Premarin

Premarin is a form of hormone replacement therapy (HRT) containing estrogens. It is used to treat some of the effects of the menopause. If you would like to purchase HRT, simply complete a 2 minute online consultation and our UK registered doctors will review your answers, before issuing a prescription if appropriate. Our NHS registered pharmacy will dispense and dispatch your medicine in discreet packaging.

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Quantity Strength Price
84 tablets1.25mg£21.99
84 tablets300mcg£21.99
84 tablets625mcg£21.99
Prices exclude a prescription fee. Find out more

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About

What is Premarin?

Premarin is a type of hormone replacement therapy (HRT) containing a mixture of hormones known as conjugated oestrogens. It works by supplementing the body’s natural oestrogen levels to relieve the symptoms of menopause and prevent the onset of osteoporosis. 

How does Premarin work?

During menopause, the amount of oestrogen produced by a woman’s ovaries decreases, resulting in symptoms such as mood swings, hot flushes and night sweats, vainal dryness and a weakening of the bones known as osteoporosis. Premarin contains a mixture of hormones known as coagulated oestrogens and works by supplementing the body’s natural oestrogen levels, relieving the symptoms of menopause and preventing the onset of osteoporosis. Oestrogen supplements also stimulate the grown of the womb lining which, if left to build up, can lead to endometrial hyperplasia (excessive growth of the womb lining), endometrial cancer or endometriosis (growth of the womb lining outside of the womb). Therefore, premarin is only suitable for use in women who have had a hysterectomy, or who have an intrauterine system (IUS) fitted, which provides a flow of progesterone to counteract excessive growth of the womb lining.  

Ingredients

Active ingredients

The active ingredient in Premarin is a mixture of hormones called conjugated oestrogens.

Inactive ingredients

The inactive ingredients in Premarin are lactose monohydrate, microcrystalline cellulose, magnesium stearate, hypromellose, sucrose, hydroxypropyl cellulose, macrogol, camauba wax, edible ink and coating.

Premarin 0.3 mg also contains hypromellose, titanium dioxide (E171), propylene glycol (E1520), quinoline yellow (E104), indigo carmine (E132), macrogol and polysorbate 80.

Premarin 0.65 mg also contains hypromellose, titanium dioxide (E171), propylene glycol (E1520), red aluminium lake (E129) indigo carmine (E132) and macrogol.

Premarin 1.25 mg also includes hypromellose, iron oxide black (E172), propylene glycol (E1520), hypromellose, titanium dioxide (E171) quinoline yellow (E104), sunset yellow (E110) macrogol and polysorbate 80.
 

Dosage

How to use Premarin

You should always take Premarin as recommended by a doctor or pharmacist.

If you are not already taking an alternative form of HRT, you can start premarin at any time. If you are already taking another form of HRT, finish the pack and start the pack of premarin without leaving a break. If your current HRT gives you a monthly beed, start Premarin on the day after your bleed stops.

Take on tablet a day at the same time each day. Try and make this a part of your routine to help you remember - for example, take your daily tablet when you brush your teeth in the morning. When you finish a pack, start the next pack on the following day without taking a break.

If you forget to take a tablet, try and remember to take it within 12 hours. If 12 have already passed, just skip the dose and take your next one at the normal time. Women who have not had a hysterectomy my experience some light bleeding or spotting in this instance, but this is nothing to worry about. Never take a double dose to make up for a missed one.
 

Premarin dosage

Premarin comes in three different doses: 0.3 mg conjugated oestrogens, 0.65 mg conjugated oestrogens and 1.25 mg conjugated oestrogens. A doctor will always prescribe the lowest dose possible for the patient. The recommended starting dose for menopause is 0.3 mg per day, while the usual dose for the prevention of osteoporosis is 0.65 mg per day.

Side Effects

Premarin side effects

Like all medications, some people may experience side effects when taking this medication. Reported side effects include:

  • Migraines or headaches
  • Dizziness
  • Changes in mood, anxiety, depression or irritability
  • Joint pain or leg cramps
  • Increase or decrease in sex drive
  • Visible swelling of the face or ankles
  • Rash, itchiness, acne, or dark/red patches on the skin
  • Changes in hair growth (loss or increase)
  • Minor changes to the eye
  • Changes in weight
  • Changes in triglyceride levels
  • Intolerance to glucose
  • Memory loss
  • A worsening of chorea (neurological disorder characterised by involuntary spasmodic movements of the body
  • Worsening of asthma
  • Worsening of hypocalcemia
  • Gallbladder disease or jaundice
  • Growth of benign meningioma
  • Inflammation of the colon, which may be characterised as pain in the lower left side of the abdomen and/or bloody diarrhoea
  • Signs of angioedema, characterised by generalised swelling in parts of the body.

Speak to your doctor for advice if you are worried about any side effects of this medication.

