Brand name:

Activella and femhrt

Why is Activella and femhrt prescribed?

These medications are designed for use in hormone replacement therapy. Both combine a form of estrogen with a substance that acts like progesterone. Both relieve the symptoms of menopause, and both are prescribed to prevent osteoporosis in postmenopausal women. (Activella is also used for vaginal atrophy.)

Estrogen, when taken by itself, poses an increased risk of uterine cancer. The progestin in these products largely counteracts this effect.

Most important fact about Activella and femhrt

Because of the risk of uterine cancer, be sure to alert your doctor if you experience any abnormal vaginal bleeding. There is little, if any, increase in risk during the first year of treatment, but the odds rise substantially after 5 to 10 years.

How should you take Activella and femhrt?

Take one tablet at the same time each day, with or without food. If you are taking Activella and femhrt to relieve menopausal symptoms, your doctor will reevaluate your need for medication every 3 to 6 months. If you are taking the product to prevent osteoporosis, you will probably continue for years.

--If you miss a dose...

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Never take 2 doses at the same time.

--Storage instructions...

Store at room temperature. Keep Activella in a tightly closed container away from moisture and light.

Activella and femhrt side effects

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this type of product.

• Side effects may include:
  Abdominal pain, breast tenderness and enlargement, depression, enlargement of uterine fibroids, headache, nausea, nervousness, skin reddening, urinary tract infection, vaginal inflammation, vomiting

Why should Activella and femhrt not be prescribed?

Do not take these products if you have:

• Known or suspected breast cancer, any other cancer stimulated by estrogen, or a past history of breast cancer associated with estrogen use
• Unexplained genital bleeding
• A history of blood clots or phlebitis
• Sensitivity to estrogen or progesterone
• Any reason to believe that you are pregnant

If you've had your uterus removed, you don't need the progestin in these products, and should take a different type of hormone replacement therapy. You should also avoid Activella if you have a liver condition.

Special warnings about Activella and femhrt

In addition to increasing the chances of uterine cancer, estrogen replacement therapy may also raise the odds of breast cancer if taken at high doses or for long periods of time. Be sure to do a monthly self-exam of your breasts, and get regular mammograms.

Estrogen replacement therapy typically doubles the chances of gallbladder disease. Notify your doctor if you experience pain, tenderness, or swelling in your abdomen.

Estrogen replacement increases the risk of blood clots in the veins, especially during the first year of therapy. Call your doctor immediately if you experience any of the following warning signs: bulging eyes, changes in vision or speech, coughing up blood, dizziness, double vision, faintness, migraine, pains in the calves or chest, severe headache or vomiting, sudden shortness of breath, sudden vision loss, weakness or numbness of an arm or leg.

Estrogen therapy sometimes causes high blood pressure, so be sure to get periodic checkups. In women prone to high blood lipid levels, estrogen can also cause a sharp spike in triglycerides, possibly leading to pancreatitis. Fluid retention is another possibility. If it develops, it can aggravate conditions such as asthma, epilepsy, heart disease, kidney disease, and migraine.

Make sure your doctor knows if you have ever been diagnosed with depression. Treatment with the products should be discontinued if depression recurs.

If you have diabetes, watch your blood sugar levels especially carefully. There's a chance that estrogen/progestin products may make diabetes worse.

Possible food and drug interactions when taking Activella and femhrt

If estrogen is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining estrogen with the following:

Acetaminophen (Tylenol)
Aspirin
Clofibrate (Atromid-S)
Cyclosporine (Neoral)
Morphine
Seizure medications such as Dilantin, Tegretol, and phenobarbital
Steroid medications such as prednisone (Deltasone)
Rifampin (Rifadin)
Temazepam (Restoril)
Theophylline (Theo-Dur)

Special information if you are pregnant or breastfeeding

Although these medications are intended only for women who are no longer in their childbearing years, it's important to note that they should never be taken during pregnancy, since they can harm the developing baby. Additionally, estrogen decreases the quantity and quality of breast milk, and progesterone finds its way into the milk.

Recommended dosage for Activella and femhrt

ADULTS

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.

• Symptoms of overdose may include:
  Nausea, vomiting, vaginal bleeding