Novofem Tablets
Novofem® is a sequential combined hormone replacement therapy (HRT) used for menopause symptom relief and osteoporosis prevention in postmenopausal women. Contains estradiol (identical to natural oestrogen) and norethisterone acetate (progestagen). This prescription medication is available through Chemist Doctor's regulated online service following consultation with UK-licensed clinicians.
You must complete a short online consultation so that our prescriber can ensure that the treatment is suitable for you.
| Product Name: | Novofem® |
|---|---|
| Manufacturer: | Novo Nordisk |
| Active Ingredients: | Estradiol, Norethisterone Acetate |
| Administration: | Oral tablets |
| Presentation: | Film-coated tablets in calendar pack |
| Available Strengths: | 1mg estradiol (red tablets), 1mg estradiol + 1mg norethisterone acetate (white tablets) |
| Prescription Required: | Yes |
| Dosage: | Once daily |
| Suitable for pregnancy? | No |
| Use with alcohol: | Consult doctor |
| Strength | Package | Current Price | |
|---|---|---|---|
| 1mg/1mg | 28 tablets (Calendar Pack) | £28.50 | |
| 1mg/1mg | 84 tablets (3 x Calendar Packs) | £79.95 | |
| Novofem® is a sequential combined HRT containing estradiol and norethisterone acetate. It's used for menopause symptom relief and osteoporosis prevention. Please consult with your healthcare provider before starting this medication. | |||
| This treatment requires an online consultation for review by our medical team. The decision to supply the specific treatment and quantity requested will be based on whether our medical team are satisfied that it will be safe, appropriate, and effective. | |||
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Table of Contents
- What is Novofem?
- What is Novofem Used For?
- Before Using Novofem
- Novofem Contraindications
- Special Population Considerations
- Novofem and Other Medicines
- Pregnancy & Breastfeeding
- Driving & Machine Operation
- Novofem Ingredients
- How to Use Novofem
- Novofem Dosage Guidelines
- Administration Instructions
- Missed Dose Management
- Overdose Information
- Novofem Side Effects
- How to Store Novofem
- Novofem Pack Information
- Novofem FAQs
What is Novofem?
Novofem® is a sequential combined Hormone Replacement Therapy (HRT) used in postmenopausal women. It contains two hormones: estradiol (an oestrogen identical to that produced by women's ovaries) and norethisterone acetate (a synthetic progestagen).
Mechanism of Action
Novofem® works through a two-hormone approach:
- Estradiol replaces the declining natural oestrogen, relieving menopausal symptoms like hot flushes and helping prevent bone loss
- Norethisterone acetate protects the womb lining from the potential overgrowth effects of oestrogen, reducing the risk of endometrial hyperplasia and cancer
Important Safety Notice:
HRT carries risks that must be carefully considered. Long-term use of combined HRT increases the risk of breast cancer, venous thromboembolism, stroke, and ovarian cancer. Regular medical check-ups are essential. Treatment should be at the lowest effective dose for the shortest necessary duration. For complete prescribing information, refer to the official Novofem® Product Information Leaflet.
What is Novofem Used For?
