Pharmacology for the Primary Care Provider by Edmunds Marilyn Winterton & Mayhew Maren Stewart

Author:Edmunds, Marilyn Winterton & Mayhew, Maren Stewart
Language: eng
Format: epub
ISBN: 978-0-323-08791-9
Publisher: Elsevier Health Sciences
Published: 2013-04-16T16:00:00+00:00

Precautions

Despite the rarity of endometrial hyperplasia in the clinical trial on which FDA approval was based, the manufacturer recommends that patients with an intact uterus take a progestin for 14 days every 6 to 12 months and that they have an endometrial biopsy at least once a year. This “long-cycle” progestin regimen has been reported to protect against endometrial hyperplasia in women taking a low dose (0.3 mg/day) of oral estrogens. In women who have had a prior hysterectomy, oral conjugated estrogens without a progestin did not increase the risk of coronary disease but did increase the risk of venous thromboembolism and stroke; the incidence of breast cancer, surprisingly, was lower with unopposed estrogen than with placebo.

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