Prempro (conjugated estrogens and medroxyprogesterone) works well but expensive. what is exact alternative?

None in US: In the us, there is no exact generic for prempro (conjugated estrogens and medroxyprogesterone) available. However, there are generic hormone therapies which may work as well for you--ask your doctor. Walmart offers Estradiol and Medroxyprogesterone at a low cost.

Options: There are options. Prempro has different dosages of estrogen and Progesterone component. Estrogen (estradiol) comes in 0.3mg, 0.45mg, and 0.625mg. The Medroxyprogesterone acetate comes as 1.5mg 2.5mg and 5mg. As your dosage of estrogen goes up, so does progesterone. You can take estrogen as pill or patch. I like the patch. And then take Provera (medroxyprogesterone) for Progesterone (2.5 or 5.0mg).