Evorel-Pak

What is it?

A combined oestrogen/progestogen preparation available as a skin patch and tablets. Skin patches deliver 50µg of oestradiol every 24 hours and white tablets contain 1mg of norethisterone, each marked C over 1.A pack comprises 8 patches and 12 tablets.

Medical Uses

Hormone replacement therapy in menopausal women who have not undergone hysterectomy. Prevention and treatment of osteoporosis after the menopause, especially in women at risk of fractures.

Dosage

Apply patch to hairless area of skin below waist and change for a new patch in a different site after 3 or 4 days. For menopausal symptoms, start with 50µg patch; adjust dose after 1 month if necessary. Use minimum effective dose with maximum of 100µg once each day. 1 tablet should be taken each day (by women who have not had a hysterectomy), on days 15 to 26 of cycle. For osteoporosis, use 50µg dose.

Special Care

Patients with history of or considered to be at risk of thrombosis, those with liver disease. Careful monitoring of women with any of the following is required: fibroids in uterus, otosclerosis, porphyria, tetany, epilepsy, gallstones, migraine, multiple sclerosis, hypertension, diabetes. Regular examination of pelvic organs and breasts required during course of therapy, especially in women with family history of breast cancer.

Avoid Use

Pregnancy, breast-feeding, women with breast cancer or other cancers which are hormone-dependent, e. g. of genital tract; serious heart, liver or kidney disease, endumetriasis, thrombosis, Dublin-Johnson or Rotor syndrome, undiagnosed vaginal bleeding.

Possible Drug and Food Interactions

Drugs which induce liver enzymes.

Known Side Effects

Enlargement and tenderness of breasts, nausea and vomiting, weight gain, breakthrough bleeding, gastrointestinal upset, headache, giddiness. Withdraw drug immediately if any sign of thrombosis, rise in blood pressure, severe and frequent headaches, migraines, disturbance of vision, jaundice, pregnancy. Stop before planned surgery.