Directions
For using this medicine, follow all the instructions as given by your doctor. Information leaflet is available for patients with the medicine. Read the information leaflet carefully. Consult your doctor, nurse, or pharmacist if you have any questions about Premarin. According to the directions, fill the applicator with the medicine. Applicator should be cleaned with warm soapy water and rinses well, do not clean it with hot water. At the time when you have taken the medicine, do not eat grapefruit or drink grapefruit juice because it may increase the amount of this medicine in your blood and cause side effects. Consult with your doctor before using grapefruit or drinking grapefruit juice with this medicine. Any doses should not be missed by you. If sometimes you do not remember that you have taken the dose a day or not and even if you missed the dose next day also then skip the missed dose and take the medicine according to your regular dosing schedule, do not take 2 doses at once.

Cautions
If you have had an allergic reaction or are allergic to any ingredient in this medicine than do not take Premarin. It is recommended not to exceed the dose as prescribed by your doctor. To observe your progress or to check for side effects, Laboratory and/or medical tests including blood pressure measurements, triglyceride blood levels, breast and pelvic examinations, PAP tests (for cervical cancer), or mammogram may be done. At the same time when you are taking the medicine, keep all doctor and laboratory appointments. If you are taking the medicine for long –term period then consult with your doctor at regular intervals to determine if you need to continue taking this medicine or not. Results of certain lab tests may be affected by using this medicine. You should inform your doctor and laboratory personnel that you are using Premarin. Inform the doctor or dentist that you are taking Premarin, before having any medical or dental treatments, emergency care, or surgery. While taking this medicine special precautions have to be taken. Dizziness may be caused by using this medicine. Without knowing about the reactions of this medicine on you do not drive, operate machinery, or do anything else that could be dangerous. Your ability to drive or to perform other potentially dangerous tasks may be reduces if you use this medicine alone, with other medicines, or with alcohol. Dark skin patches on your face (melasma) may be caused by using this medicine. Avoid exposure to the sun, sunlamps, or tanning booths because they may make these patches darker. If you are outside for a prolonged period then use a sunscreen or protective clothing. Hyperglycemia (high blood sugar) may be caused by using Premarin. Thirst, increased urination, confusion, drowsiness, flushing, rapid breathing, or fruity breath odor are the symptoms of hyperglycemia. Contact your doctor as soon as possible if any of these symptoms occur. Risk of stroke, heart attack, blood clots, high blood pressure, or other diseases of the heart and blood vessels may be increased if you smoke while using this medicine. Consult your doctor as quickly as possible, if you experience any changes in your vision, or if you wear contact lenses and you develop problems with them. All prescription and over-the-counter medicine that you are taking should be known by your doctor or pharmacist while you start taking any new medicine. More carefulness is recommended when Premarin is used in children or in the elderly because they may be more sensitive to the effects of the medicine. This medicine may affect the growth of children so while using this medicine for children, it is advised to observe the growth patterns in children. This medicine may affect your blood sugar, if you have diabetes. Before adjusting the dose of your diabetes medicine, consult with your doctor. F0R WOMEN: If you are pregnant, it is recommended not to use this medicine. Contact your doctor immediately, if you think that you could be pregnant. Consult with your doctor about all the benefits and risks of using this medicine if you plan on becoming pregnant especially during the third trimester. This medicine is excreted in breast milk. While taking this medicine, ask your doctor to discuss the risks to your baby, if you are or will be breast-feeding.