Provera vs. Bijuva
See how Provera and Bijuva compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Provera is a progestin-only tablet used to treat abnormal bleeding and protect the uterus during estrogen therapy, while Bijuva combines estradiol and progesterone in one capsule to treat hot flashes.
Provera is dosed cyclically for limited courses, whereas Bijuva is taken once daily on an ongoing basis with food.
Provera costs far less out of pocket than Bijuva, which currently has no generic option.
Provera vs. Bijuva Drug Summary
Provera
Provera (medroxyprogesterone acetate) is a synthetic progestin taken as an oral tablet. It treats secondary amenorrhea and abnormal uterine bleeding, and it protects the uterine lining in postmenopausal women taking estrogen. It is typically taken for 5 to 10 days per cycle rather than every day.
Bijuva
Bijuva combines bioidentical estradiol and progesterone in a single oral capsule. It is FDA-approved to treat moderate to severe hot flashes caused by menopause in women who still have a uterus. It is taken once daily, with food, on an ongoing basis.
Provera vs. Bijuva Side Effects
Provera
Bijuva
Provera vs. Bijuva Dosage
Provera
Bijuva
| 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 |
| STAGE | DOSE | WHEN |
| Starting dose | 0.5 mg/100 mg once daily | At the start |
| Maximum dose | 1 mg/100 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 |
Bijuva
| STAGE | DOSE | WHEN |
| Starting dose | 0.5 mg/100 mg once daily | At the start |
| Maximum dose | 1 mg/100 mg once daily | If needed |
| Dose changes | 1 increase | As tolerated |
Provera vs. Bijuva Indications
Provera
Provera is prescribed when a woman's periods have stopped due to hormone imbalance or when uterine bleeding is abnormal. It is also added to estrogen therapy in postmenopausal women with a uterus, since progestin protects against endometrial overgrowth that estrogen alone can cause. Provera is not intended to treat hot flashes or other vasomotor symptoms of menopause.
Secondary amenorrhea (absent periods)
Abnormal uterine bleeding from hormonal imbalance
Endometrial hyperplasia prevention with estrogen therapy
Not approved for contraception or heart disease prevention
Bijuva
Bijuva is prescribed specifically for moderate to severe hot flashes and night sweats linked to menopause. Because it contains both estrogen and progesterone, it can be used in women who still have a uterus without needing a separate progestin pill. Bijuva is not approved for women without a uterus or for preventing heart disease or dementia.
Moderate to severe hot flashes from menopause
Vasomotor symptom relief in women with a uterus
Combined estrogen-progesterone therapy in one capsule
Not approved for use without a uterus
Provera vs. Bijuva Pros and Cons
Provera
Provera has been available since 1959, comes in low-cost generic tablets, and is only taken for short courses rather than daily. Because it contains no estrogen, it does not relieve hot flashes and cannot replace full hormone therapy on its own.
Pros
Generic tablet, low list price ($15 to $75 per month)
Long track record dating back to 1959
Taken only 5 to 10 days per cycle, not daily
Available in three dose strengths (2.5, 5, 10 mg)
Cons
Does not treat hot flashes or other menopause symptoms
Requires a separate estrogen product for full HRT
Side effect rates not clearly quantified on the label
Cyclic dosing schedule is easy to miss or misuse
Bijuva
Bijuva pairs bioidentical estradiol with bioidentical progesterone in one capsule, so patients do not need to combine two separate hormone prescriptions. It is FDA-approved specifically for hot flash relief, but it costs substantially more out of pocket and has no generic alternative yet.
Pros
One capsule covers both estrogen and progesterone
FDA-approved specifically for hot flash relief
Bioidentical hormone formulation
Simple once-daily dosing, no titration needed
Cons
Roughly $257 to $351 per month, no generic available
Must be taken with food, ideally a high-fat meal
Not approved for women without a uterus
Newer drug (2018) with shorter track record
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