See full prescribing information for complete boxed warning. thrombophlebitis, myocardial infarction, stroke, increase in blood pressure. Gastrointestinal.
Solu-Cortef Sterile Powder is an anti-inflammatory glucocorticoid that contains hydrocortisone sodium succinate as the active ingredient. Solu-Cortef Sterile Powder is available in several packages for intravenous or intramuscular administration.
When necessary, the pH of each formula was adjusted with sodium hydroxide so that the pH of the reconstituted solution is within the USP specified range of 7 to 8. Hydrocortisone sodium succinate is a white or nearly white, odorless, hygroscopic amorphous solid. It is very soluble in water and in alcohol, very slightly soluble in acetone, and insoluble gesunde Produkte von Krampfadern chloroform.
Glucocorticoids, Dicynone Thrombophlebitis, naturally occurring and synthetic, are adrenocortical steroids that are readily absorbed from the gastrointestinal tract. Naturally occurring glucocorticoids hydrocortisone and cortisonewhich also have salt-retaining properties, are used as replacement Dicynone Thrombophlebitis in adrenocortical deficiency states.
Dicynone Thrombophlebitis synthetic analogs are primarily used for their anti-inflammatory effects in disorders of many organ systems. Hydrocortisone sodium succinate has the same metabolic and anti-inflammatory actions as hydrocortisone, Dicynone Thrombophlebitis.
When given parenterally and in equimolar quantities, Dicynone Thrombophlebitis, the two compounds are equivalent in biologic activity. The highly water-soluble sodium succinate ester of hydrocortisone permits the immediate intravenous administration of high doses of hydrocortisone in a small volume of diluent and is particularly useful where high blood levels of hydrocortisone are required rapidly.
Following the intravenous injection of hydrocortisone sodium succinate, demonstrable effects are evident within one hour and persist for Dicynone Thrombophlebitis variable period, Dicynone Thrombophlebitis. Excretion of the administered dose is nearly complete within 12 hours. Thus, Dicynone Thrombophlebitis, if constantly high blood levels are required, injections should be made every 4 to 6 hours.
This preparation is also rapidly absorbed when administered intramuscularly and is excreted in a pattern similar to that observed after intravenous injection. Glucocorticoids cause profound and varied metabolic effects. In addition, they modify the body's immune response to diverse stimuli, Dicynone Thrombophlebitis.
When oral therapy is not feasible, and the strength, dosage form, and route of administration of the drug reasonably lend the preparation to the treatment of the condition, the intravenous or intramusculat use of Solu-Cortef Sterile Powder is indicated as follows:, Dicynone Thrombophlebitis.
Control of severe or incapacitating Dicynone Thrombophlebitis conditions intractable to adequate trials of conventional treatment in asthma, atopic dermatitis, contact dermatitis, drug hypersensitivity reactions, perennial or seasonal allergic rhinitis, serum sickness, Dicynone Thrombophlebitis, transfusion reactions.
Bullous dermatitis herpetiformis, exfoliative erythroderma, mycosis fungoides, pemphigus, Dicynone Thrombophlebitis, severe erythema multiforme Stevens-Johnson syndrome. Primary Dicynone Thrombophlebitis secondary adrenocortical insufficiency hydrocortisone or cortisone is the drug of choice; synthetic analogs may be used in conjunction with mineralocorticoids where applicable; in infancy, mineralocorticoid supplementation is of particular importancecongenital adrenal hyperplasia, hypercalcemia associated with cancer, nonsuppurative thyroiditis.
To tide the patient over a critical period of the disease in regional enteritis systemic therapy and ulcerative colitis. Acquired autoimmune hemolytic anemia, congenital erythroid hypoplastic anemia Diamond Blackfan anemiaidiopathic thrombocytopenic purpura in adults intravenous administration only; intramuscular administration is contraindicatedpure red cell aplasia, select cases of secondary thrombocytopenia. Trichinosis with neurologic or myocardial involvement, tuberculous meningitis with subarachnoid block or impending block when used concurrently with appropriate antituberculous chemotherapy.
Acute exacerbations of multiple sclerosis; cerebral edema associated with primary or metastatic brain tumor, or craniotomy. Sympathetic ophthalmia, Dicynone Thrombophlebitis, uveitis and ocular Dicynone Thrombophlebitis conditions unresponsive to topical corticosteroids.
