Should Premarin remain on the market?
The bioidentical (better designated as human) hormones about which Wyeth has raised concerns are actually present in the human body, and compounded prescriptions include them in specific amounts. In sharp contrast, Wyeth’s Premarin is described as containing “…a mixture of conjugated estrogens…occurring as the sodium salts of water-soluble estrogen sulfates blended to represent the average composition of material derived from pregnant mares’ urine.” The actual composition of Premarin, as well as the amounts and pharmacologic roles of the individual components (some of which were designated for many years as “impurities”) continue to raise questions. Indeed, Wyeth has exploited this confusion for its own financial advantage by blocking the approval of generic products for many years. Products such as Cenestin and Enjuvia that contain synthetic conjugated estrogens in specific amounts are now available, as are the bioidentical hormones that can be used in compounded prescriptions for
