Premarin 1246465 225663303 2008-07-14T20:09:19Z 69.140.168.24 /* Controversy */ {{drugbox | | IUPAC_name = sodium 13-methyl-17-oxo-3-sulfonatooxy-7,8,9,11,12,14,15,16-octahydro-6H-cyclopenta<nowiki>[ a]</nowiki> phenanthrene | image = Premarin structure.png | CAS_number = 12126-59-9 | ATC_prefix = G03 | ATC_suffix =CA57 | PubChem = 9919 | DrugBank = APRD00396 | C=18 | H=21| Na=1| O=5| S=1| | synonyms = conjugated estrogens<BR>equilin sulfate | molecular_weight = 372.412 g/mol | protein_bound= >90% | smiles = CC12CCC3C(C1CCC2=O)CCC4=C3C=CC(=C4)OS(=O)(=O)[O-].[Na+] | elimination_half-life=7.2 hours | excretion = renal | pregnancy_category = X | legal_status = Rx-only | routes_of_administration = [[Oral]], [[topical]] }} '''Premarin''' is the commercial name for compound drug consisting primarily of conjugated [[estrogen]]s. Isolated from [[horse|mare's]] [[urine]] ('''PRE'''gnant '''MAR'''es' ur'''IN'''e), it is manufactured by [[Wyeth]] [[Pharmaceutical]]s and has been marketed since 1942. It is available in oral (0.3/ 0.45/ 0.625/ 1.25mg), IV, and topical form. ==Pharmacology== The major forms of estrogen in Premarin are [[estrone]] (>50%), [[equilin]] (15-25%) and [[equilenin]]. The estrogens in Premarin are often called "conjugated equine estrogens" (CEE) because the estrogen [[molecule]]s are generally present with [[hydrophilic]] side-groups attached such as [[sulfate]]. Thus, [[estrone sulfate]] is actually the major molecule in Premarin. Estrone sulfate is easily [[absorption|absorbed]] into the [[blood]] after Premarin [[tablet|pill]]s are taken by [[women]]. Estrone sulfate is [[Conversion (chemistry)|converted]] to [[estradiol]], an active estrogen normally found in women. It is not clear if estrogens such as equilin that are foreign to the human body have effects in women that are significantly different from the estrogens like estradiol that are normally made in the human body. As Premarin is not a single compound, but a mixture of many naturally derived compounds, the structural diagram above does not show Premarin but its primary ingredient, [[Estrone]] in its sulfated form. Thus, Premarin cannot be characterized by the structure of one of many compounds. ==Indications== Premarin is indicated for the treatment of mild to severe vasomotor symptoms of menopause, prevention of [[osteoporosis]], and treatment of vaginal and vulvar atrophy. Premarin has been one of the most widely used drugs in the [[United States]]. Premarin became the form of estrogen most commonly used for [[hormone replacement therapy]]. ==Controversy== Premarin is the subject of some [[contention]]. [[Animal rights]] activists claim that animal husbandry and urine collection methods used in Premarin's production cause undue stress and suffering to the [[Mare (horse)|mare]]s involved.<ref>[http://premarin.org/ premarin.org site]</ref> Additionally, it is proposed that there is an overabundance of poorly bred foals produced by Pregnant Mare Urine (PMU) farms each year, since many foals must be produced in order for Premarin to exist. ==References== {{reflist}} ==See also== [[Estrogen]] ==External links== * [http://www.premarin.com Information page of the manufacturer] * [http://www.fda.gov/cder/foi/label/2004/04782S136lbl.pdf Premarin information] at the [[Food and Drug Administration]] (FDA) website * [http://www.knowmenopause.com Menopause resource] - from [[Wyeth]] * [http://www.hsus.org/pets/issues_affecting_our_pets/equine_protection/the_facts_about_premarin.html Facts about Premarin ] - from the Humane Society [[Category:Estrogens]] [[Category:Bioethics]] [[Category:Wyeth brands]] [[Category:Horse products]]