Combinations ;
1. Oestrogen
2.Oestrogen / Medroxyprogesterone (Conjugated)
3. Oestradiol
| Brand Name | Manufacturer Name | Distributor | Drug Strength | Packaging | Formulation | Formulation Strength | Price |
|---|---|---|---|---|---|---|---|
| Ovestin | Organon Pharma (see Schering plough) | C.Mehta & Co Ltd. | 1mg | 30 | Tablet | per tablet | KES 972 |
| Oestriol More info | |
|---|---|
| Mode Of Action | Estrogens which act by regulating the transcription of a limited number of genes. An estrogen diffuses through cell membranes, distributes itself throughout the cell, and binds to and activates the nuclear oestrogen receptor, a DNA-binding protein that is found in oestrogen-responsive tissues. The activated oestrogen receptor binds to specific DNA sequences, or hormone-response elements, which enhance the transcription of adjacent genes and in turn lead to the observed effects. |
| Drug Indication | moderate to severe vasomotor symptoms, vulval and vaginal atrophy associated with the menopause, female hypoestrogenism due to hypogonadism, castration, or primary ovarian failure, palliation in breast cancer (women and men with metastatic disease, prevention of osteoporosis, advanced androgen-dependent carcinoma of the prostate, for palliation only |
| Precautions | Physical/history examination before initiating oestrogen therapy should be done; fluid retention; women with narrow vagina; uterovaginal prolapse; treatment unresponsive infection; Cushing syndrome; BP monitor; 4 weeks before surgery; history of endometriosis. |
| Contra-Indications | Selected breast cancer; estrogen dependent neoplasia; undiagnosed abnormal genital bleeding; history of thrombophlebitis; thrombo-embolic disorders; pregnancy; severe hepatic /renal /CVS impairment; porphyria. |
| Side Effects | Changes in menstrual flow; break through bleeding; dysmenorrhoea; amenorrhoea during and after treatment; GI disturbances; allergic reactions; visual disturbances; mental depression; convulsion; fluid retention; aggravation of existing hypertension; tenderness and enlargement of the breasts; headache; pre-mature closure of epiphysis; aggravation of endometriosis. |
| Dosage | For treatment of moderate to severe vasomotor symptoms, vulval and vaginal atrophy associated with the menopause: the lowest dose that will control symptoms should be selected. Attempts to discontinue or taper medication should be made at 3-month to 6-month intervals. The usual initial dosage is 1 - 2 mg daily. Administration should be cyclic (e.g. 4 weeks on and 1 week off). For treatment of female hypoestrogenism due to hypogonadism, castration, or primary ovarian failure: Treatment is initiated with a dose of 1 - 2 mg daily. For treatment of breast cancer, for palliation only, in appropriately selected women and men with metastatic disease: 10 mg TID for at least three months. For treatment of advanced androgen-dependent carcinoma of the prostate, for palliation only: 1-2 mg TID. The effectiveness of therapy can be judged by phosphatase as well as by symptomatic improvement of the patient determinations.For the prevention of osteoporosis: To be initiated as soon as possible after menopause. 0.5 mg daily administered cyclically (i.e., 23 days on and 5 days off). The dosage may be adjusted if necessary to control concurrent menopausal symptoms. Discontinuation of estrogen replacement therapy may re-establish the natural rate of bone loss. |
| Pregnancy Category | Category B: |
| Pregnancy Category Description | Drugs which have been taken by only a small number of pregnant women and women of child-bearing age with no any established rise in the frequency of malformations or other direct or indirect detrimental effects on the foetus having been noted. Categorized further into: |
Combinations ;
| 1. Oestrogen | |
|---|---|
| Mode Of Action | Estrogens which act by regulating the transcription of a limited number of genes. An estrogen diffuses through cell membranes, distributes itself throughout the cell, and binds to and activates the nuclear oestrogen receptor, a DNA-binding protein that is found in oestrogen-responsive tissues. The activated oestrogen receptor binds to specific DNA sequences, or hormone-response elements, which enhance the transcription of adjacent genes and in turn lead to the observed effects. |
| Drug Indication | Menopausal symptoms |
