Kliovance Tablets

What is Kliovance and what is it used for?

Kliovance is a continuous combined form of hormone replacement therapy (HRT), used to treat symptoms of the menopause. Each tablet has two active ingredients, which imitate the two female sex hormones: a natural version of the oestrogen (estradiol) and a synthetic version of progestogen (norethisterone). Compared to other HRT treatments, Kliovance has a lower dose of oestrogen and progesterone. It is, therefore, suitable for women who tend to be more sensitive to hormones.

Some forms of HRT contain oestrogen-only, such as Estradot Patches, however, in women who still have a uterus, an uncontrolled increase in oestrogen levels will cause the lining of the uterus (the endometrium) to grow excessively, which can lead to cancer. So, each Kliovance tablet also contains 0.5mg of norethisterone acetate, a synthetic version of progesterone to significantly reduce this risk.

This form of HRT does not involve a regular period. For this reason, Kliovance is suited for women who have already reached the menopause but still suffer from distressing symptoms. You should review your HRT with your GP at least once each year and have regular gynaecological checkups.

What is the menopause?

All women go through the menopause. This usually occurs between the ages of 45 and 55. As you approach this age, your ovaries will produce less and less oestrogen. This has the effect of stopping the menstrual cycle, but the change in hormone levels can lead to several symptoms that may substantially impact day-to-day life.

Physical symptoms include:

• Hot flushes (a spontaneous heat that spreads throughout the body, leading to blushing, sweating and an unusually strong heartbeat)
• Night sweats
• Osteoporosis
• Dryness of the eyes or vagina
• Irritability
• Insomnia
• Depression

Experiences with menopausal symptoms vary significantly depending on the individual. They can begin multiple years before menopause itself and remain for many years. Women will, on average, experience symptoms for about four years.

How does HRT work?

Hormone replacement therapy, including Kliovance help to ease the symptoms of menopause by supplementing the levels of hormones that the body, up until now, has produced naturally. Because each Kliovance tablet contains the same amount of both oestrogen and progesterone, women would not expect to experience a monthly bleed while taking this form of HRT.

As the body adjusts to Kliovance, some women may notice breakthrough bleeding or spotting. Talk to your GP if this continues after more than a few months of treatment. HRT should only be necessary as a relatively short-term treatment as your body adjusts to the menopause.

Click through to find out more about Kliovance dosage and how long Kliovance takes to work.

Kliovance and pregnancy

HRT will not prevent pregnancy in otherwise fertile women. Women under 50 are considered fertile until two years after their final menstrual cycle (for women over 50, this is reduced to one year). Do not use a hormonal contraceptive while undergoing HRT.

Alternatives to Kliovance

At The Independent Pharmacy, we stock a wide range of HRT, including alternative tablets, patches and vaginal gels that are available on prescription. For more information on HRT please visit our Advice for Menopause (HRT) page.

If you are unsure whether starting any form of HRT is the right option for you. It is recommended that you try non-medicinal alternatives to help relieve your symptoms. Some suggestions to try include:

For Night Sweats and Hot Flushes

• Using A fan
• Cool Showers
• Wearing light clothing

Vaginal Dryness

• Lubricants

Other Alternatives

• A healthy diet and regular exercise
• Stopping Smoking

Sources

• Kliovance Tablets, Patient Information Leaflet: https://www.medicines.org.uk/e...
• https://bnf.nice.org.uk/drug/e...
• https://www.nhs.uk/conditions/menopause/symptoms/

Kliovance directions

Kliovance should be taken at a similar time each day, according to the directions on the pack.

• Swallow one tablet whole with a sip of water. Once you finish a pack, start a new pack the following day without an interval. You should review your HRT with your GP at least once each year.

If, for any reason, you forget to take a tablet, take it as soon as possible. However, if it is more than 12 hours late, skip the dose that you missed. Never double your dose to compensate for a dose that you have missed.

Click through to find out more about Kliovance dosage.

Kliovance ingredients

The active ingredients contained in Kliovance tablets are: 1mg estradiol (as estradiol hemihydrate), 0.5mg norethisterone acetate.

Kliovance tablets also contain the following inactive ingredients: Lactose monohydrate, maize starch, copovidone, talc, magnesium stearate, hypromellose, triacetin.

