Can Premarin induce lupus flares?
Premarin® is a hormone therapy that contains a blend of estrogens available in low dose options. Premarin is usually safe for women with lupus in that it is not known to induce lupus flares. A study sponsored by the National Institutes of Health (NIH) and the federal Office on Women's Health showed that there were not more serious flares among patients taking Premarin than in those taking a "placebo."
However, Premarin may not be the best idea for anyone with pre-existing heart disease. Women with lupus are at higher risk for heart disease (atherosclerosis) than the general population. So a woman and her doctor need to weigh the risks and benefits in the decision of whether or not to use Premarin.
Premarin also increases risk of blood clots, so a woman with lupus who has antiphospholipid antibody syndrome and/or a history of miscarriages or blood clots should not take this drug. In the NIH study mentioned above, individuals with significant levels of antiphospholipid antibodies were not allowed to be in the study.
is a Pediatric Rheumatologist with a special clinical and research interest in Pediatric Lupus. She is involved in trial design and provides statistical support at the Cincinnati Children’s Hospital.