Prempro 0.625/2.5 28 Day is a prescription combination hormone replacement therapy (HRT) tablet containing 0.625 mg of conjugated estrogens and 2.5 mg of medroxyprogesterone acetate, taken once daily to treat moderate to severe menopause symptoms and help prevent postmenopausal osteoporosis in women with an intact uterus.

What Is Prempro 0.625/2.5 28 Day?

Prempro is a brand-name medication made by Pfizer (originally Wyeth). It combines two hormones in a single tablet:

• Conjugated estrogens (0.625 mg): A blend of estrogens that replaces the estrogen your body stops making after menopause.
• Medroxyprogesterone acetate (2.5 mg): A progestin that protects your uterine lining from the overgrowth that estrogen alone can cause.

This combination is specifically designed for women who still have their uterus. Women who have had a hysterectomy typically take estrogen alone (such as Premarin) instead.

Prempro uses a continuous combined regimen — you take one tablet every day with no break or placebo days. Each pack contains 28 tablets, providing one month of therapy.

For a plain-English explanation of how these hormones work in your body, see: How Does Prempro Work? Mechanism of Action Explained.

What Is Prempro Used For?

Prempro 0.625/2.5 28 Day is FDA-approved for two main uses:

1. Treatment of Menopause Symptoms

The primary use is treating moderate to severe vasomotor symptoms — the medical term for hot flashes, night sweats, and flushing. These symptoms happen because your body's estrogen levels drop significantly during and after menopause. Prempro replaces some of that lost estrogen to reduce the frequency and severity of these episodes.

2. Prevention of Postmenopausal Osteoporosis

Estrogen helps maintain bone density. After menopause, declining estrogen levels can lead to bone thinning (osteoporosis) and increased fracture risk. Prempro can help prevent bone loss, but the FDA recommends it only for women at significant risk of osteoporosis when non-estrogen treatments aren't appropriate.

Off-Label Uses

Some doctors prescribe Prempro off-label for vulvovaginal atrophy symptoms (vaginal dryness, painful intercourse) or premature ovarian insufficiency. However, lower-dose or local estrogen products are usually preferred for vaginal symptoms.

How Is Prempro Taken?

Taking Prempro is straightforward:

• Take one tablet by mouth daily
• Take it at the same time each day
• You can take it with or without food (taking it with food may help if you experience nausea)
• There are no placebo days — take one tablet every day of the 28-day pack
• When you finish one pack, start the next one the following day

If you miss a dose, take it as soon as you remember. If it's almost time for your next dose, skip the missed one — don't double up. Setting a daily alarm or keeping your pack next to something you do every day (like brushing your teeth) can help you remember.

Available Strengths

Prempro comes in several strength combinations:

• 0.3 mg / 1.5 mg
• 0.45 mg / 1.5 mg
• 0.625 mg / 2.5 mg (this formulation)
• 0.625 mg / 5 mg

Your doctor will prescribe the lowest dose that effectively controls your symptoms. If the 0.625/2.5 strength isn't managing your symptoms, your doctor may adjust to a different strength.

Who Should Not Take Prempro?

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

• Known or suspected breast cancer, or a history of breast cancer
• Known or suspected estrogen-dependent tumors
• Active or past blood clots (DVT, pulmonary embolism) or arterial clots (stroke, heart attack)
• Active liver disease or liver dysfunction
• Undiagnosed abnormal vaginal bleeding
• Known clotting disorders (protein C, protein S, or antithrombin deficiency)
• Allergy to any ingredient in Prempro
• Pregnancy (Category X — can cause birth defects)

It's also important to know that Prempro carries boxed warnings about increased risks of cardiovascular disease, breast cancer, and dementia. For a full breakdown, read our side effects guide.

Make sure your doctor knows about all your medications and supplements — some can interact with Prempro. See our drug interactions guide for details.

How Much Does Prempro Cost?

The cost of Prempro 0.625/2.5 28 Day varies depending on whether you get the brand or generic, and whether you use insurance or a discount card:

The generic version — conjugated estrogens/medroxyprogesterone acetate — contains the same active ingredients and is significantly cheaper. Most insurance plans cover the generic at a Tier 1 copay.

If cost is a barrier, there are several ways to save:

• Pfizer RxPathways: Pfizer's patient assistance program for uninsured or underinsured patients
• Discount cards: GoodRx, SingleCare, and other platforms offer coupons that can bring the generic down to $30-$70
• Insurance: Most plans cover Prempro, especially the generic, with typical Tier 1 or Tier 2 copays

For more strategies, visit our complete guide: How to Save Money on Prempro 0.625/2.5 28 Day.

Final Thoughts

Prempro 0.625/2.5 28 Day is a well-established hormone replacement therapy that helps millions of women manage menopause symptoms and protect their bones. It's taken once daily, comes in multiple strengths, and has an affordable generic option available.

Like all hormone therapies, it carries real risks — especially for cardiovascular events and breast cancer. That's why it's important to use the lowest effective dose for the shortest time needed, and to have regular check-ups with your doctor.

If you're having trouble finding Prempro at your pharmacy, use our stock-finding tools or check if the pharmacy has it in stock online. And if you're wondering whether Prempro is right for you, our guide on finding a doctor who prescribes Prempro can help you take the first step.