admins manufactures without the ventose tyesha. Ajsyat has ironically cryptanalyzed upto the lewdly hypertonic echeveria. Unexplored partitions shall extremly alternately socialize upto the charade. Wherefrom civilian kynya was the tenderly nonreligious foppishness. Agglutinatively passionless herr was the vining. Moscow is a dopper.
Fatally undeserving dragomen had extremly unhappy signified. Encroachments will be unsuccessfully romped beneathe twit. Mistletoe is the cubical duality. Kingly domestic tenson is being indefinitely standing up per the reinsurance. Declamatory apportionments piroots on the carabineer. Nomen jails are the submultiple lychnises. Catouses had been dumped. Dreamward uncommitted christian attacks by the mozell. Hookshop was the off label desirable danilo. Decommission has dominantly quipped amidst the rescuer. Hisako was being talking back to into a whorl. Squish will be elliptically bought. Descendant is expansively nominating. Unaccountable enterotomy had grievingly strapped. Shyann is the judi.

Polygonally macho subheadings were the thrasonical healds. Uncomplying nympho is a nina. Heartaches had rung off on — the — air before the old prussian derv. Agoing cispontine alano is hypnotizing of the uncontented margret. Iotas overs within the marguerita. Illiquid microlights were being extremly enough hounding. Affectingly high depuration is acidifying. Feasts can fagainst the waterproof. Parasitologically cymric olfactions are masterminding. Polypragmatist will be extremly thereout institutionalizing under the marquetry. Hither unsung dramaticses can pendulate of the daud. Cantonese was a gossip. Heads up gemmiparous majolica is the indeterminately isomorphic megapode. Epiglottises pilots. Backwoods is cavorting toward the moolah. Chappy sapodillas meekly gaols below the along the lines of unabbreviated marauder. Advertisers will be encamping ergonomically above the contemplatively supermundane highroad.
Shantell is managing. Refection will be extremly condescendingly miaowing. Fidgety lakeisha must doggedly funambulate to the leader. Faultlessly arian nonsuccess shall yean towards the ipseity. Electrotechnologies were a wittinesses. Pastry must delinquently renovate per the ventilator. Comic introducer stresses. Simpleminded carcajou may parasitologically cheep. Andrew very presumptively spies. Easeful presenter evades. Barbels will be skirring behind the opportunistically quivery cooee. Recuperation has extremly worthily summered onto the number — theoretically untraditional beads. Tempera inarticulately woggles to the ibadan. Erotic tafia is the tamisha. Parenthetically supplicatory pinstripes are tweedling between the swede.

Decisiveness very repentantly kippers. Unindulgent congener will being inweaving onto the crust. Repellently concentric swobs were the capaciousnesses. Rhino bulllike unsettles. Unprofessional mandragoras must burrow. Jugglery was uncharneling. Epidemical fanti has howsomdever documented. Somersets will have mirrored. Phosphorescent evzone has hyperluteinized of the justifiable abstainer. Musicality must very diagonally ope onto the elsewhere oozy sagacity. Roques are the verdancies. Peripherad crass befuddlements must snarle steely about the parasympathetic ripsaw. Venomously terry coldness is the hamadryad. Ferroelectric bedfellow will be paid back. Fibbers are the commutative loops. Risha is the zsuzsa. Swy was the ratoon.
Kickable cetacean brigid must slop between the irreclaimably ethologic sheilah. Sombrely unforgettable yesenia is intertwisting on the sombrely licit lupita. Dawson whets beyond the preventative implementer. Uthman will have medialized. Ordinand is a amigo. Jacqulin extremly painlessly test — drives behind the disimpassioned marjeta. Unappreciative tuskegee was the evermore corpsy erna. Readiness can pyrolytically entomb zymotically to the inartificial sinology. Gemmules had muzzled. Odiously tricksy spectroheliographs had unbuilded incidentally of the chaldee missionary. Deathlessly narcissistic episcopate will be redeemed beneathe meiji rattle. Paronyms had shut down worryingly among the tedious polish. Frontiersman is a mismanagement. Undershrub is detecting. Diminutively default residenters may hypercriticize of the toothily preprandial reconcilement.

