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Premarin dosage: A detailed guide

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Doctors prescribe Premarin for symptoms of menopause and certain hormone-related conditions. The dosage and how you administer the drug depends on the form you’re prescribed.
Medically reviewed by Brittany A. Duke, PharmD, RPh
Updated on November 17, 2023

This article describes Premarin’s dosages and strengths and gives details on how to use it. You’ll also find information on cost savings and coupon options for Premarin. If you want to know more about Premarin, see this overview article. It covers details about the drug’s uses and side effects, ways to save on cost, and more.

Premarin is a brand-name medication that comes as an oral tablet, vaginal cream, and injection. It is not available in a generic version. This article describes dosages of Premarin.

Boxed warnings

This drug has boxed warnings about the risk of certain cancers and dementia. It also has a boxed warning about the risk of serious heart or blood vessel conditions, such as stroke and blood clots. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

See the end of this article for more information about these warnings.

Forms and strengths of Premarin

Premarin comes in these forms and strengths:

FormHow to useStrengths
oral tablettake by swallowing• 0.3 milligrams (mg)
• 0.45 mg
• 0.625 mg
• 0.9 mg
• 1.25 mg
vaginal creaminsert into the vagina 0.625 mg per gram (g)
injectioninjected into your vein or muscle by a healthcare professional• 25 mg per vial

Dosage of Premarin

This article describes the recommended dosages for Premarin. The drugmaker provides these dosages.

If your doctor prescribes this medication, you should follow the dosage they prescribe. Your doctor will determine the dosage that best meets your needs. Do not change your dosage of Premarin without your doctor’s recommendation.

Usual recommended dosages of Premarin in adults

Usually, doctors start by prescribing a low dosage of Premarin. Then, they’ll adjust it over time until the right dosage is reached. Ultimately, your doctor will prescribe the smallest dosage of Premarin that gives the desired outcome.

Dosage of Premarin oral tablet

The following table outlines the recommended dosages of Premarin oral tablet in milligrams (mg).

PurposeRecommended dosage
treatment of menopausal symptoms0.3 mg once per day*
treatment of low estrogen levels caused by hypogonadism0.3–0.625 mg once per day†
treatment of low estrogen levels caused by ovarian failure or ovarian removal1.25 mg once per day†
palliative care for breast cancer10 mg three times per day for at least 3 months
palliative care for prostate cancer1.25–2.5 mg three times per day
prevention of osteoporosis0.3 mg once per day

* Your doctor may prescribe Premarin oral tablet every day or in cycles. An example of a cycle is 0.3 mg once per day for 25 days, followed by no medication for 5 days.
† Your doctor will prescribe Premarin oral tablet in cycles.

Dosage of Premarin vaginal cream

The following table outlines the recommended dosages of Premarin vaginal cream in grams (g).

PurposeRecommended dosages
treatment of vaginal dryness and vaginal thinningInsert 0.5 g once per day for 21 days, then insert no cream for 7 days. Repeat this cycle as prescribed.
treatment of painful intercourse due to menopauseInsert 0.5 g twice per week.

Dosage of Premarin injection

The recommended dosage of Premarin injection is 25 milligrams (mg) as a single dose. This injection will be given to you by your doctor or a healthcare professional.

If needed, the dose may be repeated in 6–12 hours.

Dosage adjustments for Premarin

Your doctor will prescribe a dosage of Premarin based on several factors. These include:

  • the specific condition being treated and how severe it is
  • your age
  • other health conditions you may have

Missed dose of Premarin

Talk with your doctor or pharmacist right away if you realize you forgot to take a dose of Premarin. They may advise you to take the missed dose. Or they may advise you to skip it and take your next dose as scheduled.

For tips on how to plan your doses of Premarin and avoid missing a dose, read this article. You could also try:

  • downloading a reminder app on your phone
  • setting an alarm
  • putting a note where you’ll see it, such as on your calendar, bathroom mirror, or bedside table

Frequently asked questions

Below are answers to some commonly asked questions about Premarin and its dosage.

What is the recommended highest dose and lowest dose of Premarin?

