Safety Concerns With Prempro
Specific Prempro Warnings and PrecautionsWarnings and precautions to be aware of prior to using Prempro include the following:
- Studies have shown that hormone replacement therapy containing estrogen and progestin (such as Prempro) increases the risk of heart attack, stroke, and blood clots in the legs and lungs. In no case should Prempro be used to prevent heart disease (see Hormone Replacement Therapy and Heart Health).
- Before you take Prempro, your healthcare provider should make sure you are appropriately treated for any risk factors for heart disease, stroke, or blood clots (such as high blood pressure, high cholesterol, diabetes, obesity, lupus, or smoking).
- Estrogen/progestin drugs (like Prempro) may increase the risk of breast cancer. Proper screening and monitoring (as determined by your healthcare provider), such as yearly mammograms and monthly self breast exams, is recommended.
- When possible, the drug should be stopped four to six weeks before many surgeries in order to help prevent blood clots.
- Let your healthcare provider know if you have abnormal vaginal bleeding, such as heavy bleeding or bleeding between periods, while taking Prempro, as this may be a sign of precancerous or cancerous changes in the uterus. Your healthcare provider can perform the necessary tests to rule out cancer.
- Estrogen-containing drugs seem to increase the risk of dementia. In no case should Prempro be used to prevent or treat dementia (it is not effective for this use).
- Prempro should be used with caution in people who have low calcium levels in the blood (known medically as hypocalcemia).
- Women who take estrogen-containing medications like Prempro have an increased risk for gallbladder disease.
- Let your healthcare provider know if you notice any vision changes. This can signal a blood clot in the retina, a possible side effect of Prempro.
- Prempro can cause high blood pressure (hypertension) or high triglycerides in some women. Your healthcare provider should monitor you for these problems while you are taking the drug.
- If you have had jaundice (yellowing of the whites of the eyes or skin) due to estrogens or pregnancy in the past, Prempro may cause similar problems to recur. If this happens, your healthcare provider will likely advise you to stop taking the drug.
- If you have an underactive thyroid (hypothyroidism), Prempro may increase your body's requirement for thyroid hormones. Your healthcare provider should monitor you and adjust the dose of your thyroid medications as necessary.
- Prempro can cause fluid retention. This can cause problems for people with congestive heart failure (CHF) or kidney problems.
- It is not clear if Prempro increases the risk of ovarian cancer. Some studies have shown an increased risk, while others have not.
- The medication can make endometriosis symptoms worse.
- Prempro can interact with a number of different medications (see Prempro Drug Interactions).
- The medication should not be used during pregnancy (see Prempro and Pregnancy).
- Prempro does pass through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Prempro and Breastfeeding).