Premarin

Do not take Premarin if you have had any circulation problem involving blood clots, or have had a stroke or heart attack in the past year.

Do not take Premarin if you have liver disease or your liver is not working properly.

Do not use Premarin if you are pregnant or trying to become pregnant.

Special warnings about Premarin

For women who have not had a hysterectomy, the risk of endometrial and uterine cancer increases when estrogen-only drugs are used for a long time or taken in large doses. Estrogen therapy can also worsen endometriosis (uterine tissue growing outside the uterus). If you've ever had endometriosis, make sure the doctor is aware of it. If you've had a hysterectomy but still have residual endometriosis, your doctor may want you to use an estrogen/progesterone combination.

Certain studies have shown that women taking estrogen for prolonged periods of time (4 years or more) face an increased risk of breast cancer, and a study by the National Heart, Lung and Blood Institute (NHLBI) has confirmed an increased risk among women taking estrogen/progesterone combinations. Use combination products (and estrogen-only preparations, too) with special caution if you have a family history of breast cancer or have ever had an abnormal mammogram. Be sure to get an annual breast exam from your doctor, and do your own self-examination each month.

The NHLBI study also found an increased risk of dementia for women taking estrogen or estrogen/progesterone combinations.

Because Premarin can increase the risk of heart attack, stroke, blood clots, and certain estrogen-dependent cancers, contact your doctor right away if you notice any of the following:

Abdominal pain, tenderness, or swelling
Abnormal bleeding from the vagina
Breast lumps
Coughing up blood
Pain in your chest or calves
Severe headache, dizziness, or faintness
Sudden shortness of breath
Vision changes

Women who take Premarin after menopause are more likely to develop gallbladder disease.

Estrogens such as Premarin can cause hypercalcemia, a severe increase of calcium levels in the blood. Women with breast or bone cancer are especially at risk and should stop taking Premarin immediately if they develop hypercalcemia. In addition, women with the opposite problem--hypocalcemia, or a severe decrease of calcium in the blood--should use Premarin with caution.