Prescription medicine
Estrogens conjugated Brand names: Premarin
Estrogens conjugated (Premarin) is a prescription medicine with an FDA approval on record since 1942. FDA's NDC Directory lists it from 1 generic labeler, and pharmacies paid $5.47 per conjugated estrogen 0.625 mg tablet in the October 7, 2026 NADAC survey.
- 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 NDA 4782 record on Drugs@FDA; every estrogens conjugated label on DailyMed.
Highlights of the record
FDA label of June 4, 2026; NDC Directory, Drugs@FDA and Orange Book, October 8, 2026; NADAC October 7, 2026
ENDOMETRIAL CANCER, CARDIOVASCULAR DISORDERS, BREAST.
CANCER and PROBABLE DEMENTIA WARNING: ENDOMETRIAL CANCER, CARDIOVASCULAR DISORDERS, BREAST CANCER and PROBABLE DEMENTIA See full prescribing information for complete boxed warning. […]
Used for
From the label: indications and usagePREMARIN is a mixture of estrogens indicated 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 )
Treatment of Hypoestrogenism due to Hypogonadism, Castration or Primary Ovarian Failure ( 1.3 )
Treatment of Breast Cancer (for Palliation Only) in Appropriately Selected Women and Men with Metastatic D
Forms and strengths
- 0.3 mg
- 0.45 mg
- 0.625 mg
- 0.9 mg
- 1.25 mg
- 0.625 mg/g
- 25 mg/5ml
Film-coated tablet; injection (powder) (lyophilized) for solution; cream.
On the market
- Earliest approval on file
- May 8, 1942 Premarin, Wyeth Pharms; Drugs@FDA’s file, where older or withdrawn approvals can be missing
- Generic approvals
- 2 first October 15, 2025; 2 with a marketed status in Drugs@FDA
- Labelers listed (NDC)
- 4 of which 1 under generic applications, 2 under brand applications, repackagers included
Supply and safety
- Pharmacy cost (NADAC)
- $5.47 per tablet Conjugated estrogen 0.625 mg tablet
- Shortage (FDA)
- No current entry
- Recalls by its makers (FDA)
- No recall recorded
- FAERS reports
- 59,243 through July 30, 2026
What is estrogens conjugated used for?
From the label: indications and usagePREMARIN is a mixture of estrogens indicated 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 )
Treatment of Hypoestrogenism due to Hypogonadism, Castration or Primary Ovarian Failure ( 1.3 )
Treatment of Breast Cancer (for Palliation Only) in Appropriately Selected Women and Men with Metastatic Disease ( 1.4 )
Treatment of Advanced Androgen-Dependent Carcinoma of the Prostate (for Palliation Only) ( 1.5 )
Prevention of Postmenopausal Osteoporosis ( 1.6 ) 1.1 Treatment of Moderate to Severe Vasomotor Symptoms due to Menopause 1.2 Treatment of Moderate to Severe […]
Conditions named in the indications of estrogens conjugated's FDA labels, with every medicine labeled for each:
FDA pharmacologic class: Estrogen.
Source: FDA drug label (Premarin), 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
Is there a generic for estrogens conjugated (Premarin)?
The FDA approved the first generic estrogens conjugated on October 15, 2025. 2 generic applications are approved; 2 of them carry a current (not discontinued) marketing status in Drugs@FDA; that status is not evidence that the generic is on sale.
FDA's NDC Directory lists estrogens conjugated from 1 labeler under a generic (ANDA) application and from 2 brand labelers. A listing means the company has registered the product for sale; it does not show that every pharmacy stocks it.
- 1942 earliest approval on file
- 2025 first generic approved
Source: Drugs@FDA, FDA NDC Directory and the Orange Book (openFDA bulk files, October 8, 2026)
What do pharmacies pay for estrogens conjugated (Premarin)?
In CMS's NADAC survey of October 7, 2026, pharmacies paid $5.47 per Conjugated estrogen 0.625 mg tablet. The chart's scale runs from the lowest to the highest price shown, not from zero. NADAC is what retail pharmacies paid their wholesalers, per unit, in CMS's monthly survey; what a patient pays depends on insurance and the pharmacy.
- Conjugated estrogens 0.3 mg tablet (generic)
- Premarin 0.625 mg tablet (brand)
| Strength and form | Brand or generic | Pharmacy cost | 30 tablets, or one pen or vial | 12-month change |
|---|---|---|---|---|
| Conjugated estrogen 0.625 mg tablet | Generic | $5.47 per tablet | $164.09 | n/a |
| Conjugated estrogens 0.3 mg tablet | Generic | $5.37 per tablet | $161.18 | n/a |
| Conjugated estrogens 0.45 mg tablet | Generic | $5.48 per tablet | $164.42 | n/a |
| Conjugated estrogens 0.9 mg tablet | Generic | $5.57 per tablet | $167.18 | n/a |
| Conjugated estrogens 1.25 mg tablet | Generic | $5.48 per tablet | $164.30 | n/a |
| Premarin 0.3 mg tablet | Brand | $6.95 per tablet | $208.42 | +3% |
| Premarin 0.45 mg tablet | Brand | $6.96 per tablet | $208.67 | +3% |
| Premarin 0.625 mg tablet | Brand | $6.94 per tablet | $208.29 | +3% |
| Premarin 0.9 mg tablet | Brand | $6.93 per tablet | $207.94 | +2% |
| Premarin 1.25 mg tablet | Brand | $6.95 per tablet | $208.61 | +3% |
| Premarin vaginal cream-appl | Brand | $15.07 per gram | n/a | +2% |
Source: CMS National Average Drug Acquisition Cost (NADAC) survey, October 7, 2026: what retail pharmacies paid per unit; not a counter price
What does the estrogens conjugated label say about other medicines?