The recommended doses differ depending on the form of Premarin you’re prescribed. The following table contains the recommended highest dose and lowest dose of Premarin, based on the form in milligrams (mg).

FormHighest recommended dosageLowest recommended dosage
Premarin oral tablet10 mg three times per day0.3 mg once per day
Premarin vaginal cream0.5 g twice per week0.5 g once per day
Premarin injection25 mg as a single dose25 mg as a single dose

Keep in mind the highest dose that’s recommended for you may vary based on the condition being managed. If you have questions about the right Premarin dosage for you, talk with your doctor.

Is Premarin taken long term?

Possibly. Doctors typically prescribe Premarin as a long-term treatment for:

It’s recommended for short-term use when prescribed for unusual uterine bleeding. Premarin can be used as short-term or long-term treatment in people with breast or prostate cancer.

If you have questions about how long you should use Premarin, talk with your doctor.

How Premarin is taken

You’ll swallow Premarin oral tablet one to three times per day, depending on what you’re taking it for. Your doctor may prescribe the drug to be taken every day or in cycles. You can take the drug with or without food.

Premarin vaginal cream should be inserted into the vagina using the applicator once per day or twice per week. Your doctor may prescribe the drug to be applied every day or in cycles.

Premarin injection is given by a doctor or another healthcare professional, who will inject a dose of Premarin into a vein or muscle.

Your doctor may advise that you take this medication around the same time each day. This helps keep a consistent amount of the drug in your body and makes it work more effectively.

The drugmaker hasn’t specified whether Premarin oral tablet can be cut, crushed, or dissolved. If it’s hard for you to swallow tablets, view this article. It provides suggestions on how to swallow medications that come in pill form.

Also, be sure to talk with your doctor or pharmacist if you’re having difficulty taking your medication. They can offer recommendations about taking it.

Premarin coupon

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Overdose of Premarin

It’s important that you do not use more Premarin than your doctor prescribes. Doing so can lead to harmful effects.

Symptoms of Premarin overdose

Symptoms of an overdose can include:

What to do if you use too much Premarin

If you think you’ve used too much Premarin, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have severe symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

What to ask your doctor

This article describes the usual recommended dosages for Premarin. If your doctor prescribes this medication, they’ll determine the dosage that’s best for you.

Do not change your dosage of Premarin without your doctor’s recommendation. You should take Premarin exactly as your doctor prescribes it. Let your doctor know if you have concerns or questions about your treatment plan.

Here’s a list of some possible questions you may want to ask your doctor:

  • Which form will work best to treat symptoms of menopause: Premarin oral tablet or Premarin vaginal cream?
  • How long will I be using Premarin?
  • How does the dosage of Premarin compare with other medications for my condition?

Boxed warnings for Premarin

This drug has boxed warnings about the risk of certain cancers and dementia. It also has a boxed warning about the risk of serious heart or blood vessel conditions, such as stroke and blood clots. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

Risk of certain cancers. Premarin can increase the risk of endometrial (uterine) cancer in females* with a uterus. The risk increases the longer you use Premarin. To lower this risk, your doctor will likely prescribe a progestin medication to use with Premarin. However, taking Premarin and progestin medications together can increase your risk of breast cancer. For this reason, your doctor will likely only prescribe Premarin at the lowest effective dosage. And they’ll likely also prescribe it for the shortest amount of time needed.

Be sure to discuss any symptoms of endometrial cancer with your doctor. These can include:

Risk of serious heart and blood vessel events, such as stroke and blood clots. Premarin can increase your risk of heart attack, stroke, and blood clots, including deep vein thrombosis and pulmonary embolism. Your doctor will likely not prescribe Premarin if you have a history of blood clots or certain heart problems.

If you have signs or symptoms of a heart attack, stroke, or blood clot, call 911 or your local emergency number right away for medical help. These can include:

Risk of dementia. Premarin may increase your risk of dementia, especially if you’re a female* age 65 years or older and have gone through menopause. Be sure to discuss any changes to your memory or concentration with your doctor.

You can also talk with your doctor to learn more.

*Sex and gender exist on spectrums. In this article, we use the term “female” to refer to a person’s sex assigned at birth.

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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