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.
Prempro is a combination of two medications:
| Common Brands | Prempro, Premphase |
|---|---|
| Drug Class | Estrogen replacement / Progestin |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | No lower-cost generic available |
| Availability | Prescription only |
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Contact your healthcare provider immediately if you experience any of the following.
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common
Bloating or swelling of the face, arms, hands, lower legs, or feet
blood in the urine
blurred vision
clear or bloody discharge from the nipple
cough or hoarseness
dimpling of the breast skin
dizziness
fast, irregular, pounding, or racing heartbeat or pulse
feeling faint, dizzy, or lightheaded
feeling of warmth or heat
fever or chills
flushing or redness of the skin, especially on the face and neck
headache
inverted nipple
lower back or side pain
lump in the breast or under the arm
nervousness
pain during sexual intercourse
painful or difficult urination
persistent crusting or scaling of the nipple
pounding in the ears
redness or swelling of the breast
severe cramping of the uterus
sore on the skin of the breast that does not heal
sweating
thick, white vaginal discharge with no odor or with a mild odor
tingling of the hands or feet
unusual weight gain or loss
vaginal bleeding that is unusual and heavy
vaginal or genital itching
vaginal yeast infection
Incidence not known
Absent, missed, or irregular menstrual periods
acid or sour stomach
backache
breast pain or tenderness
confusion
darkened urine
decreased vision or other changes in vision
difficulty with speaking
double vision
fainting
inability to move the arms, legs, or facial muscles
inability to speak
indigestion
loss of appetite
pain or discomfort in the arms, jaw, back, or neck
pain or feeling of pressure in the pelvis
pain, redness, or swelling in the arm or leg
painful or tender cysts in the breasts
pains in the stomach, side, or abdomen, possibly radiating to the back
slow speech
sudden shortness of breath or troubled breathing
unexpected or excess milk flow from the breasts
vomiting
yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Blemishes on the skin
body aches or pain
congestion
depersonalization
difficulty with moving
dryness of the vagina
dysphoria
euphoria
excessive muscle tone
feeling paranoid
flu-like symptoms
fullness or swelling of the breasts
hair loss or thinning of the hair
headache, severe and throbbing
leg cramps
loss of bladder control
menstrual periods that are longer or heavier
muscle pain or stiffness
pain in the joints
pain or tenderness around the eyes and cheekbones
quick to react or overreact emotionally
rapidly changing moods
rash
sore mouth or tongue
stuffy or runny nose
tender, swollen glands in the neck
tightness of the chest or wheezing
trouble with sleeping
trouble with swallowing
vaginal discharge that is clear or white
voice changes
white patches in the mouth or on the tongue
Incidence not known
Changes in appetite
hives or welts
inability to have or keep an erection
increased hair growth, especially on the face
increased interest in sexual intercourse
irritability
loss in sexual ability, desire, drive, or performance
loss of scalp hair
pain in the ankles or knees
painful, red lumps under the skin, mostly on the legs
patchy brown or dark brown discoloration of the skin
redness of the skin
weight changes
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Prempro can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Prempro can raise the risk of serious blood clots because it contains estrogens. Higher estrogen levels can raise blood proteins that promote clot formation. These clots can form anywhere in the body and might be life-threatening. Get medical attention right away if you have any signs or symptoms of a blood clot:
Your risk of blood clots is higher if you're older, smoke cigarettes, or have certain medical conditions. It's also higher if you're on bedrest after surgery. Your gynecologist might temporarily stop Prempro for 4-6 weeks before surgery. Talk with your gynecologist if you have any questions regarding your risk of blood clots.
Taking hormone replacement therapy with estrogen and progestin, like Prempro, can raise your risk of breast cancer. The longer you take this medication, the higher your risk is. That's why it's best to take this medication only for the shortest time necessary. Talk to your prescriber about ways to lower your risk, especially if you or a family member has had breast cancer. Make sure to check your breasts regularly for changes and get breast scans (mammograms). Let your prescriber know if you notice any unusual changes in breast shape, size, or color.
Vaginal bleeding after menopause can be a warning sign of uterine (endometrial) cancer, so let your prescriber know if you notice any unusual bleeding. Even though this Prempro contains a progestin to help protect your uterus, you should still report any unusual bleeding to your prescriber right away.
People taking medications containing estrogen, such as Prempro, might have a higher risk of dementia. Experts aren't sure why, but your risk is highest if you start taking Prempro for the first time after age 65. Early symptoms of dementia include new forgetfulness, confusion, getting lost, and wandering out. If you’re concerned about this risk, talk to your prescriber.
Prempro can cause problems with your gallbladder, and some people have needed gallbladder surgery after starting this medication. If you experience stomach pain, nausea or vomiting that doesn't go away, fever, or a yellowing of the skin and eyes (jaundice), speak with your prescriber or get medical attention right away.
