What Is Prempro 0.45/1.5 28 Day?

Prempro 0.45/1.5 28 Day is a prescription combination hormone replacement therapy (HRT) tablet containing conjugated estrogens (0.45 mg) and medroxyprogesterone acetate (1.5 mg), taken once daily to treat moderate to severe menopause symptoms and prevent postmenopausal osteoporosis.

If you've been prescribed Prempro or are researching it for the first time, this guide covers everything you need to know — what it is, what it treats, how to take it, who shouldn't use it, and what it costs.

Brand and Generic Information

• Brand name: Prempro
• Generic name: Conjugated Estrogens / Medroxyprogesterone Acetate
• Drug class: Estrogen/Progestin Combination (Hormone Replacement Therapy)
• Manufacturer: Pfizer Inc.
• Generic available? No. There is currently no FDA-approved generic version of Prempro.
• Controlled substance? No. Prempro is not a DEA-scheduled controlled substance.

Prempro is also available in other strengths: 0.3/1.5 mg, 0.625/2.5 mg, and 0.625/5 mg. A related product called Premphase uses the same active ingredients in a cyclic dosing schedule (estrogen-only tablets for the first 14 days, then combination tablets for the next 14 days).

What Is Prempro Used For?

Prempro 0.45/1.5 28 Day is FDA-approved for three uses:

1. Treatment of moderate to severe hot flashes (vasomotor symptoms) — Hot flashes, night sweats, and flushing caused by declining estrogen levels during menopause.
2. Treatment of moderate to severe vaginal dryness and atrophy — Thinning, drying, and inflammation of vaginal tissues that can cause discomfort and painful intercourse.
3. Prevention of postmenopausal osteoporosis — Prempro helps maintain bone density after menopause. However, it should only be used for this purpose when non-estrogen treatments have been considered first.

Prempro is designed for women who have an intact uterus. The medroxyprogesterone acetate (progestin) component is included specifically to protect the uterine lining from the overgrowth that estrogen alone can cause, which reduces the risk of endometrial cancer.

Off-label, doctors sometimes prescribe Prempro for premature ovarian insufficiency and hormone support after surgical menopause (bilateral oophorectomy).

How Is Prempro Taken?

Prempro is taken as follows:

• Dose: One tablet daily by mouth
• Timing: Take it at the same time every day
• With or without food: Either is fine, though taking it with food may help reduce nausea
• Swallow whole: Do not crush, chew, or split the tablets
• Duration: Use the lowest effective dose for the shortest time needed to reach your treatment goals

The 0.45/1.5 mg strength is a lower-dose option. Your doctor may have chosen this strength to help minimize side effects while still effectively managing your symptoms. For details about how the medication works in your body, read our mechanism of action explainer.

Who Should Not Take Prempro?

Prempro is not safe for everyone. You should not take Prempro if you have:

• Undiagnosed abnormal vaginal bleeding
• Known or suspected breast cancer, or a history of breast cancer
• Known or suspected estrogen-dependent tumors
• Active blood clots (DVT or PE) or a history of blood clots
• History of stroke or heart attack
• Known liver disease or impairment
• A known allergy to Prempro or any of its ingredients
• Known blood clotting disorders (protein C, protein S, or antithrombin deficiency)

Prempro carries a boxed warning about increased risks of cardiovascular events (stroke, heart attack, blood clots), invasive breast cancer, and probable dementia in women 65 and older, based on findings from the Women's Health Initiative (WHI) studies. Your doctor will weigh these risks against the benefits before prescribing.

For a deeper look at side effects, see our complete side effects guide.

How Much Does Prempro 0.45/1.5 28 Day Cost?

Without insurance, Prempro 0.45/1.5 28 Day costs approximately $256 to $370 for a 28-tablet supply (one month). There is no generic equivalent available, which keeps costs higher.

Insurance coverage: Most commercial insurance plans cover Prempro, typically on a preferred or non-preferred brand tier. Some plans may require prior authorization or step therapy through separate generic estrogen and progestin products first. Medicare Part D generally covers it, though out-of-pocket costs vary by plan.

Ways to save:

• Pfizer copay savings card — Saves up to $110 per fill for commercially insured patients. Not valid for Medicare, Medicaid, or Tricare.
• Pfizer RxPathways — For uninsured or underinsured patients. Call 1-844-989-7284 for eligibility.
• Discount cards — GoodRx, SingleCare, and other coupon programs can reduce the cash price at participating pharmacies.

For a full breakdown of savings options, check out our guide to coupons, discounts, and patient assistance programs for Prempro.

Final Thoughts

Prempro 0.45/1.5 28 Day is a well-established combination HRT that can significantly improve quality of life for women dealing with moderate to severe menopause symptoms. The 0.45/1.5 mg dose is the lower-strength option, offering a balance between symptom relief and minimizing side effects.

Like all hormone therapies, it comes with important risks that need to be discussed with your doctor. Regular follow-ups, mammograms, and health screenings are part of responsible HRT use.

Need to find Prempro 0.45/1.5 28 Day at a pharmacy? Search on Medfinder to check stock and prices near you.