To induce diuresis or remission of proteinuria in idiopathic nephrotic syndrome, or that due to lupus erythematosus. Berylliosis, fulminating or disseminated pulmonary tuberculosis when used concurrently with appropriate antituberculous chemotherapy, idiopathic eosinophilic pneumonias, symptomatic sarcoidosis. As adjunctive therapy for short-term administration to tide the patient over an acute episode or exacerbation in acute gouty arthritis; acute rheumatic carditis; ankylosing spondylitis; psoriatic arthritis; rheumatoid arthritis, including juvenile rheumatoid arthritis selected cases may require low-dose maintenance therapy.
For the treatment of dermatomyositis, Dicynone Thrombophlebitis, temporal arteritis, polymyositis, and systemic lupus erythematosus. Solu-Cortef Sterile Powder is contraindicated in systemic fungal infections and patients with known hypersensitivity to the product and its constituents. Intramuscular corticosteroid preparations are contraindicated for idiopathic thrombocytopenic purpura.
Solu-Cortef Sterile Powder is contraindicated for intrathecal administration. Reports of severe medical events have been associated with this route of administration. Serious neurologic events, some resulting in death, have been reported with epidural injection of corticosteroids. Specific events reported include, but are not limited was ein Magnet für Krampfadern, spinal cord infarction, paraplegia, quadriplegia, cortical blindness, and stroke.
These serious neurologic events have been reported with and without use of Dicynone Thrombophlebitis. The safety and effectiveness of epidural administration of corticosteroids have not been established, Dicynone Thrombophlebitis, and corticosteroids are not approved for Moers Lieferung Varison use.
In order to minimize the incidence of dermal and subdermal atrophy, care must be exercised not to exceed recommended doses in injections. Injection into the deltoid muscle should be Dicynone Thrombophlebitis because of a high incidence of subcutaneous atrophy.
Increased dosage of rapidly acting corticosteroids is indicated in patients on corticosteroid therapy subjected to any unusual stress before, during, and after the stressful situation. Results from one multicenter, randomized, placebo-controlled study with methylprednisolone hemisuccinate, an IV corticosteroid, showed an increase in early at 2 weeks and late at 6 months mortality in patients with cranial trauma who were determined not to have other clear indications for corticosteroid treatment.
High doses of systemic corticosteroids, including Solu-Cortef, should not be used for the treatment of traumatic brain injury. Average and large doses of corticosteroids can cause elevation of blood pressure, salt and water retention, and increased excretion of potassium, Dicynone Thrombophlebitis.
These effects are less likely to occur with the synthetic derivatives except when used in large doses. Dietary salt restriction and potassium supplementation may be necessary. All corticosteroids increase calcium excretion. Literature reports suggest an apparent association between use of corticosteroids and left ventricular free wall rupture after a recent myocardial infarction; therefore, therapy with corticosteroids should be used with great caution in these patients.
Hypothalamic-pituitary adrenal HPA axis suppression. Cushing's syndrome, and hyperglycemia, Dicynone Thrombophlebitis. Monitor patients for these conditions with chronic use. Corticosteroids can produce reversible HPA axis suppression with the potential for glucocorticosteroid insufficiency after withdrawal of treatment. Drug induced secondary adrenocortical insufficiency may be minimized by gradual reduction of dosage.
This type of relative insufficiency may persist for months after discontinuation of therapy; therefore, in any situation of stress occurring during that period, hormone therapy should be reinstituted.
Patients who are on corticosteroids are more susceptible to infections than are healthy individuals. There may be decreased resistance and inability to localize infection when Dicynone Thrombophlebitis are used, Dicynone Thrombophlebitis. Infection with any pathogen viral, bacterial, fungal, protozoan or helminthic in any location of the body may be associated with the use of corticosteroids alone or in combination with other immunosuppressive agents. These infections may be mild, but can be severe and at times fatal.
With increasing doses Dicynone Thrombophlebitis corticosteroids, the rate of occurrence of infectious complications increases. Corticosteroids may also mask some signs of current infection. Do not use intra-articularly, intrabursally or for intratendinous administration for local effect in the presence of acute local infection.
Corticosteroids may exacerbate systemic fungal infections and therefore should not Dicynone Thrombophlebitistrophische Geschwür am Fuß mit Schmerzen in the presence of such infections unless they are needed to control drug reactions.
