Premarin Tablet 28's belongs to the class of hormones used as ‘hormone replacement therapy’ to treat symptoms and conditions associated with menopause. During menopause, estrogen levels decrease, leading to hot flushes (feeling of heat over the face, neck, and chest). Women with menopause are at risk of developing osteoporosis (thinning of bones). Premarin Tablet 28's can be used to prevent osteoporosis after menopause.

Premarin Tablet 28's contains ‘conjugated estrogens’, which is used as hormone replacement therapy (HRT). It works by replacing the estrogen hormone in menopausal women. It also regulates the secretions of hormones such as luteinizing hormone (LH) (necessary for sexual function and the menstrual cycle) and follicle-stimulating hormone (FSH) (regulates the menstrual cycle). These effects help to improve the symptoms of menopause.

Premarin Tablet 28's should be taken as advised by your doctor. The dose of medicine and duration of treatment will be decided by the doctor based on your medical condition. Premarin Tablet 28's may cause certain side effects such as abnormal vaginal bleeding or spotting, vaginal discharge, pain and swelling in the breasts, discharge from the nipples, changes in breast tissue, feeling or being sick, bloating, abdominal pain, headache, dizziness, mood changes, irritability, joint pain, leg cramps, increased or decreased libido (sexual desire), swelling of face or ankles, rashes on the skin, changes in hair growth, eye, weight and triglyceride levels (fats), intolerance to glucose, memory loss and jaundice (yellowing of the skin or eyes).

Premarin Tablet 28's should be avoided if you have a history of breast cancer, endometrial cancer (cancer of the lining of the womb), unexplained vaginal bleeding, untreated endometrial hyperplasia (thickening of the womb lining), have a blood clot in the veins (thrombosis), in the legs (deep vein thrombosis) or the lungs (pulmonary embolism), blood clotting disorder, heart attack or angina (chest pain), inherited porphyria (a blood disorder) or liver disease. It is not recommended for use in pregnant and breastfeeding women. Stop taking Premarin Tablet 28's and consult your doctor immediately if you are allergic to it or if you develop jaundice (yellowing of the skin and eyes), high blood pressure and migraine-like headache, become pregnant or notice signs of a blood clot such as redness, swelling and pain in the legs, sudden chest pain or difficulty in breathing. Inform your doctor if you have any intolerance to sugar.

Premarin Tablet 28's contains ‘conjugated estrogens’, which is used for hormone replacement therapy (HRT). In menopause, estrogen levels become too low, so Premarin Tablet 28's works by replacing this hormone.  It also regulates the secretions of other hormones from the pituitary gland, such as luteinizing hormone (LH) (necessary for sexual function and the menstrual cycle) and follicle-stimulating hormone (FSH) (regulates the menstrual cycle). These effects help to reduce the symptoms of menopause.

• Nausea
• Stomach pain
• Headache
• Back pain
• Depression,
• Sleep problems (insomnia)
• Breast pain
• Vaginal itching or discharge
• Changes in your menstrual periods
• Unusual vaginal bleeding
• Changes in vision or speech

Before starting treatment with Premarin Tablet 28's, inform your doctor if you are allergic to it. Also inform if you have fibroids inside the womb, growth of womb lining outside the womb (endometriosis), excessive thickening of the womb lining (endometrial hyperplasia), increased risk of developing blood clots, increased risk of getting estrogen-sensitive cancer (in people with a family history of breast cancer), high blood pressure, diseases associated with liver, kidney, or heart, fluid retention (oedema), diabetes, gallbladder stones, migraine or severe headache, systemic lupus erythematosus, epilepsy (fits), asthma, osteosclerosis (a condition affecting eardrum and hearing), hypocalcemia (low calcium levels in the blood), and high levels of fat in the blood. Premarin Tablet 28's increases the risk of endometrial hyperplasia and endometrial cancer, so your doctor may prescribe you the hormonal medicine ‘progesterone’ to minimize this risk. Inform your doctor if you are pregnant or breastfeeding, as Premarin Tablet 28's is not recommended for use in such a population. Long-term use of high dosages of this medication may raise your risk of heart attack, stroke, blood clots, dementia, breast cancer, or uterine cancer. Discuss this risk with your doctor. If you still have your uterus (womb), see your doctor about whether you should take progestin.

Drug-drug interactions: Premarin Tablet 28's may interact with anticonvulsants (phenobarbital, phenytoin, and carbamazepine), medicines used to treat tuberculosis (rifampicin and rifabutin), drugs used to treat HIV (nevirapine, efavirenz, ritonavir, and nelfinavir), antibiotics (erythromycin and clarithromycin), antifungal medicines (ketoconazole and itraconazole), a herbal preparation such as St. John’s wort (Hypericum perforatum), a medicine used to treat Cushing’s syndrome (metyrapone), a drug used to treat stomach ulcers (cimetidine) and corticosteroids (dexamethasone).

Drug-food interactions: Avoid grapefruit or grapefruit juice while using this medicine to increase the risk of side effects.

Drug-disease interactions: Premarin Tablet 28's is contraindicated in conditions such as breast cancer, endometrial cancer (cancer of the lining of the womb), unexplained vaginal bleeding, untreated endometrial hyperplasia (thickening of the womb lining), having a blood clot in the veins (thrombosis), in the legs (deep vein thrombosis), or the lungs (pulmonary embolism), blood clotting disorder, heart attack or angina (chest pain), inherited porphyria (a blood disorder), or liver disease.

• PHENOBARBITAL
• PHENYTOIN
• CARBAMAZEPINE
• RIFAMPICIN
• RIFABUTIN
• EFAVIRENZ
• RITONAVIR
• NELFINAVIR
• ERYTHROMYCIN
• CLARITHROMYCIN
• KETOCONAZOLE
• ITRACONAZOLE
• CIMETIDINE
• DEXAMETHASONE
• NEVIRAPINE
• HYPERICUM PERFORATUM
• METYRAPONE

• Wear loose, layered clothing during the nighttime, especially in warm weather. This prevents hot flushes.
• Manage your weight. Shed excess weight by exercising regularly if you are obese or overweight. 
• Talk to a psychologist if you feel low, sad, isolated, or have any sleeping issues.
• Apply moisturizers to prevent skin dryness.
• Limit alcohol intake and quit smoking.

• Try to eat foods that are rich in iron and Vitamin C, including red meat, shellfish, eggs, beans, and leafy green vegetables.

• While giving blood for tests, inform your doctor that you are taking Premarin Tablet 28's as this medicine may affect some test results. 
• Take calcium and vitamin D supplements to promote bone health and reduce the risk of osteoporosis.
• Your doctor may advise you to get blood tests to examine the risks of taking this medication.

Menopause: Menopause occurs when a woman is between 45 and 55 and has not had a period for 12 months or more. However, some women may also experience menopause before 45 years or after 55 years. It occurs due to decreased production of estrogen hormone. The change in levels of other hormones such as progesterone, luteinizing hormone and the follicle-stimulating hormone is also observed during menopause. It causes symptoms such as hot flushes, vaginal dryness, insomnia (sleeplessness), weight gain, reduced sexual desire, sore breasts, hair loss, unwanted hair growth, headache and urinary tract infections.