Short answer: For menopause hot flashes, vaginal atrophy and osteoporosis prevention, the Premarin label starts most women at 0.3 mg daily, then adjusts by response at the lowest effective dose. It may be taken every day or in cycles such as 25 days on and 5 days off, with or without food. A missed dose is taken as soon as possible unless the next dose is near.
This is what the FDA label says. Follow your prescriber. Your prescriber may use a different dose or pace than the label's standard schedule.
What Premarin is approved for: Premarin is a mixture of estrogens approved to treat moderate to severe hot flashes (vasomotor symptoms) and vulvar and vaginal atrophy due to menopause; low estrogen from hypogonadism, castration or primary ovarian failure; for palliation only, certain metastatic breast cancer and advanced androgen-dependent prostate cancer; and to prevent postmenopausal osteoporosis (section 1). For vaginal symptoms alone, topical vaginal products are considered; for osteoporosis prevention alone, only women at significant risk, with non-estrogen medicines carefully considered.
Source
PREMARIN (conjugated estrogens tablets, USP) for oral administration, prescribing information and Patient Information. Wyeth Pharmaceuticals (Pfizer). DailyMed, version published June 3, 2026. DailyMed setid 258e1602-a3cf-4ccc-ca80-73dbbfb812ff
Premarin is a tablet taken by mouth, one at the same time each day, with or without food (section 2 and Patient Information).
It comes in five strengths: 0.3 mg (green), 0.45 mg (blue), 0.625 mg (maroon), 0.9 mg (white) and 1.25 mg (yellow) (section 3).
The Patient Information says to talk with the healthcare provider regularly, for example every 3 to 6 months, about the dose and whether treatment is still needed.
The table below is the label's schedule, from the Dosage and Administration section. Numbers are copied exactly; the section is in brackets.
| Use | Dose on the label | Schedule |
|---|---|---|
| Moderate to severe hot flashes due to menopause | Generally start at 0.3 mg daily; adjust by response | Continuous, or cyclic such as 25 days on and 5 days off |
| Moderate to severe vulvar and vaginal atrophy due to menopause | Generally start at 0.3 mg daily; adjust by response | Continuous, or cyclic such as 25 days on and 5 days off |
| Female hypogonadism | 0.3 mg or 0.625 mg daily | Cyclic, e.g. three weeks on and one week off |
| Female castration or primary ovarian failure | 1.25 mg daily, adjusted up or down | Cyclic |
| Metastatic breast cancer (palliation only) | 10 mg three times daily | For at least three months |
| Advanced androgen-dependent prostate cancer (palliation only) | 1.25 mg to 2 × 1.25 mg three times daily | Not stated |
| Prevention of postmenopausal osteoporosis | Generally start at 0.3 mg daily; adjust by clinical and bone density response | Continuous, or cyclic such as 25 days on and 5 days off |
For a postmenopausal woman with a uterus, a progestin should generally be considered to reduce endometrial cancer risk. A woman without a uterus does not need one, though some with a history of endometriosis may.
Estrogen, alone or with a progestin, is used at the lowest effective dose for the shortest duration consistent with treatment goals, and women are re-evaluated periodically.
For menopause symptoms (2.1, 2.2) and osteoporosis prevention (2.6), the dose is periodically reassessed by the healthcare provider.
If feasible, estrogen is stopped at least 4 to 6 weeks before surgery linked to a higher risk of blood clots, or during long immobilization.
Women on thyroid hormone replacement may need a higher thyroid dose, and thyroid function is monitored.
Something that looks like a tablet in the stool is reported to the healthcare provider.
The Patient Information says: if you miss a dose, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your normal schedule. Do not take 2 doses at the same time.
More on this: missed a dose of Premarin.
In Dose Track you set up Premarin as a protocol with the dose and schedule your prescriber gave you. A protocol can hold dose steps, each with its own dose and length in days or weeks, so a step-up plan like the one on the label can be entered once and the app moves to the next step on its own. Reminders follow the schedule, and every dose is logged with the date and time, so you can see which step you are on and when your last dose was. The app follows what you enter; it does not choose or change a dose.
This page is what the FDA label says, in plain words. It is not medical advice. Follow your prescriber, and ask them or your pharmacist about anything here.