Conjugated estrogens/medroxyprogesterone acetate
Combination of | |
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Conjugated estrogens | Estrogen |
Medroxyprogesterone acetate | Progestogen |
Names | |
Trade names | Prempro, Premphase, Premique |
Other names | CEs/MPA; CEEs/MPA |
Clinical data | |
WHO AWaRe | UnlinkedWikibase error: ⧼unlinkedwikibase-error-statements-entity-not-set⧽ |
Pregnancy category | |
Routes of use | By mouth |
External links | |
AHFS/Drugs.com | Professional Drug Facts |
Legal | |
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PubChem CID | |
ATC code |
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Chemical and physical data | |
3D model (JSmol) | |
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Conjugated estrogens/medroxyprogesterone acetate (CEs/MPA), sold under the brand names Prempro among others, is a combination medication of conjugated estrogens, an estrogen, and medroxyprogesterone acetate, a progestogen. It is used in menopausal hormone therapy for menopausal symptoms.[3]
In 2017, it was the 294th most commonly prescribed medication in the United States, with more than one million prescriptions.[4][5]
Society and culture
Cost
It was the 294th most commonly prescribed medication in the United States in 2017, in excess of one million prescriptions.[4]
- ConjugatedEstrogensMedroxyprogesterone costs (US)
- ConjugatedEstrogensMedroxyprogesterone prescriptions (US)
Clinical outcome | Hypothesized effect on risk |
Estrogen and progestogen (CEs 0.625 mg/day p.o. + MPA 2.5 mg/day p.o.) (n = 16,608, with uterus, 5.2–5.6 years follow up) |
Estrogen alone (CEs 0.625 mg/day p.o.) (n = 10,739, no uterus, 6.8–7.1 years follow up) | ||||
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HR | 95% CI | AR | HR | 95% CI | AR | ||
Coronary heart disease | Decreased | 1.24 | 1.00–1.54 | +6 / 10,000 PYs | 0.95 | 0.79–1.15 | −3 / 10,000 PYs |
Stroke | Decreased | 1.31 | 1.02–1.68 | +8 / 10,000 PYs | 1.37 | 1.09–1.73 | +12 / 10,000 PYs |
Pulmonary embolism | Increased | 2.13 | 1.45–3.11 | +10 / 10,000 PYs | 1.37 | 0.90–2.07 | +4 / 10,000 PYs |
Venous thromboembolism | Increased | 2.06 | 1.57–2.70 | +18 / 10,000 PYs | 1.32 | 0.99–1.75 | +8 / 10,000 PYs |
Breast cancer | Increased | 1.24 | 1.02–1.50 | +8 / 10,000 PYs | 0.80 | 0.62–1.04 | −6 / 10,000 PYs |
Colorectal cancer | Decreased | 0.56 | 0.38–0.81 | −7 / 10,000 PYs | 1.08 | 0.75–1.55 | +1 / 10,000 PYs |
Endometrial cancer | – | 0.81 | 0.48–1.36 | −1 / 10,000 PYs | – | – | – |
Hip fractures | Decreased | 0.67 | 0.47–0.96 | −5 / 10,000 PYs | 0.65 | 0.45–0.94 | −7 / 10,000 PYs |
Total fractures | Decreased | 0.76 | 0.69–0.83 | −47 / 10,000 PYs | 0.71 | 0.64–0.80 | −53 / 10,000 PYs |
Total mortality | Decreased | 0.98 | 0.82–1.18 | −1 / 10,000 PYs | 1.04 | 0.91–1.12 | +3 / 10,000 PYs |
Global index | – | 1.15 | 1.03–1.28 | +19 / 10,000 PYs | 1.01 | 1.09–1.12 | +2 / 10,000 PYs |
Diabetes | – | 0.79 | 0.67–0.93 | 0.88 | 0.77–1.01 | ||
Gallbladder disease | Increased | 1.59 | 1.28–1.97 | 1.67 | 1.35–2.06 | ||
Stress incontinence | – | 1.87 | 1.61–2.18 | 2.15 | 1.77–2.82 | ||
Urge incontinence | – | 1.15 | 0.99–1.34 | 1.32 | 1.10–1.58 | ||
Peripheral artery disease | – | 0.89 | 0.63–1.25 | 1.32 | 0.99–1.77 | ||
Probable dementia | Decreased | 2.05 | 1.21–3.48 | 1.49 | 0.83–2.66 | ||
