Estrogens (Conjugated/Equine, Systemic

Pediatric Medication
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This information from Lexicomp® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.

Brand Names: US

Premarin

Brand Names: Canada

C.E.S. [DSC]; Premarin

Warning
  • Do not use this drug to prevent heart disease or dementia. A study of women taking a certain dose of this drug with a progestin showed a raised chance of heart attack, stroke, blood clot, breast cancer, and dementia. The chance of stroke, blood clot, and dementia was also raised when that dose of this drug was taken alone. It is not known if the same effects may happen with all doses or forms of this drug.
  • The chance of endometrial cancer may be raised with the use of estrogen alone in patients with a uterus. Use of a progestin along with estrogen may lower the risk. Call the doctor right away if your child has unexplained or long-lasting vaginal bleeding.
  • Give this drug for the shortest time needed at the lowest useful dose. The doctor will talk with you on a regular basis to see if your child needs to keep taking this drug.

What is this drug used for?

  • It is used to add estrogen to the body when the ovaries have been taken out or do not work the right way.
  • It may be given to your child for other reasons. Talk with the doctor.

What do I need to tell the doctor BEFORE my child takes this drug?

  • If your child is allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell the doctor about the allergy and what signs your child had.
  • If your child has had any of these health problems: Bleeding disorder, blood clots, a higher risk of having a blood clot, breast cancer, liver problems or liver tumor, heart attack, stroke, tumor where estrogen makes it grow, or vaginal bleeding where the cause is not known.

If your child is pregnant:

  • Do not give this drug to your child during pregnancy.

This is not a list of all drugs or health problems that interact with this drug.

Tell the doctor and pharmacist about all of your child’s drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe to give this drug with all of your child’s other drugs and health problems. Do not start, stop, or change the dose of any drug your child takes without checking with the doctor.

What are some things I need to know or do while my child takes this drug?

  • Tell all of your child’s health care providers that your child is taking this drug. This includes your child’s doctors, nurses, pharmacists, and dentists. This drug may need to be stopped before certain types of surgery as the doctor has told you. If this drug is stopped, the doctor will tell you when to start giving this drug again after your child’s surgery or procedure.
  • If your child has high blood sugar (diabetes), you will need to watch your child’s blood sugar closely.
  • High blood pressure has happened with drugs like this one. Have your child’s blood pressure checked as you have been told by the doctor.
  • Have your child’s blood work and bone density checked as you have been told by the doctor.
  • Be sure your child has regular breast exams and gynecology check-ups. Your child will also need to do breast self-exams as the doctor has told you.
  • This drug may affect certain lab tests. Tell all of your child’s health care providers and lab workers that your child takes this drug.
  • Alcohol may interact with this drug. Be sure your child does not drink alcohol.
  • Be sure your child does not smoke. Smoking raises the chance of heart disease. Talk with the doctor.
  • If your child drinks grapefruit juice or eats grapefruit often, talk with your child’s doctor.
  • Talk with the doctor if your child will need to be still for long periods of time like long trips, bedrest after surgery, or illness. Not moving for long periods may raise the chance of blood clots.
  • The risk of certain side effects like heart attack, stroke, breast cancer, ovarian cancer, and others may not be the same for everyone. Factors like how long an estrogen is taken, if it is taken with or without a progestin, and other factors may affect the risk for certain side effects. Talk with the doctor about the benefits and risks of giving this drug to your child.
  • High triglyceride levels have happened with this drug. Tell your child’s doctor if your child has ever had high triglyceride levels.
  • This drug may affect growth in children and teens in some cases. They may need regular growth checks. Talk with the doctor.

If your child is breast-feeding a baby:

  • Tell the doctor if your child is breast-feeding a baby. You will need to talk about any risks to the baby.

Tablets:

  • If you or your child see parts of this drug in your child’s stool, call the doctor.

