How To Use Livial

Step-by-Step Usage Guide: How to Take Livial

Follow these steps to ensure you take Livial correctly and safely:

1. Confirm timing: Ensure it is appropriate for you to start Livial. If you have a natural menopause, do not start until at least 12 months after your last period. If switching from another HRT, follow your doctor's advice (see “Dosage Guide” below).
2. Remove the tablet: Press the tablet through the foil blister – do not push it through the back. Livial tablets are white, marked “Organon*” on one side and “MK2” on the other.
3. Swallow whole: Swallow the tablet with a glass of water or another drink. Do not chew or crush the tablet.
4. Take at the same time daily: Choose a time that is easy to remember, such as with breakfast or before bed. Consistency helps maintain steady levels of the active metabolites.
5. If you forget a dose:
   • If you are less than 12 hours late, take the missed tablet immediately.
   • If you are more than 12 hours late, skip the missed dose and take your next tablet at the usual time.
   • Never take a double dose to make up for a forgotten one.
6. If you need surgery: Tell your surgeon or anaesthetist that you are taking Livial. You may be advised to stop taking it 4 to 6 weeks before elective surgery to reduce the risk of blood clots. Your doctor will tell you when it is safe to restart.
7. Regular check‑ups: Visit your doctor at least once a year while taking Livial. Continue with routine breast screening and cervical smears as recommended.

Livial Dosage Guide

The recommended dose of Livial is one 2.5 mg tablet once daily. This dose is suitable for most women. Your doctor may adjust the dose based on your individual response, but the standard strength is 2.5 mg. Do not take more than one tablet in 24 hours.

When to start Livial

• If you have never used HRT before: Start Livial straight away provided it is at least 12 months since your last natural period. If you have had a hysterectomy, you may start immediately.
• If you are switching from a cyclic HRT (with monthly periods): Wait for your next period to end, then start Livial the day after the bleeding stops.
• If you are switching from a continuous combined HRT (no periods): You can start Livial any day, but it is advisable to finish the current pack of HRT first. Your doctor will provide specific instructions.
• If you have had a hysterectomy: You can start Livial at any time after your surgery.

If you have been using a hormone‑releasing intrauterine system (IUS) for endometrial protection, your doctor may advise you to keep it in place for the first few months after switching to Livial.

Who Should Use Livial

Livial is intended for postmenopausal women who are experiencing symptoms of oestrogen deficiency, such as:

• Moderate to severe hot flushes and night sweats
• Vaginal dryness, discomfort during intercourse (dyspareunia)
• Mood changes, irritability, or loss of libido related to menopause
• Prevention of osteoporosis in women at high risk of fractures who cannot take other treatments

Livial may also be suitable for women who have had a hysterectomy and need relief from menopausal symptoms without the need for a progestogen. Because Livial has built‑in progestogenic activity, it does not require additional progestogen to protect the womb lining.

Your doctor will consider your medical history and current health status before prescribing Livial. It is especially important to discuss any personal or family history of breast cancer, blood clots, or liver disease.

Who Should Not Use Livial (Contraindications)

Do not take Livial if any of the following apply to you. If you are unsure, speak to your doctor before starting.

• You have or have ever had breast cancer, or are suspected of having it.
• You have cancer that is sensitive to oestrogens, such as cancer of the womb lining (endometrium).
• You have unexplained vaginal bleeding that has not been investigated.
• You have excessive thickening of the womb lining (endometrial hyperplasia) that is not being treated.
• You have or have ever had a blood clot in a vein (deep vein thrombosis, pulmonary embolism).
• You have a blood clotting disorder (e.g., protein C, protein S, or antithrombin deficiency).
• You have or recently have had a heart attack, stroke, or angina.
• You have or have ever had a liver disease and your liver function tests have not returned to normal.
• You have a rare inherited blood disorder called porphyria.
• You are allergic to tibolone or any of the other ingredients (lactose, potato starch, etc.).
• You are pregnant or think you might be pregnant, or you are breastfeeding.

If any of these conditions appear for the first time while taking Livial, stop taking it immediately and consult your doctor.

Taking Livial with Food and Drink

Livial can be taken with or without food. You may eat and drink normally while using this medicine. However, certain substances may interact with Livial and affect its effectiveness:

• Herbal remedies containing St John’s Wort (Hypericum perforatum) can reduce the effectiveness of Livial by increasing its metabolism. Avoid using St John’s Wort while taking Livial.
• Alcohol: There is no known interaction between Livial and alcohol. However, excessive alcohol consumption may increase the risk of breast cancer and should be minimised.
• Grapefruit juice: Although not specifically studied, grapefruit juice can affect the metabolism of some drugs via CYP3A4. To be safe, avoid large amounts of grapefruit juice while on Livial.

If you have any concerns about interactions with specific foods or drinks, speak to your pharmacist or doctor.

Special Conditions: Pregnancy, Breastfeeding & Other Considerations

Pregnancy and breastfeeding

Livial is for use in postmenopausal women only. If you become pregnant while taking Livial, stop the medication immediately and contact your doctor. Livial should not be used during pregnancy or while breastfeeding, as it may pass into breast milk and affect the infant.

Pre-existing medical conditions

If you have any of the following conditions, your doctor will monitor you more closely while you take Livial, and you may need more frequent check‑ups:

• Fibroids inside the womb
• Endometriosis or a history of endometrial hyperplasia
• Increased risk of blood clots (e.g., family history, obesity, prolonged immobility)
• High blood pressure
• Liver disorders (e.g., benign liver tumour)
• Diabetes (Livial may affect insulin requirements)
• Gallstones
• Migraine or severe headaches
• Systemic lupus erythematosus (SLE)
• Epilepsy
• Asthma
• Otosclerosis (hearing condition)
• Very high levels of triglycerides in the blood
• Fluid retention due to heart or kidney problems

Surgery and prolonged immobility

As mentioned earlier, you may need to stop Livial 4–6 weeks before planned surgery or during periods of prolonged immobility (e.g., after a leg fracture) to reduce the risk of blood clots. Always inform your surgeon that you are taking Livial.

Livial Usage FAQs

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