Comprehensive medication guide to Estradiol/Norethindrone including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
With insurance, most patients pay $10 to $45 per month as Estradiol/Norethindrone generics are usually covered as a Tier 2 or Tier 3 medication.
Estimated Cash Pricing
Without insurance, Estradiol/Norethindrone typically costs $50 to $200 per month depending on the formulation, though generic oral tablets can be found for as low as $15 to $50 with a discount card.
Medfinder Findability Score
55/100
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Estradiol/Norethindrone is a combination hormone replacement therapy (HRT) containing an estrogen (estradiol) and a progestin (norethindrone acetate). It is FDA-approved for the treatment of moderate-to-severe vasomotor symptoms (hot flashes) associated with menopause, moderate-to-severe vulvar and vaginal atrophy, and the prevention of postmenopausal osteoporosis.
It is available as oral tablets under brand names such as Activella, Amabelz, Lopreeza, and Mimvey, as well as a transdermal patch sold as CombiPatch. Generic versions are widely available for the oral formulations.
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Estradiol is a synthetic form of estrogen that replaces declining estrogen levels in postmenopausal women, relieving vasomotor symptoms like hot flashes and night sweats, and preventing bone loss that can lead to osteoporosis.
Norethindrone acetate is a progestin added to protect the uterine lining (endometrium) from the overgrowth that unopposed estrogen can cause. This combination reduces the risk of endometrial hyperplasia and endometrial cancer in women who still have a uterus.
The oral tablet is taken once daily, while the transdermal patch is applied twice weekly to deliver a steady dose of both hormones through the skin.
Oral tablet — tablet
1 mg estradiol / 0.5 mg norethindrone acetate
Oral tablet — tablet
0.5 mg estradiol / 0.1 mg norethindrone acetate
Transdermal patch (CombiPatch) — patch
0.05 mg/day estradiol / 0.14 mg/day norethindrone acetate
Transdermal patch (CombiPatch) — patch
0.05 mg/day estradiol / 0.25 mg/day norethindrone acetate
Estradiol/Norethindrone has a findability score of 55 out of 100, meaning it can be intermittently difficult to find in stock. The oral tablet formulations (generic Activella, Amabelz, Lopreeza, Mimvey) are generally available at most pharmacies, but the transdermal patch (CombiPatch) has experienced significant shortages tracked by ASHP.
Broader estrogen patch shortages in 2024–2025 were driven by increased prescribing after updated FDA guidance on hormone replacement therapy safety, combined with limited manufacturing capacity for transdermal systems. If your pharmacy is out of stock, try using Medfinder to locate nearby pharmacies that have it available, or ask your prescriber about switching between oral and patch formulations.
Estradiol/Norethindrone is commonly prescribed by:
Telehealth prescribing is also available for this medication through various online hormone therapy clinics.
No. Estradiol/Norethindrone is not a controlled substance and has no DEA scheduling. It is available by prescription only but does not carry the additional restrictions associated with controlled medications.
Common side effects of Estradiol/Norethindrone include:
Serious side effects (seek medical attention immediately):
Boxed Warning: Estrogen plus progestin therapy carries increased risks of cardiovascular disorders, breast cancer, and probable dementia in women 65 and older. Use the lowest effective dose for the shortest duration needed.
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Prempro (Conjugated Estrogens/Medroxyprogesterone Acetate)
another combined estrogen/progestin oral tablet for menopausal symptoms and osteoporosis prevention
Climara Pro (Estradiol/Levonorgestrel Transdermal Patch)
a combination estrogen/progestin patch applied once weekly
Bijuva (Estradiol/Progesterone Capsules)
a combination of estradiol and bioidentical progesterone in an oral capsule
Premphase (Conjugated Estrogens/Medroxyprogesterone)
a sequential estrogen/progestin regimen for menopause management
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CYP3A4 inducers
moderate(rifampin, carbamazepine, phenobarbital, phenytoin, St. John's Wort) — may decrease hormone levels, reducing effectiveness
CYP3A4 inhibitors
moderate(ketoconazole, itraconazole, erythromycin, ritonavir) — may increase hormone levels and side effects
Thyroid replacement therapy
moderateestrogen may increase thyroid-binding globulin, potentially requiring higher thyroid medication doses
Anticoagulants
moderate(warfarin) — estrogen may affect coagulation; INR monitoring is recommended
Lamotrigine
moderateestrogen/progestin combinations may decrease lamotrigine levels
Diabetes medications
moderateestrogen may affect glucose tolerance, requiring dose adjustments
Estradiol/Norethindrone is a well-established combination hormone replacement therapy that helps millions of postmenopausal women manage hot flashes, vaginal atrophy, and osteoporosis risk. While the oral generic tablets are generally available, the CombiPatch transdermal formulation has experienced shortages due to increased demand and limited manufacturing capacity.
If you're having trouble finding Estradiol/Norethindrone in stock at your pharmacy, use Medfinder to search nearby pharmacies for real-time availability. Generic oral tablets offer significant savings at $15 to $50 per month with discount cards. Always discuss formulation changes with your prescriber, and use the lowest effective dose for the shortest duration consistent with your treatment goals.
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