The estrogens conjugated label names 11 other medicines in its interaction, contraindication or warning sections. The sentences are the labels' own; a label lists what its studies and reports found, not every interaction.
| Medicine named | Section | What the label says |
|---|---|---|
| Carbamazepine | drug interactions | Inducers of CYP3A4, such as St. John's Wort ( Hypericum perforatum ) preparations, phenobarbital, carbamazepine, and rifampin, may reduce plasma concentrations of estrogens, possibly resulting in a decrease in therapeutic effects and/or changes in the uterine bleeding profile. |
| Clarithromycin | drug interactions | Inhibitors of CYP3A4, such as erythromycin, clarithromycin, ketoconazole, itraconazole, ritonavir and grapefruit juice, may increase plasma concentrations of estrogens and may result in side effects. |
| Erythromycin | drug interactions | Inhibitors of CYP3A4, such as erythromycin, clarithromycin, ketoconazole, itraconazole, ritonavir and grapefruit juice, may increase plasma concentrations of estrogens and may result in side effects. |
| Estradiol | warnings and precautions | Free hormone concentrations, such as testosterone and estradiol, may be decreased. |
| Itraconazole | drug interactions | Inhibitors of CYP3A4, such as erythromycin, clarithromycin, ketoconazole, itraconazole, ritonavir and grapefruit juice, may increase plasma concentrations of estrogens and may result in side effects. |
| Ketoconazole | drug interactions | Inhibitors of CYP3A4, such as erythromycin, clarithromycin, ketoconazole, itraconazole, ritonavir and grapefruit juice, may increase plasma concentrations of estrogens and may result in side effects. |
| Medroxyprogesterone | boxed warning | The WHI estrogen plus progestin substudy reported increased risks of DVT, pulmonary embolism (PE), stroke and myocardial infarction (MI) in postmenopausal women (50 to 79 years of age) during 5.6 years of treatment with daily oral CE (0.625 mg) combined with medroxyprogesterone acetate (MPA) [2.5 mg], relative to … |
| Phenobarbital | drug interactions | Inducers of CYP3A4, such as St. John's Wort ( Hypericum perforatum ) preparations, phenobarbital, carbamazepine, and rifampin, may reduce plasma concentrations of estrogens, possibly resulting in a decrease in therapeutic effects and/or changes in the uterine bleeding profile. |
| Rifampin | drug interactions | Inducers of CYP3A4, such as St. John's Wort ( Hypericum perforatum ) preparations, phenobarbital, carbamazepine, and rifampin, may reduce plasma concentrations of estrogens, possibly resulting in a decrease in therapeutic effects and/or changes in the uterine bleeding profile. |
| Ritonavir | drug interactions | Inhibitors of CYP3A4, such as erythromycin, clarithromycin, ketoconazole, itraconazole, ritonavir and grapefruit juice, may increase plasma concentrations of estrogens and may result in side effects. |
| Testosterone | warnings and precautions | Free hormone concentrations, such as testosterone and estradiol, may be decreased. |
Source: FDA drug label (Premarin), 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 for estrogens conjugated?
The FDA Adverse Event Reporting System holds 59,243 reports that list estrogens conjugated among the medicines taken, through July 30, 2026, 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.
Reports received each year
The most reported reactions
Source: FDA Adverse Event Reporting System (FAERS) via openFDA, reports through July 30, 2026
What else is labeled for the same conditions as estrogens conjugated?
7 other medicines are given the same way (oral) and in the same FDA class as estrogens conjugated or labeled mainly for the same use (menopause symptoms), the same class first. Menopause symptoms lists all 11 medicines labeled for it, by any route. They are listed as records, not as substitutes: whether one can replace another is a prescriber's decision.
| Medicine | Shared indication | Generic labelers (oral) | Pharmacy cost | Shortage |
|---|---|---|---|---|
| Estradiol | Osteoporosis, Menopause symptoms, Breast cancer | 21 labelers | $0.0635 per tablet 1 mg tablet | No current entry |
| Ethinyl estradiol and norethindrone | Osteoporosis, Menopause symptoms | 15 labelers | $0.181 per tablet 21 1-20 tablet | No current entry |
| Estradiol and norethindrone | Osteoporosis, Menopause symptoms | 7 labelers | $0.802 per tablet 0.5-0.1 mg tablet | No current entry |
| Drospirenone and estradiol | Menopause symptoms | none listed | $6.37 per tablet 0.25 mg-0.5 mg tablet | No current entry |
| Fezolinetant | Menopause symptoms | none listed | $18.58 per tablet 45 mg tablet | No current entry |
| Elinzanetant | Menopause symptoms | none listed | $9.97 per capsule 60 mg capsule | No current entry |
| Ospemifene | Menopause symptoms | none listed | $8.17 per tablet 60 mg tablet | No current entry |
Every medicine labeled for the same conditions as estrogens conjugated
Source: FDA drug labels (indications), NDC Directory, NADAC of October 7, 2026, FDA shortages (October 8, 2026)
What next?
- Alternatives to estrogens conjugated
- 7 medicines for the same use
- Other estrogens
- the pharmacologic class, with prices and generics
- Estrogens conjugated side effects
- the label's list beside FAERS reports
- Check an interaction
- what two or more labels say about each other