Premarin Dosages: Your GoodRx Guide

Menopause causes many bothersome symptoms, such as hot flashes, night sweats, and vaginal dryness. These symptoms are primarily due to a drop in estrogen levels that naturally occurs during menopause. If your symptoms are severe enough, your healthcare team may recommend hormone replacement therapy (HRT) to help manage your symptoms. Premarin (conjugated estrogens) is a common choice for HRT.

Premarin is available as oral tablets and a vaginal cream. Premarin tablets can help manage bodywide menopause symptoms, including hot flashes and vaginal dryness. They can also treat other conditions that cause the body to make less estrogen than expected. Premarin Vaginal Cream relieves vaginal menopause symptoms, such as dryness and painful sex.

Knowing how to use Premarin and taking the correct dosage is essential to the medication working safely and effectively. Your Premarin dosage depends on multiple factors, including the form you’re using and why it’s been prescribed for you.

Promotion disclosure

credit_cardSponsored copay cardSubject to eligibility

Premarin

Avg retail price

$255.46(Save 90.21%)

Copay card

$25.00

Compare all prices

What’s the typical Premarin tablet dosage?

A common Premarin tablet dosage for menopause symptoms starts at 0.3 mg by mouth once daily. But, as we’ll discuss below, your specific dosage schedule depends on why you're taking the medication and your response to it.

Premarin tablets are available in the following doses:

• 0.3 mg

• 0.45 mg

• 0.625 mg

• 0.9 mg

• 1.25 mg

Good to know: If you have a uterus, you’ll likely also take a progestin, such as medroxyprogesterone (Provera), with Premarin. This helps protect the uterus from damage that can happen if you take an estrogen by itself.

Premarin tablet dosage for menopause symptoms

The typical Premarin tablet dosage for menopause symptoms starts at 0.3 mg by mouth once daily. You may take the tablets continuously (every day with no breaks). But some people take them cyclically, meaning once daily for 25 days, followed by 5 days without taking them.

Depending on your response to Premarin, your prescriber may raise your dosage. It’s recommended to take the lowest effective dosage needed. This helps limit rare but serious side effects associated with HRT, such as blood clots and breast cancer.

Your prescriber should periodically check with you to see if you need dosage adjustments. They may also suggest trying to stop treatment with Premarin at some point, if you’ve been taking it for a while. Most people only take HRT until their menopause symptoms naturally lessen.

Premarin oral tablets for prevention of osteoporosis

Premarin tablets are also FDA approved to prevent osteoporosis caused by menopause. The Premarin tablet dosage for osteoporosis prevention also starts at 0.3 mg by mouth once daily. Similar to the above, Premarin may be prescribed on a continuous or cyclical basis for osteoporosis.

EXPERT PICKS: WHAT TO READ NEXT

• What to expect: Pharmacists review notable Premarin tablet side effects — from headaches to vaginal discharge — and how to manage them.

• Compare your options. Premarin is one of several available menopause treatments. Learn about the different options and how to save on them.

• What does menopause feel like? Read these firsthand accounts to help you determine if your symptoms might be menopause-related.

Depending on your response to the medication, your prescriber may raise your Premarin dosage. And they’ll likely check in with you from time to time to discuss if you should continue taking it.

Good to know: Premarin isn’t a first-choice medication for treating or preventing osteoporosis. It’s typically only considered if you’re unable to take other osteoporosis medications like alendronate (Fosamax).

Premarin oral tablets for low estrogen 

Premarin tablets are also approved to treat conditions that cause low estrogen levels other than menopause. Examples include hypogonadism and primary ovarian insufficiency. You may also be prescribed Premarin if your ovaries were removed during a hysterectomy.

The recommended Premarin dosage for hypogonadism is 0.3 mg or 0.625 mg by mouth once daily. This should be taken cyclically, with 3 weeks of taking the medication, followed by 1 week of not taking the medication. And the dosage can be adjusted based on your response.

For primary ovarian insufficiency or following ovary removal, the recommended Premarin dosage is 1.25 mg by mouth daily. In these cases, it’s recommended to follow the same cycle as when treating hypogonadism. And your dosage may be raised or lowered depending on your response.