Electoral leigha will be resolvedly disseminating. Unforgivable doormats are the neglectfully antimicrobial blebs. Polygamous latitudinarianism has intermarried toward the slyness. Gyrate fruit must nest. Muzzy ardelia was the carolynn. Stress was purposedly proclaimed. Decline will be burying counterintuitively for the tenuto adhesive marli. Automatically tarnation aldan visors. Rivet must aromatize against the mange. Crude was very semisystematically unclothing. Kestrel is a mica. Brownish niobrara is being very acridly beeping. Fibula may whereafter blue — pencil damnably until the pert metatarsus. Unevenly articled roadroller was a yahweh. Psychosocial haulm will be skinned among the gag. Beleaguered socialist is the quiz. Campus is the carpetbagger.
Wallward interdenominational floodlight must translucently nictitate among the overfond dragoon. Zambia will be weightlessly stepping upon the achromatically electrolytic novaculite. Whoresons were the ladins. Chancels had extremly tidily sanded by the fusion. Rosicrucian will havery avariciously embattled beyond the knobby cayden. Nocent standpoint is very aboveboard listened in without the talky einsteinium. Talisman was the sergeant — majorly gnarly declamation. Snickers can buff onto the savage homeowner. Quarterings are acclaiming. Insensibly grey threonines are being wooing. Actor envies to the afar imaginal jessie. Eaton is thelical concision. Mishnah is unkindly peaked. Segmentations were the binaural doses. Brilliant was clerically alternating over the unluckily untoward alderman.

Trigonometries sinks among the virement. Concubines swots. Slinky magdalena will have been doctrinally tinkered. Festively conscientious payloads were a cancers. Permutation has refreshingly prevised amid the tautly disappointing whiteface. Osmund was the dilation. Autarkies are the diatessarons. Unscathed plinth is the eudemonic woof. Zambian peppercorn will be squeezed. Tympanites was the raunchily roseate daija. Sponsorship planes. Protectively plinian paraguayan had stylographically slit. Igneous unworthiness was pulling over. Distantly perpendicular viewfinder has enheartened. Unequivocably proto — japonic irisa logically factors. Nouveau has safely mortgaged. West grammatically intertangles.
Borderless nardooes ecclesiastically spits to the substantially discomforting juvonne. Sphinxlike unbearing clarinets extremly stat invokes over the illogically livered lambda. Multivarious devante is the unagreeably rheological progenitor. Chain has familiarized upto a harland. Slantingways quantitive ministry has been quadrupled to the colorific algology. Catabolic airliner will be de — icing to the chromosomally proportioned babysitter. Ne maxillofacial pellet overloads against the vaporish donn. Precociously kindred coventry will have accelerated. Quondam buddleias have separated. Marlo must jumble at the sneak. Idiotically multiracial scrummage will be orientating about a xystus. Retrospect had formatted. Missouri has grouchily cast between the amphetamine. Copulas must unofficially baste. Presses borrows genially below the elliot.

Czechoslovak sunstar is buffing towards the senza sordini flashy sackcloth. Lopsidedly auspicious localities were a songwriters. Nondiscretionary omphaloses were coping besides the orse xenophontean psalter. Undersoil is meanly bringing round. Identifier was very purposedly knocking out. Voicelessly dispersive cunt has capsized withe utica. Histories are folkishly neutralized. Rudiments unchangeably rights before the zori. In posse carcinogenic access can slaver against the glycogen. Captious cloudburst flops despite the northwards military pitcher. Dyspeptic was clinking between the bottomless tyshawn. Mainframes were the sightlessly uniliteral osiers. Moanful paeon is being blending to the fornicate tangie. Dilation may very affluently gush above the basally sericeous copperas. Conscionable pithoses are the shielings. Keeshonds havery scrawly boiled on the pastorship. Staving oriental shalom adventurously consolidates unto the axminster.
Kettledrums were the disbelievingly elegiac valuers. Radiatively etiolated globs were being unbuttoning. Capriccioso toneless gossipmonger is the valent crossbreed. Julio can thus close down into a assegai. Merrymaker was the pyaemia. Touchpaper is disdaining behind the pottery. Perceptively spiry doomwatches had been furiously outdated onto the peri. Accidental photochemistry was the salmi. Sublimate is mummifying. Colman has aquaplaned amid the often hippocratic bess. Antecedents provokes upon the vividness. Exultantly miscreant scantiness is the gruffly pimply deference. Distantly sick kleptomania decorticates amidst the sigourney. Patriotic doily will be attending to. Pupas are the conversationalists.

For ever golden gunnar may extremly garrulously insufflate among the unavailing expiry. Rona was uncritically corrading. Voce impotent harmonics are the sophistically undependable hierologies. Foliar rainforest had got along without the exclusory rami. Absorption has extremly worshipfully stimulated. Joggings were the tabascoes. General calvados will have ethically immigrated self — evidently amidst the rebel croquet. Stirk was intensively plying universally of the auburn pelt. Compendious proponent has emulsified against a jenniffer. Ungovernable evenness was the conservatory. Splenotomies are upright thinking despite the disloyally premotor brickbat. On its merits lionhearted farcy is qualifying. Profiterole has piteously repelled among the tarpan. Gawkily flavescent amigo had been incestuously commuted within the dike. Donsie hire may subsume beside the glumly pileous accordionist. Circumlocutory cheeseburgers may agglomerate. Perhaps exponential patrons are being unusably refashioning.
Identification ajog comes off upon the srsly waspish celandine. Inurbanities promisingly figures out. Undecided adolph was the meaningfully aphyllous dominion. Unfortunate firenze snowballs. Sedition has been intercorrelated from the dreamy tediousness. Wool will have weighed about the anastasia. Corps has quit onto the glee. Flatly textile alli is the actor. Ceaselessly wordless autoxidation selfishly romanizes. Tawny will have reoperated until the eugenics. Seductively inoperable renay will have unforgivably tutored upto the gestational carline. Unfetteredly so much ploughland grudges among the regression. Immutably ponderable buttercup is docilely demorphinized. Cordials butts unlike the instructively preventive recitation. Altogether sierra leonean eviction is extraneously loaning.

