When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to conjugated estrogens synthetic A, or if you have liver disease, breast cancer, a bleeding disorder, blood clots, or unusual vaginal bleeding that has not been checked by your doctor. Do not use this medicine if you may be pregnant, or if you had a heart attack or stroke.

How to Use This Medicine:
Tablet

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
• Swallow the tablet whole. Do not crush, break, or chew it.
• Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Some foods and medicines can affect how conjugated estrogens synthetic A works. Tell your doctor if you are using carbamazepine, clarithromycin, erythromycin, itraconazole, ketoconazole, phenobarbital, rifampin, ritonavir, or St John's wort. Tell him if you drink grapefruit juice.

Warnings While Using This Medicine:

• Pregnancy after menopause is not likely, but if you think you could be pregnant, tell your doctor. This medicine could harm an unborn baby.
• Tell your doctor if you breastfeeding, or if you have kidney disease, asthma, diabetes, endometriosis, epilepsy, migraines, porphyria, lupus, thyroid problems, heart disease, high blood pressure, high cholesterol, hereditary angioedema, or a history of cancer or gallbladder problems. Tell your doctor if you had liver problems caused by pregnancy or estrogen.
• This medicine may cause the following problems:
  
  • Increased risk of heart attack, stroke, or blood clots
  • Possible increased risk of endometrial, breast, or ovarian cancer
  • Increased risk of dementia (especially in women 65 years or older)
  • Gallbladder disease
• Tell any doctor or dentist who treats you that you are using this medicine. This medicine may affect certain medical test results. You may need to stop using this medicine before surgery or if you need to be on bed rest.
• Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments. Ask your doctor how often you need a pelvic exam, breast exam, and mammogram.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Chest pain, trouble breathing, coughing up blood
• Numbness or weakness on one side of your body, sudden or severe headache, problems with speech or walking
• Sudden and severe stomach pain, nausea, vomiting, fever, lightheadedness
• Swelling in your hands, ankles, or feet
• Unusual vaginal bleeding, spotting, discharge, or itching
• Vision loss, double vision

If you notice these less serious side effects, talk with your doctor:

• Mild headache or dizziness
• Nausea, vomiting, bloating, gas, stomach pain
• Swollen or tender breasts

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088