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Prometrium vs Provera

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Comparative Analysis


For patients dealing with hormonal imbalances or deficiencies, particularly related to progesterone, certain treatments can help restore balance and alleviate symptoms. Prometrium and Provera are two such medications that are often indicated for these conditions. Both drugs synthetically replicate the effects of progesterone in the body but they do so through different methods. Prometrium is a bio-identical hormone therapy that utilizes micronized progesterone identical to the one naturally produced by the body. On the other hand, Provera uses medroxyprogesterone acetate (MPA), a synthetic derivative of progesterone which has similar but not identical properties as natural progesterone. Each medication may provide relief for specific conditions like menopause symptoms or abnormal uterine bleeding, yet they have distinct pharmacological profiles and potential side effects.

Prometrium vs Provera Side By Side

Brand NamePrometriumProvera
ContraindicationsShould not be taken with certain drugs for Hepatitis C (such as boceprevir/telaprevir) due to potential interactions.Should not be taken with certain drugs for Hepatitis C (such as boceprevir/telaprevir) due to potential interactions.
CostFor brand name, around $160 for 30 capsules of 100 mg. Generic versions cost between $25 and $50 for 30 capsules at 100mg.For brand name, about $80 for 30 tablets of 10 mg. Generic medroxyprogesterone starts from $.04/tablet or up to about $.90/day.
Generic NameProgesteroneMedroxyprogesterone Acetate
Most Serious Side EffectSigns of an allergic reaction, yellowing eyes/skin, sudden severe headache, confusion, chest pain, swelling hands/ankles/feet.Signs of an allergic reaction, unusual fluctuations in mood or behavior, chest pain, sudden numbness or weakness, severe headaches.
Severe Drug InteractionsPotential interactions with drugs for Hepatitis C like boceprevir/telaprevir.Potential interactions with drugs for Hepatitis C like boceprevir/telaprevir.
Typical Dose200-300 mg/day, up to 400 mg/day for secondary amenorrhea.5–10 mg/day, up to a maximum of 20 mg/day based on response.

What is Prometrium?

Prometrium and Provera are both forms of the hormone progesterone, which plays a crucial part in women's menstrual cycles and pregnancy. Prometrium, also known as micronized progesterone, was first approved by the FDA in 1998. It is identical to the naturally occurring progesterone produced by the ovaries during a normal menstrual cycle. It's commonly used for supplementation or replacement as part of Assisted Reproductive Technology (ART) treatment for infertile women with progesterone deficiency and also used to induce menstruation in women who have stopped having menstrual periods.

On the other hand, Provera is medroxyprogesterone acetate (MPA), a synthetic derivative of natural progesterone. While it performs similar functions to Prometrium, its chemical structure differs somewhat from that of bioidentical hormones; this results in subtle changes in how it interacts with body tissues leading potentially more side effects than natural ones like Prometrium.

Both drugs serve important roles but may affect individuals differently due to their unique compositions and mechanisms.

What conditions is Prometrium approved to treat?

Prometrium and Provera are both approved for the treatment of various hormonal conditions:

  • Secondary amenorrhea, a condition where periods stop
  • Abnormal uterine bleeding due to hormonal imbalance when no organic pathology (like fibroids or uterine cancer) is diagnosed
  • Endometrial hyperplasia, which is an overgrowth of the lining of the uterus, as part of menopausal hormone therapy with estrogen.

Please note that while they serve similar functions, Prometrium and Provera are different medications with distinct chemical structures. Always consult your healthcare provider before deciding on a medication regimen.

How does Prometrium help with these illnesses?

Prometrium is a brand name for progesterone, a hormone naturally produced by the female body that plays an important role in the menstrual cycle and pregnancy. It works by preparing the lining of the uterus (endometrium) for implantation of a fertilized egg, prevents uterine contractions which could disturb such implantation, and helps to maintain pregnancy once it has been established.

Provera is a brand name for medroxyprogesterone acetate, another type of progesterone. Like Prometrium, Provera also contributes to establishing and maintaining pregnancy. However, it's often used therapeutically to treat conditions like abnormal menstruation or endometriosis due to its ability to mimic natural progesterone.

Both drugs serve similar functions but differ in their chemical composition and how they're metabolized in the body. Prometrium is bio-identical to human progesterone while Provera isn't; this difference might contribute towards different side effect profiles between these medications.

What is Provera?

Provera is a brand name for medroxyprogesterone acetate, which is a synthetic progestin. Progestins are part of the two major classes of hormones produced by the body's adrenal glands and ovaries, with their function being to prepare the lining of the uterus for implantation of a fertilized egg and maintain pregnancy.

For therapeutic use, Provera was first approved by FDA in 1959. It does not inhibit nor boost serotonin or dopamine in any way since it's not an antidepressant but rather a hormone-based therapy primarily used to treat conditions like abnormal uterine bleeding or amenorrhea (absence of menstrual periods). Its side-effect profile differs from those associated with SSRIs such as Prometrium (an oral progesterone), primarily because it can cause weight gain and bloating, among other symptoms that mimic pre-menstrual syndrome. However, its effectiveness at addressing hormonal imbalance issues makes it an essential drug especially in patients who do not respond well to regular contraceptives or other hormone therapies.