Drug Interactions, Amphotericin B injection and potassium-depleting agents. Latent disease may be activated or there may be an Dicynone Thrombophlebitis of intercurrent infections due to pathogens, including those caused by Amoeba, Candida, Cryptococcus, Dicynone Thrombophlebitis, Mycobacterium, Nocardia, Pneumocystis, and Toxoplasma.
It is recommended that latent amebiasis or active amebiasis be ruled out before initiating corticosteroid therapy in any patient who Dicynone Thrombophlebitis spent time in the tropics or in any patient with unexplained diarrhea. Similarly, corticosteroids should be used with great care in patients with known or suspected Strongyloides threadworm infestation.
In such patients, corticosteroid-induced immunosuppression Dicynone Thrombophlebitis lead to Strongyloides hyperinfection and dissemination with Dicynone Thrombophlebitis larval migration, often accompanied by severe enterocolitis and potentially fatal gram-negative Dicynone Thrombophlebitis. Corticosteroids should not be used in cerebral malaria. There is currently no evidence Dicynone Thrombophlebitis benefit from steroids in this condition.
The use of corticosteroids in active tuberculosis should be restricted to those cases of fulminating or disseminated tuberculosis in which the corticosteroid is used for the management of the disease in conjunction with an appropriate antituberculous Dicynone Thrombophlebitis. If corticosteroids are indicated in patients with latent tuberculosis or tuberculin reactivity, close observation is necessary as reactivation of the disease may occur.
During prolonged corticosteroid therapy, these patients should receive chemoprophylaxis. Administration of live or live, attenuated vaccines is contraindicated in patients receiving immunosuppressive doses of corticosteroids. Killed or inactivated vaccines may be administered. However, the reponse to such vaccines cannot be predicted.
Immunization procedures may be undertaken in patients who are receiving corticosteroids as replacement therapy e, Dicynone Thrombophlebitis.
Chicken pox and measles can have a more serious or even fatal course in pediatric and adult patients on corticosteroids. In pediatric and adult patients who have not had these diseases, particular care should Dicynone Thrombophlebitis taken to avoid exposure. If exposed to chicken pox, prophylaxis with varicella zoster immune globulin VZIG may be indicated. If exposed to measles, Dicynone Thrombophlebitis, prophylaxis with immunoglobulin IG may be indicated, Dicynone Thrombophlebitis.
If chicken pox develops, treatment with antiviral agents should be considered, Dicynone Thrombophlebitis. Use of corticosteroids may produce posterior subcapsular cataracts, glaucoma with possible damage to the optic nerves, and may enhance the establishment of secondary ocular infections due to bacteria, fungi, or viruses.
The use of oral corticosteroids is not recommended in the treatment of optic neuritis and may lead to an increase in the risk of new episodes. Corticosteroids should be used cautiously in patients with ocular Schmerzen in den Beinen, Krampfadern, die tun simplex because of corneal Dicynone Thrombophlebitis. Corticosteroids should not be used Dicynone Thrombophlebitis active ocular herpes simplex.
This product, like many other steroid formulations, is Dicynone Thrombophlebitis to heat. Therefore, it should not be autoclaved when it is desirable to sterilize the exterior of the vial. The lowest possible dose of corticosteroid should be used to control the condition under treatment. When reduction in dosage is possible, the reduction should be gradual. Kaposi's sarcoma has been reported to occur in patients receiving corticosteroid therapy, most often for chronic conditions, Dicynone Thrombophlebitis.
Discontinuation of corticosteroids may result in clinical improvement. As sodium retention with resultant edema and potassium loss may occur in patients receiving corticosteroids, these agents should be used with caution in patients with congestive heart failure, hypertension, Dicynone Thrombophlebitis, or renal insufficiency.
Drug-induced secondary adrenocortical insufficiency may be minimized Dicynone Thrombophlebitis gradual reduction of dosage. Metabolic clearance of corticosteroids is decreased in hypothyroid patients and increased in hyperthyroid patients.
Changes in thyroid status of Dicynone Thrombophlebitis patient may necessitate adjustment in dosage. Steroids should be used with caution in active or latent peptic ulcers, Dicynone Thrombophlebitis, diverticulitis, fresh intestinal anastomoses, and Varizen trocken Fasten ulcerative colitis, since they may increase the risk of a perforation.
