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Prempro vs. Vivelle-Dot

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

 

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Vivelle-Dot

(estradiol patch)

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Summary for Prempro

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.

Indications for Prempro

Pros and Cons for Prempro

Pros

  • Only need to take once a day by mouth
  • Relieves multiple menopausal symptoms
  • Includes a progestin which helps protect your uterus
  • Lowers your risk of fractures by keeping your bones healthy

Cons

  • Raises your risk of certain cancers, blood clots, and strokes
  • Has more possible side effects than similar alternatives
  • Not safe if you have liver problems
  • Can't be used if you have a history of breast cancer

Common Side Effects for Prempro

  • Breast pain (up to 36%)
  • Headaches (up to 19%)
  • Stomach pain (up to 17%)
  • Menstrual cramps (up to 13%)
  • Gas (up to 8%)
  • Nausea (up to 8%)
  • Depression (up to 8%)
  • More vaginal discharge than usual (up to 8%)

Warnings for Prempro

  • Risk of blood clot
  • Breast cancer
  • Uterine (endometrial) cancer
  • Dementia
  • Gallbladder and liver problems
  • Changes in calcium levels in the blood
  • Vision problems
  • High triglycerides
  • Low thyroid hormone levels (hypothyroidism)
  • Fluid Retention
  • Severe allergic reaction
  • Worsening of other medical conditions

Summary for Vivelle-Dot

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.

This twice weekly patch is also available as a generic called Dotti.

Indications for Vivelle-Dot

Pros and Cons for Vivelle-Dot

Pros

  • Typically has fewer side effects than oral estrogen pills
  • Relieves multiple menopause symptoms
  • Good option if you have trouble swallowing pills
  • Available in different strengths, allowing you to customize your dose

Cons

  • Commonly causes headache, breast pain, and sinus swelling
  • Need to apply a new patch twice a week
  • Raises your risk of certain cancers, blood clots, and strokes
  • Might need to take it with another hormone called progestin if you have a healthy uterus

Common Side Effects for Vivelle-Dot

  • Headache (up to 50%)
  • Common cold symptoms (up to 20%)
  • Breast tenderness (up to 17%)
  • Sinus swelling (up to 13%)
  • Bleeding in-between periods (up to 11%)
  • Depression (up to 11%)
  • Back pain (up to 11%)
  • Sinus headache (up to 10%)
  • Indigestion (up to 9%)
  • Weight gain (up to 9%)
  • Joint pain (up to 9%)

Warnings for Vivelle-Dot

  • Blood clots and related complications (e.g., heart attack, stroke)
  • Uterine (endometrial) cancer
  • Breast cancer
  • Ovarian cancer
  • Dementia
  • Gallbladder and liver problems
  • Vision problems
  • High triglycerides
  • Low thyroid hormone levels (hypothyroidism)
  • Fluid Retention
  • Severe allergic reactions
  • Worsening of other health conditions

Prices with our coupons for Prempro vs. Vivelle-Dot

Price Card Drug Icon
Prempro1 package / 28 tablets of 0.3mg/1.5mg
$98.84$303.04
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Estradiol3 cartons / 8 twice-weekly patches of 0.05mg/day
$84.47$115.98
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