Folks Premarin is not good. It is dangerous to use. I will not let my wife or family use it. Thats the good of Premarin. The bad is where the bastards from Wyeth-Ayerst get this drug. They mutilate horses to get the urine to extract the estrogens. My god. These estrogens are available in pharmaceutically pure powder form that can be applied transdermally very inexpensively. SEE: FEMALE HORMONES
This just sent to me by the P E T A people. Talk to P E T A and the S P C A and your governmental representatives to stop the abuse of the noblest of animals.
Premarin: Straight From the Horse's What?
Tuesday, August 28, 2001; Page HE03
On Aug. 8, two lots of the estrogen replacement therapy Premarin were recalled by its manufacturer, Wyeth-Ayerst. Each day, some 10 million women take Premarin to treat hot flashes and other symptoms of menopause and to prevent osteoporosis. The company asked wholesalers to return more than 10 million pills, marking the third such voluntary recall of Premarin in less than a year.
What's going on? Are my pills safe? The tablets were recalled, said Wyeth-Ayerst, because they failed to meet U.S. Food and Drug Administration (FDA) standards for dissolving. These standards, established in 1998, help ensure that the drug is properly absorbed in the bloodstream, said Larry D. Sasich, a pharmacist and research associate at Public Citizen.
Few, if any, of the recalled pills had reached drugstores or consumers, according to Wyeth-Ayerst spokesperson Audrey Ashby. They would have been safe and effective if taken, she said, though they fell short of the federal standards.
Sasreedand other experts familiar with the drug agreed that the recalled pills posed no special danger to consumers. Still, Premarin has been provoking questions for years.
What's in this stuff? Premarin, the second most widely prescribed brand-name drug in the nation (behind the statin Lipitor), is short for pregnant mares' urine. That's right, this estrogen-rich liquid is the source of Premarin, though there's no actual urine in the final product, the company says. Rather, estrogen components are extracted from the raw material and then refined in a process that includes more than 100 steps.
Although Premarin has been sold for nearly 60 years and has been dubbed "the Kleenex of hormone replacement therapy" for its huge market presence, it has no generic competitor. Why? It appears that the complex nature of horse urine makes the drug hard to replicate without knowledge of Wyeth-Ayerst's processing techniques. In fact, even the manufacturer has not identified all of the drug's active ingredients, said Wyeth-Ayerst and the FDA.
Neither is it known exactly how Premarin works and what constitute its full benefits and risks. "We're talking about a very commonly prescribed drug, and we have very little clinical trial data on it," said Rita Redberg, research director for the National Center for Excellence in Women's Health at the University of California, San Francisco. According to Rudi Ansbacher, professor of obstetrics and gynecology at University of Michigan, studies support the ability of Premarin and other estrogens to relieve hot flashes and vaginal symptoms and ward off osteoporosis, though there are questions about whether any estrogen drugs deliver the heart benefits that many experts once anticipated.
Despite the unknowns, Redberg said Premarin is safe to take, particularly over the relatively few years that women typically experience hot flashes. But not everyone feels kindly toward it.
They shoot horses, don't they? Animal rights activists say the "PMU" (pregnant mare urine) ranches that supply the manufacturer are sheer misery for horses. Wyeth-Ayerst emphatically denies charges that horses are treated harshly and that foals are routinely slaughtered to allow the mares to become pregnant again more quickly. The company says periodic reports from veterinary inspectors have called such allegations unfounded.
Animal rights issues aside, the drug draws plenty of criticism.
"Unfortunately, Premarin has been promoted for many, many years for a wide variety of indications for which there isn't any evidence to prove it's effective, such as prevention of heart disease, prevention of memory loss, making your skin look younger," said Amy Allina, program director for the National Women's Health Network, a nonprofit education and advocacy group based in Washington. "Premarin is not simply a harmless aid for getting through menopause. It can increase other health problems, and women need to know that."
Premarin may increase the risk of uterine cancer and blood clots, according to the manufacturer. Other studies suggest it may pose an increased risk of breast and ovarian cancers.
Adds Sasich: "We're running out of excuses for prescribing this drug."
Mystery to be solved? At the FDA's direction, Wyeth-Ayerst is working to identify all the drug's components, Ashby said, adding that this "could provide information to facilitate competition." As for when the secrets of Premarin may be revealed, she said, "We don't have a timetable . . ."
-- Beth Baker
© 2001 The Washington Post Company