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Tibolone tablets

Livial

Take one tablet every day.

During the treatment you will be invited for regular check-ups with your doctor/nurse. It is important that you keep these appointments.

At a glance

  • Tibolone is a man-made female hormone available as tablets.

  • It is used by women after menopause for symptoms of oestrogen deficiency.

  • It also helps to prevent thinning of the bones (osteoporosis).

  • Take one 2.5 mg tablet every day at the same time.

  • Tell your doctor if you have unexplained vaginal bleeding or a history of certain cancers.

  • Common side-effects can include lower abdominal pain or breast tenderness.

  • If you notice any changes in your breasts, speak with your doctor.

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About tibolone

Typ av medicin

A man-made female hormone

Används för

Symptoms of oestrogen deficiency

To prevent osteoporosis

Även kallad

Livial®

Tillgänglig som

Tabletter

Tibolone works by mimicking the activity of the female sex hormones, oestrogen and progesterone. It also has some male hormone (androgen) effects. Tibolone helps to restore the balance of female hormones in women who have a lack of oestrogen; it helps to ease symptoms such as hot flushes and night sweats. You will only be prescribed it if these symptoms seriously interfere with your daily life.

Tibolone is also prescribed to help prevent 'thinning' of the bones (osteoporosis). It is only suitable for women who have been through the menopaus, and providing there have been at least 12 months since the last natural period. It is prescribed when other, more preferred, treatments are not suitable.

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking tibolone it is important that your doctor or pharmacist knows:

  • If you (or a close family member) have had breast cancer.

  • If you have had a cancer that you have been told is hormone-dependent.

  • If you have any unexplained vaginal bleeding.

  • If you have liver disease, or if you have any problems with the way your kidneys work.

  • If you know you have high levels of fat (triglycerides or cholesterol) in your blood.

  • If you have ever had a blood clot in your leg or lungs, or if you have had inflammation of a vein (thrombophlebitis).

  • If you have angina, or if you have had a heart attack or stroke.

  • If there is a possibility you might be pregnant.

  • If you have diabetes mellitus.

  • If you have migraines, or migraine-like headaches.

  • If you have epilepsy.

  • If you have gallstones.

  • If you have a rare inherited blood condition, called porphyria.

  • Om du tar några andra läkemedel. Detta inkluderar alla läkemedel du tar som finns att köpa utan recept, samt växtbaserade och komplementära läkemedel.

  • Om du någonsin har haft en allergisk reaktion mot en medicin.

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  • Before you start taking the tablets, read the manufacturer's printed information leaflet from inside your pack. The manufacturer's leaflet will give you more information about tibolone and a full list of the side-effects which you may experience from taking it.

  • Take one 2.5 mg tablet every day. You may take tibolone at whatever time of day you find easiest to remember, but try to take your doses at the same time of day, each day. You can take the tablets before or after meals. You may find it helps to swallow the tablet with a drink of water.

  • If you forget to take a dose, take it as soon as you remember unless you are more than 12 hours late. If you are more than 12 hours late, leave out the forgotten dose and take your next tablet at the usual time. Do not take two tablets together to make up for a missed dose.

  • Studies have shown that tibolone is associated with a small increased risk of both stroke and endometrial cancer. It may also be associated with an increased risk of breast cancer. Before you take tibolone, your doctor will discuss with you the benefits of the treatment versus its risks. Your doctor will then continue to consider the benefits and risks as you carry on taking the tablets. This is to make sure that the treatment remains suitable for you.

  • Although tibolone is usually suited to short-term use, you will be invited for regular check-ups during treatment. Remember to keep these appointments so that your doctor can check on your progress.

  • It is also important that you go for any regular breast screening and cervical smear tests. Check your breasts regularly for any skin changes, dimpling and lumps. If you notice any changes, speak with your doctor as soon as possible.

  • If you are due to have an operation, tell the person carrying out the treatment that you are taking tibolone. Your treatment may need to be stopped for a while, especially if you are not expected to be fully mobile for a time. This is to reduce the risk of a blood clot.

  • If you are taking tibolone to prevent 'thinning' of the bones (osteoporosis), there are a number of lifestyle measures that will also help slow down bone loss. Exercise stimulates bone-making cells, which strengthens your bones, so try to take some regular weight-bearing exercise (such as brisk walking, aerobics, dancing, or running). If you smoke, you should try to stop. Also, you should try to cut down on your alcohol intake if you drink more than two units of alcohol daily.

