Prempro

Prempro is an FDA-registered drug product whose active ingredient is CONJUGATED ESTROGENS AND MEDROXYPROGESTERONE ACETATE. It is labelled by Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc. taken by oral and marketed as a human prescription drug product. Identifiers on file: NDC 0046-1105, application NDA020527, label effective 20260428. This page reproduces the FDA-approved label text so you can check what a product is, who makes it and how it is supplied before discussing it with a pharmacist or prescriber.

Across FDA labelling, products containing CONJUGATED ESTROGENS AND MEDROXYPROGESTERONE ACETATE are most often described in connection with: treatment moderate, due menopause, severe vasomotor, vaginal atrophy, prevention postmenopausal, usage prempro, premphase estrogen, plus progestin. Wording differs between labels, and the full indications section on this page takes precedence when it is present.

1 INDICATIONS AND USAGE PREMPRO/PREMPHASE is an estrogen plus progestin indicated in a woman with a uterus for: • Treatment of Moderate to Severe Vasomotor Symptoms due to Menopause ( 1.1 ) • Treatment of Moderate to Severe Vulvar and Vaginal Atrophy due to Menopause ( 1.2 ) • Prevention of Postmenopausal Osteoporosis ( 1.3 ) 1.1 Treatment of Moderate to Severe Vasomotor Symptoms due to Menopause 1.2 Treatment of Moderate to Severe Vulvar and Vaginal Atrophy due to Menopause 1.3 Prevention of Postmenopausal Osteoporosis

2 DOSAGE AND ADMINISTRATION Use of estrogen-alone, or in combination with a progestin, should be with the lowest effective dose and for the shortest duration consistent with treatment goals and risks for the individual woman. Postmenopausal women should be re-evaluated periodically as clinically appropriate to determine if treatment is still necessary. PREMPRO: one tablet containing conjugated estrogens (CE) plus medroxyprogesterone acetate (MPA) taken orally once daily. ( 2 ) PREMPHASE: one maroon tablet containing 0.625 mg CE taken orally on days 1 through 14, and one light-blue tablet containing 0.625 mg CE plus 5.0 mg MPA taken orally on days 15 through 28. ( 2 ) 2.1 Treatment of Moderate to Severe Vasomotor Symptoms due to Menopause PREMPRO therapy consists of a single tablet to be taken orally once daily. PREMPHASE therapy consists of two separate tablets: one maroon 0.625 mg Premarin [conjugated estrogens (CE)] tablet taken daily on days 1 through 14 and one light-blue tablet containing 0.625 mg CE and 5 mg of medroxyprogesterone acetate (MPA) taken on days 15 through 28. 2.2 Treatment of Moderate to Severe Vulvar and Vaginal Atrophy due to Menopause PREMPRO therapy consists of a single tablet to be taken orally once daily. PREMPHASE therapy consists of two separate tablets: one maroon 0.625 mg CE tablet taken daily on days 1 through 14 and one light-blue tablet containing 0.625 mg CE and 5 mg MPA taken on days 15 through 28. When prescribing solely for the treatment of moderate to severe vulvar and vaginal atrophy, topical vaginal products should be considered. 2.3 Prevention of Postmenopausal Osteoporosis PREMPRO therapy consists of a single tablet to be taken orally once daily. PREMPHASE therapy consists of two separate tablets: one maroon 0.625 mg CE tablet taken daily on days 1 through 14 and one light-blue tablet containing 0.625 mg CE and 5 mg of MPA taken on days 15 through 28. When prescribing solely for the prevention of postmenopausal osteoporosis, therapy should only be considered for women at significant risk of osteoporosis and non-estrogen medications should be carefully considered.

4 CONTRAINDICATIONS PREMPRO and PREMPHASE are contraindicated in women with any of the following conditions: • Undiagnosed abnormal genital bleeding [see Warnings and Precautions (5.2) ] • Breast cancer or a history of breast cancer [see Warnings and Precautions (5.2) ] • Estrogen-dependent neoplasia [see Warnings and Precautions (5.2) ] • Active DVT, PE, or a history of these conditions [see Warnings and Precautions (5.1) ] • Active arterial thromboembolic disease (for example, stroke and MI), or a history of these conditions [see Warnings and Precautions (5.1) ] • Known anaphylactic reaction or angioedema with PREMPRO/PREMPHASE [see Warnings and Precautions (5.15 , 5.16 )] • Hepatic impairment or disease [see Warnings and Precautions (5.10) ] • Protein C, protein S, or antithrombin deficiency, or other known thrombophilic disorders • Undiagnosed abnormal genital bleeding ( 4 ) • Breast cancer or history of breast cancer ( 4 , 5.2 ) • Estrogen-dependent neoplasia ( 4 , 5.2 ) • Active DVT, PE, or a history of these conditions ( 4 , 5.1 ) • Active arterial thromboembolic disease (for example, stroke and MI), or a history of these conditions ( 4 , 5.1 ) • Known anaphylactic reaction or angioedema to PREMPRO/PREMPHASE ( 5.15 , 5.16 ) • Hepatic impairment or disease ( 4 , 5.10 ) • Protein C, protein S, or antithrombin deficiency, or other known thrombophilic disorders ( 4 )

