Adverse Drug Reaction Classification System

Pharmaceutical Information
Drug Name Conjugated estrogens
Drug ID BADD_D00528
Description The conjugated estrogens are noncrystalline mixtures of purified female sex hormones obtained either by its isolation from the urine of pregnant mares or by synthetic generation from vegetal material. Both of these products are later conjugated to natrium sulfate by ester bonds in order to make them more water soluble.[L5605, T475] The conjugated estrogen product contains a mix of estrogen from which about 50% is represented by estrone sulfate followed by 25% of equilin sulfate, 15% of 17-alpha-dehydroequilenin sulfate, 3% of equilenin sulfate, 5% of 17-alpha and 17-beta-dihydroequilenin sulfate, 2% of 17-alpha-estradiolsulfate and 3% of 17-beta-estradiolsulfate. It also presents a large number of unidentified molecules with weak estrogenic activity as well as non-human molecules when it is obtained from pregnant mares urine.[T475] The conjugated estrogen mixture was approved for marketing in US in 1942 based on the efficacy against certain conditions. However, until 1986 official clinical trials were performed and this product was determined to be effective for the treatment of osteoporosis.[T484] The currently approved product of conjugated estrogens was developed by Wyeth Ayerst and FDA approved in 2003.[L5608]
Indications and Usage Conjugated Equine Estrogens (CEEs) are indicated for the following conditions: treatment of moderate to severe vasomotor symptoms and vulvovaginal atrophy associated with menopause; hypoestrogenism due to hypogonadism, castration or primary ovarian failure; palliation of metastatic breast cancer; palliation of advanced androgen-dependent carcinoma of the prostate; and for prevention of postmenopausal osteoporosis.
Marketing Status Prescription; Discontinued
ATC Code G03CA57
DrugBank ID DB00286
KEGG ID D04070
MeSH ID D004966
PubChem ID 45357473
TTD Drug ID D0T0LU
NDC Product Code 42816-1104; 0046-0749; 0046-0872; 70203-101; 42816-1101; 42816-1100; 42816-1102; 42816-0101; 42816-1103
Synonyms Estrogens, Conjugated (USP) | Estrogenic Hormones, Conjugated | Conjugated Estrogenic Hormones | Estrogens, Conjugated | Estrogenic Substances, Conjugated | Conjugated Estrogenic Substances | Conjugated Estrogens | Conjugated Estrogen | Estrogen, Conjugated | Congest | Conjugated Equine Estrogens | Equine Estrogens, Conjugated | Conjugated Equine Estrogen | Equine Estrogen, Conjugated | Estrogen, Conjugated Equine | Dagynil | Oestrofeminal | Oestro-Feminal | Oestro Feminal | Estro-Feminal | Estro Feminal | Premarin | Climopax | Climarest | Presomen | Progens | Progen | Transannon | Femavit | Carentil | Prelestrin
Chemical Information
Molecular Formula C18H21NaO5S
CAS Registry Number 12126-59-9
SMILES CC12CCC3C(C1CCC2=O)CCC4=C3C=CC(=C4)OS(=O)(=O)[O-].[Na+]
Chemical Structure
ADR Related Proteins Induced by Drug
ADR Term Protein Name UniProt AC TTD Target ID PMID
Bone density increasedEstrogen receptorP03372T89534Not Available
ADRs Induced by Drug
ADR Term ADReCS ID ADR Frequency (FAERS) ADR Severity Grade (FAERS) ADR Severity Grade (CTCAE)
Abdominal discomfort07.01.06.001--Not Available
Abdominal distension07.01.04.001--
Abdominal pain07.01.05.0020.005704%
Abdominal pain upper07.01.05.003--
Acne23.02.01.0010.001556%Not Available
Affective disorder19.04.04.001--Not Available
Alopecia23.02.02.0010.004667%
Anaphylactic reaction24.06.03.006; 10.01.07.001--
Anaphylactoid reaction10.01.07.003; 24.06.03.007--Not Available
Anger19.04.02.0010.001556%Not Available
Angioedema23.04.01.001; 10.01.05.009--Not Available
Anxiety19.06.02.0020.006741%
Arthralgia15.01.02.001--
Arthritis15.01.01.0010.004148%
Arthropathy15.01.01.0030.003111%Not Available
Asthenia08.01.01.001--Not Available
Asthma22.03.01.002; 10.01.03.0100.001037%Not Available
Atrophic vulvovaginitis21.02.01.0030.001556%Not Available
Back disorder15.03.01.0140.001037%Not Available
Back pain15.03.04.0050.003630%
Blindness06.02.02.001; 17.17.01.0030.001556%Not Available
Blood luteinising hormone increased13.10.03.0040.001037%Not Available
Blood oestrogen decreased13.10.05.0100.001037%Not Available
Blood pressure abnormal13.14.03.0010.001556%Not Available
Blood pressure decreased13.14.03.0020.001037%Not Available
Blood pressure increased13.14.03.0050.004148%Not Available
Blood triglycerides increased13.12.03.001--Not Available
Bone pain15.02.01.0010.001556%
Breast cancer21.05.01.003; 16.10.01.0010.006222%Not Available
Breast cyst21.05.01.006; 16.14.01.0040.001037%Not Available
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