Nuvelle

What is it?

A combined oestrogen/progestogen preparation available as sugar-coated tablets. 16 white tablets contain 2mg of oestradiol valerate and 12 pink tablets contain 2mg of oestradiol valerate and 75µg of levonorgestrel.

Medical Uses

Post-menopausal osteoporosis, hormone replacement therapy for climacteric syndrome (symptoms associated with the menopause).

Dosage

1 white tablet each day for 16 days then 12 days of taking 1 pink tablet. Start on fifth day of menses (bleeding) if present.

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 circulatory diseases, 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, carbamazepine, 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, head aches, vaginal discharge, loss of libido, nausea, brown patches on skin (chloasma). Stop drug immediately in event of pregnancy.