Conjugated Estrogens / Medroxyprogesterone
Conjugated estrogens combined with medroxyprogesterone is a hormone therapy used in women with a uterus to treat moderate to severe menopausal symptoms, vaginal and vulvar changes due to menopause, and to help prevent postmenopausal osteoporosis.
🧬 Where this information comes from Click to expand
The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 1 clinical label set within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →
⚠️ FDA Boxed Warning — the FDA’s strongest safety alert ▾
This medication carries serious FDA boxed warnings — the highest-level safety alert. Clinical studies found that women taking estrogen plus progestin (like this combination) had increased risks of stroke, blood clots (DVT and pulmonary embolism), heart attack, invasive breast cancer, and probable dementia. Women 65 and older had a roughly doubled risk of developing probable dementia. This medication should not be used to prevent heart disease or dementia. Separately, estrogen used alone (without a progestin) in women who still have a uterus raises the risk of endometrial cancer (cancer of the uterine lining) — this is why the progestin is included in this combination product. Any unexplained vaginal bleeding should be reported to a doctor right away. Always use the lowest effective dose for the shortest time possible.
📖 Conjugated Estrogens / Medroxyprogesterone: Patient Information Guide
A plain-language walkthrough of Conjugated Estrogens / Medroxyprogesterone — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.
🎯What it's used for▾
Conjugated estrogens / medroxyprogesterone is a combination hormone therapy approved for use in postmenopausal women who have a uterus. Supported uses include:
- Prempro (oral tablet): Treatment of moderate to severe vasomotor symptoms (hot flashes, night sweats) due to menopause
- Prempro (oral tablet): Treatment of moderate to severe vulvar and vaginal atrophy (dryness, irritation, tissue thinning) due to menopause — when treating vaginal symptoms only, topical vaginal products should be considered first
- Prempro (oral tablet): Prevention of postmenopausal osteoporosis — reserved for women at significant risk; non-estrogen medications should be carefully considered first
⚙️How it works▾
After menopause, estrogen levels fall sharply because the ovaries no longer produce it in meaningful amounts. The conjugated estrogens in this medication attach to estrogen receptors in tissues throughout the body — including the brain, blood vessels, bones, and vaginal lining — helping to restore the signals estrogen normally provides. This helps reduce hot flashes, prevents bone loss, and restores moisture and tissue health in the vaginal area. Medroxyprogesterone acetate (the progestin) is paired with estrogen because estrogen alone can cause the uterine lining to overgrow; the progestin counteracts this by reducing estrogen-receptor activity in the uterine lining, lowering the risk of endometrial hyperplasia (uterine lining overgrowth) and endometrial cancer.
💊How it's taken▾
Prempro is taken as one tablet by mouth once daily. Food affects absorption — a high-fat meal can significantly raise the peak blood level of the progestin component — so try to take it consistently either always with food or always without. There is no specific missed-dose instruction in the label; follow your pharmacist's or prescriber's guidance. Your prescriber should periodically reassess whether you still need this therapy, aiming for the lowest effective dose for the shortest duration.
🤒Side effects — in detail▾
The most commonly reported side effects include:
- Abdominal pain or stomach discomfort
- Headache
- Back pain
- Nausea and gas (flatulence)
- Breast pain or tenderness
- Fatigue or weakness
- Vaginal discharge (leukorrhea)
- Painful periods (dysmenorrhea)
- Depression or mood changes
- Itching (pruritus)
Seek immediate medical attention for serious symptoms such as sudden chest pain, leg swelling, shortness of breath, sudden vision loss, or signs of stroke (face drooping, arm weakness, speech difficulty) — these could signal a dangerous blood clot or cardiovascular event.
⚠️Warnings & precautions▾
- Blood clots, stroke, and heart attack: Studies found increased rates of deep vein thrombosis, pulmonary embolism, stroke, and heart attack in women using estrogen plus progestin. Stop the medication and call 911 if these symptoms occur. Stop at least 4–6 weeks before major surgery or prolonged bed rest.