Signs of peritoneal irritation following gastrointestinal perforation in patients receiving corticosteroids may be minimal or absent, Dicynone Thrombophlebitis. There is an enhanced effect due to decreased metabolism of corticosteroids in patients with cirrhosis.
Corticosteroids decrease bone formation and increase bone resorption both through their effect on calcium regulation e.
Rutin is a yellow crystalline flavonol glycoside superficial thrombophlebitis, skin rash, hair loss, gastritis (stomach (contains rutin), Dicynone® or.
There is an increased risk of endometrial cancer in a woman with a uterus who uses unopposed estrogens, Dicynone Thrombophlebitis. Adding a progestin to estrogen therapy has been shown to reduce the risk of endometrial hyperplasia, which may be a precursor to endometrial cancer. Adequate diagnostic measures, including directed or random endometrial sampling when indicated, should be undertaken to rule out malignancy in postmenopausal women Dicynone Thrombophlebitis undiagnosed persistent or recurring abnormal genital bleeding [see Warnings and Precautions 5.
Estrogen-alone therapy should not be used for the prevention of cardiovascular disease or dementia [see Warnings and Precautions 5. The Women's Health Initiative WHI estrogen-alone substudy reported increased risks of stroke Dicynone Thrombophlebitis deep vein thrombosis DVT in postmenopausal women 50 to 79 years of age during 7.
It is unknown whether this finding applies to younger postmenopausal women [see Warnings and Dicynone Thrombophlebitis 5. In the absence of comparable data, these risks should be assumed to be similar for other doses of CE and other dosage forms of estrogens. Estrogens with or without progestins should be prescribed at the lowest effective doses and for the shortest duration consistent with treatment goals and risks for the individual woman.
Estrogen plus progestin therapy should not be used for the prevention of cardiovascular disease or dementia [see Warnings and Precautions 5, Dicynone Thrombophlebitis. The WHI estrogen plus progestin substudy reported increased risks of DVT, pulmonary embolism PEstroke and myocardial infarction MI in postmenopausal women 50 to 79 years of age during 5.
The WHIMS estrogen plus progestin ancillary study of the WHI, reported an increased risk of developing probable dementia in postmenopausal women 65 years Dicynone Thrombophlebitis age or older during 4 years of treatment with daily CE 0. The WHI estrogen plus progestin substudy also demonstrated an increased risk of invasive breast cancer [see Warnings and Precautions 5.
In the absence of comparable data, these risks should be assumed to be similar for other doses of CE and MPA, and other combinations and dosage forms of estrogens and progestins. When prescribing solely for the treatment of moderate to severe symptoms of vulvar and vaginal atrophy due to menopause, topical vaginal products should be considered.
When prescribing solely for the prevention of postmenopausal osteoporosis, therapy should only be considered for women at significant risk of osteoporosis and non-estrogen medication should be carefully considered.
Generally, when estrogen therapy is prescribed for a postmenopausal woman with a uterus, a progestin should be considered to reduce the risk of endometrial cancer [see Boxed Warning ]. A woman without a uterus does not need progestin. In some cases, however, hysterectomized women with a history of endometriosis may need a progestin [see Warnings and Precautions 5. Use of estrogen-alone, or in combination with a progestin, should be with the lowest effective dose and for the shortest duration consistent with treatment goals and risks for the individual woman.
Postmenopausal women should be re-evaluated periodically as clinically appropriate to determine if treatment is still necessary. Patients should be treated with the lowest effective dose. Generally, Dicynone Thrombophlebitis, women should be started at 0.
Subsequent dosage adjustment may be made based upon the individual patient response. This dose should be periodically reassessed by the healthcare provider.
PREMARIN therapy may be given continuously, with no interruption in therapy, or in cyclical regimens regimens such as 25 days on drug followed by 5 days off drugas is medically appropriate on an individual basis. Doses are adjusted depending on the severity of symptoms and responsiveness of the endometrium [ see Clinical Studies Female castration or primary ovarian failure: Dicynone Thrombophlebitis dosage, upward or downward, according to severity of symptoms and response of the patient.
For maintenance, Dicynone Thrombophlebitis, adjust dosage to lowest level that will provide effective control. Suggested dosage is 10 mg three times daily, for a period of at least three months. The effectiveness of therapy can be judged by phosphatase determinations as well as by symptomatic improvement of the patient. Subsequent dosage adjustment may be made based upon the individual clinical and bone mineral density responses.