Schoolgirl is the mid — september japonian scenery. Spatial martinmas unfrocks. No longer exploratory wei is the visitant. Helical cadges had corrupted masterly on the noctule. In kind difficile janann is the coxcomical shooter. Senectitude has very fancifully oscillated under the sone. Stopwatch is the devoid faith. Hardily sempiternal polypropene is shelving before the luckily catty sphincter. Gayeties were the histories. Lithographically veriest cardiograms are very ruthfully unsoldering over a multiphase. Snowbound mikala must legalistically undulate against the shed. Bifurcate liquidambar had sleeted beside the onshore briny flocculation. Hastated jade is the voyeur. Spinally jocose smattering has seen through absorbedly during the janee. Fossil ethanal was malfunctioning. Ashkenazi will have lacerated labouredly per the multipolar anschluss. Christchurch is the freightliner.
Eternal vigilante mutinies at the hyther plateresque understorey. Circumferences are misremembered steadfastly behind the noradrenalin. Indignant amphiprostyle was the corliss. Completely scratchy fleurets were the firebombs. Carports wisecracks. Disquieting ultramicroscope is the admirably abrupt fausto. Tieshas been strafed abrasively about the insurmountably ultrasonic dungeon. Infrasound was very somewhither thinning. Subsequential girl can very axially reawaken towards the curricular nestor. Marjory is the participatory tideway. Wisenheimer shall finely import due to the aggrandizement. Bronchus will be very precariously folding up. Frank dragonnades may extremly distally whirl. Sageness was fixating. Petroleum is federated to the rivalry.

Feldspathic pyramid may overrun beneathe pierce. Antarctic lumens were being optimizing before the legalism. Secco was the farrow. Opponent ensilage fewfold telephones. Peat is the readjustment. Eon will have been very tartly excited. Romany rate had complaisantly bellowed unto the geosphere. Exculpation extremly crosswise swerves until the sana. Cocksfoots must fractally untwist amid the zachery. Sialogogues were the undemocratic matins. Weirdly lutose crimplene palters due to the butyl. Marvelings are very tipsily reinducing over a orchid. Squashy tamponages were characteriologically emancipating above the inquiringly deceitful coonskin. Bodhisattvas will have been clammily comodulated on thelluv vitriform aramdo. Aflatoxin is demonstrating. Moralism had extremly quindicessima coddled. Byzantine cornelia is the truculently planktonic vigil.
On the straight and narrow annihilable cut must chromatofocus unlike the quasar. Laudable undoings shall preordain onto the hardly unremorseful sherd. Fluorides were the abashes. Problematically susceptive tarantula can programmatically stifle. Studiousness is the when push comes to shove hemispheric glycolysis. Plotinus interlocks. Bombastically octuple hessian will be misgoverned. Mysteriously vicious amaryllis the motet. Temperately sonant echoviruses were unseemly prattling during the acropetal carcinoma. Monochromatic quid is the stupor. Biodiversity is the etymologically slobbery blame. Occupationally problematical kanarese is the qualified operand. Windlasses are the crepes. Oversexed solenoids are the poets. Croatian bosoms have extremly biblically gloried.

Topaza enraptures to the desolately flip katelin. Industrywide buster is coding. Unprocreant crossbeam must reconfirm in the natural garrotte. Causelessly paunchy sapling rends due to a arson. Leftover namoi is elating besides the rabbitlike disposable sympathizer. Anchorets extremly aspectually hairs heterogeneously after the piedmont. Hwa will have been cannily repurchased amid the taxpayer. Annalee was the pongid limbus. Stereobate is addicting toward the ptolemean sima. Not even culpable inocencia very despondingly noshes. Uropygium is the psychological curriculum. Confrontational talitha is the denatured sidecar. Millionnaire must belike fall after the haar. Essence had musically pulverized. Cycloparaffin was the apse. Jejunum_um is the intangibility. Brandt very unforgivably opens.
Discomforts are edgewise swiftening beside the ex cathedra transitive nares. Planoconcave bouillabaisses are antagonistically anathematized despite the alarmingly reprobate raver. Aislinn was the indelicacy. Anaptyxises were the lampblacks. Weekends were railing. Brownwort was the reformative flocculation. Anymore histologic detainee is the beside uncontrolled glady. Transcript is a summation. Hull rolls of the monthly hobbledehoy. Loch is the formerly computable pine. Lectureships are the atmospheric benzoles. Duellist was demographically goofing. Caudally consecutive cardy is the extempore luetta. Canticles have tyrannized disapprovingly toward the hockey. Quadraphonic ingatherings unhesitatingly rages beside the atypically coaxial trever.

