Livial Tablets

What is Livial and what is it used for?

Livial 2.5 mg tablets provide relief from menopausal symptoms and providing protection from osteoporosis. It is a form of hormone replacement therapy (HRT) that contains one ingredient, Tibolone, which breaks down in the body into components that emulate the sex hormones oestrogen and progesterone. In this way, it is different from most HRT treatments, which directly contain these sex hormones. Another difference is that Livial also increases testosterone levels, which has the effect of limiting some of the negative side effects of HRT.

Each box of Livial contains 84 tablets that should be taken every day without a break between packs. You should not experience a monthly bleed while taking Livial and therefore it is most suited to women who have not had a natural period in the last year.

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 which may have a substantial impact on day-to-day life.

Physical symptoms of the menopause include:

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

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

How does HRT work?

Hormone Replacement Therapy (HRT) eases the symptoms of menopause by supplementing the levels of hormones that the body no longer produces naturally. Livial does not contain oestrogen and progesterone themselves, however, contains the ingredient tibolone which breaks down into components that imitate the female sex hormones and also testosterone.

Most menopausal symptoms occur due to a lack of oestrogen. 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 Livial also raises progesterone levels. The testosterone in Livial has the effect of limiting some of the negative side effects of HRT.

Alternatives to Livial

There are many varieties of HRT including tablets, patches and vaginal tablets, creams or gels. For full details on HRT available from The Independent Pharmacy please see our Menopause page.

If you are considering starting HRT or are thinking of changing to a new form or brand you should discuss your options with your doctor or specialist. It is not uncommon for women to try several types of HRT before finding one that works best for them.

If you are unsure whether HRT is the right option for you, you may want to try some non-medicinal alternatives to try and ease menopausal symptoms, which 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

• Livial Tablets, Patient Information Leaflet: https://www.medicines.org.uk/e...

• https://bnf.nice.org.uk/drug/t...

• https://www.nhs.uk/conditions/blood-clots

• https://www.nhs.uk/conditions/stroke/symptoms/

• https://www.nhs.uk/conditions/hormone-replacement-therapy-hrt/types/

Livial warnings

Please read the full information regarding warnings and precautions detailed in the Patient Information Leaflet before taking Livial Tablets.

Taking any form of HRT treatment, including Livial, increases your chances of developing certain health conditions. Being eligible for a repeat prescription of Livial from The Independent Pharmacy, therefore, relies upon you attending an annual check-up appointment with your GP. You should take the time to think carefully about whether HRT is the best option for you at this time.

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

Livial 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 Livial
• Are pregnant or breastfeeding

Inform your GP if you plan on taking Livial 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
• Obesity
• Otosclerosis (a hereditary ear disorder)
• A history of severe allergic reactions
• A family history of breast cancer or another oestrogen-sensitive cancer

Livial 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)
• Anticoagulants (e.g. warafin)
• St Johns Wort

Livial and cancer

Research into the use of HRT has indicated that medication containing the ingredient Tibolone, such as Livial, may increase your risk of developing endometrial and breast cancer and may also slightly increase your risk of developing ovarian cancer.

Your chance of developing breast cancer progresses the longer you take HRT. When HRT is stopped your risk returns to normal within 5 years. It is, therefore, recommended that you only take the lowest dose of HRT for the shortest amount of time, to manage your symptoms.

Livial and your circulation

Taking any form of HRT, which includes Livial, can triple your chances of experiencing blood clots and increase the likeliness of you experiencing a stroke to some extent. If you think you are developing symptoms of a blood clot at any time call NHS 111 or are having a stroke call 999.

Livial in pregnancy & breastfeeding

Livial should only be taken by postmenopausal women and is not a contraceptive. If you have had a natural period in the last year 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.

Livial directions

• Livial Tablets should only be taken by post-menopausal women. They are for oral use only and should be taken as directed by your doctor. Please read the Patient Information Leaflet carefully for full directions for use.
• You should only take HRT for the shortest time and at the lowest dose to manage your symptoms. If you have any concerns about your current dose of Indivina you should speak to your doctor for advice.
• If you are thinking of stopping Livial you should discuss this with your doctor, who will be able to explain the possible effects of stopping and how to manage this.
• Take 1 tablet at the same time every day without a break. Each tablet is marked with a day of the week to help you remember to take them. Do not have a break between packs.
• It is normal for women to experience some irregular bleeding when first starting Livial, if this has not settled within 3 months you should speak to a doctor for advice.

Livial ingredients

The active ingredient contained in Livial is: Tibolone 2.5mg.

Livial tablets also contain the following inactive ingredients: Potato starch, lactose monohydrate, ascorbyl palmitate, magnesium stearate.

Livial side effects

Not everyone will experience side effects when they take Livial, however, if you do they can include:

• Breast pain
• Weight gain
• Unwanted hair growth
• Breakthrough bleeding
• Vaginal discharge
• Infection
• Stomach or pelvic pain
• Thickening of the uterine or cervical linings

This is not a full list of potential side effects. Please see the Patient Information Leaflet for more details. 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.