Indivina

What is it?

A hormonal preparation of oestrogen and progestogen available as white tablets in 3 different strengths. White tablets marked 1+2.5 contain 1 mg of oestradiol valerate and 2.5mg of medroxyprogesterone; white tablets marked 1+5 contain 1mg of oestradiol valerate and 5mg of medroxyprogesterone acetate; white tablets marked 2+5 contain 2mg of oestradiol vale rate and 5mg of medroxyprogesterone acetate.

Medical Uses

Menopausal symptoms and prevention of osteoporosis after the menopause in women who have womb intact.

Dosage

Women, start with lowest dose tablets and take one each day continuously; change to 1mg/5mg tablets if breakthrough bleeding occurs and is persistent. Change to 2mg/5mg tablets if symptoms caused by deficiency of oestrogen are not controlled with lower dose.

Special Care

Hypertension, severe kidney disease receiving dialysis, Raynaud's disease, diabetes, multiple sclerosis, asthma, varicose veins, elevated levels of prolactin (a hormone) in the blood (hyperprolactinemia). Risk of thrombosis increases with smoking, age and obesity. Blood pressure, breasts and pelvic organs should be checked during period of treatment.

Avoid Use

Pregnancy, heart and circulatorydiseases, angina, sickle cell anaemia, pulmonary hypertension. Also, hormone-dependent cancers, undiagnosed vaginal bleeding, chorea, liver disease, history of cholestatic jaundice of pregnancy, infectious hepatitis, Dublin-Johnson syndrome, Rotor syndrome, recent trophoblastic disease.

Possible Drug and Food Interactions

Phenytoin, earbamazepine, tetracyclines, primidone, chloral hydrate, glutethimide, phenylbutazone, rifampicin, griseofulvin, ampicillin, dichloralphenazone, ethosuximide, barbiturates, St John's Wort.

Known Side Effects

Feeling of bloatedness due to fluid retention, leg pains, breast enlargement, erosion of cervix, muscular cramps, weight gain, breakthrough bleeding, depression, headaches, vaginal discharge, loss of libido, nausea, brown patches on skin (chloasma). Stop drug immediately in event of pregnancy, if frequent, severe headaches occur or signs of thromboses, severe pain in upper abdominal region, enlarged liver, jaundice, rise in blood pressure, severe depression, increased number of fits. Drug should be discontinued 6 weeks before major planned surgery and re-started 2 weeks afterwards, as long as woman is fully mobile. Should be discontinued during long periods of immobility. Any adverse side effects should be reported to the Committee on the Safety of Medicines (CSM).