- Breast cancer: The WHI study found an increased risk of invasive breast cancer with estrogen plus progestin use. Tumors were detected at a more advanced stage. Get yearly breast exams and mammograms.
- Probable dementia: Women 65 and older had roughly double the risk of probable dementia in one large study. This medication should not be used to prevent dementia.
- Ovarian and endometrial cancer: There is a possible increased risk of ovarian cancer. Adding the progestin reduces — but does not eliminate — the risk of endometrial (uterine lining) cancer. Report any unexplained vaginal bleeding promptly.
- Gallbladder disease: A 2- to 4-fold increased risk of gallbladder disease requiring surgery has been reported with estrogen use.
- Vision problems: Retinal blood clots have been reported. Discontinue and seek care immediately for sudden vision loss, double vision, or eye bulging.
- Liver disease: Do not use if you have liver impairment or disease. Stop if jaundice (yellowing of the skin or eyes) develops.
🔀What it interacts with▾
This medication is processed partly by a liver enzyme called CYP3A4, so drugs that affect that enzyme can change how much estrogen ends up in your bloodstream:
- St. John's Wort, phenobarbital, carbamazepine, rifampin — these speed up estrogen metabolism, lowering blood levels and possibly making the medication less effective or changing your bleeding pattern
- Erythromycin, clarithromycin, ketoconazole, itraconazole, ritonavir — these slow estrogen breakdown, raising blood levels and increasing the risk of side effects
- Grapefruit juice — can raise estrogen levels in the blood, potentially increasing side effects
- Aminoglutethimide (a cancer treatment) — can significantly reduce the absorption of the medroxyprogesterone component, making it less effective
This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.
📋Before taking it▾
- Do not use if you have or have had breast cancer, or any cancer that is fueled by estrogen
- Do not use if you have or have had blood clots (DVT or pulmonary embolism), stroke, or heart attack
- Do not use if you have unexplained abnormal vaginal bleeding — the cause must be identified first
- Do not use if you have liver disease or liver impairment
- Do not use if you have inherited clotting disorders such as protein C, protein S, or antithrombin deficiency
- Do not use if you have had a severe allergic reaction (anaphylaxis or angioedema) to Prempro
- Pregnancy: This medication is not for use during pregnancy
- Breastfeeding: Estrogens pass into breast milk and can reduce its quantity and quality; discuss with your doctor before use
- Children: Not indicated for use in children
- Women over 65: Face higher risks of stroke, invasive breast cancer, and probable dementia — weigh benefits and risks carefully with your doctor
- Thyroid replacement therapy: Tell your doctor if you take thyroid medication — estrogens can affect thyroid hormone levels and your dose may need monitoring
- Kidney or liver impairment: The effects of kidney or liver disease on how this medication is processed have not been fully studied; discuss your history with your prescriber
🚑If you take too much▾
Taking too much of this medication may cause nausea, vomiting, breast tenderness, abdominal pain, drowsiness, and fatigue. Withdrawal bleeding can also occur. If you think you or someone else has taken too much, stop the medication and contact your healthcare provider or poison control right away for guidance on next steps.
🔬Pharmacokinetics — how your body processes it▾
Both ingredients in Prempro are well absorbed from the gastrointestinal tract after you take it by mouth — the medroxyprogesterone component is released immediately, while the conjugated estrogens are released more slowly over several hours. Eating a high-fat meal can significantly increase peak blood levels of the progestin and modestly affect estrogen levels, so consistency around mealtimes matters. Estrogens circulate in the blood largely bound to proteins (SHBG and albumin), and medroxyprogesterone is about 90% protein-bound as well. Both components are processed in the liver and ultimately cleared from the body, with the estrogen components having half-lives (the time for blood levels to drop by half) ranging from roughly 10 to 37 hours depending on the specific estrogen fraction.
📦How to store it▾
Store at 20° to 25°C (68° to 77°F); excursions permitted to 15° to 30°C (59° to 86°F) .