An increased risk of stroke and DVT has been reported with estrogen-alone therapy, Dicynone Thrombophlebitis. Should any of these events occur or be suspected, estrogen with or without progestin therapy should be discontinued immediately.
In the WHI estrogen-alone substudy, Dicynone Thrombophlebitis, a statistically significant increased risk of stroke was reported in women 50 to 79 years of age receiving daily CE 0. The increase in risk was demonstrated in year 1 and persisted [see Clinical Studies Should a stroke occur or be suspected, Dicynone Thrombophlebitis, estrogen-alone therapy should be discontinued immediately.
Subgroup analyses of women Dicynone Thrombophlebitis to 59 years of age suggest no increased risk of stroke for those women receiving CE 0. In the WHI estrogen plus progestin substudy, a statistically significant increased risk of stroke was reported in women 50 to 79 years of age receiving daily CE 0.
The increase in risk was demonstrated after the first year and persisted. Subgroup analyses of Dicynone Thrombophlebitis 50 to 59 years of age suggest a statistically non-significant reduction in CHD events CE [0.
In the WHI estrogen plus progestin substudy, there was a statistically non-significant increased risk of Dicynone Thrombophlebitis events reported in women receiving daily CE 0. During an average follow-up of 4. Should a VTE occur or be suspected, estrogen-alone therapy should be discontinued immediately. Statistically significant increases in risk for both DVT 26 versus 13 per 10, Dicynone Thrombophlebitis, women-years and PE 18 versus 8 per 10, women-years were also demonstrated.
The increase in VTE risk was demonstrated during the first year and persisted 4 [see Clinical Studies Should a VTE occur or be suspected, estrogen plus progestin therapy should be discontinued immediately.
If feasible, Dicynone Thrombophlebitis, estrogens should be discontinued at least 4 to 6 weeks before surgery of the type associated with an increased risk of thromboembolism, or during periods of prolonged immobilization. An increased risk of endometrial cancer Dicynone Thrombophlebitis been reported with the use of unopposed estrogen therapy in a woman with a uterus. The reported endometrial cancer risk among unopposed estrogen users is about 2 to 12 times greater than in non-users, and appears dependent on duration of treatment and on estrogen dose.
Most studies show no significant increased risk associated with use of estrogens for less than 1 year, Dicynone Thrombophlebitis. The greatest risk appears associated with prolonged use, with increased risks of to fold for 5 to 10 years or more, and this risk has been shown to persist for at least 8 to 15 years after estrogen therapy is discontinued. Clinical surveillance of all women using estrogen-alone or estrogen plus progestin therapy is important. Adequate diagnostic measures, including directed or random endometrial sampling when indicated, Dicynone Thrombophlebitis, should be undertaken to rule out malignancy in postmenopausal women with undiagnosed persistent or recurring abnormal genital bleeding.
There is no evidence that the use of natural estrogens results in a different endometrial risk profile than synthetic estrogens of equivalent estrogen Dicynone Thrombophlebitis. Adding a progestin to postmenopausal estrogen therapy has been shown to reduce the risk of endometrial hyperplasia, which may be a precursor to endometrial cancer, Dicynone Thrombophlebitis.
The most important randomized clinical trial providing information about breast cancer in estrogen-alone users is the WHI substudy of daily CE 0. In the WHI estrogen-alone substudy, after an average follow-up Dicynone Thrombophlebitis 7. The most important randomized clinical trial providing information about breast cancer in estrogen plus progestin users is the WHI substudy of daily CE 0. After a mean follow-up of 5.
In this substudy, prior use of estrogen-alone or estrogen plus progestin therapy was reported by 26 percent of the women. The relative risk of invasive breast cancer was 1. Among women who reported no prior use of hormone therapy, the relative risk Dicynone Thrombophlebitis invasive breast cancer Dicynone Thrombophlebitis 1. In the same substudy, invasive breast cancers were larger, were more likely to be node positive, and were diagnosed at a more advanced stage in the CE 0.
Metastatic disease was rare, with no apparent difference between the two groups, Dicynone Thrombophlebitis. Other prognostic Dicynone Thrombophlebitis, such as histologic subtype, Dicynone Thrombophlebitis, grade and hormone receptor status did not differ between the groups [see Clinical Studies Consistent with the WHI clinical Dicynone Thrombophlebitis, observational studies have also reported an increased risk of breast cancer for estrogen plus progestin therapy, and a smaller increased risk for estrogen-alone therapy, Dicynone Thrombophlebitis, after several years of use.
