Livial Tablets

Livial tablets are a hormone replacement therapy (HRT) containing tibolone, this medicine is used to relieve symptoms occurring after menopause. Tibolone is a substance that has favourable effects on different tissues in the body, such as brain, vagina and bone. This medicine is used in postmenopausal women with at least 12 months (1 year) since their last natural period.

Common symptoms of menopause include:

• hot flushes
• night sweats
• mood swings
• vaginal dryness
• reduced sex drive

You can buy Livial tablets online from trusted prescribers such as e-Surgery or from your local GP. If you choose to buy Livial tablets from e-Surgery we will require you to fill out a quick 2-minute health questionnaire to ensure the medication is right for you.

Livial is different from other HRT. Instead of actual hormones (such as oestrogen and progestogen) it contains tibolone. Your body breaks down tibolone to make hormones. Its effects and benefits are similar to combined HRT.

Tibolone is a synthetic steroid in Livial. Taken as an oral treatment, Tibolone breaks down into three separate ingredients once inside the body. These ingredients act in a similar way to the hormones progestogene, testosterone and oestrogen. This ensures that the usual hormone balance is maintained, reducing many of the bothersome symptoms of menopause that can develop after menopause.

You can find more details in the Livial tablet patient information leaflet.

Talk your doctor before taking Livial:

• If you have or have ever had breast cancer, or if you are suspected of having it
• If you have cancer which is sensitive to oestrogens, such as cancer of the womb lining (endometrium), or if you are suspected of having it
• If you have any unexplained vaginal bleeding
• If you have excessive thickening of the womb lining (endometrial hyperplasia) that is not being treated.
• If you have or have ever had a blood clot in a vein (thrombosis), such as in the legs (deep venous thrombosis) or the lungs (pulmonary embolism)
• If you have a blood clotting disorder (such as protein C, protein S, or antithrombin deficiency)
• If you have or recently have had a disease caused by blood clots in the arteries, such as a heart attack, stroke or angina
• If you have or have ever had a liver disease and your liver function tests have not returned to normal
• If you have a rare blood problem called porphyria which is passed down in families (inherited)
• If you are allergic to tibolone or any of the other ingredients of this medicine
• If you are pregnant or think you might be pregnant.
• If you are breastfeeding.

You may have irregular bleeding or drops of blood (spotting) during the first 3-6 months of taking Livial tablets. But if the bleeding or spotting carries on for more than the first 6 months, starts after you have been taking Livial for more than 6 months, or carries on even after youve stopped taking Livial tablets speak to your doctor.

Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.

The recommended dose is one tablet every day. Take this dose unless your doctor or pharmacist told you to do something different.

Swallow the tablet with some water or other drink, without chewing. Take Livial at the same time each day.

If you forget to take a Livial tablet, take it as soon as you remember unless you are more than 12 hours late. If you are more than 12 hours late, just skip it, and take your next tablet at the usual time.

Don’t take a double dose.

It is unlikely that taking more than one tablet will do you any harm, but you may feel sick, be sick or have some vaginal bleeding.

Like all medicine, Livial tablets have possible side effects. Find out more about this in the Livial tablet patient information leaflet.

The following diseases are reported more often in women using HRT compared to women not using HRT:

• breast cancer
• abnormal growth or cancer of the lining of the womb (endometrial hyperplasia or cancer)
• ovarian cancer
• blood clots in the veins of the legs or lungs (venous thromboembolism)
• heart disease
• stroke
• probable memory loss if HRT is started over the age of 65

Some common side effects are:

• breast pain
• stomach or pelvic pain
• unusual hair growth
• vaginal bleeding or spotting.
• vaginal problems such as more secretions, itching, irritation and thrush
• thickening of the lining of the womb or the lining of the cervix
• weight gain.

Some medicines may interfere with the effect of Livial tablets. This might lead to irregular bleeding. This applies to the following medicines:

• Medicines against blood clotting (such as warfarin)
• Medicines for epilepsy (such as phenobarbital, phenytoin and carbamazepine)
• Medicines for tuberculosis (such as rifampicin)
• Herbal remedies containing St Johns Wort (Hypericum perforatum).

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. This includes medicines obtained without a prescription, herbal medicines or other natural products.

Yes, you can legally buy Livial tablets online from a trusted prescriber such as e-Surgery.

Whenever you buy Livial tablets online, or any other medication make sure you check for the green GPhC logo on the bottom of each page of the website you are using.

You can use theGPhC website to check if a pharmacy is registered. This will ensure that when you buy Livial tablets online they are genuine.

e-Surgeryuses Royal Mail delivery with choices starting from Royal Mail tracked 48 delivery, Royal Mail tracked 24and Royal Mail 1pm special delivery (discover more aboute-Surgery delivery). When you buy Livial tablets online they will arrive in discreet, recyclable packaging at a delivery address of your choice.

If you are unsure please find out more information on how torecycle packaging from e-Surgery.

Do not use this medication after the expiry date and keep it in a cool, dry environment away from children.

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

If you need more information before you buy Livial tablets online please read the Livial tablet patient information leaflet.

Alternatively, you can use our free Ask-a-Pharmacistservice to gain additional support in answering any questions you might have. We are always here to help!