What conditions is Provera approved to treat?

Provera, also known as medroxyprogesterone acetate, is approved by the FDA for various conditions including:

  • Secondary amenorrhea (absence of menstrual periods in women who were previously menstruating)
  • Abnormal uterine bleeding due to hormonal imbalance without organic pathology
  • Endometrial and renal carcinoma prevention.

How does Provera help with these illnesses?

Provera, also known as medroxyprogesterone acetate, is a progestin hormone used in various treatment plans. It plays roles in many processes within the body, notably within women’s health by regulating ovulation and menstrual cycles. Like norepinephrine's impact on depression symptoms, Provera can alleviate some symptoms of menopause or irregular menstruation by supplementing a lack of naturally occurring progesterone. Its action may play a role in preventing overgrowth in the lining of the uterus in postmenopausal women receiving estrogen hormone replacement therapy. Compared to Prometrium (natural progesterone), Provera might be associated with more side effects and risks but it's often prescribed when natural forms are not sufficiently effective or suitable for specific patients' needs.

How effective are both Prometrium and Provera?

Both Prometrium (micronized progesterone) and Provera (medroxyprogesterone acetate) have established histories in hormone replacement therapy, primarily used to treat menopausal symptoms or menstrual disorders. They were approved by the FDA several years apart but are both types of progestins, synthetic versions of the female sex hormone progesterone.

The efficacy of Prometrium and Provera at managing symptoms associated with menstruation or menopause has been studied extensively. For example, a 2002 trial showed that both drugs managed these symptoms effectively but differed slightly in their safety profiles; some patients experienced fewer side effects such as bloating, breast tenderness and mood swings with micronized progesterone compared to medroxyprogesterone acetate.

A comprehensive review from 2013 indicated that micronized progesterone could be considered a safe alternative for women who experience side effects from other progestin therapies like medroxyprogesterone. The same study suggested that micronized progesterone might also be beneficial for bone health.

A more recent meta-analysis conducted in 2015 concluded that while medroxyprogesterone is effective at treating abnormal uterine bleeding and hot flashes related to menopause, it may carry an increased risk for cardiovascular events compared to natural progestogens like micronized progeterone. Despite this potential risk, many practitioners still consider it a viable treatment option because its benefits can outweigh the risks in certain patient populations.

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At what dose is Prometrium typically prescribed?

Oral dosages of Prometrium range from 200-300 mg/day, usually given as a single dose at bedtime or in divided doses (100 mg twice per day). This is sufficient for most people when used to prevent endometrial hyperplasia during estrogen replacement therapy. For the treatment of secondary amenorrhea, the dosage may be reduced to 400 mg/day taken in two divided doses for ten days. In either case, if there's no response after several weeks, your doctor might consider adjusting the dosage. However, it’s important not to exceed the maximum daily dosage which is typically set around 600mg.

At what dose is Provera typically prescribed?

Provera treatment is typically initiated at a dosage of 5–10 mg/day, which can then be titrated up to a maximum of 20 mg/day based on the patient's response and any side effects. The dosages are often split into one or two doses and taken at the same times each day for best effect. If there is insufficient therapeutic effect seen after several weeks, your healthcare provider may choose to increase the dose to as much as 40 mg/day, divided into two equal doses spaced approximately 12 hours apart. It’s always important that changes in medication regimens should only be made under direct medical supervision.

What are the most common side effects for Prometrium?

Side effects of Prometrium can include:

  • Dizziness or lightheadedness
  • Headache
  • Breast pain or tenderness
  • Diarrhea, nausea, bloating, abdominal cramps
  • Mood swings and depression
  • Joint pain
  • Hot flashes

On the other hand, Provera may cause:

  • Nervousness,
  • Changes in weight (increase or decrease)
  • Unusual vaginal bleeding or spotting,
  • Acne, -Hair loss and unwanted facial/body hair.

Always consult your healthcare provider for a better understanding of potential side effects and to discuss any concerns you may have.

abstract image of a patient experiencing side effect

Are there any potential serious side effects for Prometrium?

While most people tolerate Prometrium well, it can occasionally cause serious side effects. These might include:

  • Signs of an allergic reaction: rash, itching or hives on the skin; shortness of breath, wheezing or difficulty breathing; swelling of the face, lips, tongue or other parts of the body
  • Yellowing eyes/skin (a sign of jaundice)
  • Sudden severe headache, confusion, problems with vision speech or balance (these may be symptoms of a rare neurological condition known as PRES - Posterior Reversible Encephalopathy Syndrome)
  • Unusual tiredness and dark urine (symptoms associated with liver function abnormality)
  • Chest pain radiating to jaw/left arm (possible signs of heart attack)
  • Swelling hands/ankles/feet -Unusually slow/fast heartbeat

For Provera users:

-Severe headaches/migraines that are not normal for you -Vomiting up blood/blood in your stools/dark tarry stools -Lumps in your breasts -Sudden chest pain/coughing up blood/painful breathing/shortness of breath/swollen legs. -Pain behind one eye/Bulging eyes/Loss/Sudden change in vision.

