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Patients with a history of GI toxicity, particularly when elderly, should report any unusual abdominal symptoms especially GI bleeding. Caution is recommended in patients receiving concomitant medications which could increase the risk of ulceration or bleeding, such as systemic corticosteroids, anticoagulants such as warfarin, selective serotonin-reuptake inhibitors SSRIs or anti-platelet agents such as acetylsalicylic acid see section 4.
Close medical surveillance and caution should be exercised in patients with ulcerative colitis, or with Crohn's disease as these conditions may be exacerbated see section 4.
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Therefore, you should assume the risks will be similar for other medicines containing oestrogen and progestogen combinations. Talk regularly with your doctor about whether you still need treatment with Premarin. Treatment with oestrogens, with or without progestogens should be used at the lowest effective dose and for the shortest period of time.
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