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What the label lists and what reports show

Estrogens conjugated side effects

Estrogens conjugated's FDA label: “Most common adverse reactions (≥5%) are: abdominal pain, asthenia, pain, back pain, headache, flatulence, nausea, depression, insomnia, breast pain, endometrial hyperplasia, leucorrhea, vaginal hemorrhage, and vaginitis.” FAERS holds 59,243 reports naming it through July 30, 2026; the reaction reported most often, leaving out the conditions it is used for, product-use terms and outcomes, is breast cancer female (8,869 reports).

  • Generic listed
  • Boxed warning

Check it at the source: the estrogens conjugated FDA label on DailyMed (effective June 4, 2026, Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc.); the FDA FAERS public dashboard.

What does the patient leaflet say about side effects?

From the patient leaflet: What are the possible side effects of PREMARIN?

Side effects are grouped by how serious they are and how often they happen when you are treated. […]

Source: FDA drug label, Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc., effective June 4, 2026 (SPL set 258e1602-a3cf-4ccc-ca80-73dbbfb812ff), via openFDA; the full label on DailyMed

What does the label list?

From the label: adverse reactions

Most common adverse reactions (≥5%) are: abdominal pain, asthenia, pain, back pain, headache, flatulence, nausea, depression, insomnia, breast pain, endometrial hyperplasia, leucorrhea, vaginal hemorrhage, and vaginitis.

Table 1: Treatment-Related Adverse Reactions at a Frequency ≥1%

ReactionPREMARIN 0.625 mg (n=348)PREMARIN 0.45 mg (n=338)PREMARIN 0.3 mg (n=326)Placebo (n=332)
Abdominal pain38 (11)28 (8)30 (9)21 (6)
Asthenia16 (5)8 (2)14 (4)3 (1)
Back pain18 (5)11 (3)13 (4)4 (1)
Chest pain2 (1)3 (1)4 (1)2 (1)
Generalized edema7 (2)6 (2)4 (1)8 (2)
Headache45 (13)47 (14)44 (13)46 (14)
Moniliasis5 (1)4 (1)4 (1)1 (0)
Pain17 (5)10 (3)12 (4)14 (4)
Pelvic pain10 (3)9 (3)8 (2)4 (1)
Hypertension4 (1)4 (1)7 (2)5 (2)
Migraine7 (2)1 (0)03 (1)
Palpitation3 (1)3 (1)3 (1)4 (1)
Vasodilatation2 (1)2 (1)3 (1)5 (2)
Constipation7 (2)6 (2)4 (1)3 (1)
Diarrhea4 (1)5 (1)5 (2)8 (2)
Dyspepsia7 (2)5 (1)6 (2)14 (4)
Eructation1 (0)1 (0)4 (1)1 (0)
Flatulence22 (6)18 (5)13 (4)8 (2)
Increased appetite4 (1)1 (0)1 (0)2 (1)
Nausea16 (5)10 (3)15 (5)16 (5)
Hyperlipidemia2 (1)4 (1)3 (1)2 (1)
Peripheral edema5 (1)2 (1)4 (1)3 (1)
Weight gain11 (3)10 (3)8 (2)14 (4)
Arthralgia6 (2)3 (1)2 (1)5 (2)
Leg cramps10 (3)5 (1)9 (3)4 (1)

Rows and numbers as the label prints them, under its own column headings (the first rows of a longer table where it runs on). A reaction in a trial table is not necessarily caused by the medicine, and trials differ from everyday use.

From the label: adverse reactions, continued

The following serious adverse reactions are discussed elsewhere in labeling: • Cardiovascular Disorders [see Boxed Warning, Warnings and Precautions (5.1) ] • Malignant Neoplasms [see Boxed Warning, Warnings and Precautions (5.2) ] Most common adverse reactions (≥5%) are: abdominal pain, asthenia, pain, back pain, headache, flatulence, nausea, depression, insomnia, breast pain, endometrial hyperplasia, leucorrhea, vaginal hemorrhage, and vaginitis. ( 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 Study Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice. During the first year of a 2-year clinical trial with 2,333 postmenopausal women with a uterus between 40 and 65 years of age (88% Caucasian), 1,012 women were treated with CE, and 332 were treated with placebo. Table 1 summarizes treatment-related adverse reactions that occurred at a rate of ≥1% in any treatment group.

Source: FDA drug label, Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc., effective June 4, 2026 (SPL set 258e1602-a3cf-4ccc-ca80-73dbbfb812ff), via openFDA; the full label on DailyMed

What do FAERS reports show?

59,243 reports list estrogens conjugated among the medicines taken, each a report of something that happened, not proof the medicine caused it; 1,856 are coded as a death and 9,535 as a hospital stay. Counts follow how widely a medicine is used and watched, and they are not a measure of how risky it is. Of the 22 reactions below, 12 are named by the same term (in US spelling) in the label's adverse reactions, warnings or patient leaflet; a reaction the label does not name may still be there under another word, and a report does not show that the medicine caused it.

Reports received each year

The 25 most reported reactions

  • Breast Cancer (a use or a product term, not a reaction)9,645
  • Breast Cancer Female8,869
  • Drug Ineffective (a use or a product term, not a reaction)3,449
  • Nausea (named in the label)2,422
  • Headache (named in the label)2,374
  • Pain2,312
  • Fatigue (named in the label)2,286
  • Off Label Use (a use or a product term, not a reaction)2,226
  • Dizziness (named in the label)1,691
  • Breast Cancer Metastatic1,682
  • Dyspnoea1,667
  • Malaise1,615
  • Diarrhoea (named in the label)1,569
  • Arthralgia (named in the label)1,495
  • Anxiety (named in the label)1,453
  • Depression1,446
  • Insomnia (named in the label)1,353
  • Pain In Extremity1,312
  • Fall1,308
  • Asthenia (named in the label)1,257
  • Hypertension (named in the label)1,249
  • Cerebrovascular Accident1,210
  • Feeling Abnormal1,209
  • Vomiting (named in the label)1,165
  • Hot Flush (named in the label)1,136

Source: FDA Adverse Event Reporting System (FAERS) via openFDA, reports through July 30, 2026; reactions as MedDRA preferred terms

What next?

Estrogens conjugated: the full record
label, generics, price, shortages, recalls
Side effects hub
the most reported medicines and reactions