Novofem® is prescribed for two main purposes in postmenopausal women (with at least 6 months since their last natural period):
Approved Indications
| Indication | Purpose | Patient Criteria |
|---|---|---|
| Symptom Relief | Alleviation of menopausal symptoms such as hot flushes, night sweats, vaginal dryness, and mood changes | Postmenopausal women whose symptoms significantly affect quality of life |
| Osteoporosis Prevention | Prevention of postmenopausal osteoporosis in women at increased risk of fractures | Postmenopausal women at high fracture risk when other treatments are unsuitable |
Target Patient Population
- Postmenopausal women (≥6 months since last natural period)
- Women experiencing moderate to severe menopausal symptoms
- Women at increased risk of osteoporotic fractures
- Not recommended as first-line treatment for osteoporosis prevention
Before Using Novofem
Before starting Novofem®, a comprehensive medical assessment is essential. According to BNF guidelines, a thorough evaluation should include:
Medical History Assessment Checklist
- Personal and family history of breast cancer or other hormone-sensitive cancers
- History of venous or arterial thromboembolism
- Liver disease or abnormal liver function tests
- Cardiovascular disease (angina, heart attack, stroke)
- Migraine with aura
- Endometriosis or uterine fibroids
Required Baseline Evaluations
- Breast examination (clinical and mammography if appropriate)
- Blood pressure measurement
- Liver function tests if indicated
- Assessment of fracture risk for osteoporosis indication
Novofem Contraindications
Absolute contraindications where Novofem must not be used:
Absolute Contraindications
- Known, past, or suspected breast cancer
- Known or suspected oestrogen-dependent malignancies
- Unexplained vaginal bleeding
- Untreated endometrial hyperplasia
- Current, past, or high risk of venous thromboembolism
- Active or recent arterial thromboembolic disease
- Acute liver disease or severe hepatic impairment
- Porphyria
- Pregnancy or breastfeeding
Relative Contraindications (Use with Extreme Caution)
| Condition | Risk Level | Action Required |
|---|---|---|
| Migraine with aura | High | Generally contraindicated; consider alternative |
| Severe hypertension | High | Control BP before starting; frequent monitoring |
| Hypertriglyceridaemia | Moderate | Monitor lipids; risk of pancreatitis |
Special Population Considerations
Elderly Patients (>65 years)
- Limited experience in women over 65
- Increased risk of stroke, VTE, and dementia
- Not recommended for initiation after age 65
- Regular cognitive function assessment advised
Renal Impairment
- No dosage adjustment needed in mild to moderate renal impairment
- Use with caution in severe renal impairment due to potential fluid retention
Hepatic Impairment
- Contraindicated in acute or severe liver disease
- Use with caution in mild impairment
- Monitor liver function regularly
Novofem and Other Medicines
Significant interactions requiring monitoring:
High-Risk Combinations
| Medication Class | Examples | Effect | Recommendation |
|---|---|---|---|
| Enzyme Inducers | Carbamazepine, Phenytoin, Rifampicin | Reduces HRT effectiveness | Monitor efficacy; consider higher dose |
| Anticoagulants | Warfarin | HRT may reduce anticoagulant effect | Monitor INR closely |
| Antihypertensives | Various | HRT may affect blood pressure control | Monitor BP regularly |
Specific Interactions
- Anticonvulsants: Phenobarbital, phenytoin, carbamazepine - reduce HRT effectiveness
- Antibiotics: Rifampicin, rifabutin - reduce HRT effectiveness
- Herbal Supplements: St. John's Wort - reduces HRT effectiveness
Pregnancy & Breastfeeding
CONTRAINDICATED
Novofem® is absolutely contraindicated during pregnancy and breastfeeding.
Pregnancy
- Novofem® is for postmenopausal women ONLY
- If pregnancy occurs, stop immediately and consult doctor
- Not a contraceptive - additional contraception needed if <12 months since last period or <50 years old
Breastfeeding
- Contraindicated during breastfeeding
- Hormones may pass into breast milk
- Alternative treatments should be considered
Driving & Machine Operation
- Novofem® has no known effect on the ability to drive or operate machinery
- Some individuals may experience dizziness (common side effect)
- Migraine or severe headaches may occur (uncommon side effect)
- Visual disturbances have been reported (frequency unknown)
- Do not drive if experiencing significant side effects affecting concentration
Novofem Ingredients
Active Ingredients
| Tablet Colour | Active Ingredient | Strength |
|---|---|---|
| Red tablets (Days 1-16) | Estradiol (as hemihydrate) | 1mg |
| White tablets (Days 17-28) | Estradiol (as hemihydrate) | 1mg |
| White tablets (Days 17-28) | Norethisterone acetate | 1mg |
Excipients (Other Ingredients)
- Core tablet: Lactose monohydrate, maize starch, hydroxypropylcellulose, talc, magnesium stearate
- Red film-coating: Hypromellose, talc, titanium dioxide (E171), propylene glycol, red iron oxide (E172)
- White film-coating: Hypromellose, triacetin, talc
Allergen Warnings
- Lactose: Contains lactose - not suitable for patients with lactose intolerance, lactase deficiency, or glucose-galactose malabsorption
- Maize starch: Contains starch - caution in corn allergy (rare)