Contraindications

Always consult a doctor before starting this medication. You should NOT take premarin if:

  • You are allergic to any of the ingredients in this medication
  • You have, have had or are suspected of having breast cancer
  • You have, have had or are suspected of having an oestrogen-sensitive cancer
  • You have unexplained vaginal bleeding
  • You have endometrial hyperplasia (excessive thickening of the womb lining) that is not being treated
  • If you have ever had a thrombosis (bod clot in the vein)
  • You have or have recently had angina, a heart attack, or any other disease caused by blood clots in the arteries
  • You have or have ever had liver disease
  • You have porphyria 
  • You are pregnant or breastfeeding

Before taking Premarin, you should inform your doctor and go for regular check-ups if you have ever had any of the following:

  • Fibroids inside your womb
  • Endometriosis (growth of the womb lining outside of the womb) or endometrial hyperplasia (excessive growth of the womb lining)
  • Increased risk of developing blood clots
  • Increased risk of developing oestrogen-sensitive cancer
  • High blood pressure
  • Heart disease
  • A liver disorder
  • Kidney disease
  • Fluid retention due to cardiac or kidney problems
  • Diabetes
  • Gallbladder disease or gallstones
  •  Migraines or severe headaches
  • Systemic lupus erythematosus (SLE), a disease of the immune system affecting many organs of the body
  • Epilepsy
  • Asthma
  • Otosclerosis (a disease affecting the eardrum and hearing
  • Hypocalcaemia (low blood calcium levels)
  • Triglycerides (a very high level of fat in your blood)

Drug interactions

Before taking Premarin, tell your doctor if you are taking any other medication, including those bought over the counter without a prescription. In particular, tell your doctor if you are taking any of the following:

  • Epilepsy medication such as phenobarbital, phenytoin and carbamazepine
  • Tuberculosis medication such as rifampicin and rifabutin
  • HIV medication such as nevirapine, efavirenz, ritonavir and nelfinavir
  • Antibiotics or antifungal medications such as erythromycin, clarithromycin, ketoconazole, itraconazole
  • Medication containing St John’s wort
  • Metyrapone
  • Cimetidine
  • Dexamethasone

Treatment Options

Alternatives to HRT

HRT is the most accessible and effective treatment for the symptoms of menopause. It can be accessed on prescription through the NHS and online at Dr Felix. Herbal supplements are another popular choice for relieving symptoms such as hot flushes and mood swings, although their effectiveness in unknown. It is important to speak to a doctor or pharmacist about the contents and effects of herbal supplements before trying them.

Premarin cream vs tablets

Premarin comes in both tablet form (to be taken orally) and in the form of a cream that is applied topically to the vaginal area. While both contain conjugated estrogens, Premarin vaginal cream only helps relieve symptoms of menopause local to the vaginal area, such as dryness and pain during sex. 

It is of note that Premarin cream has a weakening effect on latex condoms. Speak to your doctor about alternative means of contraception whilst using this medication.
 

Premarin vs other types of HRT

HRT is available in many different forms and brands, and your doctor will be able to help you choose which is right for you. Premarin is an oestrogen-only type of HRT and is therefore only suitable for use in women who have had a hysterectomy, have an IUS fitted, or who are regularly taking a progesterone supplement. Elleste Solo is the other oral form of oestrogen-only HRT available form Dr Felix, and is also available in the form of transdermal patches. Elleste Solo MX80, Elleste Solo MX40 and Evorel patches are applied to the skin and changed twice a week, by passing the digestive system and transferring an oestrogen supplement directly to the bloodstream.


Women who still have a womb and who do not have an IUS will require a form of HRT containing both an oestrogen and a progesterone supplement, such as Climesse, Elleste Duet, Elleste Duet Conti and Kliovance. Elleste Duet is suitable in women going through menopause who have had a natural period in the past 12 months, and allows for a monthly bleed at the end of each pack. Alternatively, tibolone (brand name Livial) is a synthetic steroid which mimics the actions of oestrogen and progesterone in the body, and is thought to carry a slightly lower risk of breast cancer.

Lifestyle changes to improve menopause symptoms

Making a few simple lifestyle changes can help you to manage the symptoms of menopause, as well as increasing the effectiveness of HRT. Cutting down on caffeine, alcohol and spicy food can help reduce the impact of hot flushes, as can quitting smoking. To keep your bones healthy and strong, exercise regularly and increase your intake of vitamin D, which is vital in the production of calcium. For those experiencing vaginal dryness, a range of moisturisers and lubricants can be purchased from any pharmacy with the advice of a pharmacist.

Q&A

Will Premarin help with hot flushes?

Hot flushes are a common symptom of menopause which, for some women, can be unbearable. Experts believe they are caused by the drop in oestrogen levels, which causes the hypothalamus (the part of the brain which regulates body temperature) to detect too much heat. The hypothalamus then signals the heart rate to rise and blood vessels to dilate in order to dissipate the heat, resulting in a feeling of overwhelming heat and sweats.

By supplementing the body’s natural oestrogen levels, Premarin prevents oestrogen levels from falling and effectively prevents hot flushes.
 

Will Premarin improve my libido?

A drop in oestrogen levels can cause some women to lose their sex drive. The symptoms of menopause are different for everyone, but supplementing oestrogen is a recommended way of preventing the drop in libido that accompanies menopause.

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