📄 Written from Conjugated Estrogens / Medroxyprogesterone’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →
🩺 Pharmacist Counseling Corner
Quick, plain-English answers to the questions patients ask most about Conjugated Estrogens / Medroxyprogesterone — the kind of thing our pharmacy team would talk through with you at the counter.
Why do I need to take a progestin with the estrogen — can't I just take estrogen alone? ▾
How long will I need to stay on this medication? ▾
What warning signs should make me stop the medication and call for help right away? ▾
Does it matter whether I take Prempro with food or on an empty stomach? ▾
I've heard estrogen therapy raises the risk of breast cancer — should I be worried? ▾
Are there any common medications or supplements I should avoid while taking Prempro? ▾
Is Conjugated Estrogens / Medroxyprogesterone available over the counter? ▾
When was Conjugated Estrogens / Medroxyprogesterone first available? ▾
Who makes Conjugated Estrogens / Medroxyprogesterone? ▾
💬 Answers drafted from Conjugated Estrogens / Medroxyprogesterone’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →
🧰 Keep exploring
💊 How Conjugated Estrogens / Medroxyprogesterone comes
Conjugated Estrogens / Medroxyprogesterone is available in 1 form. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.
Tablet
How this form is used
- Prempro is used to treat moderate to severe hot flashes and night sweats (vasomotor symptoms) due to menopause
- Prempro is used to treat moderate to severe vulvar and vaginal dryness and atrophy due to menopause
- Prempro is used to help prevent postmenopausal osteoporosis in women at significant risk
- Prempro is taken as one tablet by mouth once daily
- Taking Prempro with a high-fat meal can significantly increase the peak blood level of the progestin component — take it consistently the same way each day
- Use the lowest effective dose for the shortest duration that meets your treatment goals, as directed by your prescriber
- Your prescriber should periodically re-evaluate whether you still need this treatment
Show 2 more strengths Show fewer strengths
📊 Conjugated Estrogens / Medroxyprogesterone across the U.S. market
How Conjugated Estrogens / Medroxyprogesterone appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.
Also listed with the FDA, not a patient dose form: Kit (3) — bulk drug substance sold to compounders/manufacturers and multi-item kits. These aren’t counted in the dose-form total above.
Share of FDA-listed product records by manufacturer — FDA National Drug Code Directory. Record counts are not sales or prescription volume.
📈 How widely Conjugated Estrogens / Medroxyprogesterone is used
A general measure of how commonly Conjugated Estrogens / Medroxyprogesterone is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.
Think of this as a proxy for how widely Conjugated Estrogens / Medroxyprogesterone is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.
How commonly is Conjugated Estrogens / Medroxyprogesterone prescribed? Of the 1,596 medications we measure, Conjugated Estrogens / Medroxyprogesterone ranks #640 by Medicaid prescriptions — more than 60% of them.
Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Conjugated Estrogens / Medroxyprogesterone, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 5 of 9 listed Conjugated Estrogens / Medroxyprogesterone NDCs with Medicaid activity.
