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Prempak-C is a form of hormone replacement therapy (HRT), used to treat symptoms of the menopause. Prempak-C is known as a sequential hormone replacement therapy. Sequential treatments are best suited for women who have started suffering from menopausal symptoms but still have somewhat of a menstrual cycle. Prempak-C Tablets are available in two different strengths, 0.625mg & 1.25mg. Your doctor will decide which strength you hould take based on your symptoms and medical history.
There are two types of tablets – you will take an oestrogen tablet every day, as well as a progestogen tablet for each of the last 12 days of the treatment cycle. This more closely mimics the changes in hormones over the menstrual cycle, and will ease symptoms and side effects.
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 include hot flushes (a spontaneous heat that spreads throughout the body, leading to blushing, sweating and an unusually strong heartbeat), night sweats, osteoporosis and 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. You can reduce the impact of some symptoms (especially hot flushes) by avoiding alcohol or caffeine, quitting smoking, exercising regularly or staying cool.
Hormone Replacement Therapy eases the symptoms of menopause by supplementing the levels of hormones which the body can produce naturally. 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. This will substantially increase your risk of complications such as endometrial cancer. This is why Prempak-C introduces a tablet with norgestrel, a synthetic version of progesterone, towards the end of a treatment cycle.
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.
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Take Prempak-C tablets in the order indicated on the pack. For the first 16 days, you will take one oestrogen tablet. For the remainder of the 28-day treatment cycle, you will take one oestrogen tablet as well as one norgestrel tablet. When you finish a pack, begin the next one the following day without an interval.
Prempak-C 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.
If, for any reason, you forget to take a tablet, take it as soon as possible. However, if it is more than 12 hours late, skip the dose that you missed. Never double your dose to compensate for a dose that you have missed.
Not everyone will experience side effects when they take Prempak-C, however if you do they may include:
Breast pain or tenderness, irregular or painful periods, breakthrough bleeding, leg cramps, aching joints or muscles, weight change, depression, 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.
Reading the following warnings carefully will help to ensure you are selecting an appropriate product.
Prempak-C is unsuitable for you if you:
Inform your GP if you plan on taking Prempak-C and have ever had any of the following health complications:
Tell your GP or pharmacist if you have taken or plan to take any of the following medicines:
As your body adjusts to Prempak-C, 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 Prempak-C and seek medical attention immediately if you notice early signs of any of the following:
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.
The active ingredients contained in Prempak-C are conjugated oestrogens & norgestrel.
Prempak-C also contains the following inactive ingredients to make up the complete product:
Oestrogen tablets – lactose monohydrate, sucrose, methylcellulose, magnesium stearate, glyceryl mono-oleate, Macrogol, carnauba wax, calcium sulfate anhydrous, microcrystalline cellulose, shellac, titanium dioxide (E171), edible ink, coating
Norgestrel tablets – lactose monohydrate, sucrose, starch, povidone, talc, magnesium stearate, Macrogol, calcium carbonate, bleached wax, carnauba wax, titanium dioxide (E171), colour (E172).
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