The risk increased with duration of use, and appeared to return to baseline over about 5 years after stopping treatment only the observational studies have substantial data on risk after stopping. Observational studies also suggest that the risk of breast cancer was greater, and became apparent earlier, with estrogen plus progestin therapy as compared to estrogen-alone therapy.
However, Dicynone Thrombophlebitis, these studies have not found significant variation in the risk of breast cancer among different estrogen plus progestin combinations, doses, or routes of administration.
The use of estrogen-alone and estrogen plus progestin has been reported to result in an increase in abnormal mammograms, requiring further Massage für Krampfadern der unteren Extremitäten. All women should receive yearly breast examinations by a healthcare provider and perform monthly breast self-examinations. In addition, mammography examinations should be scheduled based on patient age, risk factors, and prior mammogram results.
The WHI estrogen plus progestin Dicynone Thrombophlebitis reported a statistically non-significant increased risk of ovarian cancer. After an average follow-up of 5.
A meta-analysis of 17 prospective and 35 retrospective epidemiology studies found that women who used hormonal therapy for menopausal symptoms had an increased risk for ovarian cancer. The primary Dicynone Thrombophlebitis, using case-control comparisons, included 12, cancer cases from the 17 prospective studies. The relative risks associated with current use of hormonal therapy was 1. The relative risk associated with combined current and recent use discontinued use within 5 years before cancer diagnosis was 1.
The exact duration of hormone therapy use associated with an increased risk of ovarian cancer, however, is unknown. The relative risk of probable dementia for CE-alone versus placebo was 1. The absolute risk of probable dementia for CE-alone versus placebo was 37 versus 25 cases per 10, women-years 8 [see Use in Specific Populations 8.
After an average follow-up of 4 years, 40 Dicynone Thrombophlebitis in the CE plus MPA group and 21 women in the placebo group were diagnosed with probable dementia. The absolute risk of probable dementia for CE plus MPA versus placebo was Dicynone Thrombophlebitis versus 22 cases per 10, women-years 8 [see Use in Specific Populations 8. When data from the two populations in the WHIMS estrogen-alone and estrogen plus progestin ancillary studies were pooled as planned in the WHIMS protocol, the reported overall relative risk for probable dementia was 1, Dicynone Thrombophlebitis.
Since both ancillary studies were conducted in Dicynone Thrombophlebitis 65 to 79 years of age, it is unknown whether these findings apply to younger postmenopausal women 8 [see Use in Specific Populations 8. A 2- to 4-fold increase in the risk of gallbladder disease requiring surgery in postmenopausal women receiving estrogens has been reported.
Estrogen administration may lead to severe Dicynone Thrombophlebitis in patients with breast cancer and bone metastases. If hypercalcemia occurs, use of the drug should be stopped and appropriate measures taken to reduce the serum calcium level. Retinal vascular thrombosis has been reported in patients receiving estrogens. Discontinue medication pending examination if there is sudden partial or complete loss of vision, or a sudden onset of proptosis, diplopia, or migraine.
If examination reveals papilledema or retinal vascular lesions, estrogens should be permanently discontinued. Cases of anaphylaxis, which developed within minutes to hours after taking PREMARIN and require emergency medical management, Dicynone Thrombophlebitis, have been reported in the postmarketing setting, Dicynone Thrombophlebitis. Skin hives, pruritis, swollen lips-tongue-face and either respiratory tract respiratory compromise Dicynone Thrombophlebitis gastrointestinal tract abdominal pain, vomiting involvement has been noted.
If angioedema involves the tongue, glottis, or larynx, Dicynone Thrombophlebitis, airway obstruction may occur. Studies of the addition of a progestin for 10 or more days of a cycle of estrogen administration or daily with estrogen in a continuous regimen, have reported a lowered incidence of endometrial die Antwort ist, dass Krampfadern than would be induced by estrogen treatment alone.
Endometrial hyperplasia may be a precursor to endometrial cancer. There are, however, possible risks that may be associated with the use of progestins with estrogens compared to estrogen-alone regimens. These include an increased risk of breast cancer.