Evorel Sequi Patches

What is Evorel Sequi & what is it used for?

Evorel Sequi is a form of hormone replacement therapy (HRT), used to treat symptoms of menopause. Evorel Sequi is known as a sequential hormone replacement therapy because it contains two types of patches. Each box contains four Evorel 50 patches that's contains just an oestrogen, called estradiol. The box also contains four Evorel Conti patches that, as well as estradiol, also contain synthetic progesterone called norethisterone.

When these patches are changed twice a week, a controlled measure of the hormones is absorbed into the blood, mimicking the menstrual cycle, to reduce unpleasant menopausal symptoms. Read this more detailed guide for more information on how to use Evorel Sequi.

Evorel Sequi patches are manufactured by Theramex UK and can be prescribed for women who are currently experiencing the menopause and those who have been through it that still have an intact uterus.

Evorel Sequi features

• Evorel Sequi contains two different kinds of patches: Evorel 50 patches are used in the first two weeks, and Evorel conti patches are used in the second two weeks of treatment.
• Evorel Sequi patches contain both estradiol and norethisterone — imitators of the female sex hormones oestrogen and progesterone.
• The patches are applied directly to the skin and replaced twice weekly.
• One pack contains enough patches for four weeks of HRT treatment.
• Hormone replacement therapy can effectively relieve the unpleasant symptoms of the menopause, and may also be used to treat osteoperosis in post-menopausal patients.

Menopause symptoms

As women age, their ovaries gradually produce less oestrogen. This hormonal imbalance can lead to some uncomfortable physical and psychological symptoms, including:

• Insomnia
• Hot flushes
• Mood swings
• Osteoporosis
• Excessive sweating
• Dry vagina, mouth or eyes

Evorel Sequi patches work by restoring the hormonal balance in the body, reducing or preventing menopausal symptoms from occurring.

How does Evorel Sequi work?

Hormone Replacement Therapy eases the symptoms of menopause by supplementing the levels of hormones that the body can produce naturally. Some medicines are oestrogen-only. 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. This will substantially increase your risk of complications such as endometrial cancer. This is why Evorel Sequi releases norethisterone, a synthetic version of progesterone, during the second half of a treatment cycle.

HRT should only be necessary as a relatively short-term treatment as your body adjusts to the menopause. You should review your HRT with your GP at least once each year and have regular gynaecological checkups.

Benefits of HRT patches

What makes HRT patches different to tablets and gels? The benefits of using the patch are not vastly different to taking HRT in tablet form, so to some extent, it depends on your preference. The patch contains hormones that are absorbed through the skin, allowing you to receive hormone replacement without taking tablets by mouth – and likewise for the gel. Some doctors believe it’s preferable for hormones to be absorbed through the skin, thereby avoiding the liver.

HRT patches and weight gain

While some say that HRT is a cause of weight gain in women, research suggests that this is not the case. After menopause, women are likely to gain more weight on their belly than on their hips and thighs – HRT can potentially help women to lose this unwanted fat.

Non-medicinal alternatives for the symptoms of Menopause are:

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

You can read more about managing your symptoms on the NICE Menopause page.

Sources

• Evorel Sequi, Patient Information Leaflet: https://www.medicines.org.uk/emc/files/pil.10930.pdf
• https://bnf.nice.org.uk/drug/estradiol-with-norethisterone.html
• https://www.nhs.uk/conditions/blood-clots/

How to use Evorel Sequi

Evorel Sequi contains four Evorel 50 patches and 4 Evorel Conti patches. Evorel 50 should be applied twice a week for the first 2 weeks of each 4 week period, followed by twice-weekly changes of Evorel Conti. As soon as you remove your fourth Evorel 50 patch, replace it with the first Evorel Conti patch. Do not leave a break between packs.

• Change your patch on the same two days every week. This will mean that one patch is on for three days and the next patch for four days.
• Apply the patch to an area of skin that is dry and clean. Press down firmly to ensure that the patch is in place.
• Do not place the new patch on the exact same section of skin.
• Evorel should not be used on or around the breasts, broken skin or under elasticated parts of clothing.

For full details on how to use Evorel Sequi patches please read the Patient Information Leaflet contained within the product packaging.

Evorel Sequi ingredients

The active ingredients contained in Evorel Sequi are:

Evorel 50 Patches: Estradiol hemihydrate 3.2mg

Evorel Conti Patches: Estradiol hemihydrate 3.2mg, norethisterone acetate 11.2mg.

Evorel Sequi also contains the following inactive ingredients: Duro-Tak 387-2287, guar gum, Hostaphan MN19

Evorel Sequi side effects

Not everyone will experience side effects when they take Evorel Sequi, however, if you do they may include:

• Itchy or inflamed skin where the patch is applied
• Mood swings
• Anxiety
• Difficulty sleeping
• Nausea
• Headache
• Stomach pain
• Diarrhoea
• Muscle pain
• Breast pain
• Joint pain
• Weight gain
• Breakthrough bleeding
• Painful periods
• Fluid retention

If you are concerned about these effects, or if the product affects you in any other way, stop using it and talk to your doctor or pharmacist.

Read our additional guide for more information about Evorel Sequi side effects.

Evorel Sequi warnings

Reading the following warnings carefully will help to ensure you are selecting an appropriate product.

The use of HRT – whether you choose tablets or patches – carries risks that should be considered when deciding whether to start using it. In your online consultation, you will be asked about your personal and family medical history. After starting treatment, you should see your doctor for regular check-ups and breast screening.

Evorel Sequi 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 a history of liver disease
• Suffer from porphyria (a rare hereditary blood disease)
• Are allergic to any of the ingredients in the patch

Inform your GP if you plan on using Evorel Sequi and have ever had any of the following health complications:

• Fibroids
• Unexplained vaginal bleeding
• 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
• Systemic lupus erythematosus
• Asthma
• Epilepsy
• Fluid retention
• High blood pressure
• High fat levels in the blood
• Otosclerosis (a hereditary ear disorder)
• Thyroid problems
• A family history of breast cancer or another oestrogen-sensitive cancer
• A history of severe allergic reactions

Evorel Sequi 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. lamotrigine, carbamazepine)
• Tuberculosis medicines (e.g. rifampicin)
• HIV medicines (e.g. nevirapine, ritonavir, nelfinavir)
• Bosentan (to reduce blood pressure in the lungs)
• St Johns Wort

Evorel Sequi and cancer

HRT may increase your risk of breast cancer and endometrial cancer. The extent of this risk will vary depending on the length of your HRT treatment and whether you are taking combined or oestrogen-only HRT. Check your breasts regularly for changes to the skin or nipple, or for any noticeable lump. For women who use HRT for more than 5 years, there may also be a slight increase in the risk of ovarian cancer.

Evorel Sequi and blood clots

Taking any form of HRT, including Evorel Sequi, can triple your chances of experiencing blood clots and make you 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.

Evorel Sequi, pregnancy and breastfeeding

Indivina should only be taken by postmenopausal women and is not a contraceptive. If you have had a natural period in the last year or you are under 50 years old you should discuss contraception options with your doctor before taking Indivina.

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

Please read all packaging and the Patient Information Leaflet contained within the product packaging before taking any new medicine and inform your doctor of medicines you are taking or intend to take.