The drug Premarin is an estrogen medicine. It’s used in hormone replacement therapy (HRT) and acts as a conjugated equine estrogen (CEE).

Around 9 million women in the US take Premarin to treat the symptoms of menopause. This drug alleviates these symptoms, such as hot flashes and vaginal dryness. It replaces estrogen in a woman’s body who has estrogen deficiency.

Premarin Forms

Premarin is available in a range of oral tablet strengths, from 0.3 milligrams (mg) to 1.25 mg. While a 2 mg dose exists, it’s rarely prescribed. It’s also available as a vaginal cream. So, tablets and topical vaginal creams are the two most common forms of Premain.

A third but less common form is injection (a single 25mg dose), which is known for its rapid results. But it’s safer to take Premain in tablet form.

Precautions and Warnings with Premarin

These are the most important precautions for Premarin users:

  • Don’t smoke when you’re on Premarin
  • You may suffer from elevated blood pressure
  • It can worsen diseases like asthma, epilepsy, and migraine
  • This drug can make condoms and other rubber products ineffective
  • Some studies show that older women taking Premarin may develop dementia

Premarin Side Effects

Some common side effects of Premarin are:

  • Gallbladder disease
  • Headaches and dizziness
  • Depression and insomnia
  • Unusual vaginal discharge
  • Upset stomach (vomiting/nausea)
  • Breast pain, tenderness, or swelling
  • Pain in genitals, pelvis, breasts, and back

Cardiovascular Complications

In extreme cases, women taking or applying Premarin experience cardiovascular complications. Some users have reported developing rare cancers after using this medicine. In rare cases, dark patches may appear on your skin, and you’ll have to spend less time in the sun. Also, women using contact lenses can develop vision-related issues after taking Premarin.

Drug Interactions with Premarin

Premarin affects how your body processes other drugs. Also, different drugs may change the way your body uses Premarin. For this reason, you should tell your caregiver which drugs you are on before getting an estrogen recommendation.

It would help if you did not mix grapefruit juice with Premarin as well because grapefruits may increase estrogen plasma concentrations. Also, don’t use this drug when you’re breastfeeding since Premarin can decrease milk production and even pass into breast milk.

In general, Premarin is known to interact with these medicines:

Cost of Premain in the USA

Premarin tablets (30 tablets, 0.625mg dosage each) can cost around $211 at the lower end and over $273 at the higher end. If you buy Premarin vaginal tube, it will cost you $450 to $500 (for a 30g dosage).

Why is Premarin so expensive?

It’s made from the urine of pregnant mares, and there is a lot of research behind its manufacturing. Rigorous testing makes Premarin safe and effective enough to be sold as a brand-name drug.

Since the testing phase costs a lot, drug manufacturers can legally sell this drug exclusively for the next twenty years. Then, other brands can develop and sell generic versions.

Strengths and Dosages of Premarin

Premarin comes in multi-colored oval tablets with the brand name “PREMARIN” emblazoned on the body with the number indicating its dose (e.g., “0.3” for 0.3mg). You should take it orally without chewing, crushing, or breaking. It usually is available in these strengths for daily use or weekly consumption:

Dosage (mg)Color (oval-shaped)

Your doctor will prescribe you the strength tailored to your unique needs. Usually, women will get a starting dose of 0.3mg. A typical user will take this drug once per day or twice every week. The second-most commonly starting dose is 0.625mg. The tube comes in 14g and 30g dosages in neat pink or white-colored packaging.

Overdosing on Permarin can lead to tender breasts, drowsiness, pain in your abdomen, urine discoloration, and other side effects.

Premarin Alternatives

Premarin is available primarily as a name-brand drug. However, you can also buy conjugated estrogens (CEs) other than Premarin if they cost less than the branded version. Some doctor-approved Premarin alternatives are:

Premarin FAQs

What is Premarin used for?

Premarin treats the major symptoms of menopause and makes sexual intercourse less painful for women in their fifties and sixties. It’s a form of estrogen therapy for older females.

Therefore, women suffer from vaginal dryness, night sweats, hot flashes, thinning of the bones, and several other medical issues. It’s also used as used as a treatment for ovarian failure.

How long does Premarin stay in your system?

Premarin can stay active for 11 to 26 hours, depending on the dosage. But it should leave your body within 24 hours, especially if you haven’t used to cream but have taken Premarin orally.

What are the side effects of stopping Premarin?

Some common side effects of Premarin are:

  • Hair loss
  • Leg cramps
  • Nausea/vomiting
  • Break enlargement
  • Headaches and dizziness
  • Vaginal discharge
  • Dementia (in users aged 65+)

How is Premarin made?

Equine estrogens are the source of Premarin. The horses whose urine is used to produce this drug are called PMU horses. The very name of this drug means “pregnant mare urine,” where the first three letters PRE refer to “pregnant,” MA means “mare,” and RIN stands for “urine.”

How long does it take for Premarin cream to be absorbed?

It was believed that vaginal creams are absorbed instantly after application. However, it takes products like Premarin 15 to 30 minutes to be absorbed.

Showering two hours after applying this cream will help toward maximum absorption and allow these estrogens to travel into the user’s bloodstream through the vagina.

Is Premarin effective?

Yes, clinical studies have shown that Premarin makes sexual intercourse more enjoyable and less painful for menopausal women. One study from 2018 proves that even low doses of creams like Premarin applied twice a week, reduce vaginal dryness in just twelve weeks.

What is Premarin made from?

Premarin is made of estrogen hormones in a non-liquefying base. Urine samples extracted from pregnant mares are purified to get these conjugated estrogens. It’s a blend of sodium estrone sulfate and sodium equilin sulfate.

How do I apply Premarin cream?

You’ll administer Premarin in a cyclic routine, which means applying it daily for three weeks and then taking it off for the next seven days. You must apply this cream in this manner:

  • Remove the cap from the Premarin tube
  • Lie on your back
  • Draw up your knees
  • Insert the applicator into your vagina
  • Press on the plunger
  • Screw the applicator’s nozzle onto the tube
  • Finish up and take the applicator out

When should I take Premarin tablets?

If you are taking Premarin tablets, then please take them right after dinner; otherwise, it may upset your stomach.

Health experts recommend starting Premarin therapy after your last period. In case you don’t remember when you had your last period, you should begin taking Premarin on Monday. It’ll keep you on track.

Does Premarin work better at night?

It doesn’t matter whether you use Premarin in the morning or before sleeping. But you should always apply Premarin at the same time every day. Consistency is the key to getting the most out of this tablet and vaginal cream.

What are the major indications for Premarin?

Hot flashes and vaginal dryness are a few symptoms of menopause in women. Estrogen meds can treat these symptoms as they replace estrogen in the user’s body. That’s why women can take Premarin to treat any condition that causes estrogen deficiency, such as ovarian failure.

Can you apply Premarin to your face?

Yes, you can use Premarin as a facial cream and de-ageing agent. A study reveals that women in their fifties and sixties who used Premarin on their faces saw improvements in fine wrinkles.

IMPORTANT NOTE: The information provided here is for educational purposes only and is not intended to serve as medical advice, diagnosis, or treatment recommendations. It should not be taken as an endorsement of any specific medication or treatment. Individual health conditions and responses to treatment can vary greatly; therefore, this information should not be seen as a guarantee of safety, suitability, or effectiveness for any particular individual. Always consult with a healthcare professional for personalized medical advice and before making any decisions regarding your health or treatment plans.

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