Skip to main content
Drug Info

When is the best time to take Prempro?

Whether morning or nighttime dosing is best depends on if you experience side effects
Christine Bryant headshot
By | Feb. 28, 2025 Medically reviewed by Leslie Greenberg, MD
Alarm clock next to a pack of pills - should i take Prempro in the morning or night

Key takeaways

  • Prempro can be taken at any time of day. Consistency is key. Whether morning or nighttime dosing is best depends on what time of day is easiest for you to take medication and if you experience side effects.

  • If you miss a dose of Prempro, take it as soon as possible unless the next dosage is already near.

  • You may notice relief from menopause symptoms within a few weeks, although certain effects can take longer.

In this article:

Prempro is a commonly prescribed hormone replacement therapy medication that helps decrease perimenopause or menopause symptoms. If you are experiencing hot flashes, night sweats, vaginal dryness, mood swings, or even osteoporosis, Prempro can help. You can take this medication at any time of day. However, experts agree that consistency is key.

Should I take Prempro in the morning or at night?

Prempro allows you the flexibility to choose whether to take your medications in the morning or at night. Yet, there’s an important caveat to remember. “While Prempro can be taken at any time of day, it is advisable to take it at the same time each day to maintain consistent hormone levels,” says Soma Mandal, MD, a board-certified internist and women’s health specialist with Summit Health in New Providence, New Jersey.

Every day, about 6,000 women in the United States reach menopause, according to the Society for Women’s Health Research. Menopause occurs when one year has passed since a woman’s last menstrual period. Typically, women enter menopause in their late 40s or early 50s. Perimenopause is a period of five to ten years before the last menstrual period when certain hormone levels start to decline. During this time, a drop in estrogen can cause symptoms such as menstrual irregularities, hot flashes, night sweats, vaginal dryness, painful intercourse, and moodiness. These symptoms often impact everyday quality of life.

“[Prempro] combines conjugated estrogens and medroxyprogesterone acetate (progesterone), which help regulate hormone levels in postmenopausal women,” says Pamela Tambini, MD, medical director of Engage Wellness in Acton, Massachusetts. Potential side effects of Prempro include back pain, nausea, gas, loss of strength, and difficulty sleeping.

How this medication affects you may help determine the best time of day to take Prempro. “Many patients prefer taking it in the evening if they experience initial side effects like nausea, which can be alleviated by taking it with food,” Dr. Mandal says.

Opting to take Prempro in the morning with food can also help if patients notice sleep issues after starting the medication. “While it can help reduce night sweats, which improves sleep, some people report insomnia or strange dreams,” says Taher Saifullah, MD, founder of the Spine & Pain Institute in Los Angeles, California. “If you’re having trouble sleeping, try switching to a morning dose.”

RELATED: Prempro alternatives

What if I miss a dose of Prempro?

If you miss a dose of Prempro, take it as soon as you remember unless you are close to your next scheduled dosage. “If it is close to the time of your next dose, skip the missed dose and continue with your regular schedule,” Dr. Tambini says. “It is important not to take two doses at once.”

While missing one dose is not usually a big concern, frequent missed doses could reduce the effectiveness of symptom management. “Skipping days isn’t recommended because it can cause hormone fluctuations, leading to breakthrough bleeding or a return of menopause symptoms,” says Dr. Saifullah.

While Prempro is generally prescribed for daily use to maintain stable hormone levels, in some cases, your provider may adjust the dosing schedule, especially for women transitioning off hormone replacement therapy (HRT) or experiencing side effects. “If a woman is sensitive to hormone therapy, her doctor may gradually taper the medication by reducing the frequency of doses,” Dr. Tambini says. “However, any change in dosing should only be done under medical supervision.”

How long does it take for Prempro to start working?

Women usually notice significant relief from symptoms of menopause within a few weeks, although maximum effectiveness can take longer. “Individual metabolism and symptom severity can influence this onset,” Dr. Mandal says.

Prempro is primarily prescribed for the treatment of moderate to severe menopausal symptoms. However, the medication is also used for the prevention of postmenopausal osteoporosis in women at risk. “Many women start to feel relief from menopausal symptoms like hot flashes within a few weeks, while other benefits, such as osteoporosis prevention, take longer to become noticeable,” Dr. Tambini explains. Improvements in bone density may take months to years. “Regular follow-ups with a healthcare provider can help track progress,” Dr. Tambini suggests.

How do I get the most out of my Prempro?

To get the most out of Prempro, store it at room temperature and take the medication as prescribed. Additionally, certain lifestyle changes can make this prescription more effective, according to Drs. Tambini and Mandal.

  • Eat a protein-rich diet. When there are no specific protein requirements for Prempro use, Dr. Tambini says getting enough protein is essential for women’s health, particularly for maintaining bone strength and muscle mass. “Women should aim for at least 0.8 to 1.2 grams of protein per kilogram of body weight daily, with higher amounts recommended for those physically active or at risk for osteoporosis,” she explains. Additionally, consuming adequate calcium is essential for bone health.
  • Avoid smoking or excessive alcohol use. These both increase your risk of cardiovascular complications, such as blood clots, when taking hormone therapy such as Prempro. Additionally, they may reduce the effectiveness of the medication.
  • Exercise regularly, especially weight-bearing activities. These types of exercises can improve bone health, which can decline during menopause, Dr. Tambini says. This happens when the ovaries gradually stop producing estrogen, causing a hormonal shift in the body that disrupts bone remodeling. Bone loss then accelerates, making it possible to lose as much as 25% of a woman’s bone mass in the 10 years after menopause begins.
  • Discuss all medications and supplements you take with your healthcare provider or pharmacist. Some supplements, such as high doses of vitamin C, iron supplements, and St. John’s wort, can interfere with how your body processes hormone therapy. Providing a list of all over-the-counter and prescription pills you take can help to avoid a drug interaction.
  • Report any side effects to your healthcare team. Your provider can adjust a dose or suggest changes to make your experience go more smoothly, Dr. Saifullah suggests.

It’s also important to give your provider a list of current and past medical conditions because they may affect your use of Prempro, according to the Mayo Clinic:

  • Abnormal vaginal bleeding
  • Blood clotting disorders, such as antithrombin deficiency, protein C deficiency, protein S deficiency, deep vein thrombosis, or pulmonary embolism
  • Breast cancer
  • Heart attack
  • Hysterectomy
  • Liver disease
  • Stroke
  • Tumor (estrogen-dependent)
  • Asthma
  • Congestive heart failure
  • Diabetes
  • Edema
  • Epilepsy
  • Gallbladder disease
  • Hereditary angioedema
  • Hypertension (high blood pressure)
  • Hypertriglyceridemia
  • Hypothyroidism (underactive thyroid)
  • Migraine headache (severe headache)
  • Porphyria
  • Systemic lupus erythematosus (SLE)

Performing routine follow-up appointments and maintaining communication with your provider about your symptoms, medication changes, or concerns is essential to getting the most out of this treatment.

The bottom line 

There is no single best time to take Prempro. However, consistency is key to maintaining stable hormone levels. Some patients prefer to take Prempro in the evening to minimize side effects like nausea. Others opt to take it in the morning to avoid potential sleep disturbances.

Ultimately, the best time to take Prempro depends on individual tolerance and lifestyle. Discuss any concerns and changes to a medication schedule with a healthcare provider to ensure Prempro works as effectively as possible for you. “As an expert in women’s health, I believe that navigating menopause doesn’t have to be daunting,” Dr. Mandal says. “With the right information and support, women can embrace this transformative phase with confidence.”

Sources