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Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with tibolone. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

Common

tibolone side-effects (these affect fewer than 1 in 10 women)

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Pain in the lower abdomen, increased weight, unusual hair growth, breast tenderness

Om något av dessa blir besvärligt, tala med din läkare

Vaginal thrush (redness and itching in the vagina)

Speak with your doctor or pharmacist for advice

Vaginal bleeding and spotting

This may happen when you first start tibolone and is nothing to worry about. If it continues for more than a few months, you should let your doctor know about it

If you experience any other symptoms which you think may be due to the medicine, speak with your doctor or pharmacist.

  • Keep all medicines out of the sight and reach of children.

  • Förvara på en sval, torr plats, borta från direkt värme och ljus.

Viktig information om alla läkemedel

Ta aldrig mer än den föreskrivna dosen. Om du misstänker att du eller någon annan kan ha tagit en överdos av denna medicin, gå till akutmottagningen på ditt lokala sjukhus. Ta med behållaren, även om den är tom.

Denna medicin är för dig. Ge den aldrig till andra människor även om deras tillstånd verkar vara detsamma som ditt.

Om du köper några läkemedel, kontrollera med en apotekare att de är lämpliga att ta tillsammans med dina andra läkemedel.

Behåll inte föråldrade eller oönskade mediciner. Ta dem till ditt lokala apotek som kommer att ta hand om dem åt dig.

Om du har några frågor om denna medicin, fråga din apotekare.

Rapportera biverkningar av ett läkemedel eller vaccin

Om du upplever biverkningar kan du rapportera dem online via Yellow Card website.

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Vanliga frågor

How quickly can I expect tibolone to relieve my menopausal symptoms?

Tibolone is prescribed to help ease symptoms like hot flushes and night sweats by mimicking female hormones. The article implies it helps to restore balance, but doesn't specify an exact timeframe for how quickly symptoms improve. You will be prescribed it if your symptoms seriously interfere with your daily life.

What is meant by 'hormone-dependent cancer' and why is it important to tell my doctor if I've had one?

A hormone-dependent cancer is a cancer whose growth is influenced by hormones. Tibolone works by mimicking female sex hormones, so if you've had a hormone-dependent cancer, it's crucial for your doctor to know this as it could make tibolone unsuitable for you.

Will I need regular check-ups while taking tibolone?

Yes, you will be invited for regular check-ups during your treatment with tibolone. It's important to keep these appointments so your doctor can monitor your progress and ensure the treatment remains suitable for you, as the benefits and risks will be continuously assessed.

What should I do if I forget to take a dose of tibolone?

If you miss a dose, take it as soon as you remember, unless it has been more than 12 hours since you should have taken it. If you are more than 12 hours late, you should skip the forgotten dose and take your next tablet at your usual time. Do not take two tablets at once to catch up.

Are there any lifestyle changes I should make to support my bone health if I'm taking tibolone for osteoporosis prevention?

Yes, alongside taking tibolone for osteoporosis, certain lifestyle measures can help slow bone loss. Regular weight-bearing exercise such as brisk walking, aerobics, dancing, or running is beneficial as it stimulates bone-making cells. If you smoke, you should try to stop, and if you drink more than two units of alcohol daily, you should try to reduce your intake.

If I experience vaginal bleeding or spotting after starting tibolone, should I be concerned?

Vaginal bleeding and spotting can occur when you first start taking tibolone, and this is generally not a cause for concern initially. However, if this bleeding continues for more than a few months, you should inform your doctor about it.

Vidare läsning och referenser

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About the authorView full bio

Author image

Michael Stewart, MRPharmS

Medicine Leaflet Review Manager – Contractor, Pharmacist

BPharm (Hons), MRPharmS

Michael is a community pharmacist practicing in the Midlands and South Yorkshire with more than 20 years’ experience advising on medicines and medical conditions. He has a strong background in healthcare training, having produced and delivered training courses for pharmacy teams and staff of residential care settings, including nurses. He has also contributed to pharmacy advisory boards for the management of low acuity conditions in the community.

About the reviewer

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Sid Dajani

Sultan Dajani qualified at the London School of Pharmacy in 1994 and became the youngest elected member of the Royal Pharmaceutical Society council since its founding in 1842.

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