Abbreviations: CEs = conjugated estrogens. MPA = medroxyprogesterone acetate. p.o. = per oral. HR = hazard ratio. AR = attributable risk. PYs = person–years. CI = confidence interval. Notes: Sample sizes (n) include placebo recipients, which were about half of patients. "Global index" is defined for each woman as the time to earliest diagnosis for coronary heart disease, stroke, pulmonary embolism, breast cancer, colorectal cancer, endometrial cancer (estrogen plus progestogen group only), hip fractures, and death from other causes. Sources: See template. |
Type | Route | Medications | Odds ratio (95% CI) |
---|---|---|---|
Menopausal hormone therapy | Oral | Estradiol alone ≤1 mg/day >1 mg/day | 1.27 (1.16–1.39)* 1.22 (1.09–1.37)* 1.35 (1.18–1.55)* |
Conjugated estrogens alone ≤0.625 mg/day >0.625 mg/day | 1.49 (1.39–1.60)* 1.40 (1.28–1.53)* 1.71 (1.51–1.93)* | ||
Estradiol/medroxyprogesterone acetate | 1.44 (1.09–1.89)* | ||
Estradiol/dydrogesterone ≤1 mg/day E2 >1 mg/day E2 | 1.18 (0.98–1.42) 1.12 (0.90–1.40) 1.34 (0.94–1.90) | ||
Estradiol/norethisterone ≤1 mg/day E2 >1 mg/day E2 | 1.68 (1.57–1.80)* 1.38 (1.23–1.56)* 1.84 (1.69–2.00)* | ||
Estradiol/norgestrel or estradiol/drospirenone | 1.42 (1.00–2.03) | ||
Conjugated estrogens/medroxyprogesterone acetate | 2.10 (1.92–2.31)* | ||
Conjugated estrogens/norgestrel ≤0.625 mg/day CEEs >0.625 mg/day CEEs | 1.73 (1.57–1.91)* 1.53 (1.36–1.72)* 2.38 (1.99–2.85)* | ||
Tibolone alone | 1.02 (0.90–1.15) | ||
Raloxifene alone | 1.49 (1.24–1.79)* | ||
Transdermal | Estradiol alone ≤50 μg/day >50 μg/day | 0.96 (0.88–1.04) 0.94 (0.85–1.03) 1.05 (0.88–1.24) | |
Estradiol/progestogen | 0.88 (0.73–1.01) | ||
Vaginal | Estradiol alone | 0.84 (0.73–0.97) | |
Conjugated estrogens alone | 1.04 (0.76–1.43) | ||
Combined birth control | Oral | Ethinylestradiol/norethisterone | 2.56 (2.15–3.06)* |
Ethinylestradiol/levonorgestrel | 2.38 (2.18–2.59)* | ||
Ethinylestradiol/norgestimate | 2.53 (2.17–2.96)* | ||
Ethinylestradiol/desogestrel | 4.28 (3.66–5.01)* | ||
Ethinylestradiol/gestodene | 3.64 (3.00–4.43)* | ||
Ethinylestradiol/drospirenone | 4.12 (3.43–4.96)* | ||
Ethinylestradiol/cyproterone acetate | 4.27 (3.57–5.11)* | ||
Notes: (1) Nested case–control studies (2015, 2019) based on data from the QResearch and Clinical Practice Research Datalink (CPRD) databases. (2) Bioidentical progesterone was not included, but is known to be associated with no additional risk relative to estrogen alone. Footnotes: * = Statistically significant (p < 0.01). Sources: See template. |
See also
References
- 1 2 "Conjugated estrogens / medroxyprogesterone Use During Pregnancy". Drugs.com. 16 February 2019. Archived from the original on 28 November 2020. Retrieved 5 May 2020.
- ↑ "Premique Low Dose 0.3mg/1.5mg Modified Release Tablets - Summary of Product Characteristics (SmPC)". (emc). 1 November 2016. Archived from the original on 28 August 2021. Retrieved 5 May 2020.
- ↑ Hochadel M, Avorn J (1 January 2007). The AARP Guide to Pills: Essential Information on More Than 1,200 Prescription and Nonprescription Medications, Including Generics. Sterling Publishing Company Incorporated. pp. 235–. ISBN 978-1-4027-4446-4.
- 1 2 "The Top 300 of 2020". ClinCalc. Archived from the original on 12 February 2021. Retrieved 11 April 2020.
- ↑ "Conjugated Estrogens; Medroxyprogesterone - Drug Usage Statistics". ClinCalc. Archived from the original on 8 July 2020. Retrieved 11 April 2020.
External links
- "Estrogens mixture with medroxyprogesterone acetate". Drug Information Portal. U.S. National Library of Medicine. Archived from the original on 28 August 2021. Retrieved 5 May 2020.
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