Head-to-head comparisons of medication uses, side effects, warnings, and more.
Key takeaways
Premarin (conjugated estrogens) and Vivelle-Dot (estradiol patch) are both estrogen replacement medications used to treat menopause symptoms like hot flashes and vaginal dryness, to treat low estrogen levels, and to prevent osteoporosis after menopause. However, they differ in several ways. Premarin is an oral tablet also used for certain advanced stages of breast and prostate cancers and is taken daily or in cycles, depending on the condition. Vivelle-Dot is a patch applied to the lower stomach or buttocks twice a week. Premarin only comes in a branded version, but Vivelle-Dot is available as a generic called Dotti. Common side effects of Premarin include headache, stomach pain, and nausea, while Vivelle-Dot commonly causes headaches, breast tenderness, and sinus swelling. Both medications can increase the risk of blood clots, strokes, and certain cancers, and may require the addition of progestin if you have a uterus.
Premarin
Vivelle-dot (estradiol patch)
Premarin
Vivelle-dot (estradiol patch)
Summary of Premarin vs. Vivelle-Dot
Summary for Estrogen replacement
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.
Summary for Estrogen replacement
Prescription only
Vivelle-Dot (estradiol patch) is a twice-weekly hormonal patch used to treat menopause symptoms and low estrogen levels. It also helps prevent bone loss (osteoporosis) in people who have gone through menopause. The patch is a form of hormone replacement therapy. The usual dose is one patch applied to the lower stomach or buttocks twice a week, or every 3 to 4 days. Side effects include headache, breast pain, and sinus swelling.
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This twice weekly patch is also available as a generic called Dotti.