6 ADVERSE REACTIONS The following serious adverse reactions are discussed elsewhere in the labeling: • Cardiovascular Disorders [see Boxed Warning , Warnings and Precautions (5.1) ] • Malignant Neoplasms [see Boxed Warning , Warnings and Precautions (5.2) ] In two prospective, randomized clinical studies, the most common adverse reactions >5% are abdominal pain, asthenia, back pain, headache, flatulence, nausea, depression, pruritus, breast pain, dysmenorrhea, and leukorrhea. ( 6.1 ) To report SUSPECTED ADVERSE REACTIONS, contact Pfizer Inc. at 1-800-438-1985 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch . 6.1 Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trial of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. In a 1-year clinical trial that included 678 postmenopausal women treated with PREMPRO and 351 postmenopausal women treated with PREMPHASE, the following adverse reactions occurred at a rate ≥ 1%, see Table 1 . Table 1: Treatment-Related Adverse Reactions at a Frequency ≥1% Body System PREMPRO 0.625 mg/2.5 mg continuous PREMPRO 0.625 mg/5 mg continuous PREMPHASE 0.625 mg/5 mg sequential Adverse event (n = 340) (n = 338) (n = 351) Body As A Whole Abdominal pain 35 (10%) 51 (15%) 58 (17%) Asthenia 13 (4%) 18 (5%) 21 (6%) Back pain 19 (6%) 16 (5%) 23 (7%) Chest pain 5 (1%) 4 (1%) 4 (1%) Flu syndrome 1 (<1%) 1 (<1%) 4 (1%) Generalized edema 12 (4%) 12 (4%) 8 (2%) Headache 64 (19%) 52 (15%) 66 (19%) Infection 2 (<1%) 4 (1)% 0 Moniliasis 4 (1%) 3 (<1%) 4 (1%) Pain 12 (4%) 14 (4%) 15 (4%) Pelvic pain 11 (3%) 13 (4%) 16 (5%) Cardiovascular System Hypertension 7 (2%) 7 (2%) 6 (2%) Migraine 6 (2%) 8 (2%) 7 (2%) Palpitation 2 (<1%) 3 (<1%) 4 (1%) Vasodilatation 2 (<1%) 7 (2%) 2 (<1%) Digestive System Diarrhea 4 (1%) 3 (<1%) 7 (2%) Dyspepsia 5 (1%) 5 (1%) 7 (2%) Eructation 0 2 (<1%) 4 (1%) Flatulence 25 (7%) 27 (8%) 24 (7%) Increased appetite 1 (<1%) 5 (1%) 5 (1%) Nausea 26 (8%) 19 (6%) 26 (7%) Metabolic and Nutritional Edema 5 (1%) 6 (2%) 3 (<1%) Glucose tolerance decreased 2 (<1%) 5 (1%) 4 (1%) Peripheral edema 11 (3%) 10 (3%) 11 (3%) Weight gain 9 (3%) 10 (3%) 11 (3%) Musculoskeletal System Arthralgia 6 (2%) 2 (<1%) 7 (2%) Leg cramps 8 (2%) 11 (3%) 12 (3%) Nervous System Depression 14 (4%) 26 (8%) 29 (8%) Dizziness 9 (3%) 8 (2%) 7 (2%) Emotional lability 5 (1%) 5 (1%) 6 (2%) Hypertonia 4 (1%) 4 (1%) 7 (2%) Insomnia 7 (2%) 6 (2%) 4 (1%) Nervousness 4 (1%) 9 (3%) 6 (2%) Skin and Appendages Acne 1 (<1%) 5 (1%) 4 (1%) Alopecia 3 (<1%) 4 (1%) 0 Dry skin 2 (<1%) 3 (<1%) 4 (1%) Pruritus 20 (6%) 18 (5%) 13 (4%) Rash 8 (2%) 6 (2%) 7 (2%) Sweating 2 (<1%) 4 (1%) 2 (<1%) Urogenital System Breast engorgement 5 (1%) 5 (1%) 0 Breast enlargement 14 (4%) 14 (4%) 14 (4%) Breast neoplasm 2 (<1%) 2 (<1%) 4 (1%) Breast pain 110 (32%) 123 (36%) 109 (31%) Cervix disorder 10 (3%) 6 (2%) 10 (3%) Dysmenorrhea 26 (8%) 18 (5%) 44 (13%) Leukorrhea 19 (6%) 13 (4%) 29 (8%) Menstrual disorder 7 (2%) 1 (<1%) 5 (1%) Menorrhagia 0 1 (<1%) 5 (1%) Metrorrhagia 13 (4%) 5 (1%) 7 (1%) Papanicolaou smear suspicious 5 (1%) 0 8 (2%) Urinary incontinence 4 (1%) 2 (<1%) 1 (<1%) Uterine spasm 7 (2%) 4 (1%) 7 (2%) Vaginal hemorrhage 5 (1%) 3 (<1%) 8 (2%) Vaginal moniliasis 5 (1%) 6 (2%) 7 (2%) Vaginitis 13 (4%) 13 (4%) 10 (3%) In addition, phargyngitis and sinusitis were reported as two of the more frequent adverse events (>5%) in the PREMPRO clinical study. For pharyngitis, of the 121 events, six events were considered by the investigator causally related to study drug. For sinusitis, of the 73 events, one event was considered as casually related to study drug. During the first year of a 2-year clinical trial with postmenopausal women between 40 and 65 years of age (88% Caucasian), 989 postmenopausal women received continuous regimens of PREMPRO, and 332 received placebo tablets. Table 2 summarizes adverse reactions that occurred at a rate ≥ 1% in at least 1 treatment group. Table 2: All Treatment-Related Adverse Reactions at a Frequency of ≥1% Body System Adverse event PREMPRO 0.625/2.5 