How to Use Novofem
Step-by-Step Administration
- Starting Treatment: Begin on any convenient day if not switching from other HRT
- Daily Timing: Take at about the same time each day
- With or Without Food: Can be taken with or without food and drink
- Swallowing: Swallow whole with a glass of water
- Calendar Pack: Follow the sequential order: red tablets first, then white tablets
Using the Calendar Pack
The Novofem® calendar pack has a special design to help you track your doses:
- Set day reminder: Turn inner disc to set current day of week
- Take first tablet: Break plastic tab and tip out first tablet
- Daily rotation: Move transparent dial clockwise one space each day
Novofem Dosage Guidelines
Standard Dosage Schedule
| Pack Days | Tablet Colour | Active Ingredients | Frequency |
|---|---|---|---|
| Days 1-16 | Red | Estradiol 1mg | Once daily |
| Days 17-28 | White | Estradiol 1mg + Norethisterone acetate 1mg | Once daily |
Treatment Principles
- Lowest effective dose: Prescribed at minimum dose for symptom control
- Shortest duration: Continued only while benefits outweigh risks
- Regular review: Treatment reassessed at least annually
- Symptom evaluation: If no relief after 3 months, consult doctor
Administration Instructions
Starting Treatment
If not switching from another HRT: Start on any convenient day
If switching from another HRT: Consult doctor for specific start timing
Daily Routine
- Choose a convenient time of day (e.g., morning with breakfast)
- Take ONE tablet at this same time each day
- Swallow whole with water - do not crush or chew
- Follow the sequence: 16 red tablets, then 12 white tablets
- Start new pack immediately after finishing previous pack
Expected Bleeding Pattern
- Withdrawal bleed usually occurs during the last days of white tablets or shortly after
- Bleeding typically starts at beginning of new pack
- Pattern may become lighter or stop over time
Missed Dose Management
Time-Based Guidance
| Time Since Missed Dose | Action | Additional Notes |
|---|---|---|
| Less than 12 hours late | Take tablet as soon as remembered | Continue with next dose at usual time |
| More than 12 hours late | Skip missed dose | Take next dose at usual time next day |
Important Notes
- DO NOT take double dose to make up for missed tablet
- Missing doses may cause breakthrough bleeding or spotting
- If multiple doses missed, contact doctor for advice
Overdose Information
EMERGENCY ACTION REQUIRED
If you suspect overdose, contact your doctor immediately or go to the nearest hospital emergency department.
Symptoms of Overdose
- Estradiol (Oestrogen): Breast tenderness, nausea, vomiting, abdominal pain, irregular vaginal bleeding
- Norethisterone (Progestagen): Depressive mood, fatigue, acne, hirsutism
Management Protocol
- Immediate action: Stop taking Novofem®
- Medical attention: Contact doctor or hospital immediately
- Symptomatic treatment: No specific antidote - supportive care only
Possible Side Effects
SERIOUS SIDE EFFECTS - SEEK IMMEDIATE MEDICAL HELP
Stop taking Novofem® and contact doctor immediately if you experience:
- Signs of blood clots: painful/swollen legs, chest pain, breathlessness
- Signs of stroke: sudden weakness/numbness, speech problems, vision changes
- Signs of allergic reaction: swelling, difficulty breathing, rash
- Yellowing of skin/eyes (jaundice)
- Severe headache with visual disturbances
- Unexpected vaginal bleeding
Very Common (more than 1 in 10 people)
- Headache
- Breast tenderness/pain
Common (1 in 10 to 1 in 100 people)
- Increased blood pressure
- Vaginal fungal infection (thrush)
- Dizziness, insomnia, depression
- Nausea, abdominal pain
- Vaginal bleeding/spotting
- Weight increase
Serious Side Effects
| Effect | Frequency | Action Required |
|---|---|---|
| Venous Thromboembolism | Uncommon | DISCONTINUE immediately |
| Stroke | Rare | Emergency treatment |
| Endometrial Cancer | Rare | Medical evaluation |
| Gallbladder Disease | Uncommon | Medical evaluation |
How to Store Novofem
Storage Conditions
- Temperature: Store below 25°C
- Do not refrigerate
- Protect from light: Keep in outer carton
- Keep dry: Store in original container
Safety Precautions
- Keep out of sight and reach of children
- Do not use after expiry date (stated on pack)
- Do not transfer tablets to other containers
Disposal
- Do not dispose of via wastewater or household waste
- Return unused/expired medication to pharmacy
- Ask pharmacist about safe disposal options
Pack Information
Pack Sizes
- 28 tablets (16 red + 12 white) - Calendar Pack
- 84 tablets (48 red + 36 white) - 3 x Calendar Packs
Appearance
- Red tablets: Round, red film-coated, engraved "NOVO 282"
- White tablets: Round, white film-coated, engraved "NOVO 283"
- Pack design: Calendar pack with day reminder
Manufacturer Information
- Marketing Authorisation Holder: Novo Nordisk Limited, UK
- Manufacturer: Novo Nordisk A/S, Denmark
- UK Product Licence: PL 44272/0004
Where Can I Buy Novofem Online in the UK
Secure Novofem Prescription & Next-Day Delivery Service
Order Novofem with confidence through our UK-registered medical prescribers, who review all requests within 4 working hours. We guarantee same-day prescription approval for eligible patients and dispatch orders placed before 3pm for next-day tracked delivery.
