Prometrium vs. Provera
See how Prometrium and Provera compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Both Prometrium and Provera are progestins used to protect the uterus during estrogen therapy, but Prometrium is bioidentical progesterone while Provera is a synthetic compound.
Prometrium capsules contain peanut oil and are unsafe for people with peanut allergies, while Provera tablets contain no peanut oil.
Provera has been on the market since 1959 and typically costs far less per month than Prometrium, which was approved in 1998.
Prometrium vs. Provera Drug Summary
Prometrium
Prometrium is a progestin that contains micronized progesterone identical to the hormone the body makes naturally. It is FDA-approved to prevent endometrial hyperplasia in postmenopausal women taking estrogen and to treat secondary amenorrhea. It comes as an oral capsule, usually taken once daily at bedtime.
Provera
Provera is a synthetic progestin called medroxyprogesterone acetate. It is FDA-approved to treat secondary amenorrhea, abnormal uterine bleeding from hormonal imbalance, and to prevent endometrial hyperplasia in postmenopausal women on estrogen. It comes as an oral tablet taken once daily for a set number of days each cycle.
Prometrium vs. Provera Side Effects
Prometrium
Provera
Prometrium vs. Provera Dosage
Prometrium
Provera
| STAGE | DOSE | WHEN |
| Starting dose | 200 mg once daily | At the start |
| Maximum dose | 400 mg once daily | If needed |
| Dose changes | 1 increase | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 5 mg or 10 mg daily | At the start |
| Maximum dose | 10 mg daily | If needed |
| Dose changes | 1 increase | As tolerated |
Prometrium
| STAGE | DOSE | WHEN |
| Starting dose | 200 mg once daily | At the start |
| Maximum dose | 400 mg once daily | If needed |
| Dose changes | 1 increase | As tolerated |
Provera
| STAGE | DOSE | WHEN |
| Starting dose | 5 mg or 10 mg daily | At the start |
| Maximum dose | 10 mg daily | If needed |
| Dose changes | 1 increase | As tolerated |
Prometrium vs. Provera Indications
Prometrium
Prometrium is FDA-approved to prevent endometrial hyperplasia in postmenopausal women taking estrogen and to treat secondary amenorrhea. It is also widely prescribed off-label for fertility treatment and hormone support, uses not covered by its FDA label.
Endometrial hyperplasia prevention with estrogen therapy (FDA-approved)
Secondary amenorrhea treatment (FDA-approved)
Luteal phase support in IVF (off-label)
Preterm birth prevention in high-risk pregnancies (off-label)
Provera
Provera is FDA-approved to treat secondary amenorrhea and abnormal uterine bleeding caused by hormonal imbalance. It is also approved to prevent endometrial hyperplasia in postmenopausal women taking estrogen, but it is not approved for contraception or for preventing heart disease or dementia.
Secondary amenorrhea treatment (FDA-approved)
Abnormal uterine bleeding from hormone imbalance (FDA-approved)
Endometrial hyperplasia prevention with estrogen therapy (FDA-approved)
Distinct from injectable Depo-Provera formulations
Prometrium vs. Provera Pros and Cons
Prometrium
Prometrium's bioidentical structure appeals to patients who prefer a hormone chemically identical to what the body produces. It carries the same class-wide boxed warnings as other progestins used with estrogen, plus a peanut allergy risk from its capsule formulation.
Pros
Chemically identical to the progesterone the body makes
Approved for secondary amenorrhea and endometrial protection
Widely used off-label for IVF luteal support and pregnancy loss prevention
Cons
Unsafe for people with peanut allergy due to peanut oil in capsules
Costs roughly $497 to $936 per month without insurance
Fewer decades of real-world outcome data than Provera
Provera
Provera's synthetic formulation has been used clinically since 1959, giving it a long track record for treating bleeding disorders and amenorrhea. Its label lists side effects without specific rates, and it is not approved for fertility-related or hormone replacement uses.
Pros
Contains no peanut oil, safe for people with peanut allergy
Decades of established clinical use since 1959
Costs roughly $15 to $75 per month, far less than Prometrium
Cons
Synthetic progestin, not chemically identical to natural progesterone
Not approved for fertility treatment or pregnancy support
Side effect rates are not quantified in the FDA label
Common Symptoms and Related Diseases You Can Explore
Explore a range of common symptoms the Doctronic Symptom Checker can help you understand.