A clinical briefing for providers on Premphase 28 Day availability in 2026, including prescribing implications, alternatives, and patient access tools.
If your patients have been reporting difficulty filling Premphase 28 Day prescriptions, this briefing provides the current landscape on availability, prescribing implications, and practical tools to help maintain continuity of care.
Premphase 28 Day (Conjugated Estrogens 0.625 mg / Medroxyprogesterone Acetate 5 mg, sequential 28-day kit) remains an FDA-approved option for postmenopausal hormone therapy in women with an intact uterus. However, its availability at retail pharmacies has become increasingly inconsistent, creating challenges for both providers and patients.
Premphase was first approved by the FDA in 1995 and has been manufactured by Pfizer (originally Wyeth) throughout its history. The medication offers a sequential dosing regimen — 14 days of estrogen-only therapy followed by 14 days of combined estrogen/progestin therapy — designed to more closely mimic the natural hormonal cycle.
Over the past decade, prescribing patterns have shifted significantly toward continuous combined regimens (e.g., Prempro, generic CE/MPA combinations) and newer HRT formulations. This trend has reduced the number of Premphase prescriptions being filled nationally, leading to inventory reduction at many retail pharmacy chains.
Key timeline points:
The limited retail availability of Premphase 28 Day has several practical implications for prescribers:
When patients cannot readily fill their prescriptions, adherence suffers. Gaps in HRT can lead to return of vasomotor symptoms, disruption of bone protection, and patient frustration. Consider proactive discussions about availability when initiating or continuing Premphase therapy.
Many insurance formularies have moved Premphase to non-preferred or specialty tiers, requiring prior authorization. Some plans may require step therapy — documentation that the patient has tried and failed on a generic continuous CE/MPA product before covering brand-name Premphase. Be prepared to provide clinical justification for why sequential dosing is necessary for specific patients.
While most patients can be effectively managed on continuous combined HRT, some patients specifically benefit from sequential dosing:
For these patients, maintaining access to Premphase — or replicating its dosing schedule with separate components — is clinically important.
As of early 2026, Premphase 28 Day is not listed on the FDA or ASHP drug shortage databases. Pfizer continues to manufacture the product. The availability challenges are primarily driven by:
Availability is generally better at:
Understanding the cost landscape helps inform prescribing decisions and patient counseling:
For patients facing financial barriers, Pfizer RxPathways (pfizerrxpathways.com) offers patient assistance programs that may provide Premphase at no cost to eligible patients.
Several tools can help streamline the process of ensuring your patients get their medication:
Medfinder for Providers allows you and your staff to quickly check which pharmacies near your patient have Premphase 28 Day in stock. This can be integrated into your prescribing workflow to avoid sending patients to pharmacies that don't carry the medication.
Consider including a backup plan on the prescription itself or in your patient instructions. For example:
This approach ensures the patient has a fallback without needing to schedule another appointment or call your office.
Direct your patients to these resources:
The hormone replacement therapy market continues to evolve. Key trends to watch in 2026 and beyond:
Premphase 28 Day remains a valid therapeutic option for postmenopausal women who benefit from sequential HRT dosing. While it is not in formal shortage, the practical challenges of finding it at retail pharmacies require proactive management by prescribers.
Using tools like Medfinder for Providers, documenting clinical rationale for sequential dosing, and equipping patients with backup plans can help ensure continuity of care even when the brand-name product is difficult to locate.
For additional provider resources on managing HRT availability challenges, visit medfinder.com/providers.
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