Prempro side effects and how to avoid them

Prempro is a brand-name medication manufactured by Wyeth Pharmaceuticals Inc. It is classified as a hormone replacement therapy and is used to treat the symptoms of menopause. While Prempro is generally well tolerated, there are some potential side effects that people should be aware of. The most common side effects of Prempro include breast pain and tenderness. Less common, but more serious side effects, can include blood clots.

Learn more about the side effects of Prempro and what you can do to avoid them.

What is Prempro?

Prempro is given to women who are going through menopause or who have been through menopause. It used to treat:

  • Moderate to severe night sweats, hot flashes, and hot flushes (vasomotor symptoms) caused by the menopause
  • Moderate to severe vaginal dryness, inflammation, and pain (vaginal atrophy) caused by the menopause
  • Thinning and weakening of your bones (osteoporosis) caused by the menopause

If you’re going through menopause, or have gone through it, and you have symptoms like hot flushes and flashes, vaginal atrophy, or you are at risk of osteoporosis, your doctor may have prescribed Prempro to you. Prempro is a hormone replacement therapy that replaces lost estrogen and progesterone, easing your symptoms and reducing your risk of osteoporosis.

How does Prempro work?

Prempro contains two types of active ingredients, conjugated estrogens, and medroxyprogesterone acetate (a progestin). Conjugated estrogens are a mixture of purified versions of the hormone estrogen and medroxyprogesterone acetate is a form of the hormone progesterone. You can think of Prempro as helping to top up the estrogen and progesterone your body has lost during menopause. This helps to ease your symptoms.

Prempro dosage

Prempro is available in tablet form containing conjugated estrogens (CE) and medroxyprogesterone acetate (MPA), in the following doses: 0.3 mg CE and 1.5 mg MPA, 0.45 mg CE and 1.5 mg MPA, 0.625 mg CE and 2.5 mg MPA, 0.625 mg CE and 5 mg MPA.

Take Prempro as tablets once a day at the same time each day. You are advised to read the medication guide provided with this medicine for the drug information and patient information, and always speak with your healthcare provider for medical advice about any changes to your dose so they can monitor and evaluate your condition.

What are Prempro side effects?

The most common side effects caused by Prempro include:

  • Headaches
  • Back pain
  • Nausea, vomiting
  • Stomach pain and bloating
  • Abdominal pain
  • Fluid retention
  • Hair loss
  • Breast pain
  • Breast tenderness
  • Irregular vaginal bleeding or spotting
  • An increase in vaginal yeast infections
  • Less common side effects – menorrhagia, hematuria, urinary incontinence, urinary tract infection, and vaginal dryness

In rare instances, Prempro can cause more serious side effects, such as:

  • Severe headaches
  • Severe allergic reactions
  • An increased risk of breast cancer, ovarian cancer, or endometrial cancer
  • Enlargement of benign tumors of the uterus (called fibroids)
  • An increased risk of heart attacks, strokes, deep vein thrombosis, and pulmonary embolism – symptoms include chest pains or pains in your legs, trouble breathing, shortness of breath, weakness, and fatigue
  • An increased risk of dementia and depression
  • An increased risk of gallbladder disease
  • High blood pressure
  • High blood sugar
  • Liver problems – jaundice (yellowing of the skin or eyes)
  • Pancreatitis (inflammation of the pancreas)

If you experience any of these serious side effects, stop taking Prempro and seek medical attention immediately. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit, or call 1-800-FDA-1088.

What are the long-term side effects of Prempro?

Prempro can increase the risk of heart attacks, stroke, blood clots in the legs or lungs, breast cancer, or cancer of the ovaries in postmenopausal women. The risk of side effects will depend on the strength of the HRT taken and how long it has been used.

Prempro drug interactions

Prempro can interact with other medications. When this occurs, it can change how Prempro and the other medications work, as well as make some side effects more likely. It is important to tell your prescribing doctor about all drugs you’re taking, including vitamins, and herbal and dietary supplements, particularly:

  • Any other hormone therapy medications
  • Any antibiotics taken to treat bacterial infections, including rifampin, clarithromycin, or telithromycin
  • Any antifungal medications taken to treat fungal infections, including ketoconazole and itraconazole
  • Any anticonvulsant medications taken to reduce the chances of you having seizures, like carbamazepine, phenobarbital, or phenytoin
  • Any antiviral medications you take to treat an HIV infection, including ritonavir, atazanavir, indinavir, saquinavir, or nelfinavir
  • St. John’s wort
  • Grapefruit or grapefruit juice

Prempro warnings & precautions

Prempro isn’t suitable for everyone. Don’t take Prempro if you:

  • Are allergic to estrogen
  • Are allergic to the other active ingredient called medroxyprogesterone acetate
  • Are allergic to any of the other ingredients in Prempro
  • Have unusual vaginal bleeding
  • Have or have ever had breast cancer or uterine cancer
  • Have heart diseases such as heart attack or stroke
  • Have ever had a blood clot
  • Have any liver problems
  • Are pregnant, think you are pregnant or are planning to become pregnant – using this medicine while pregnant may harm your unborn baby
  • Are not a woman who has reached the menopause

Talk to your doctor before taking Prempro if you:

  • Are taking any of the medications that could interact with Prempro
  • Have vaginal bleeding of unknown cause
  • Have a family history of angioedema
  • Have high blood pressure
  • Have diabetes
  • Have an underactive thyroid
  • Have a high or low blood calcium level
  • Have gallbladder disease
  • Suffer from seizures or epilepsy
  • Have high cholesterol or triglyceride levels, or if you are overweight
  • Are breastfeeding or are planning to breastfeed
  • Are due to have surgery or will be on bed rest

You should always check with your doctor or pharmacist before taking any medication, including Prempro, to make sure it is safe for you.

Does taking Prempro make you gain weight?

There is no evidence that Prempro will cause you to gain weight, but weight gain may occur naturally during menopause, whether you are taking HRT or not.

How long can I take Prempro?

Treatment is normally for 2 to 3 years in most women to decrease symptoms of menopause.

Do Prempro side effects go away?

Some side effects of Prempro that do not need medical attention may go away within 3 months as your body adjusts to the treatment.

Does Prempro help with mood swings?

Hormone therapy helps most women with symptoms such as hot flashes, but will also help with mood, depression, and other emotional symptoms.

Can I take Prempro with ibuprofen?

Yes, as interactions were not found to occur between Prempro and ibuprofen.

Can I take Prempro if I’m pregnant?

Do not take Prempro if you are pregnant. Speak to your doctor immediately if you believe you are pregnant.

Does Prempro make you feel better?

Prempro will help manage symptoms of menopause, such as mood, weight gain, and hot flushes, but may cause more serious side effects, such as heart attacks and stroke.

How to avoid Prempro side effects

The best way to avoid side effects is to take Prempro as directed by your doctor. Follow your doctor’s instructions carefully and do not take more or less than prescribed.

If you experience any side effects, talk to your doctor or pharmacist. They may be able to recommend ways to help reduce or prevent some of the side effects.

1. Stick to the recommended dosage

Take your prescribed dose of Prempro that has been recommended by your healthcare professional. Do not take more or less than prescribed.

2. Monitor your blood sugar levels

If you have diabetes, it is important to monitor your blood sugar levels closely while taking Prempro. Check your blood sugar levels as directed by your doctor and report any changes to your doctor immediately.

3. Drink plenty of fluids

Drink eight to 10 glasses of water or fluids every day to help prevent dehydration, which can make side effects worse.

4. Avoid alcohol

Avoid drinking alcohol while taking Prempro as it can increase your risk of breast cancer.

5. Don’t skip meals

Eating regular meals and snacks will help to prevent low blood sugar levels (hypoglycemia).

6. Check your feet

If you have diabetes, check your feet for any cuts, sores, or redness regularly. Tell your doctor if you experience any problems with your feet while taking Prempro.

7. Know the signs and symptoms of Prempro side effects

Signs and symptoms of side effects include stomach pain, unusual vaginal bleeding, and breast tenderness. If you experience any of these symptoms speak to your doctor for medical advice.

8. Monitor your weight

Prempro may cause weight gain or weight loss. If you experience this side effect while taking Prempro, get medical advice from your doctor.

9. Tell your doctor about all medications you’re taking

Be sure to tell your doctor about all other medications you’re taking, including over-the-counter drugs, vitamins, and herbal supplements, as they can interact with Prempro.

10. Get regular medical check ups

It is important to get regular medical check ups and monitor your medical conditions. Your doctor will monitor your side effects and may adjust your dose of Prempro as needed.

Medically reviewed

A medical professional has reviewed this article.

Jamie Winn, PharmD
Jamie Winn, PharmD

Jamie Winn, PharmD

Medical Writer & Reviewer

Jamie Winn, PharmD

Medical Writer & Reviewer

Dr. Jamie Winn received his Doctor of Pharmacy in 2002 from the University of South Carolina College of Pharmacy, Columbia, SC. Jamie is a medical reviewer for NiceRx.

Share this page

Sources (3)

  1. WebMD - Prempro - Uses, Side Effects, and More

  2. - Prempro side effects

  3. FDA - highlights of prescribing information for Prempro

The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.