continuous (N=331) PREMPRO 0.45/1.5 continuous (N=331) PREMPRO 0.3/1.5 continuous (N=327) PLACEBO daily (N=332) Any adverse event 214 (65) 208 (63) 188 (57) 164 (49) Body as a Whole Abdominal pain 38 (11) 33 (10) 24 (7) 21 (6) Asthenia 11 (3) 11 (3) 12 (4) 3 (1) Back pain 12 (4) 12 (4) 8 (2) 4 (1) Chest pain 4 (1) 2 (1) 1 (0) 2 (1) Generalized edema 7 (2) 5 (2) 6 (2) 8 (2) Headache 45 (14) 45 (14) 57 (17) 46 (14) Moniliasis 3 (1) 6 (2) 4 (1) 1 (0) Pain 9 (3) 10 (3) 17 (5) 14 (4) Pelvic pain 9 (3) 7 (2) 5 (2) 4 (1) Cardiovascular System Hypertension 2 (1) 3 (1) 1 (0) 5 (2) Migraine 11 (3) 8 (2) 5 (2) 3 (1) Palpitation 1 (0) 1 (0) 2 (1) 4 (1) Vasodilatation 0 3 (1) 1 (0) 5 (2) Digestive System Constipation 5 (2) 7 (2) 6 (2) 3 (1) Diarrhea 5 (2) 2 (1) 6 (2) 8 (2) Dyspepsia 10 (3) 9 (3) 6 (2) 14 (4) Flatulence 16 (5) 18 (5) 13 (4) 8 (2) Increased appetite 6 (2) 2 (1) 0 2 (1) Nausea 13 (4) 13 (4) 16 (5) 16 (5) Metabolic and nutritional Peripheral edema 7 (2) 8 (2) 4 (1) 3 (1) Weight gain 9 (3) 8 (2) 6 (2) 14 (4) Musculoskeletal System Arthralgia 2 (1) 3 (1) 3 (1) 5 (2) Leg cramps 13 (4) 7 (2) 10 (3) 4 (1) Nervous System Anxiety 5 (2) 4 (1) 1 (0) 4 (1) Depression 23 (7) 11 (3) 11 (3) 17 (5) Dizziness 3 (1) 8 (2) 6 (2) 5 (2) Emotional lability 10 (3) 10 (3) 9 (3) 8 (2) Insomnia 8 (2) 7 (2) 9 (3) 14 (4) Nervousness 6 (2) 3 (1) 4 (1) 6 (2) Skin and Appendages Acne 7 (2) 3 (1) 0 3 (1) Alopecia 1 (0) 6 (2) 4 (1) 2 (1) Pruritus 8 (2) 10 (3) 9 (3) 3 (1) Rash 0 6 (2) 4 (1) 2 (1) Skin discoloration 5 (2) 1 (0) 3 (1) 1 (0) Sweating 3 (1) 1 (0) 0 4 (1) Urogenital System Breast disorder 7 (2) 6 (2) 5 (2) 6 (2) Breast enlargement 18 (5) 9 (3) 5 (2) 3 (1) Breast neoplasm 8 (2) 7 (2) 5 (2) 7 (2) Breast pain 87 (26) 66 (20) 41 (13) 26 (8) Cervix disorder 7 (2) 2 (1) 2 (1) 0 Dysmenorrhea 14 (4) 18 (5) 9 (3) 2 (1) Hematuria 4 (1) 3 (1) 1 (0) 2 (1) Leukorrhea 7 (2) 14 (4) 9 (3) 6 (2) Metrorrhagia 7 (2) 14 (4) 4 (1) 1 (0) Urinary tract infection 0 1 (0) 1 (0) 4 (1) Uterine spasm 13 (4) 11 (3) 7 (2) 2 (1) Vaginal dryness 2 (1) 1 (0) 0 6 (2) Vaginal hemorrhage 18 (5) 14 (4) 7 (2) 0 Vaginal moniliasis 13 (4) 11 (3) 8 (2) 5 (2) Vaginitis 6 (2) 8 (2) 7 (2) 1 (0) In addition, the following events were considered as related to the study drug with an incidence less than 1%, including accidental injury, infection, myalgia, cough increased, rhinitis, sinusitis, and upper respiratory infection. 6.2 Postmarketing Experience The following adverse reactions have been identified during post-approval use of PREMPRO or PREMPHASE. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. Genitourinary System Abnormal uterine bleeding, dysmenorrhea or pelvic pain, increase in size of uterine leiomyomata, vaginitis, vaginal candidiasis, amenorrhea, changes in cervical secretion, ovarian cancer, endometrial hyperplasia, endometrial cancer. Breasts Tenderness, enlargement, pain, nipple discharge, galactorrhea, fibrocystic breast changes, breast cancer. Cardiovascular Deep and superficial venous thrombosis, pulmonary embolism, superficial thrombophlebitis, myocardial infarction, stroke, increase in blood pressure. Gastrointestinal Nausea, vomiting, abdominal pain, bloating, cholestatic jaundice, increased incidence of gallbladder disease, pancreatitis, changes in appetite, ischemic colitis. Skin Chloasma or melasma that may persist when drug is discontinued, erythema multiforme, erythema nodosum, loss of scalp hair, hirsutism, pruritus, urticaria, rash, acne. Eyes Retinal vascular thrombosis, intolerance of contact lenses. Central Nervous System Headache, migraine, dizziness, mental depression, exacerbation of chorea, mood disturbances, anxiety, irritability, exacerbation of epilepsy, dementia, growth potentiation of benign meningioma. Miscellaneous Increase or decrease in weight, arthralgia, glucose intolerance, edema, changes in libido, exacerbation of asthma, increased triglycerides, hypersensitivity. Additional postmarketing adverse reactions have been reported in patients receiving other forms of hormone therapy.

