Drug vs. Drug

Estrace vs Premarin: Main Differences and Similarities

By | June 25, 2019

Estrace and Premarin are two brand name products that are used as hormone replacement therapy (HRT) in women. They have similar uses to ease symptoms of menopause such as hot flashes and vaginal changes. However, Estrace contains estradiol and Premarin contains conjugated estrogens. Read on to learn about how these two medications differ.

Estrace

Estrace contains a form of estrogen called estradiol, an important female hormone that regulates several processes in the body. While it can help treat menopausal symptoms, it can also prevent osteoporosis in menopausal women. Sometimes, it is also used as part of cancer treatment in both men and women.

Estrace is available as an oral tablet or vaginal cream. Dosing will depend on your condition and your doctor’s instruction. Estrace can increase the risk of blood clots and should not be used in those with a history of cardiovascular disorders.

Premarin

Premarin is the brand name for conjugated estrogens. It contains a mix of estrogen hormones to produce its effects. Premarin is approved to treat menopausal symptoms, decrease the risk of osteoporosis, and treat certain cancers in men and women.

Premarin is available as an oral tablet, vaginal cream, and intravenous injection. Like other estrogens, dosing will depend on the condition being treated. Premarin can also increase the risk of blood clots in those with a history of cardiovascular disorders.

Estrace vs Premarin Side by Side Comparison

Estrace and Premarin are similar drugs that can treat similar conditions. Their differences and similarities can be found in the table below.

Estrace Premarin
Prescribed For
  • Hormone Replacement Therapy
  • Vaginal atrophy
  • Menopausal symptoms
  • Prevention of postmenopausal osteoporosis
  • Treatment of breast cancer
  • Treatment of prostate cancer
  • Hormone Replacement Therapy
  • Vaginal atrophy
  • Menopausal symptoms
  • Prevention of postmenopausal osteoporosis
  • Treatment of breast cancer
  • Treatment of prostate cancer
Drug Classification
  • Estrogen
  • Estrogen
Manufacturer
  • Allergan
Common Side Effects
  • Headache
  • Fatigue
  • Breast pain
  • Vaginal pain
  • Back pain
  • Depression
  • Insomnia
  • Vaginitis
  • Nausea
  • Flatulence
  • Weight gain
  • Edema
  • Bloating
  • Changes in menstrual bleeding
  • Upper respiratory tract infection
  • Headache
  • Fatigue
  • Breast pain
  • Vaginal pain
  • Back pain
  • Depression
  • Insomnia
  • Vaginitis
  • Nausea
  • Flatulence
  • Weight gain
  • Edema
  • Bloating
  • Changes in menstrual bleeding
  • Upper respiratory tract infection
Is there a generic?
  • No generic available
Is it covered by insurance?
  • Varies according to your provider
  • Varies according to your provider
Dosage Forms
  • Oral tablet
  • Vaginal cream
  • Oral tablet
  • Vaginal cream
  • Powder for intravenous solution
Average Cash Price
  • $178 for a supply of 30, 1 mg oral tablets
  • $209 for a supply of 30, 0.625 mg tablets
SingleCare Discount Price
Drug Interactions
  • CYP3A4 inducers (St. John’s Wort, phenobarbital, phenytoin, carbamazepine, rifampin, dexamethasone, etc.)
  • CYP3A4 inhibitors (clarithromycin, erythromycin, ketoconazole, itraconazole, cimetidine, ritonavir, grapefruit juice, etc.)
  • CYP3A4 inducers (St. John’s Wort, phenobarbital, phenytoin, carbamazepine, rifampin, dexamethasone, etc.)
  • CYP3A4 inhibitors (clarithromycin, erythromycin, ketoconazole, itraconazole, cimetidine, ritonavir, grapefruit juice, etc.)
Can I use while planning pregnancy, pregnant, or breastfeeding?
  • Estrace is in Pregnancy Category X and may cause fetal harm. Estrace is contraindicated in pregnant women.
Premarin is in Pregnancy Category X and may cause fetal harm. Premarin is contraindicated in pregnant women

Summary

Estrace and Premarin are similar hormone replacement therapies that can treat symptoms of menopause. These symptoms include hot flashes, vaginal atrophy, and vaginal dryness. Estrace contains estradiol while Premarin contains conjugated estrogens.

Both drugs are available as oral tablets and vaginal creams. While Estrace is available in generic versions, Premarin is not available as a generic. Therefore, Premarin may be a more expensive option.

Both medications have similar adverse effects and drug interactions. They may cause changes in menstrual bleeding, breast tenderness, and fatigue. They also interact with other drugs that affect the metabolism of estrogens.

Estrace and Premarin use can increase the risk of blood clots, heart attacks, stroke, breast cancer, and uterine cancer. It should be used cautiously in those with a higher risk for these conditions. Discuss these medications with your doctor to determine the best option for you.