Our Novofem service combines competitive pricing with strict adherence to MHRA safety standards, ensuring your HRT medication is dispensed through GPhC-registered pharmacies. Every purchase includes discreet packaging and a GDPR-compliant consultation process.
Our clinical team ensures:
- Comprehensive medical history review including breast cancer risk assessment
- Blood pressure monitoring and baseline evaluations
- Drug interaction checks with existing medications
- Personalised HRT dosing guidance according to NHS HRT guidelines
Always consult your GP before starting HRT treatment. Not recommended for women with history of breast cancer, thromboembolic disorders, or liver disease. Regular monitoring required.
Novofem® (Estradiol/Norethisterone Acetate) FAQs
How quickly does Novofem work for hot flushes?
Most women notice improvement in hot flushes within 4-8 weeks. Maximum benefit is usually seen by 3 months. If no improvement after 3 months, consult your doctor as the dose may need adjustment or alternative treatments considered.
Can I drink alcohol while taking Novofem?
Moderate alcohol consumption is generally acceptable, but discuss with your doctor. Alcohol may affect liver metabolism of hormones and could increase breast cancer risk associated with HRT. Excessive alcohol should be avoided.
Will Novofem make me gain weight?
Weight increase is a common side effect (affects up to 1 in 10 users). HRT can cause fluid retention and changes in fat distribution. Maintaining a healthy diet and regular exercise can help manage weight while on treatment.
What happens if I miss my period while taking Novofem?
It's normal for withdrawal bleeds to become lighter or stop over time. However, if you miss a bleed AND might be pregnant (if still potentially fertile), take a pregnancy test. Always report any change in bleeding pattern to your doctor.
Can I take Novofem if I have high blood pressure?
Novofem can be used in controlled hypertension but requires careful monitoring. Your blood pressure should be well-controlled before starting. HRT may increase blood pressure in some women, so regular monitoring (every 6-12 months) is essential.
How long can I safely take Novofem?
Treatment duration should be as short as possible, reassessed annually. For symptom relief, many women take it for 2-5 years. For osteoporosis prevention, discuss long-term strategy with your doctor considering individual risks vs benefits.
Does Novofem protect against heart disease?
No, Novofem does not prevent heart disease. In women over 60, combined HRT may slightly increase heart disease risk. HRT should not be used for cardiovascular protection.
Can I switch from another HRT to Novofem?
Yes, but timing is important. Consult your doctor for specific instructions. Usually, you would start Novofem immediately after finishing your current pack, but this depends on what HRT you're currently taking. Follow NHS guidance on HRT switching.
What should I do if I experience breast tenderness?
Breast tenderness is very common (affects more than 1 in 10 users). It often improves after the first few months. If persistent or severe, consult your doctor. Regular breast self-examination is important regardless.
Is Novofem suitable for women who've had a hysterectomy?
Women who've had a hysterectomy (womb removal) usually only need oestrogen-only HRT, not combined HRT like Novofem. The progestagen in Novofem is specifically to protect the womb lining, which isn't needed after hysterectomy.