2 FDA recall record(s) match this product name or manufacturer. A match means the firm or product name appears in the enforcement report; confirm lot numbers and dates against the official FDA notice before acting.

What is Prempro used for?
1 INDICATIONS AND USAGE PREMPRO/PREMPHASE is an estrogen plus progestin indicated in a woman with a uterus for: • Treatment of Moderate to Severe Vasomotor Symptoms due to Menopause ( 1.1 ) • Treatment of Moderate to Severe Vulvar and Vaginal Atrophy due to Menopause ( 1.2 ) • Prevention of Postmenopausal Osteoporosis ( 1.3 ) 1.1 Treatment of Moderate to Severe Vasomotor Symptoms due to …

Who makes Prempro?
Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc. is the labeler of record for Prempro.

What form does Prempro come in?
administered by oral. Strengths and pack sizes vary by label, so compare the NDC on your pack with the identifier listed on this page.

Is Prempro prescription or over-the-counter?
The FDA label for this product is recorded as human prescription drug. Marketing status can differ between strengths and countries, so check the dispensing rules where you live.

Has Prempro been recalled?
2 FDA recall record(s) match this product name or manufacturer. Review the recall and safety notices section on this page and confirm lot numbers against the official FDA enforcement report.

Where does this information come from?
All content is reproduced from FDA Structured Product Labelling data via openFDA. It is provided for identification and reference only and is not medical advice.