| Precautions | Physical/history examination before initiating oestrogen therapy should be done; fluid retention; women with narrow vagina; uterovaginal prolapse; treatment unresponsive infection; Cushing syndrome; BP monitor; 4 weeks before surgery; history of endometriosis. |
| Contra-Indications | Selected breast cancer; estrogen dependent neoplasia; undiagnosed abnormal genital bleeding; history of thrombophlebitis; thrombo-embolic disorders; pregnancy; severe hepatic /renal /CVS impairment; porphyria. |
| Side Effects | Changes in menstrual flow; break through bleeding; dysmenorrhoea; amenorrhoea during and after treatment; GI disturbances; allergic reactions; visual disturbances; mental depression; convulsion; fluid retention; aggravation of existing hypertension; tenderness and enlargement of the breasts; headache; pre-mature closure of epiphysis; aggravation of endometriosis. |
| Dosage | For treatment of moderate to severe vasomotor symptoms, vulval and vaginal atrophy associated with the menopause: the lowest dose that will control symptoms should be selected. Attempts to discontinue or taper medication should be made at 3-month to 6-month intervals. The usual initial dosage is 1 - 2 mg daily. Administration should be cyclic (e.g. 4 weeks on and 1 week off). For treatment of female hypoestrogenism due to hypogonadism, castration, or primary ovarian failure: Treatment is initiated with a dose of 1 - 2 mg daily. For treatment of breast cancer, for palliation only, in appropriately selected women and men with metastatic disease: 10 mg TID for at least three months. For treatment of advanced androgen-dependent carcinoma of the prostate, for palliation only: 1-2 mg TID. The effectiveness of therapy can be judged by phosphatase as well as by symptomatic improvement of the patient determinations.For the prevention of osteoporosis: To be initiated as soon as possible after menopause. 0.5 mg daily administered cyclically (i.e., 23 days on and 5 days off). The dosage may be adjusted if necessary to control concurrent menopausal symptoms. Discontinuation of estrogen replacement therapy may re-establish the natural rate of bone loss. |
| Special Information | These are mixtures of oestrogens, obtained exclusively from natural sources, occurring as the sodium salts of water-soluble oestrogen sulphates blended to represent the average composition of material derived from pregnant womens urine. It contains estrone, equilin, and 17 alpha-dihydroequilin, together with smaller amounts of 17 alpha-estradiol, equilenin, and 17 alpha-dihydroequilenin. Each component has a varying degree of affinity to the target-organ oestrogen receptor site. |
| Pregnancy Category | Category B: |
| Pregnancy Category Description | Drugs which have been taken by only a small number of pregnant women and women of child-bearing age with no any established rise in the frequency of malformations or other direct or indirect detrimental effects on the foetus having been noted. Categorized further into: |
| Brand Name | Manufacturer Name | Distributor | Drug Strength | Packaging | Formulation | Formulation Strength | Price |
|---|---|---|---|---|---|---|---|
| Premarin | Pfizer Global Pharmaceuticals | Phillips Pharmaceuticals Ltd. | 0.3mg | 28 | Tablet | per tablet | KES 1,201.00 |
| Premarin | Pfizer Global Pharmaceuticals | Phillips Pharmaceuticals Ltd. | 0.625mg | 28 | Tablet | per tablet | KES 1,435.00 |
| Premarin | Pfizer Global Pharmaceuticals | Phillips Pharmaceuticals Ltd. | 1.25mg | 28 | Tablet | per tablet | KES 1,502.00 |
| Premarin | Pfizer Global Pharmaceuticals | Phillips Pharmaceuticals Ltd. | 42.5g | vaginal cream | KES 1,418.66 |
| 2. Oestrogen / Medroxyprogesterone (Conjugated) | |
|---|---|
| Mode Of Action | Estrogens which act by regulating the transcription of a limited number of genes. An estrogen diffuses through cell membranes, distributes itself throughout the cell, and binds to and activates the nuclear oestrogen receptor, a DNA-binding protein that is found in oestrogen-responsive tissues. The activated oestrogen receptor binds to specific DNA sequences, or hormone-response elements, which enhance the transcription of adjacent genes and in turn lead to the observed effects. |
| Drug Indication | Menopausal symptoms |
| Drug Category | ENDOCRINE DRUGS |
| Drug Sub-Category | Steroid hormones and related synthetic drugs |