If any such symptoms arise during use either medication consult your doctor immediately.

What are the most common side effects for Provera?

With Provera, patients might experience a range of side effects such as:

  • Dry mouth or throat discomfort
  • Mild nausea, stomach pain, bloating, constipation
  • Dizziness and headache
  • Feeling nervous or anxious
  • Possible changes in weight
  • Breast tenderness
  • Changes in menstrual periods
  • Sleep issues like insomnia These are just some of the common reactions to this medication. Despite these potential adverse responses, it's important to remember that doctors prescribe Provera because they believe its benefits outweigh the risks. As with any drug therapy, if you notice any unusual symptoms while taking Provera or your condition worsens instead of improving after using it for a period of time, consult your physician immediately.

Are there any potential serious side effects for Provera?

While Provera is generally safe and effective, it can sometimes lead to severe side effects. If you experience any of the following symptoms while taking Provera, seek immediate medical attention:

  • Signs of an allergic reaction such as hives; difficulty breathing; swelling in your face or throat
  • Unusual fluctuations in mood or behavior, including persistent feelings of sadness or irritability
  • Chest pain or pressure, often spreading to your jaw or shoulder
  • Sudden numbness or weakness (particularly on one side of the body)
  • Severe headaches, blurred vision, pounding in your neck and ears
  • Shortness of breath even with minimal exertion
  • Swelling in your hands, ankles and feet Remember that these are not common occurrences but should be considered seriously if they occur.

Contraindications for Prometrium and Provera?

Both Prometrium and Provera, along with most other hormonal medications, may cause side effects such as mood changes, nervousness or problems sleeping. If you notice your symptoms worsening or if any of these side effects persist or worsen, seek immediate medical attention.

Neither Prometrium nor Provera should be taken if you are taking certain drugs for Hepatitis C (such as boceprevir/telaprevir) due to potential interactions. Always inform your healthcare provider about the current list of medications you are taking; it's important to note that some drugs might affect how well Prometrium and Provera work for you. These could also potentially require a period for clearance from your system to prevent harmful interactions with either Prometrium or Provera.

How much do Prometrium and Provera cost?

For the brand name versions of these drugs:

  • The price for 30 capsules of Prometrium (100 mg) averages around $160, which works out to approximately $5.33/day.
  • The cost for a pack of 30 tablets of Provera (10 mg) is about $80, working out to approximately $2.67/day.

If you are taking the higher dosage range for Prometrium (i.e., 300 mg/day), then brand-name Provera is less expensive on a per-day treatment basis. However, it's important to remember that cost should not be your primary consideration when determining which medication is right for you.

As far as generic alternatives go, they tend to be significantly cheaper:

  • Generic progesterone (the active ingredient in Prometrium) costs between $25 and $50 for 30 capsules at the common dose strength of 100mg, resulting in daily costs ranging from around $0.83 to over approximatingly$1.66.

  • Medroxyprogesterone acetate - the generic form of Provera - can be purchased in packs starting from just ten up through hundreds with prices beginning at roughly $.04/tablet or $.40/day if taking ten milligrams daily at most, but no more than about $.90/ day even if using larger packs containing hundred(s).

Popularity of Prometrium and Provera

Prometrium and Provera are both forms of the hormone progesterone, commonly prescribed to women for a variety of reasons such as treating menstrual disorders or supporting pregnancy.

In its generic form, Provera (medroxyprogesterone) was estimated to have been prescribed to about 3 million people in the US in 2020. This accounted for approximately 26% of synthetic progestin prescriptions across the country. Medroxyprogesterone has generally maintained a steady prevalence over recent years.

On the other hand, Prometrium (micronized progesterone), including brand versions and generics alike, was prescribed to just under 2 million people in the USA in 2020. Micronized progesterone accounts for around 16% of natural progestin prescriptions throughout US pharmacies. The use of micronized progesterone has seen an increase over the last decade due to its more favorable side effect profile compared with synthetic derivatives like medroxyprogesterone.


Both Prometrium (progesterone) and Provera (medroxyprogesterone) are commonly used in the treatment of irregular menstrual periods or abnormal uterine bleeding. They work by mimicking the natural hormone progesterone, regulating ovulation and menstruation. Although they have similar indications, they differ slightly in their composition; Prometrium is a bioidentical hormone derived from plants, while Provera is a synthetic derivative.

These drugs may be combined with estrogen therapy for menopausal women but this should always be done under careful supervision of healthcare professionals due to potential interactions and risks associated with hormonal therapies.

Prometrium tends to cause fewer side effects than Provera, which can sometimes lead to weight gain and mood swings. However, both medications carry the risk of serious side effects such as blood clots, stroke and heart disease especially when taken over long periods or in high doses.

Like most medications, both Prometrium and Provera come in generic forms offering cost savings for patients who pay out-of-pocket expenses. It's important that individuals taking these medications monitor their health closely during treatment; alerting medical professionals immediately if symptoms like shortness of breath or chest pain emerge.