LYCOS RETRIEVER 
Premarin: Estrogens
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Premarin is an estrogen replacement drug. The tablets are used to reduce moderate to severe symptoms of menopause, including feelings of warmth in the face, neck, and chest, and the sudden intense episodes of heat and sweating known as "hot flashes." Cenestin tablets, containing a synthetic form of conjugated estrogens, may ... be prescribed for these symptoms. In addition to the symptoms of menopause, Premarin tablets are prescribed for teenagers who fail to mature at the usual rate, and to relieve the symptoms of certain types of cancer, including some forms of breast and prostate cancer. In addition, either the tablets or Premarin vaginal cream can be used for other conditions caused by lack of estrogen, such as dry, itchy external genitals and vaginal irritation. Along with diet, calcium supplements, and exercise, Premarin tablets are also prescribed to prevent postmenopausal osteoporosis, a condition in which the bones become brittle and easily broken. Before taking Premarin solely for this purpose, you should carefully consider using alternative, nonestrogen therapies.
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Premarin is 50% estrone sulfate, 25% equilin, 15% eqilenin. The rest consists of numerous metabolites, some very biologically active. There may be trace amounts of hormones other than estrogens. Thus Premarin is a very complex blend of hormones. It ... provides certain metabolites that are metabolized relatively slowlyÑin contrast to Estrace, for instance, which has a half-life of less than three hours. This persistence can be an advantage if the result is a steady level of energy and good sleep, or a disadvantage if a woman happens to have side effects.
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Premarin® (conjugated estrogens tablets, USP) 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, 17a -dihydroequilin, 17a -estradiol, and 17b -dihydroequilin. Tablets for oral administration are available in 0.3 mg, 0.45 mg, 0.625 mg, 0.9 mg, and 1.25 mg strengths of conjugated estrogens.
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Premarin, a drug made up of conjugated estrogens obtained from the urine of pregnant mares, is the most widely prescribed drug in the United States and the drug of choice for hormone replacement therapy. Wyeth-Ayerst, the sole manufacturer of the drug, is owned by American Home Products (AHP), a company with sales of $14 billion in 1996. A July 23, 1997 Wall Street Journal article reported that AHP's sales of Premarin rose 45 percent in the second quarter of 1997, to $291 million. Wyeth's revenues from Premarin are $1 billion a year.
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Premarin is indicated for the treatment of mild to severe vasomotor symptoms of menopause, prevention of osteoporosis, and treatment of vaginal and vulvar atrophy. Premarin has been one of the most widely used drugs in the United States. Premarin became the form of estrogen most commonly used for hormone replacement therapy.
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The defenders of Premarin cite studies that show its remarkable safety, while its attackers cite studies to the contrary. For every point, there seems to be a counterpoint. For instance, Premarin lowers the insulin-like growth factor 1 (IGF-1). This is cited as an anti-carcinogenic effect. Others point out that by lowering IGF-1, Premarin eventually leads to some loss of muscle mass, always an undesirable, pro-aging phenomenon (it can be prevented by simultaneous use of androgens such as DHEA). In common with other oral estrogens, Premarin ... raises triglycerides; it's been argued, however, that this rise is harmless, and anyway it can be prevented with correct doses of progesterone and androgens, or even with exercise.
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