Kliovance side effects

Kliovance, like other medications, may cause some people to experience side effects. If you experience severe side effects or an allergic reaction when taking Kliovance, you must seek medical advice or attend your nearest emergency department as soon as possible.

If you are concerned about side effects or they are bothering you, please speak to a pharmacist or doctor for advice.

Please ensure that you have read the full list of reported side effects in the Patient Information Leaflet before starting treatment using Kliovance.

You should also take time to familiarise yourself with all the warnings and precautions as Kliovance, like other HRT, may increase your chances of getting certain health conditions. You should discuss any questions you have with your doctor before taking this medicine.

The most commonly reported side effects associated with Kliovance are:

• Headache and migraines
• Breast tenderness
• Vaginal thrush & vaginal bleeding
• Dizziness & sleeplessness
• Indigestion, abdominal pain, wind
• Nausea & vomiting
• Rashes & itching
• Swelling of the hands, ankles and feet & muscle cramps
• Weight gain
• Changes in libido
• Hair loss
• Muscle cramps
• Depression

Find out more about Kliovance side effects here.

Kliovance warnings

Reading the following warnings and the Patient Information Leaflet carefully will help ensure you select an appropriate product.

Using any HRT treatment, including Kliovance, carries risks. You should take time to consider whether you would like to take HRT or if you want to continue taking it. If you have any questions or concerns you should discuss these with your GP or specialist.

Being eligible to get Novofem on repeat prescription from The Independent Pharmacy is reliant on you continuing to see your doctor for a check-up at least once a year, this must include a breast screen, blood pressure and blood tests and a cervical smear test.

Kliovance is unsuitable for you if you:

• Have ever had breast cancer
• May have cancer which is sensitive to oestrogen (including uterine cancer)
• Have untreated endometrial hyperplasia (an excessively thick womb lining)
• Suffer from a blood clotting disorder, or have ever had a blood clot
• Have recently had a heart attack or stroke
• Have unexplained vaginal bleeding
• Have a history of liver disease
• Suffer from porphyria (a rare hereditary blood disease)
• Are allergic to any of the ingredients in Kliovance
• Are pregnant or breastfeeding

Inform your GP if you plan on taking Kliovance and have ever had any of the following health complications:

• Fibroids
• Impaired liver function
• Uterine problems including endometriosis or endometrial hyperplasia
• Circulation problems (e.g. angina, heart attack)
• High risk of blood clots
• Diabetes
• Migraine
• Gallstones
• An autoimmune disorder
• Asthma
• Epilepsy
• Fluid retention
• High blood pressure
• High-fat levels in the blood
• Otosclerosis (a hereditary ear disorder)
• Lactose intolerance
• A family history of breast cancer or another oestrogen-sensitive cancer

Kliovance and other medicines

Tell your GP or pharmacist if you have taken or plan to take any of the following medicines:

• Epilepsy medicines (e.g. phenytoin, carbamazepine)
• Tuberculosis medicines (e.g. rifampicin)
• HIV medicines (e.g. nevirapine, ritonavir, nelfinavir)
• Antifungal medicines containing ketoconazole
• Hepatitis C medicines (e.g. telaprevir)
• St Johns Wort

Kliovance and cancer

Research has highlighted that taking a combined oestrogen-progestogen HRT such as Kliovance can increase your risk of developing breast cancer and slightly increase your risk of developing ovarian cancer. This risk appears to increase the longer you take HRT but does return to normal up to 5 years after stopping treatment. For this reason, it is recommended that you only take HRT for the shortest amount of time to manage your symptoms.

Kliovance and your circulation

Taking any form of HRT makes you 3 times more likely to experience blood clots and 1.5 times more likely to experience a stroke. If you think you are developing symptoms of a blood clot at any time call NHS 111 or are having a stroke call 999.

Stop taking Kliovance and seek medical attention immediately if you notice early signs of any of the following:

• Blood clots – pain and swelling of the legs, difficulty breathing
• Stroke – sudden migraines, blurred vision
• Heart disease – chest pain that extends to the neck or arm
• Liver disease – yellow colouration of the skin or eyes

Novofem in pregnancy & breastfeeding

Kliovance is only suitable in postmenopausal women and is not a contraceptive. If you have had a menstrual period in the last 12 months or are under 50 years old you should discuss contraception with your doctor before taking Kliovance.

If you become pregnant while taking Novofem stop taking it straight away and contact your doctor. You should also not take Novofem while breastfeeding.