🔍 Compare Conjugated Estrogens / Medroxyprogesterone products
A representative set of FDA-listed product records for Conjugated Estrogens / Medroxyprogesterone — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)
| Strength | Route | Manufacturer / Labeler | Category ⓘ | Details |
|---|---|---|---|---|
| 💊Tablet | ||||
| 0.625; 2.5 mg/1; mg | Oral | A-S Medication Solutions | NDA | Find on DailyMed ↗ |
| ESTROGENS, CONJUGATED 0.3 mg/1; MEDROXYPROGESTERONE ACETATE 1.5 mg | — | Pfizer Ireland Pharmaceuticals Unlimited Company | DRUG FOR FURTHER PROCESSING | View NDC → |
| ESTROGENS, CONJUGATED 0.45 mg/1; MEDROXYPROGESTERONE ACETATE 1.5 mg | — | Pfizer Ireland Pharmaceuticals Unlimited Company | DRUG FOR FURTHER PROCESSING | View NDC → |
| ESTROGENS, CONJUGATED 0.625 mg/1; MEDROXYPROGESTERONE ACETATE 2.5 mg | — | Pfizer Ireland Pharmaceuticals Unlimited Company | DRUG FOR FURTHER PROCESSING | View NDC → |
| ESTROGENS, CONJUGATED 0.625 mg/1; MEDROXYPROGESTERONE ACETATE 5 mg | — | Pfizer Ireland Pharmaceuticals Unlimited Company | DRUG FOR FURTHER PROCESSING | View NDC → |
| ESTROGENS, CONJUGATED 0.3 mg/1; MEDROXYPROGESTERONE ACETATE 1.5 mg | Oral | Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc. | NDA | View NDC → |
| ESTROGENS, CONJUGATED 0.45 mg/1; MEDROXYPROGESTERONE ACETATE 1.5 mg | Oral | Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc. | NDA | View NDC → |
| ESTROGENS, CONJUGATED 0.625 mg/1; MEDROXYPROGESTERONE ACETATE 2.5 mg | Oral | Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc. | NDA | View NDC → |
| ESTROGENS, CONJUGATED 0.625 mg/1; MEDROXYPROGESTERONE ACETATE 5 mg | Oral | Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc. | NDA | View NDC → |
| 0.3; 1.5 mg/1; mg | Oral | Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc. × 2 listings | NDA | View NDC → |
| 0.45; 1.5 mg/1; mg | Oral | Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc. × 2 listings | NDA | View NDC → |
| 0.625; 2.5 mg/1; mg | Oral | Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc. × 2 listings | NDA | View NDC → |
| 0.625; 5 mg/1; mg | Oral | Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc. × 2 listings | NDA | View NDC → |
| 💊Kits | ||||
| — | — | Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc. × 3 listings | NDA | View NDC → |
Showing 20 of 20 products — FDA National Drug Code Directory. See every product, package size and price: browse all 20 Conjugated Estrogens / Medroxyprogesterone NDCs →
📈 What people report — real-world data (FDA FAERS)
After a medicine reaches the market, patients, doctors and drugmakers can send the FDA reports of problems they think may be linked to it. Here’s what’s been reported for Conjugated Estrogens / Medroxyprogesterone — a signal of what to watch for, not proof the drug caused it.
Source: openFDA, from the FDA Adverse Event Reporting System (FAERS). These are voluntary reports — they don’t prove the drug caused the effect, and counts reflect how often something was reported, not how often it actually happens. Reports also often name the very problem the medicine is taken for — a common reason to file one is that the drug didn’t help — so for a pain reliever you may see “pain” high on the list; that points to why the report was filed, not to the drug causing the symptom. This counts every report that lists Conjugated Estrogens / Medroxyprogesterone in any role, so the total runs higher than the FDA’s official dashboard, which counts only cases where the drug is the suspect. For the authoritative figures, see the FDA FAERS Public Dashboard. Always talk to your pharmacist or doctor.
🏛️ The road to your pharmacy
How Conjugated Estrogens / Medroxyprogesterone went from FDA review to the pharmacy shelf — the key milestones in its regulatory journey.
Source: Drugs@FDA.
🚨 Recall history
A recall is when a specific batch of a medicine is pulled from the market — usually a manufacturing issue, not a problem with the drug itself. Class I is most serious, Class III least.
Source: openFDA drug enforcement (recall) reports.
📦 Supply & shortage status
Whether Conjugated Estrogens / Medroxyprogesterone is in short supply in the U.S. right now, plus any shortage history the FDA has on record. A shortage usually reflects a manufacturing or demand issue — not a safety problem with the drug.
Source: openFDA, from the FDA Drug Shortages database.
🏷️ Sold under these brand names
🏭 Manufacturers & labelers
RxNorm drug class
Conjugated Estrogens / Medroxyprogesterone belongs to the Estrogen class.
Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.
🔬 Where this comes from
Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.
How we combine label and product data
HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 1 FDA-filed SPL label set within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.
For canonical ingredient pages, bounded product-attributed indication and administration excerpts may be added to the AI evidence, and the generator is instructed to preserve available product, brand, route, and form qualifiers instead of treating one label as universal. Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc. is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.
This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.