The estrogen in Prempro is processed by the liver. So if your liver isn't working properly, you might have more side effects from this medication. If you currently have or have had any liver problems, including issues during a past pregnancy, you shouldn't use Prempro.
Taking Prempro can lead to severely high calcium levels in people with breast cancer that has spread to their bones. High calcium can cause symptoms like thirst, stomach pain, nausea, vomiting, constipation, bone pain, muscle weakness, or confusion. Tell your prescriber if you have any of these symptoms because you might have to stop taking Prempro.
Use Prempro carefully if you have low parathyroid hormone levels (hypoparathyroidism), which can lead to low calcium in your body. Let your prescriber know if you have signs of low calcium such as burning or tingling of your fingers, toes, or lips, muscle pain and cramps, or confusion.
Although very rare, some people taking estrogens have experienced vision problems caused by a blood clot in the eyes. If you have sudden partial or complete vision loss, bulging eyes, double vision, or migraines, stop taking Prempro and tell your prescriber immediately.
Estrogens can raise the amount of fats in your blood (triglycerides), which can lead to heart problems or pancreatitis, a serious inflammation of the pancreas. Your prescriber might recommend regular blood tests to watch for this while you're taking Prempro. If you experience sudden stomach or back pain, nausea, vomiting, sudden weight loss, or a fast heart rate, contact your prescriber or seek medical care right away.
Prempro can affect thyroid hormone levels in your blood. If you're taking medications for low thyroid hormone levels, you might need a higher dose of your thyroid replacement therapy. Your prescriber might recommend regular blood tests to check your thyroid hormone levels while you're taking this medication.
Estrogen products like Prempro can cause some fluid retention or edema, especially in people with heart conditions, like congestive heart failure, or kidney problems. If you notice unusual swelling in any part of your body or if you suddenly gain weight over a short period of time, let your care team know.
Serious allergic reactions like anaphylaxis have been reported in people taking Prempro. These reactions can happen within minutes to hours and can require emergency treatment. Let your prescriber know if you have symptoms including trouble breathing, hives, itching, or swelling of your lips, tongue, or face.
Taking estrogen-containing medications like Prempro can worsen certain medical conditions. These include high blood pressure, hereditary angioedema, asthma, diabetes, migraine, and seizures. Before you start Prempro let your healthcare team know about your past medical history so they can talk with you about the risks and benefits of taking this medication.
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Prempro will not be safe for you to take.
Prescription savings
Stop paying too much for your prescriptions. Compare prices, get pharmacy coupons, and save up to 80%.
Find expert answers to your health questions so you can make the best decisions for yourself and your family.Health conditions
Medications & treatment
Access & affordability
Our monthly healthcare membership can help you save thousands on your prescription costs.Resources
It’s important to take Prempro exactly as prescribed. Taking it every other day instead of every day can affect how well the medication works. If you’re thinking about changing how you take Prempro, talk to your prescriber first to make sure it’s safe and right for you.
Possibly. In clinical studies, about 3% of people taking Prempro experienced weight gain. Keep in mind that weight changes are a common symptom of menopause. Staying active with a regular exercise routine, like walking or running, can help reduce this risk and also lower your chances of bone loss (osteoporosis).
You can take Prempro in the morning or at night, but it's important to take it at the same time every day (e.g., always in the morning or always in the evening). Since Prempro might cause sleep problems like insomnia, you could try taking a dose in the morning if it keeps you awake at night.
Prempro contains 0.625 mg of conjugated estrogens. Generally, 0.5 mg of estrogen daily is considered "low dose" and 1 mg is a "standard dose". Talk to your prescriber if you have questions about the right amount of estrogen for you.
Most people begin to feel relief from menopausal symptoms within a few weeks of starting Prempro. If you don’t notice any improvement after a month, talk to your prescriber.
A pack of Prempro contains 28 tablets that are all the same. Each tablet contains both conjugated estrogens and medroxyprogesterone. On the other hand, Premphase has two different types of tablets: the first 14 tablets contain only conjugated estrogens, while tablets for days 15 to 28 include both conjugated estrogens and medroxyprogesterone. Speak with your prescriber to determine which medication is best for you.
No. Premarin contains only conjugated estrogens, while Prempro contains both conjugated estrogens and medroxyprogesterone. Prempro is typically only prescribed for people with a uterus, whereas Premarin can also be given to people without a uterus and is used to treat more conditions, including certain advanced stages of breast cancer and prostate cancer.
Hair loss from taking Prempro is rare, with less than 2% of people in clinical studies reporting it. Your prescriber will likely recommend using this medication for the shortest amount of time to manage your symptoms. If hair loss continues after stopping the medication, speak with your healthcare team about other possible causes.
