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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Prempak-C Shortage

The manufacturer of Conjugated Estrogens / Norgestrel (Prempak-C)® has written to clinicians to inform them of stock shortages.

The letter from the Medical Director states that there is a short-term production difficulty that is affecting supplies. They are working urgently to resolve the manufacturing difficulties and they provide a website address for weekly updates.

Prempak-C is licensed for hormone replacement therapy (HRT) in oestrogen deficiency and for prevention of osteoporosis in high-risk women who cannot take alternative products. The findings of the Women's Health Initiative have restricted the place of HRT products since many expected benefits of HRT were not demonstrated in real life studies while many of the harms remain.

Action: The shortage of Prempak-C is an opportunity to review the need for treatment. Prescribing should be stopped where the risks now outweigh the benefits of treatment.

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76 Comments to “Prempak-C Shortage”

  1. I stopped taking Prempak-C 0.625 in May 2017 due to the withdrawal of the product. I was advised to immediately stop taking it by my GP. I had been on HRT for 32 years at that stage. I was aged 60 then and GP advised this would be the best time to stop taking HRT rather than starting to take an alternative. Since then I have had nothing but problems having previously had no issues and having a full time job. I am now losing my hair, my skin is hanging off my stomach/inner arms/inner thighs/breasts and face. I also have mood swings and sleeping issues. I have always been slim and petite and never been over 8 stone in weight. I have been on various alternatives since; Evorel Conti, Evorel 25, Ultrogestan 100mg tablets and Oestrogel 80mg pump and I am now on Kilovance 1mg / 0.5mg Tablets. I wonder if anyone else has had similar issues to me please and if they have found anything that has helped. Thank you.

    Comment by Paula — September 14, 2020 #

  2. I was on Prempak C from the age of 21 to 46 - when it was no longer available I got the sweats, kidney issues, and severe joint pain. I also gained weight which was unexpected. I'm devastated at the loss of this treatment. The GP tried femoston and that did not agree with me at all. I'm taking nothing now apart from herbal medication for my joints. Again not really helping.

    Any suggestions? It's 2020 now.

    Comment by Ali McAllister — May 21, 2020 #

    1. @Ali McAllister,

      It seems you only really tried one alternative - others are available. In tablet form Elleste is an option but patches may be an option for you too - there are some supply issues in several of the patch range but your local pharmacists should be able to advise your GP and you what they can obtain at the moment.

      Comment by Matthew Robinson — May 21, 2020 #

  3. My life has changed dramatically now I can no longer get Prempak-C 0.625mg. I do appreciate the problems with the drug, but I really would like my life back.

    Comment by Christine — August 29, 2019 #

  4. I too am in the same boat. Tried all sorts of other tablets from doctor.
    Then I tried Evorel patches. And after a few months trial and error with the dosage, I'm feeling ok. Not quite as good as Prempak-C, as the flushes start when I'm due for another patch, but I have my life back.

    Comment by Steph — August 10, 2019 #

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