Livial Tablets

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.