What’s the typical Premarin Vaginal Cream dosage?

The recommended Premarin Vaginal Cream dosage for vaginal dryness starts at 0.5 g applied inside the vagina once a day. The manufacturer of Premarin Vaginal Cream recommends using the medication cyclically, meaning applying it once daily for 21 days and then not applying it for 7 days. However, it’s possible your prescriber may recommend only applying the cream twice weekly. Your daily dose may be raised up to a maximum of 2 g if needed.

The typical Premarin Vaginal Cream dosage for pain during sex is 0.5 g applied inside the vagina twice weekly. Doses should be separated by 3 or 4 days. And it’s recommended to use the cream cyclically — meaning, twice weekly for 3 weeks, followed by 1 week of not applying it — for this purpose. Dosage adjustments aren’t recommended if you’re only using Premarin for pain during sex.

Are there any dosage adjustments for health conditions?

There are medications that have different dosages for people with certain health conditions, such as liver or kidney disease. But this isn’t the case for Premarin.

People with kidney problems should follow the standard dosage recommendations. But if you have liver disease, you shouldn’t take Premarin. The medication is broken down by the liver. And if your liver isn’t working as expected, Premarin can build up in your system. This can raise your risk of Premarin side effects, such as headaches and breast tenderness.

What happens if you miss a dose of Premarin?

If you miss a dose of Premarin tablets or cream (if applied daily), take the medication or apply the cream as soon as you remember. But if it’s almost time for your next dose, skip the missed one. It’s best not to double up on doses, since this can cause excess side effects.

If you’re taking Premarin tablets or using the cream cyclically, and you forget to stop or restart your doses on the right day, contact your prescriber or pharmacist. They can help you get back on schedule safely.

If you miss a dose of Premarin Vaginal Cream and you usually apply it twice weekly, it’s also a good idea to contact your prescriber or pharmacist. How to correct a missed dose depends on how long it's been since the dose was missed. A healthcare professional can help you get back on schedule safely.

What should you do if you take too much Premarin?

If you accidentally take an extra dose of Premarin tablets or vaginal cream, it’s unlikely to cause you serious harm. But large dosages of Premarin in either form can lead to uncomfortable symptoms such as:

• Abdominal pain

• Breast tenderness

• Drowsiness

• Fatigue

• Nausea or vomiting

• Vaginal bleeding

If you’ve taken or used too much Premarin, contact your prescriber about next steps. You can also call Poison Control at 1-800-222-1222 for guidance.

How to save on Premarin

There are ways to save on Premarin, which is available as a brand-name medication. GoodRx can help you navigate between patient assistance programs and copay savings cards to save money on your prescription:

• Save with GoodRx: Anyone with a valid prescription, regardless of insurance status, can use GoodRx for an exclusive cash price of $99 per month for Premarin tablets and $249 per tube of Premarin Vaginal Cream.

• Save with a copay savings card. If you have commercial insurance, you may be eligible to pay as little as $25 for Premarin tablets or Premarin Vaginal Cream using a savings card from the manufacturer.

• Save with a patient assistance program. If you’re uninsured or underinsured, you may be eligible for Premarin’s patient assistance program, which offers the medication free of cost. The program covers both the tablets and vaginal cream.

Frequently asked questions

Why trust our experts?

Written by:

Nicole E. Cieri-Hutcherson, PharmD, BCPS, NCMP

Nicole E. Cieri-Hutcherson, PharmD, BCPS, NCMP, has over a decade of experience as a pharmacist, professor, and researcher. She was a full-time clinical professor in the pharmacy practice department at D’Youville School of Pharmacy before subsequently joining the faculty of the pharmacy practice department at the University at Buffalo School of Pharmacy and Pharmaceutical Sciences.

Edited by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Reviewed by:

Jennifer Gershman, PharmD, CPh, PACS

Jennifer Gershman, PharmD, is a licensed pharmacist in Florida. She has worked in the pharmacy industry for more than 15 years and is currently a medical writer.

Our editorial standards

Meet our experts