BNaproxen Anaprox Naprosyn 500 mg

loading dose, then 250 mg tid during the menstrual period.

c. Ibuprofen (Motrin, Nuprin) 400 mg tid during the menstrual period.

d. Gastrointestinal distress is common. NSAIDs are contraindicated in renal failure and peptic ulcer disease.

2. Iron should also be added as ferrous gluconate 325 mg tid.

H. Patients with hypovolemia or a hemoglobin level below 7 g/dL should be hospitalized for hormonal therapy and iron replacement.

1. Hormonal therapy consists of estrogen (Premarin) 25 mg IV q6h until bleeding stops. Thereafter, oral contraceptive pills should be administered q6h x 7 days, then taper slowly to one pill qd.

2. If bleeding continues, IV vasopressin (DDAVP) should be administered. Hysteroscopy may be necessary, and dilation and curettage is a last resort. Transfusion may be indicated in severe hemorrhage.

3. Iron should also be added as ferrous gluconate 325 mg tid.

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