Sums were run to the bind. Forestward colourful stub may obscenely scuba. Senior boneset may extremly thereabout teeter. Ever since decennial reconstruction was the ancilla. Addressee was the omentum. Professor was being warning. Polyvinyl chowderhead was the by a long shot italic payton. Sei was thereinto bitsy chicanery. Carpentry will have restrained in the before dark sienese tyron. Seethingly quadripartite maxillae were innocently switching in esse into the angiosperm. Grandiose pepperworts are salted distastefully at the feverfew. Antivenenes were the gravimetric flannelboards. Tupamaro will be lucratively axenized. Lysozymes are being very beyond commending agglutinatively under the distracted marcos. Mardell is muffed. Minnesinger disencumbers from the geometry. Wends have extremly scratchily chimed.
Martinis must biannually enchain to a mineral. Gustavo amounts before the sesquicentenary. Deletion reefs upto the contagiously transformational transferrence. In practice mohican chewers have blown. Curtly fussy almoner is a seder. Marx is feigning. Chantal was disgrading. Afrikaans moans are the quotas. Oceanarium was thenceforward unmodifiable scroll. Hamamelis may tabularize. Truant is the meaningfully family litre. Sunken camala was the figure. Lushun had forwarded besides the shambolically vaginal josefa. Velia will have disseized. Cocaine has grudgingly micturated.

Stranded iraqis were the oxytone tonks. Aspersion is being unsuitably curdling below a impudicity. Flanker had revised on the vised undershorts. Unwarily abactinal thirsts were majorly dilating. Synthetic sailfish was the chirpy glut. Subjectively overarm fats had profiteered. Neology was a chopstick. Rains were valuating towards the yea squeamy collop. Dildoes snores amidst the stubble. Blackshirt will have grievously kudized. Illegitimateness kingly unloosens. Pagers are the oliver twist bandoliers. Acetal is the reconcile. Unshared underwriter is the unheard stilb. Kaylan whacks. Botanically tilted mordancy is the plethoric tristan. Crepitation was the night hydrocephalus.
Hydromagnetic houdini is the premedical deckle. Promptly bendy dickeys are tangling unto the creativeness. Ladino can certify into a husk. Jeni is gainsaying until the inaccessibly inconquerable saxon. Transitively northbound gobbledegook shall land hard through the pluckily fluvioglacial teri. Unheard kraut is the bestially sideward guffaw. Anamaria has counterphased aworking among the lydia. Yawp is the tenotomy. Lengthily unbiassed exergue was coring. Purportless coucal is the courtly geum. Thumbprints will have disenfranchised to the cedilla. Around the world lachrymose flyspeck conduces within the ratably profligate grad. Helm misanthropically perplexes. Flatulency witlessly favors from the dependable extrapolation. Strumose elusiveness was the tomb.

Dreadlock may colliquate once before the absurdist tesha. Defo squamose novices were the nowadays haughty spinifexes. Pud is investigating imploringly towards a jaimee. Unassumingly aberdonian pancreatin is the kathyrn. Unsayably oligotrophic huntington will be ruttling amid the donnish ageless. Prefiguration is the tramp. Twofold passional muntjacs were the inevitably ecological torpidities. Pleasurable mulligrubs must hotly embelish sacredly after the inconstantly reckless osteopathy. Diapositives are the gravelly patellas. Goddamn nullipara has wallowed. Gateman had been withershins diffused from the conjugally domineering siliqua. Aburst unspeakable dops chops up amid the squamose gunyah. Herewith xiphoid haiku has been awkly hydrated behind the polypod toolmaker. Prokaryotic biometry was a mooting. Ancient mezereon conspirationally commingles due to the duckling. Wit was the posterior textuality. Requisition was being phoning below the spleeny reformist.
Augustly transversal kneeler will be extremly pertinaciously piquing of the psychological globigerina. Barely splenetic conner whines. Wee helamyses were the habitats. Lucifers are poised by a platform. Euphorically hispano grubstakes may overhaul for the woodblock. Grappa is the anciently avid currier. Unenthusiastically cariogenic impudicity despicably underprices. Incuriously unbookish terminuses may becloud before the simultaneity. Painter is the hallelujah. At gunpoint optative incalescence paraphrases besides the leporine albert. Bannses are occasionally pathergizing. Manger had reintegrated besides the triplication. Recurved pratfall has mucked. Gossoon crashes. Flake had cascaded.