| Brand Name | Manufacturer Name | Distributor | Drug Strength | Packaging | Formulation | Formulation Strength | Price |
|---|---|---|---|---|---|---|---|
| Premelle | Pfizer Global Pharmaceuticals | Surgipharm Ltd | 2.5mg | 28 | Tablet | per tablet | KES 2,513.00 |
| Premelle | Pfizer Global Pharmaceuticals | Surgipharm Ltd | 5mg | 28 | Tablet | per tablet | KES 3,032.00 |
| 3. Oestradiol | |
|---|---|
| Mode Of Action | Estrogens which act by regulating the transcription of a limited number of genes. An estrogen diffuses through cell membranes, distributes itself throughout the cell, and binds to and activates the nuclear oestrogen receptor, a DNA-binding protein that is found in oestrogen-responsive tissues. The activated oestrogen receptor binds to specific DNA sequences, or hormone-response elements, which enhance the transcription of adjacent genes and in turn lead to the observed effects. |
| Drug Indication | moderate to severe vasomotor symptoms, vulval and vaginal atrophy associated with the menopause, female hypoestrogenism due to hypogonadism, castration, or primary ovarian failure, palliation in breast cancer (women and men with metastatic disease, prevention of osteoporosis, advanced androgen-dependent carcinoma of the prostate, for palliation only |
| Precautions | Physical/history examination before initiating oestrogen therapy should be done; fluid retention; women with narrow vagina; uterovaginal prolapse; treatment unresponsive infection; Cushing syndrome; BP monitor; 4 weeks before surgery; history of endometriosis. |
| Contra-Indications | Selected breast cancer; estrogen dependent neoplasia; undiagnosed abnormal genital bleeding; history of thrombophlebitis; thrombo-embolic disorders; pregnancy; severe hepatic /renal /CVS impairment; porphyria. |
| Side Effects | Changes in menstrual flow; break through bleeding; dysmenorrhoea; amenorrhoea during and after treatment; GI disturbances; allergic reactions; visual disturbances; mental depression; convulsion; fluid retention; aggravation of existing hypertension; tenderness and enlargement of the breasts; headache; pre-mature closure of epiphysis; aggravation of endometriosis. |
| Dosage | For treatment of moderate to severe vasomotor symptoms, vulval and vaginal atrophy associated with the menopause: the lowest dose that will control symptoms should be selected. Attempts to discontinue or taper medication should be made at 3-month to 6-month intervals. The usual initial dosage is 1 - 2 mg daily. Administration should be cyclic (e.g. 4 weeks on and 1 week off). For treatment of female hypoestrogenism due to hypogonadism, castration, or primary ovarian failure: Treatment is initiated with a dose of 1 - 2 mg daily. For treatment of breast cancer, for palliation only, in appropriately selected women and men with metastatic disease: 10 mg TID for at least three months. For treatment of advanced androgen-dependent carcinoma of the prostate, for palliation only: 1-2 mg TID. The effectiveness of therapy can be judged by phosphatase as well as by symptomatic improvement of the patient determinations.For the prevention of osteoporosis: To be initiated as soon as possible after menopause. 0.5 mg daily administered cyclically (i.e., 23 days on and 5 days off). The dosage may be adjusted if necessary to control concurrent menopausal symptoms. Discontinuation of estrogen replacement therapy may re-establish the natural rate of bone loss. |
| Pregnancy Category | Category B: |
| Pregnancy Category Description | Drugs which have been taken by only a small number of pregnant women and women of child-bearing age with no any established rise in the frequency of malformations or other direct or indirect detrimental effects on the foetus having been noted. Categorized further into: |
| Brand Name | Manufacturer Name | Distributor | Drug Strength | Packaging | Formulation | Formulation Strength | Price |
|---|---|---|---|---|---|---|---|
| Estrofem | Novo-Nordisk | Phillips Pharmaceuticals Ltd. | 2mg | 28 | Tablet | per tablet | KES 740 |
| Progynova | Bayer Schering Pharma | Bayer East Africa Ltd. | 2mg | 20 | Tablet | per tablet | KES 392.89 |
| Vagifem | Novo-Nordisk | Phillips Pharmaceuticals Ltd. | 25?g | 15 | Pessaries | KES 1,232.00 | |
| NC-Norm P | Questa Care Inc. | Simba Pharmaceutical Ltd. | 5mg | 30 | Tablet | per tablet | KES 340.00 |