GENERIC NAME: conjugated estrogens, synthetic

BRAND NAME: Cenestin

DRUG CLASS AND MECHANISM: Cenestin is a combination of nine estrogens. Estrogens are hormones produced by the ovaries that are necessary for the proper development of the female reproductive system and sexual characteristics. After menopause , there is a decrease in the amount of estrogen that is produced by the ovaries. This decrease in estrogen production is responsible for hot flashes, mood changes, sleep disturbance, decreased sexual function and other symptoms associated with menopause. Estrogen deficiency also has been linked to heart disease and bone loss (osteoporosis). Cenestin is similar to conjugated estrogens (Premarin), the other drug used for treating hot flashes. Unlike the estrogens in Premarin which are obtained from the urine of pregnant horses, the estrogens in Cenestin are synthetic (man- made) and are produced from plant material. Therefore, the estrogens in Cenestin are different than the estrogens found in Premarin.

GENERIC AVAILABLE: No

PRESCRIPTION: Yes

PREPARATIONS: Tablets: 0.45, 0.625, and 0.9 mg .

STORAGE: Tablets should be stored at room temperature, 15-30°C (59-86°F).

PRESCRIBED FOR: Cenestin is used for the relief of moderate to severe hot flashes and other symptoms of estrogen deficiency.

DOSING: The lowest effective dose should be used, starting with 0.625 mg and gradually increasing to 1.25 mg a day.

DRUG INTERACTIONS: Drug interactions studies between Cenestin and other drugs have not been conducted. In general, rifampin, carbamazepine (Tegretol), barbiturates, atorvastatin (Lipitor), primidone (Mysoline) and phenytoin (Dilantin) increase the ability of the liver to convert estrogens into inactive compounds. Therefore, use of these drugs with Cenestin may decrease the effectiveness of Cenestin.

PREGNANCY: Estrogens such as Cenestin should not be used during pregnancy because they increase the risk of birth defects in the fetus.

NURSING MOTHERS: Estrogens such as Cenestin may decrease the quantity and quality of breast milk and produce unpredictable effects in the infant. Nursing mothers should avoid taking estrogens.

SIDE EFFECTS: The most frequent side effects associated with Cenestin are abdominal discomfort, weakness, back pain, headaches, abnormal heart rhythm, nausea, flatulence (excessive production of gas), water retention, depression , insomnia (difficulty sleeping), nervousness, dizziness, breast pain and uterine bleeding or spotting.

Estrogens, including Cenestin, may increase the risk of developing breast and endometrial cancer, blood clots and gallbladder disease.

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