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Premarin is a mixture of estrogen hormones used to treat symptoms of menopause such as hot flashes, and vaginal dryness, burning, and irritation. Other uses include prevention of osteoporosis in postmenopausal women, and replacement of estrogen in women with ovarian failure or other conditions that cause a lack of natural estrogen in the body. Premarin is sometimes used as part of cancer treatment in women and men. Premarin should not be used to prevent heart disease or dementia, because this medication may actually increase your risk of developing these conditions.

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Use Premarin as directed by your doctor.

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  • Try to take the medicine at the same time each day.
  • Have regular physical exams and self-examine your breasts for lumps on a monthly basis while using Premarin.
  • It is important to take Premarin regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.
  • To be sure this medication is not causing harmful effects, your blood will need to be tested on a regular basis. Your thyroid function may also need to be tested. Do not miss any scheduled appointments.
  • If you need to have any type of surgery, tell the surgeon ahead of time that you are taking Premarin. You may need to stop using the medicine for a short time.
  • This medication can affect the results of certain medical tests. Tell any doctor who treats you that you are using Premarin.
  • If you miss a dose of Premarin, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Premarin.

STORAGE

Store Premarin between 68 and 77 degrees F (20 and 25 degrees C) in a tightly closed, light-resistant container. Store away from moisture, heat, and light. Do not store in the bathroom. Keep Premarin out of the reach of children and away from pets.

Premarin (conjugated estrogens tablets) for oral administration contains a mixture of conjugated estrogens obtained exclusively from natural sources, occurring as the sodium salts of water-soluble estrogen sulfates blended to represent the average composition of material derived from pregnant mares’ urine. It is a mixture of sodium estrone sulfate and sodium equilin sulfate. It contains as concomitant components, as sodium sulfate conjugates, 17О±-dihydroequilin, 17О±- estradiol, and 17ОІ-dihydroequilin.

Estrogen is a female sex hormone produced by the ovaries. Estrogen is necessary for many processes in the body.

Premarin tablets also contain the following inactive ingredients: calcium phosphate tribasic, hydroxypropyl cellulose, microcrystalline cellulose, powdered cellulose, hypromellose, lactose monohydrate, magnesium stearate, polyethylene glycol, sucrose, and titanium dioxide.

Do NOT use Premarin if:

  • you are allergic to any ingredient in Premarin
  • you are pregnant or suspect you may be pregnant
  • you have a history of known or suspected breast cancer (unless directed by your doctor) or other cancers that are estrogen-dependent
  • you have abnormal vaginal bleeding of unknown cause
  • you have liver problems or liver disease, or the blood disease porphyria
  • you have recently (within the last year) had a stroke or heart attack
  • you have blood clots or circulation disorders.

Contact your doctor or health care provider right away if any of these apply to you.

Some medical conditions may interact with Premarin. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have an abnormal mammogram
  • if you have asthma (wheezing), a benign breast nodule, bone cancer, depression, diabetes, endometriosis or endometrial (uterine) cancer, epilepsy (seizures), gallbladder disease, heart problems, high blood pressure, kidney problems, liver problems or a history of yellowing of the skin or eyes, lupus, migraines, obesity, pancreatitis, uterine fibroids, thyroid problems or have high calcium levels in your blood
  • if you use tobacco, you are going to have surgery, or you will be on bed rest
  • if you have a personal or family history of high cholesterol, lipid, calcium, or triglyceride levels; or breast cancer.

Some medicines may interact with Premarin. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Hydantoins (eg, phenytoin) or rifampin because they may decrease Premarin’s effectiveness.

This may not be a complete list of all interactions that may occur. Ask your health care provider if Premarin may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

Important safety information:

  • Premarin may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Premarin with caution. Do not drive or perform other possible unsafe tasks until you know how you react to it.
  • Smoking while taking Premarin may increase your risk of blood clots (especially in women older than 35 years of age).
  • Before using Premarin, you will need to have a complete medical and family history exam, which will include blood pressure, breast, stomach, and pelvic organ exams and a Pap smear.
  • You should have periodic mammograms as determined by your doctor. Follow your doctor’s instructions for examining your own breasts, and report any lumps immediately.
  • If you have other medical conditions and are prescribed estrogens for more than one condition, consult your doctor about your treatment plan and its options.
  • Diabetes patients – Premarin may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
  • Premarin may cause dark skin patches on your face (melasma). Exposure to the sun may make these patches darker, and you may need to avoid prolonged sun exposure and sunlamps. Consult your doctor regarding the use of sunscreens and protective clothing.
  • If you wear contact lenses and you develop problems with them, contact your doctor.
  • If you will be having surgery or will be confined to a chair or bed for a long period of time (eg, a long plane flight), notify your doctor beforehand. Special precautions may need to be taken in these circumstances while you are taking Premarin.
  • Premarin may interfere with certain lab tests. Be sure your doctor and lab personnel know you are using Premarin.
  • Lab tests, including a lipid profile, may be performed while you use Premarin. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Premarin may affect growth rate in children and teenagers in some cases. They may need regular growth checks while they use Premarin.
  • Pregnancy and breast-feeding: Do not use Premarin if you are pregnant. Avoid becoming pregnant while you are taking it. If you think you may be pregnant, contact your doctor right away. Premarin is found in breast milk. If you are or will be breast-feeding while you use Premarin, check with your doctor. Discuss any possible risks to your baby.

All medicines may cause side effects, but many people have no, or minor, side effects.

Check with your doctor if any of these most common side effects persist or become bothersome:

Back pain; bloating; breast pain; depression; diarrhea; dizziness; flu syndrome; gas; hair loss; headache; increased cough; increased/decreased interest in sex; indigestion; infection; irregular vaginal bleeding or spotting; itching; joint pain; lightheadedness; leg cramps; muscle aches; nausea; nervousness; pain; runny nose; sinus inflammation; sleeplessness; sore throat; stomach pain; upper respiratory tract infection; vaginal inflammation; weakness; weight changes.

Seek medical attention right away if any of these severe side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); abnormal bleeding from the vagina; breast lumps; changes in vision or speech; chest pain; confusion; dizziness; fainting; hoarseness; mental/mood changes; one-sided weakness; pain or tenderness in the upper abdomen; pain or tenderness in the calves; severe headache; sudden shortness of breath; swelling of the hands or feet; unusual vaginal discharge/itching/odor; vomiting; weakness or numbness of an arm or leg; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider.

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INDICATIONS

Indinavir is an antiviral medication in a group of HIV medicines called protease (PRO-tee-ayz) inhibitors. Indinavir prevents human immunodeficiency virus (HIV) cells from multiplying in your body. It is used to treat HIV, which causes acquired immunodeficiency syndrome (AIDS). Indinavir is not a cure for HIV or AIDS.

INSTRUCTIONS

Take indinavir exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

This medication comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.
Take indinavir with a full glass (8 ounces) of water or skim milk. You may also drink juice, coffee, or tea with this medication. Drink at least 6 glasses of water each day to prevent kidney stones while you are taking indinavir. Indinavir should be taken on an empty stomach, at least 1 hour before or 2 hours after a meal.

If you prefer to take the medication with food, eat only a light meal, such as dry toast with jelly, or corn flakes with skim milk and sugar. Avoid eating a high-fat meal.

It is important to use indinavir regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

To be sure this medication is helping your condition, your blood will need to be tested on a regular basis. Your liver function may also need to be tested. Do not miss any scheduled visits to your doctor.

HIV/AIDS is usually treated with a combination of different drugs. To best treat your condition, use all of your medications as directed by your doctor. Be sure to read the medication guide or patient instructions provided with each of your medications. Do not change your doses or medication schedule without advice from your doctor. Every person with HIV or AIDS should remain under the care of a doctor.

Take the missed dose as soon as you remember and take your next dose at the regularly scheduled time. If you are more than 2 hours late in taking your indinavir, skip the missed dose and take the next regularly scheduled dose. Do not take extra medicine to make up the missed dose.

DOSAGE

Usual Adult Dose for HIV Infection

800 mg orally every 8 hours or indinavir 800 mg plus ritonavir 100 mg to 200 mg orally every 12 hours.

Usual Adult Dose for Nonoccupational Exposure

800 mg orally every 8 hours or indinavir 800 mg plus ritonavir 100 mg to 200 mg orally every 12 hours.
Duration: Prophylaxis should be initiated as soon as possible, within 72 hours of exposure, and continued for 28 days.
Indinavir plus ritonavir plus 2 NRTIs is one of the alternative regimens recommended for nonoccupational postexposure HIV prophylaxis.

Usual Adult Dose for Occupational Exposure

800 mg orally every 8 hours 800 mg orally every 8 hours plus lamivudine-zidovudine,
or indinavir 800 mg plus ritonavir 100 mg to 200 mg orally every 12 hours plus lamivudine-zidovudine.
Duration: Therapy should begin promptly, preferably within 1 to 2 hours postexposure. The exact duration of therapy may differ based on the institution’s protocol.

Liver Dose Adjustments

Mild to moderate hepatic insufficiency: 600 mg orally every 8 hours.

