This following list include preparations routinely stocked in Wythenshawe pharmacy.
Please note : The Trust policy is for all non-urgent prescribing to be referred to the patients's GP. HRT preparations normally fall into this category.
|
Unopposed Oestrogen |
Community cost for 28 days £ |
|
|
Oestradiol (Elleste-Solo) tablets |
1mg, 2mg |
1.78 |
|
Conjugated oestrogens (Premarin) tabs |
0.625mg, 1.25mg |
3.24 - 4.40 |
|
Oestradiol (Evorel) patches |
25mg, 50mg, 75mg, 100mg |
4.39 - 5.33 |
|
Oestradiol (Oestrogel) gel |
1.5mg |
7.95 (Consultant only) |
|
Progestogen |
||
|
Medroxyprogesterone acetate (Provera) tablets |
2.5mg, 5mg, 10mg |
1.72 - 6.89 |
|
Dydrogesterone (Duphaston) tablets |
10mg |
2.09 |
|
Combined Therapy |
||
|
Cyclical |
||
|
Oestradiol/norethisterone (Climagest) tablets |
1mg/1mg |
4.78 |
|
Oestradiol/dydrogesterone (Femoston) tablets |
1mg/10mg |
4.99 |
|
Oestradiol/levonorgestrel (Nuvelle) tabs |
2mg/75mcg |
5.05 |
|
Conjugated oestrogens/norgestrel (Prempak-C) tablets |
0.625mg/150mcg |
5.89 |
|
Conjugated oestrogens/ medroxyprogesterone (Premique Cycle) tabs |
0.625mg/10mg |
8.29 |
|
Oestradiol/norethisterone (Evorel-Pak) patch/tablet |
50mcg/1mg |
8.45 |
|
Continuous Combined |
||
|
Oestradiol/Dydrogesterone (Femoston-Conti) tablets |
1mg/5mg |
7.54 |
|
Oestradiol/Medroxyprogesterone (Indivina) |
1mg/2.5mg |
7.54 |
|
Oestradiol/norethisterone (Kliofem) tabs |
2mg/1mg |
5.15 |
|
Oestradiol/norethisterone (Kliovance) tablets |
1mg/0.5mg |
5.15 |
|
Conjugated oestrogens/medroxyprogesterone (Premique) tablets |
0.625mg/5mg |
9.05
|
Prescribing notes
HRT should only be used to treat
the short-term symptoms of the menopause. It should no longer be
considered as a first-line therapy for treating osteoporosis.
HRT in any form
taken before the age of 50 has no impact on the risk of breast cancer.
Use of
oestrogen alone for 10 years to the age of 60 increases the risk of
breast cancer from 38/1000 in non-users to 43/1000 in users.
Combined oestrogen/progestogen preparations taken for 10 years to the age of 60 increases breast cancer risk from 38/1000 in non-users to 57/1000 in users.
Oral therapy is the first choice for most patients. If side effects are unacceptable, a transdermal patch is indicated.
Bone conservation occurs with doses of 0.625mg conjugated oestrogens, 2mg oestradiol or 50mcg transdermal oestradiol.
Patients with an intact uterus require progestogen for at least 10 - 14 days at the end of each cycle to prevent endometrial hyperplasia and potential carcinoma.
Doses of oestrogen should be adjusted to minimise vasomotor, psychological and urogenital symptoms.
The continuous combined preparations are intended to produce amenorrhoea. The incidence of breakthrough bleeding is minimised if treatment is commenced at least one year after the last menstrual bleed. Patients should be warned that a little irregular bleeding may occur for up to two months after commencing therapy.
For further information see
http://www.prodigy.nhs.uk/guidance.asp?gt=Menopause