NOTE: Depending on the supplier/strength selected, the products shipped may have different packaging.

Why is Livial prescribed?

Livial is a Hormone Replacement Therapy (HRT) medication that contains tibolone. Tibolone has beneficial effects on various tissues in the body, including the vagina, brain, and bones. This medicine is intended for use in postmenopausal women who have gone at least 12 months (1 year) since their last natural menstrual period.

What does it do?

Livial works by using Tibolone, a synthetic hormone that mimics the effects of natural hormones like estrogen and progesterone in the body. It helps relieve menopausal symptoms by acting on different tissues such as the brain, vagina, and bones, helping to reduce symptoms like vaginal dryness, hot flashes, and preventing bone loss after menopause.

How should I take it?

Take one tablet daily, preferably at the same time each day. Swallow the tablet with water or another non-alcoholic beverage. The Livial pack contains 28 white tablets, with each strip labeled by the days of the week. Begin by taking the tablet corresponding to the current day.

What if I missed a dose?

If you miss Livial, take it promptly after you remember unless it’s been over 12 hours. If more than 12 hours have passed, skip the missed dose and take your next one at the usual time. Do not take two doses at once.

What are the special precautions before taking Livial?

Before starting Livial, inform your doctor if you have ever had any of the following conditions, as they may return or worsen during treatment. You may require more frequent check-ups. Also, let your doctor know immediately if you notice any changes in your health while taking Livial.

• Asthma
• Diabetes
• Gallstones
• Epilepsy
• Fibroids in the womb
• High blood pressure
• Endometriosis or thickened womb lining
• History of blood clots or a family tendency to develop them
• Family history of hormone-related cancers, like breast cancer
• Liver problems (including non-cancerous liver tumors)

Let your doctor know if you are lactose intolerant or have difficulty digesting milk products before starting Livial, as the tablets contain lactose.

Stop taking Livial and seek medical help immediately if you experience:

• Pregnancy)
• New or severe migraine-like headaches)
• Yellowing of the skin or eyes (possible liver issue))
• Signs of a blood clot)

Does it have any side effects?

If you feel unwell while taking Livial, contact your doctor or pharmacist promptly.

Women using hormone replacement therapy (HRT) like Livial have a higher risk of certain conditions compared to those not using HRT, including:

• Abnormal growth or cancer of the womb lining
• Breast cancer
• Stroke
• Heart disease
• Ovarian cancer
• Blood clots in the legs or lungs
• Possible memory loss if started after age 65

While Livial helps most women manage menopausal symptoms, it can cause side effects in some people. Side effects may be serious but are usually not.

Common side effects may include:
• Breast pain
• Abdominal pain
• Vaginal bleeding or spotting
• Vaginal discomfort (irritation or discharge)

Other reported side effects may include:
• Digestive issues
• Fluid retention
• Rash or itching
• Visual disturbances
• Joint or muscle pain

There have been reports linking Livial to breast cancer and increased growth or cancer of the womb lining. If you experience vaginal bleeding or spotting, or if side effects concern you, inform your doctor.

Other HRT-related side effects can include gall bladder disease and various skin conditions such as skin discoloration (chloasma), painful skin nodules, or rash with red sores.

If you notice any side effects not listed here, tell your doctor or pharmacist.

Is it safe to take it with another drug?

Tell your doctor or pharmacist if you are taking any other medications, including those you can buy without a prescription, or herbal remedies. Some medicines can affect how Livial works.

This applies to the following types of medicines:

• Blood thinners (e.g., Warfarin)
• Tuberculosis treatments (e.g., Rifampicin)
• Herbal products containing St John’s Wort (Hypericum perforatum)
• Epilepsy medications (e.g., Phenobarbitone, Carbamazepine)

Your doctor may need to change the dose of these medicines. Always consult your doctor or pharmacist before starting any new medication.

How should I store it?

Store your Livial tablets in a secure location, out of reach of children. Keep them in their original packaging in a cool, dry place where the temperature does not exceed 25°C.

What action should I take in case of overdose?

If you have ingested more tablets than prescribed, promptly contact your doctor. Symptoms of an overdose may include vomiting, nausea, and vaginal bleeding, which may occur several days afterward.

Is it safe for pregnant or breastfeeding women?

Livial is intended for use only in postmenopausal women. Inform your doctor if you are pregnant, planning to become pregnant, or are breastfeeding. Do not take Livial if you are pregnant or breastfeeding, or if you suspect you may be pregnant.

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