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Premarin vs. Evamist

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Premarin (conjugated estrogens) and Evamist (estradiol) are both estrogen replacement therapies used to relieve menopausal symptoms like hot flashes and night sweats. However, they differ in their forms and applications. Premarin is an oral tablet that can also treat low estrogen levels due to other conditions and certain cancers in advanced stages, and helps prevent osteoporosis, while Evamist is a topical spray specifically for managing menopausal symptoms. Premarin can be taken daily or in cycles, whereas Evamist is applied once daily to the forearm. Premarin has a broader range of side effects, including weight gain and more severe risks like blood clots and certain cancers. Evamist, on the other hand, has milder side effects but can still pose serious risks, including early puberty in children if Evamist is transferred through skin contact as well as blood clots and certain cancers. Both medications require a prescription and are available only as brand-name products.

Premarin

 

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Evamist

(estradiol)

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Summary for Premarin

Prescription only

Premarin (conjugated estrogens) is an oral estrogen hormone tablet that's used to treat various conditions in adults. Most commonly, it relieves menopausal symptoms such as vaginal dryness and hot flashes. The medication is also used for treating low estrogen levels, certain advanced stages of breast or prostate cancers, and osteoporosis after menopause. Depending on what you're using it for, the medication can be taken daily or in cycles. Side effects include headache, stomach pain, nausea, and breast pain.

Indications for Premarin

Pros and Cons for Premarin

Pros

  • Relieves multiple menopausal symptoms
  • Available in multiple strengths, allowing you to customize your dose
  • Comes as a tablet that you take by mouth

Cons

  • Raises your risk of certain cancers, blood clots, and strokes
  • Some people might need to take it with another hormone called progestin
  • Not a first-choice medication for treating bone loss after menopause

Common Side Effects for Premarin

  • Headache (13-14%)
  • Abnormal vaginal bleeding (2-13%)
  • Breast pain (7-12%)
  • Stomach pain (8-11%)
  • Passing gas (4-6%)
  • Vaginal discharge (4-5%)
  • Back pain (3-5%)
  • General pain (3-5%)
  • Nausea (3-5%)
  • Insomnia (3-5%)
  • Depression (3-5%)
  • Weakness (2-5%)

Warnings for Premarin

  • Uterine (endometrial) cancer
  • Breast cancer
  • Blood clots and stroke
  • Heart disease and heart attacks
  • Dementia
  • Gallbladder and liver problems
  • Vision problems
  • High triglycerides
  • Low thyroid hormone levels (hypothyroidism)
  • Fluid Retention
  • Changes in calcium levels in the blood
  • Worsening of other health conditions

Summary for Evamist

Prescription only

Evamist (estradiol) is a topical hormone spray that helps relieve the hot flashes and night sweats caused by menopause. It's a hormone replacement therapy (HRT) that's sprayed onto the skin of your inner forearm once a day. The typical dose ranges from 1 to 3 sprays daily, depending on your symptoms. Some potential side effects of this medication include headache, tender breasts, and back pain.

Indications for Evamist

Pros and Cons for Evamist

Pros

  • Dries within 2 minutes, doesn't need to be rubbed in
  • Possible option if you can't swallow pills
  • Only needs to be applied once a day

Cons

  • Raises your risk of certain cancers, blood clots, and strokes
  • Need to use with progestin to lower your risk of uterine cancer (in females who have uterus)
  • Must cover with clothing to prevent exposure to others

Common Side Effects for Evamist

  • Headache (up to 12%)
  • Breast tenderness (up to 7%)
  • Nipple pain (up to 7%)
  • Cold-like symptoms (up to 5%)
  • Back pain (up to 5%)
  • Joint pain (up to 4%)

Warnings for Evamist

  • Uterine or endometrial cancer
  • Breast cancer
  • Blood clots, heart attacks, and strokes
  • Risk of dementia
  • Risk of harm in children (accidental contact with medication)
  • Gallbladder problems
  • Higher risk of side effects
  • Vision problems
  • High triglycerides
  • Changes in calcium levels in the blood
  • Low thyroid hormone levels (hypothyroidism)
  • Swelling from fluids
  • Worsening of other medical conditions

Prices with our coupons for Premarin vs. Evamist

Price Card Drug Icon
Premarin30 tablets / 0.625mg
$99.00$261.61
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Evamist1 bottle / 8.1ml of 1.53mg/spray
$75.00$178.77
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