Premique Low-Dose Tablets

What is Premique and what is it used for?

Premique is a combined form of hormone replacement therapy (HRT), used to treat the symptoms of the menopause. Its two active ingredients are conjugated oestrogens and medroxyprogesterone acetate. These emulate the female sex hormones oestrogen and progesterone, respectively.

Please note: Premique tablets are no longer made by the manufacturer. Premique Low-Dose tablets are still available.

Each Premique tablet contains medroxyprogesterone acetate alongside an oestrogen to help reduce the risks of developing endometrial cancer associated with taking oestrogen-only HRT in women that have an intact uterus.

As your body adjusts to Premique, you may notice breakthrough bleeding or spotting. Talk to your GP if this continues after more than a few months of treatment. HRT should only be necessary as a relatively short-term treatment as your body adjusts to the menopause. You should review your HRT with your GP at least once each year and have regular gynaecological checkups.

HRT will not prevent pregnancy in women who are otherwise fertile. Women under 50 are considered fertile until two years after their final menstrual cycle (for women over 50, this is reduced to one year). Do not use a hormonal contraceptive while undergoing HRT.

What is the menopause?

All women go through the menopause. This usually occurs between the ages of 45 and 55. As you approach this age, your ovaries will produce less and less oestrogen. This has the effect of stopping the menstrual cycle, but the change in hormone levels can lead to several symptoms which may have a substantial impact on day-to-day life.

Physical symptoms of the menopause include:

• Hot flushes (a spontaneous heat that spreads throughout the body, leading to blushing, sweating and an unusually strong heartbeat)
• Night sweats
• Osteoporosis
• Dryness of the eyes or vagina

The hormonal change can also cause distressing psychological effects such as irritability, insomnia and depression. Experiences with menopausal symptoms vary significantly depending on the individual. They can begin multiple years prior to the menopause itself and remain for many years. Women will, on average, experience symptoms for about four years.

How does HRT work?

Hormone Replacement Therapy (HRT) eases the symptoms of menopause by supplementing the levels of hormones that the body can produce naturally before experiencing the menopause. Some medicines are oestrogen-only. However, in women who still have a uterus, an uncontrolled increase in oestrogen levels will cause the lining of the uterus (the endometrium) to grow excessively. Substantially increasing your risk of complications such as endometrial cancer. This is why HRT such as Premique contains progesterone to counteract these risks.

Non-medicinal alternatives for the symptoms of menopause

For Night Sweats and Hot Flushes

• Using A fan
• Cool Showers
• Wearing light clothing

Vaginal Dryness

• Lubricants

Other Alternatives

• A healthy diet and regular exercise
• Stopping Smoking

Sources

• Premique Low-Dose Tablets, Patient Information Leaflet: https://www.medicines.org.uk/e...
• https://www.nhs.uk/conditions/hormone-replacement-therapy-hrt/types/
• https://patient.info/medicine/oestrogen-and-progestogen-for-hrt
• https://www.nhs.uk/conditions/blood-clots
• https://www.nhs.uk/conditions/stroke/symptoms/

Premique warnings

Reading the following warnings carefully will help to ensure you are selecting an appropriate product.

Premique is unsuitable for you if you:

• Have ever had breast cancer
• May have a cancer which is sensitive to oestrogen (including uterine cancer)
• Have untreated endometrial hyperplasia (an excessively thick womb lining)
• Suffer from a blood clotting disorder, or have ever had a blood clot
• Have recently had a heart attack or stroke
• Have unexplained vaginal bleeding
• Have impaired liver function
• Suffer from porphyria (a rare hereditary blood disease)
• Are allergic to any of the ingredients in Premique
• Are pregnant or breastfeeding.

Inform your GP if you plan on taking Premique and have ever had any of the following health complications:

• Fibroids
• Impaired liver function
• Uterine problems including endometriosis or endometrial hyperplasia
• Circulation problems (e.g. angina, heart attack)
• Heart disease
• High risk of blood clots
• Diabetes
• Migraine
• Gallstones
• Systemic lupus erythematosus
• Asthma
• Epilepsy
• Fluid retention
• High blood pressure
• High fat levels in the blood
• Low calcium levels in the blood
• Otosclerosis (a hereditary ear disorder)
• A family history of breast cancer or another oestrogen-sensitive cancer.

Tell your GP or pharmacist if you have taken or plan to take any of the following medicines:

• Epilepsy medicines (e.g. phenytoin, carbamazepine)
• Tuberculosis medicines (e.g. rifampicin)
• HIV medicines (e.g. nevirapine, ritonavir, nelfinavir)
• Metyrapone
• Aminoglutethimide
• St Johns Wort.

As your body adjusts to Premique, you may notice breakthrough bleeding or spotting. Talk to your GP if this continues after more than a few months of treatment.

HRT may increase your risk of breast cancer. The extent of this risk will vary depending on the length of your HRT treatment and whether you are taking combined or oestrogen-only HRT. Check your breasts regularly for changes to the skin or nipple, or for any noticeable lump. For women who use HRT for more than five years, there may also be a slight increase in the risk of ovarian cancer.

Stop taking Premique and seek medical attention immediately if you notice early signs of any of the following:

• Blood clots – pain and swelling of the legs, difficulty breathing
• Stroke – sudden migraines, blurred vision
• Heart disease – chest pain which extends to the neck or arm
• Liver disease – yellow colouration of the skin or eyes.

Discuss with your doctor whether your personal benefits of HRT outweigh the risks mentioned above.

Please read all packaging and the Product Information Leaflet before taking any new medicine and inform your doctor of medicines you are taking or intend to take.

Premique directions

Premique should be taken at a similar time each day, according to the directions on the pack. Swallow the tablet whole with a sip of water. This can be done with or without food. Once you finish a pack (28 days), start a new pack the following day without an interval. You should review your HRT with your GP at least once each year.

If, for any reason, you forget to take a tablet, take it as soon as possible. However, if it is nearly time for your next dose, skip the dose that you missed. Never double your dose to compensate for a dose that you have missed.

Premique ingredients

The active ingredients contained in Premique are conjugated oestrogens & medroxyprogesterone acetate.

Premique also contains the following inactive ingredients to make up the complete product:

Lactose monohydrate, sucrose, calcium phosphate tribasic, calcium sulfate anhydrous, microcrystalline cellulose, carnauba wax, glyceryl mono-oleates, magnesium stearate, methylcellulose, macrogol, pharmaceutical glaze, povidone, titanium dioxide (E171), stearic acid and colour (E132, indigo carmine), iron oxide black (E172) shellac, n-Buutyl alcohol, propylene glycol, ethyl acetate.

Premique side effects

Not everyone will experience side effects when they take Premique, however if you do they may include:

• Breakthrough bleeding
• Breast pain or tenderness
• Mood swings
• Aching muscles or joints
• Weight change
• Leg cramps
• Vaginal inflammation
• Change in fat levels in the blood

If you are concerned about these effects, or if the product affects you in any other way, stop using it and talk to your doctor or pharmacist.