Here’s How to Save on Premarin For Menopause

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Tori Marsh
Tori Marsh, MPH, is on the Research Team at GoodRx, and is the resident expert on drug pricing and savings.
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If you’re over the age of 50, you may have started to experience some of those difficult menopause symptoms. Hot flashes, fatigue, night sweats, osteoporosis…not fun.

Luckily there are medications that can help you through menopause. But are they affordable?

One of the more commonly prescribed estrogens to treat menopausal symptoms and prevent osteoporosis is Premarin, but it’s expensive. Premarin is a brand-only medication, and a 30-day supply can cost well over $200. Currently, there is no generic for Premarin, and there may never be. So how can you save on Premarin?

When will generic Premarin be available?

Premarin’s patent protection expired in 2012, so other manufacturers are allowed to create a generic with the same active ingredients, but none have been approved. Why? The answer lies in how Premarin is made.

The estrogens in Premarin are made from – wait for it – the urine of pregnant mares. Yes, horse pee. Because of this, the active ingredients in Premarin have not been defined, and the FDA will not approve a synthetic version. Moral of the story, we may never see a Premarin generic.

So, how can I save on Premarin?

While Premarin is expensive, there are ways to save.

In addition to these savings tips, there are also other affordable alternatives to Premarin. More on that below.

Are there any cheaper alternatives to Premarin?

There are many forms of estrogens available to treat symptoms of menopause or prevent osteoporosis. While none of them are made from conjugated estrogens, in some cases they can be substituted for Premarin.

Estradiol, the generic for Climara and Estrace, is the most popular estrogen used for symptoms of menopause, and it’s more affordable than Premarin – a 30 day supply of estradiol is around $37 with a GoodRx coupon. There is one big difference between estradiol and Premarin, though. While Premarin is a natural hormone, derived from mare urine, Estradiol is synthetic, meaning it is made in a lab.

Another alternative, Activella, also has a generic option – estradiol/norethindrone. This combination estrogen and progesterone pill is used to relieve symptoms of menopause and lower your risk of osteoporosis, just like Premarin. Both estradiol/norethindrone and Premarin have potential side effects caused by the hormone, so the only big difference is the price. While Premarin can cost over $200 for a 30-day supply, the cash price for generic estradiol/norethindrone is around $50.

Estropipate (Ogen) is another alternative also used to treat symptoms of menopause and prevent osteoporosis. While it is affordable, estropipate only comes in tablet form, so it wouldn’t be a proper substitution for those using the tube of cream.

Premarin is expensive, so it is always worth talking to your doctor about switching to a more affordable medication, but keep in mind you will need a new prescription to fill for any of these alternatives.

Does Premarin have any side effects?

Since Premarin is a hormone, there can be a lot of side effects. Women taking Premarin may experience headache, abdominal pain, breast pain, nausea, back pain, insomnia, or depression.

Premarin can also increase the risk for more serious side effects, like uterine and breast cancer, blood clots, and stroke.

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