What are some side effects that I need to call my child’s doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your child’s doctor or get medical help right away if your child has any of the following signs or symptoms that may be related to a very bad side effect:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of gallbladder problems like pain in the upper right belly area, right shoulder area, or between the shoulder blades; yellow skin or eyes; fever with chills; bloating; or very upset stomach or throwing up.
  • Signs of high blood pressure like very bad headache or dizziness, passing out, or change in eyesight.
  • Signs of liver problems like dark urine, tiredness, decreased appetite, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.
  • Signs of a pancreas problem (pancreatitis) like very bad stomach pain, very bad back pain, or very bad upset stomach or throwing up.
  • Weakness on 1 side of the body, trouble speaking or thinking, change in balance, drooping on one side of the face, or blurred eyesight.
  • Pelvic pain.
  • Eyesight changes or loss, bulging eyes, or change in how contact lenses feel.
  • A lump in the breast, breast pain or soreness, or nipple discharge.
  • Vaginal itching or discharge.
  • Vaginal bleeding that is not normal.
  • Depression or other mood changes.
  • Memory problems or loss.
  • This drug may cause your child to swell or keep fluid in the body. Tell your child’s doctor if swelling, weight gain, or trouble breathing happens after this drug is given.
  • Call the doctor right away if your child has signs of a blood clot like chest pain or pressure; coughing up blood; shortness of breath; swelling, warmth, numbness, change of color, or pain in a leg or arm; or trouble speaking or swallowing.
  • High calcium levels have happened with drugs like this one in some people with cancer. Call your child’s doctor right away if your child has signs of high calcium levels like weakness, confusion, feeling tired, headache, upset stomach or throwing up, constipation, or bone pain.

If your child is or may be sexually active:

  • Change in sex interest.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your child’s doctor or get medical help if any of these side effects or any other side effects bother your child or do not go away:

All products:

  • Headache.
  • Hair loss.
  • Enlarged breasts.
  • Breast soreness.
  • Leg cramps.
  • Swelling.
  • Stomach pain or cramps.
  • Bloating.
  • Upset stomach or throwing up.
  • Vaginal bleeding or spotting.
  • Feeling tired or weak.
  • Back pain.
  • Gas.
  • This drug may cause dark patches of skin on your child’s face. Avoid lots of sun, sunlamps, and tanning beds. Use sunscreen and dress your child in clothing and eyewear that protects from the sun.

Injection:

  • Irritation where the shot is given.

These are not all of the side effects that may occur. If you have questions about side effects, call your child’s doctor. Call your child’s doctor for medical advice about side effects.

You may report side effects to your national health agency.

How is this drug best given?

Give this drug as ordered by your child’s doctor. Read all information given to you. Follow all instructions closely.

Tablets:

  • Give this drug at the same time of day.
  • Give this drug with or without food.
  • Keep giving this drug to your child as you have been told by your child’s doctor or other health care provider, even if your child feels well.
  • There may be days when your child will not take this drug.

Injection:

  • It is given as a shot into a muscle or vein.

What do I do if my child misses a dose?

Tablets:

  • Give a missed dose as soon as you think about it.
  • If it is close to the time for your child’s next dose, skip the missed dose and go back to your child’s normal time.
  • Do not give 2 doses at the same time or extra doses.

Injection:

  • Call your child’s doctor to find out what to do.

How do I store and/or throw out this drug?

Tablets:

  • Store at room temperature in a dry place. Do not store in a bathroom.

Injection:

  • If you need to store this drug at home, talk with your child’s doctor, nurse, or pharmacist about how to store it.

All products:

  • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
  • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

General drug facts

  • If your child’s symptoms or health problems do not get better or if they become worse, call your child’s doctor.
  • Do not share your child’s drug with others and do not give anyone else’s drug to your child.
  • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your child’s doctor, nurse, pharmacist, or other health care provider.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.

Last Reviewed Date

2024-03-21

Copyright

© 2024 UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.

Last Updated

Monday, December 12, 2022