Can Novofem affect my mood or cause depression?
Depression is a common side effect (up to 1 in 10 users). HRT can affect mood in either direction - some women feel better, some worse. If you experience significant mood changes, discuss with your doctor.
What's the difference between red and white Novofem tablets?
Red tablets (days 1-16) contain oestrogen only (estradiol 1mg). White tablets (days 17-28) contain both oestrogen (estradiol 1mg) and progestagen (norethisterone acetate 1mg). This sequential design mimics the natural menstrual cycle.
Do I need a mammogram before starting Novofem?
You should be up-to-date with breast screening as per national guidelines. HRT increases breast density, which can make mammogram interpretation harder. Always inform mammography staff you're on HRT.
Can I take herbal supplements with Novofem?
Avoid St. John's Wort as it reduces HRT effectiveness. Other supplements should be discussed with your doctor. Some may interact with HRT or affect hormone levels.
What happens when I stop taking Novofem?
Symptoms may return after stopping. Gradual withdrawal is often recommended. Bone protection benefits decline after stopping. Always discuss stopping with your doctor first - don't stop abruptly without medical advice.
Medical Content Manager
Nabeel is a co-founder, and medical content manager of Chemist Doctor. He works closely with our medical team to ensure the information is accurate and up-to-date.
Medical Doctor
Dr. Talal is a GMC registered doctor and medical reviewer at Chemist Doctor. He ensures clinical accuracy and reliability across health content.
Medical Director
Usman is a co-founder, and medical director of Chemist Doctor. He leads the organisation's strategic vision, bridging clinical and operational priorities.
Review Date: 24 December 2025
Next Review: 24 June 2026
Published on: 24 December 2025
Last Updated: 24 December 2025
Getting your Novofem® medication is quick and easy with our simple 4-step process:
Start Consultation
Complete our brief health questionnaire about your menopausal symptoms and medical history.
Medical Review
UK-registered clinicians review your consultation for safe HRT prescribing.
Pharmacy Processing
If approved, our partner pharmacy prepares your Novofem® medication.
Fast Dispatch
Your order is dispatched via your chosen delivery method.
What does the online consultation involve?
You'll answer questions about your menopausal symptoms, medical history, and current health to ensure safe HRT prescribing. Honest responses are vital for your safety.
How do I reorder Novofem?
Use the login details emailed after your first order to access your account and reorder. Annual medical review required for continued HRT prescriptions.
At Chemist Doctor, we respect your privacy and ensure complete discretion at every step of your HRT treatment journey.
Discreet Packaging
All HRT orders are sent in tamper-evident, plain white boxes sealed within anonymous grey mailing bags with no external medication labels.
Secure Medical Data
Your personal and medical information is kept strictly confidential with NHS-level SSL encryption and GDPR-compliant storage.
Private Consultations
All menopause and HRT consultations are conducted privately by UK-registered clinicians specialising in women's health.
Anonymous Billing
Credit card statements show a neutral descriptor "CD Healthcare" with no reference to HRT or menopause medications.
Will my GP be informed about my HRT order?
Only with your consent. We recommend updating your GP directly for seamless care coordination of your menopause treatment.
We offer two reliable delivery options to suit your needs for HRT medication:
| Service Type | Delivery Speed | Order Cut-off | Carrier |
|---|---|---|---|
| Standard Delivery | 2-3 business days | No cut-off | Royal Mail |
| Premium Next-Day Delivery | Next business day | 3 PM weekdays | Royal Mail 24 |
Next-day delivery guarantee applies to orders approved before 3 PM to these regions:
- England
- Scotland
- Wales
- Northern Ireland
Is HRT packaging discreet?
Yes. All HRT orders are shipped in plain, unmarked packaging via tracked courier services with no indication of contents.
Do you deliver on weekends or bank holidays?
Deliveries occur Monday–Friday only. We do not ship on weekends or UK bank holidays.
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Can I return prescription HRT medication?
No. UK law prohibits returns of dispensed prescription treatments for safety reasons.
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Pay in 3 by Klarna UK allows you to split your purchase into 3 equal payments. The first payment is made at checkout, with the remaining two payments automatically collected every 30 days. There are no interest or fees when you pay on time.
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