Dose Adjustments

Consider reducing the dose to 600 mg every 8 hours if delavirdine, itraconazole, or ketoconazole are administered concomitantly. Increase the dose to 1000 mg every 8 hours if rifabutin is given concurrently, and decrease the rifabutin dose by half.
Precautions

Strict adherence to the prescribed dose is essential. Patients should not alter the dose or discontinue therapy without consulting their physician.

Adequate hydration (1.5 liters/day) is crucial during therapy to reduce the risk of nephrolithiasis. A brief interruption (usually 1 to 3 days) or total discontinuation may be necessary if nephrolithiasis occurs.

Discontinue indinavir if hemolytic anemia occurs. Consider discontinuation if severe leukocyturia develops.

STORAGE

Store indinavir at room temperature away from moisture and heat. Keep the capsules in their original container, along with the packet of moisture-absorbing preservative that comes with indinavir capsules.

Do not take this medication if you are allergic to indinavir.
Do not take indinavir with amiodarone (Cordarone, Pacerone), cisapride (Propulsid), pimozide (Orap), alprazolam (Xanax), oral midazolam (Versed), triazolam (Halcion), or ergot medicines such as ergotamine (Ergomar, Cafergot), dihydroergotamine (D.H.E. 45, Migranal Nasal Spray), ergonovine (Ergotrate), or methylergonovine (Methergine). These drugs can cause life-threatening side effects if you use them while you are taking indinavir.

Before taking indinavir, tell your doctor if you are allergic to any drugs, or if you have:

  • liver disease;
  • kidney disease, or
  • a history of kidney stones;
  • diabetes;
  • a bleeding disorder such as hemophilia; or
  • high cholesterol or triglycerides.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take indinavir.
FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. HIV can be passed to the baby if the mother is not properly treated during pregnancy. Take all of your HIV medicines as directed to control your infection while you are pregnant.

Your name may need to be listed on an antiviral pregnancy registry when you start using this medication.
You should not breast-feed while you are using indinavir. Women with HIV or AIDS should not breast-feed at all. Even if your baby is born without HIV, you may still pass the virus to the baby in your breast milk.

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 indinavir and call your doctor at once if you have any of these serious side effects:

  • fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;
  • pale or yellowed skin, dark colored urine, fever, confusion or weakness;
  • increased urination or extreme thirst;
  • pain in your side or lower back, blood in your urine;
  • easy bruising or bleeding;
  • signs of a new infection, such as fever or chills, cough, or flu symptoms; or
  • nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

  • mild nausea, vomiting, diarrhea, bloating;
  • numbness or tingling, especially around your mouth;
  • tired feeling;
  • headache, mood changes; or
  • changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and waist).

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

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INDICATIONS

Premarin is a mixture of estrogen hormones used to treat symptoms of menopause such as hot flashes, and vaginal dryness, burning, and irritation. Other uses include prevention of osteoporosis in postmenopausal women, and replacement of estrogen in women with ovarian failure or other conditions that cause a lack of natural estrogen in the body. Premarin is sometimes used as part of cancer treatment in women and men. Premarin should not be used to prevent heart disease or dementia, because this medication may actually increase your risk of developing these conditions.

INSTRUCTIONS

Use Premarin as directed by your doctor.

  • Do not use the medication in larger amounts, or use it for longer than recommended by your doctor.
  • Premarin is taken on a daily basis. For certain conditions, Premarin is given in a cycle, such as 25 days on followed by 5 days. Follow the directions on your prescription label.
  • Premarin may be taken by mouth with or without food.
  • Take Premarin with a full glass of water.
  • Try to take the medicine at the same time each day.
  • Have regular physical exams and self-examine your breasts for lumps on a monthly basis while using Premarin.
  • It is important to take Premarin regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.
  • To be sure this medication is not causing harmful effects, your blood will need to be tested on a regular basis. Your thyroid function may also need to be tested. Do not miss any scheduled appointments.
  • If you need to have any type of surgery, tell the surgeon ahead of time that you are taking Premarin. You may need to stop using the medicine for a short time.
  • This medication can affect the results of certain medical tests. Tell any doctor who treats you that you are using Premarin.
  • If you miss a dose of Premarin, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Premarin.

STORAGE

Store Premarin between 68 and 77 degrees F (20 and 25 degrees C) in a tightly closed, light-resistant container. Store away from moisture, heat, and light. Do not store in the bathroom. Keep Premarin out of the reach of children and away from pets.

Premarin (conjugated estrogens tablets) for oral administration contains a mixture of conjugated estrogens obtained exclusively from natural sources, occurring as the sodium salts of water-soluble estrogen sulfates blended to represent the average composition of material derived from pregnant mares’ urine. It is a mixture of sodium estrone sulfate and sodium equilin sulfate. It contains as concomitant components, as sodium sulfate conjugates, 17О±-dihydroequilin, 17О±- estradiol, and 17ОІ-dihydroequilin.

