Head-to-head comparisons of medication uses, side effects, warnings, and more.
Key takeaways
Prempro (conjugated estrogens/medroxyprogesterone) and Alora (Vivelle-Dot, estradiol patch) are both hormone replacement medications used to treat menopause symptoms like hot flashes and vaginal dryness, as well as to prevent bone loss (osteoporosis) after menopause. However, they differ in several ways. Prempro is a combination of estrogen and progestin, taken orally once a day, and is available only as a brand-name medication. In contrast, Vivelle-Dot is an estrogen-only patch applied to the skin twice a week and is available as a generic called Dotti. Prempro includes a progestin, which is important for people with a uterus to help protect against uterine cancer. Vivelle-Dot does not contain a progestin, so if you have a uterus you may need to take progestin separately. Both medications can cause headaches and breast pain or tenderness and increase the risk of serious side effects like blood clots and certain cancers. However, Vivelle-Dot is generally considered to have fewer side effects than oral hormone replacement medications.
Prempro
Vivelle-dot (estradiol patch)
Prempro
Vivelle-dot (estradiol patch)
Summary of Prempro vs. Vivelle-Dot
Summary for Estrogen replacement / Progestin
Prescription only
Prempro is a combination estrogen/progestin medication that relieves menopausal symptoms like vaginal dryness and hot flashes. It's also used for preventing osteoporosis after menopause. This hormone replacement therapy is an option for people with a uterus. The medication is brand only since there is no generic available. Follow your prescriber's instructions for the correct dose. Prempro is taken by mouth once a day with the same dose each day. Premphase is also taken daily but contains two types of tablets: one with estrogen and one with conjugated estrogens plus medroxyprogesterone, taken on different days. Common side effects include breast pain, headaches, and menstrual cramps.
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.