Provera vs. Bijuve

See how Provera and Bijuve compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Provera is a progestin-only tablet used to treat abnormal uterine bleeding, secondary amenorrhea, and to protect the uterus during estrogen therapy, while Bijuve is a combination capsule made specifically for hot flashes.

  • Bijuve pairs bioidentical estradiol and progesterone in one daily capsule to relieve moderate to severe menopausal hot flashes, something Provera alone does not do.

  • Provera has decades of clinical use and a much lower monthly cost, while Bijuve is newer and priced several times higher.

Provera vs. Bijuve Drug Summary

Provera

Provera (medroxyprogesterone acetate) is a synthetic progestin tablet approved in 1959 to treat secondary amenorrhea and abnormal uterine bleeding caused by hormonal imbalance. It is also used alongside daily estrogen therapy to prevent endometrial hyperplasia in postmenopausal women. It is taken orally, usually for 5 to 10 days depending on the condition being treated.

Bijuve

Bijuve (estradiol and progesterone) is a combination hormone capsule approved in 2018 to treat moderate to severe hot flashes from menopause. It is meant for women who still have a uterus, pairing estrogen with progesterone to protect the uterine lining. It is taken as one capsule by mouth once a day.

Provera vs. Bijuve Side Effects

Provera

Most common
Headache
Nausea
Breast tenderness/galactorrhea
Abnormal uterine bleeding

Bijuve

Most common
Headache (up to 3.4%)
Nausea (up to 2.2%)
Breast tenderness (up to 10.4%)
Vaginal bleeding (up to 3.4%)

Provera vs. Bijuve Dosage

Provera

Dosage
Dosage Table
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

Bijuve

Dosage
Dosage Table
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. Bijuve Indications

Provera

Provera is FDA-approved to treat secondary amenorrhea and abnormal uterine bleeding caused by hormonal imbalance. It is also used alongside daily estrogen therapy to prevent endometrial hyperplasia in postmenopausal women who have not had a hysterectomy. It is not approved as a standalone contraceptive.

  • Secondary amenorrhea treatment

  • Abnormal uterine bleeding management

  • Endometrial hyperplasia prevention with estrogen

  • Not approved as a standalone contraceptive

Bijuve

Bijuve is FDA-approved to treat moderate to severe hot flashes caused by menopause in women who still have a uterus. The progesterone component protects the uterine lining from the effects of the estrogen included in the same capsule. It is not approved for women without a uterus.

  • Moderate to severe hot flash relief

  • For women with an intact uterus

  • Protects uterine lining from estrogen effects

  • Not approved for women without a uterus

Provera vs. Bijuve Pros and Cons

Provera

Provera has been available since 1959, giving it a long track record and a low cost, typically $15 to $75 per month. It only contains progestin, so it does not address hot flashes on its own and is often paired with a separate estrogen product. It is a widely prescribed generic with broad insurance coverage.

Pros

  • Long track record dating back to 1959

  • Roughly $15 to $75 per month, much lower cost than Bijuve

  • Available in three tablet strengths for flexible dosing

Cons

  • Does not treat hot flashes on its own

  • Requires pairing with separate estrogen for menopause symptoms

  • Side effect rates not clearly quantified in the label

  • Boxed warning when combined with estrogen therapy

Bijuve

Bijuve combines bioidentical estradiol and progesterone in one capsule, offering a simpler regimen for treating hot flashes. It typically costs $257 to $351 per month, well above Provera's price range. As a newer drug approved in 2018, it has less long-term real-world experience behind it.

Pros

  • Combines estrogen and progesterone in a single daily capsule

  • FDA-approved specifically for menopausal hot flashes

  • Bioidentical hormone formulation

Cons

  • Roughly $257 to $351 per month, several times costlier than Provera

  • Boxed warnings for cardiovascular events, dementia, and cancer risks

  • Not approved for women without a uterus

  • Less long-term usage history since approval in 2018

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