Conjugated Oestrogens/Medroxyprogesterone Low Dose

Conjugated Oestrogens/Medroxyprogesterone Low Dose is a Hormone Replacement Therapy (HRT) previously sold under the brand name Premique is used to treat some of the symptoms associated with the menopause. Conjugated Oestrogens/Medroxyprogesterone Low Dose is a period-free HRT (an HRT product where you do not have a monthly bleed).

During the menopause, the amount of oestrogen produced by a woman’s body drops. This can cause symptoms such as hot face, neck and chest (“hot flushes”). This medication alleviates these symptoms after menopause.

It should be taken in a continuous combined 28-day regimen of one tablet daily with no break between packs.

Please Note: This medication is not a contraceptive. If it is less than 12 months since your last menstrual period or you are under 50 years old, you may still need to use additional contraception to prevent pregnancy. Do not use a hormonal contraceptive while using HRT.

The recommended dose is one tablet every day. Take your tablet at the same time each day as this will help to remind you to take your medicine. If you are not currently taking HRT or you are taking another period-free HRT, you may start your first pack at any convenient time.

Begin your pack by taking the first tablet marked for that day of the week. Continue to take one tablet each day following the arrows until all 28 tablets have been taken. While you are taking this medication you will have no “pill-free” days. You should start your next pack the day after you finish the previous one.

While this medication does not cause bleeding, you may experience some irregular bleeding or light bleeding (spotting) during your first few months of taking it. If the bleeding is troublesome, or continues beyond the first 3 months of treatment you should discuss this with your doctor. Do not try to take off the coating, divide or crush the tablets as this could affect the way Conjugated Oestrogens/Medroxyprogesterone Low Dose works.

If you forget to take your tablet: If you forget to take a tablet don’t worry. Take it as soon as you remember and then carry on taking the remaining tablets at the usual time. If more than one tablet has been forgotten, do not take extra to try to make up for the forgotten tablets. Missed tablets may cause a short period of light bleeding in women who have not had a hysterectomy.

Like all medicines, this medicine can cause side effects, although not everybody gets them. The following side effects have been associated with Conjugated Oestrogens/Medroxyprogesterone Low Dose:

Very common: may affect more than 1 in 10 women

• breast pain

Common: may affect up to 1 in 10 women

• breakthrough bleeding or spotting, vaginal inflammation, period pain
• breast tenderness, swollen breasts, nipple discharge
• depression
• muscle and joint aches, leg cramps
• weight change (increase or decrease)
• changes in your triglyceride levels (fatty substances in the blood)

The list above isn’t exhaustive. If you experience serious side effects or side effects lasting longer than 3 months, then you should consult your doctor immediately. Make sure you read the patient information leaflet for a full list of side effects, cautions and contraindications. You should only take HRT once you have understood all the warnings and precautions as HRT may increase your chances of getting certain cancers or cardiovascular disease. If you are concerned discuss this with your doctor or The Family Chemist clinician.

If any of the following applies to you. If you are not sure about any of the points below, talk to your doctor before taking.

Do not take if you:

• are allergic to conjugated oestrogens or medroxyprogesterone acetate or any of the other ingredients of this medicine.
• have or have ever had breast cancer, or if you are suspected of having it.
• have cancer which is sensitive to oestrogens, such as cancer of the womb lining (endometrium) or if you are suspected of having it.
• have any unexplained vaginal bleeding.
• have excessive thickening of the womb lining (endometrial hyperplasia) that is not being treated.
• have or have ever had a blood clot in a vein (thrombosis), such as in the legs (deep venous thrombosis) or the lungs (pulmonary embolism).
• have a blood clotting disorder (such as protein C, protein S, or antithrombin deficiency).
• have or recently have had a disease caused by blood clots in the arteries, such as a heart attack, stroke or angina.
• have or have ever had a liver disease and your liver function tests have not returned to normal.
• have a rare blood problem called “porphyria” which is passed down in families (inherited).
• are pregnant, or you are breastfeeding.

If any of the above conditions appear for the first time while taking this medication, stop taking it at once and consult your doctor immediately.

You should discuss with your GP or pharmacist before taking Conjugated Oestrogens/Medroxyprogesterone Low Dose, especially if you have a history of the following:

• fibroids inside your womb
• growth of womb lining outside your womb (endometriosis) or a history of excessive growth of the womb lining (endometrial hyperplasia)
• increased risk of developing blood clots
• increased risk of getting an oestrogen-sensitive cancer (such as having a mother, sister or grandmother who has had breast cancer)
• high blood pressure
• heart disease
• a liver disorder (e.g. a benign liver tumour)
• diabetes
• gallbladder disease or gallstones
• migraine or severe headaches
• fluid retention due to cardiac or kidney problems
• a disease of the immune system that affects many organs of the body (systemic lupus erythematosus, SLE)
• epilepsy
• asthma
• a disease affecting the eardrum and hearing (otosclerosis)
• low blood calcium levels (hypocalcaemia)
• a very high level of fat in your blood (triglycerides).

You should discuss these with your GP or pharmacist as these conditions may return or become worse during treatment, or may mean that your GP might request more regular check-ups while taking this medication to ensure you remain healthy.

If you notice any of the following when taking HRT:

• Any of the conditions mentioned in the ‘Do not take’ section above.
• Yellowing of your skin or the whites of your eyes (jaundice). These may be signs of a liver disease.
• A large rise in your blood pressure (symptoms may be headache, tiredness, dizziness).
• Migraine-like headaches which happen for the first time.
• If you become pregnant.
• Have an allergic reaction, signs of which include rash, itching, shortness of breath, difficulty breathing and a swollen face.
• If you notice signs of a blood clot, such as:
  • painful swelling and redness of the legs
  • sudden chest pain
  • difficulty in breathing

• https://www.medicines.org.uk/emc/files/pil.100946.pdf
• https://www.womens-health-concern.org/
• https://patient.info/medicine/oestrogen-and-progestogen-for-hrt
• https://www.nhs.uk/conditions/menopause/
• https://www.nhs.uk/conditions/hormone-replacement-therapy-hrt/