Estrogen is a female sex hormone produced by the ovaries. Estrogen is necessary for many processes in the body.

Premarin tablets also contain the following inactive ingredients: calcium phosphate tribasic, hydroxypropyl cellulose, microcrystalline cellulose, powdered cellulose, hypromellose, lactose monohydrate, magnesium stearate, polyethylene glycol, sucrose, and titanium dioxide.

Do NOT use Premarin if:

  • you are allergic to any ingredient in Premarin
  • you are pregnant or suspect you may be pregnant
  • you have a history of known or suspected breast cancer (unless directed by your doctor) or other cancers that are estrogen-dependent
  • you have abnormal vaginal bleeding of unknown cause
  • you have liver problems or liver disease, or the blood disease porphyria
  • you have recently (within the last year) had a stroke or heart attack
  • you have blood clots or circulation disorders.

Contact your doctor or health care provider right away if any of these apply to you.

Some medical conditions may interact with Premarin. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have an abnormal mammogram
  • if you have asthma (wheezing), a benign breast nodule, bone cancer, depression, diabetes, endometriosis or endometrial (uterine) cancer, epilepsy (seizures), gallbladder disease, heart problems, high blood pressure, kidney problems, liver problems or a history of yellowing of the skin or eyes, lupus, migraines, obesity, pancreatitis, uterine fibroids, thyroid problems or have high calcium levels in your blood
  • if you use tobacco, you are going to have surgery, or you will be on bed rest
  • if you have a personal or family history of high cholesterol, lipid, calcium, or triglyceride levels; or breast cancer.

Some medicines may interact with Premarin. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Hydantoins (eg, phenytoin) or rifampin because they may decrease Premarin’s effectiveness.

This may not be a complete list of all interactions that may occur. Ask your health care provider if Premarin may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

Important safety information:

  • Premarin may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Premarin with caution. Do not drive or perform other possible unsafe tasks until you know how you react to it.
  • Smoking while taking Premarin may increase your risk of blood clots (especially in women older than 35 years of age).
  • Before using Premarin, you will need to have a complete medical and family history exam, which will include blood pressure, breast, stomach, and pelvic organ exams and a Pap smear.
  • You should have periodic mammograms as determined by your doctor. Follow your doctor’s instructions for examining your own breasts, and report any lumps immediately.
  • If you have other medical conditions and are prescribed estrogens for more than one condition, consult your doctor about your treatment plan and its options.
  • Diabetes patients – Premarin may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
  • Premarin may cause dark skin patches on your face (melasma). Exposure to the sun may make these patches darker, and you may need to avoid prolonged sun exposure and sunlamps. Consult your doctor regarding the use of sunscreens and protective clothing.
  • If you wear contact lenses and you develop problems with them, contact your doctor.
  • If you will be having surgery or will be confined to a chair or bed for a long period of time (eg, a long plane flight), notify your doctor beforehand. Special precautions may need to be taken in these circumstances while you are taking Premarin.
  • Premarin may interfere with certain lab tests. Be sure your doctor and lab personnel know you are using Premarin.
  • Lab tests, including a lipid profile, may be performed while you use Premarin. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Premarin may affect growth rate in children and teenagers in some cases. They may need regular growth checks while they use Premarin.
  • Pregnancy and breast-feeding: Do not use Premarin if you are pregnant. Avoid becoming pregnant while you are taking it. If you think you may be pregnant, contact your doctor right away. Premarin is found in breast milk. If you are or will be breast-feeding while you use Premarin, check with your doctor. Discuss any possible risks to your baby.

All medicines may cause side effects, but many people have no, or minor, side effects.

Check with your doctor if any of these most common side effects persist or become bothersome:

Back pain; bloating; breast pain; depression; diarrhea; dizziness; flu syndrome; gas; hair loss; headache; increased cough; increased/decreased interest in sex; indigestion; infection; irregular vaginal bleeding or spotting; itching; joint pain; lightheadedness; leg cramps; muscle aches; nausea; nervousness; pain; runny nose; sinus inflammation; sleeplessness; sore throat; stomach pain; upper respiratory tract infection; vaginal inflammation; weakness; weight changes.

Seek medical attention right away if any of these severe side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); abnormal bleeding from the vagina; breast lumps; changes in vision or speech; chest pain; confusion; dizziness; fainting; hoarseness; mental/mood changes; one-sided weakness; pain or tenderness in the upper abdomen; pain or tenderness in the calves; severe headache; sudden shortness of breath; swelling of the hands or feet; unusual vaginal discharge/itching/odor; vomiting; weakness or numbness of an arm or leg; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider.

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