Menobon

Indications

Tibolone is used to relieve symptoms of menopause, such as hot flushes, night sweats, mood changes and vaginal dryness, in women at least one year after their last natural period. It may also be used to help prevent bone thinning (osteoporosis) in postmenopausal women at high risk of fractures when other medicines are not suitable.

How It Works

Tibolone is a synthetic steroid. In the body it is changed into substances that act like the hormones oestrogen, progesterone and, to a small degree, testosterone. This replaces some of the effects of the hormones that fall at menopause, easing symptoms and helping protect bone.

Dosage and Administration

Take as prescribed by your doctor, usually one tablet once a day at about the same time each day, swallowed with water. Use the lowest effective dose for the shortest time needed. Do not start it within 12 months of your last natural period, as irregular bleeding is more likely. Your doctor will review the treatment at least once a year.

Interactions

Tibolone can increase the effect of blood thinners such as Warfarin. Medicines that speed up liver enzymes, such as Carbamazepine, Phenytoin, Rifampicin and St John's wort, may reduce its effect. Do not take it together with other hormone replacement therapy.

Contraindications

Do not use if you are pregnant or breastfeeding; have or have had breast cancer or a hormone-dependent cancer such as womb cancer; have unexplained vaginal bleeding; have untreated thickening of the womb lining; have had blood clots, stroke or heart attack; have active liver disease; have porphyria; or are allergic to Tibolone.

Side Effects

Possible side effects include vaginal spotting or bleeding, breast tenderness, stomach pain, weight gain, increased hair growth, headache, dizziness, swelling of the ankles and skin rash.

Get urgent medical help if you notice signs of a blood clot (painful swelling of one leg, sudden chest pain or breathlessness), signs of a stroke (sudden weakness or numbness on one side, trouble speaking, sudden severe headache), yellowing of the skin or eyes, a breast lump, or unexpected heavy vaginal bleeding.

Pregnancy and Lactation

Tibolone is only for women after menopause. It must not be used during pregnancy or while breastfeeding.

Precautions and Warnings

Tibolone slightly increases the risk of stroke, and the risk of breast and womb cancer may be raised with long-term use. Have regular check-ups, including breast checks as advised. Report any vaginal bleeding that starts after several months of treatment. Use with care if you have high blood pressure, diabetes, migraine, epilepsy, high cholesterol, liver or kidney problems, or a history of endometriosis. It is not a contraceptive.

Overdose

Serious harm is unlikely, but nausea, vomiting and vaginal bleeding can occur. Contact a doctor or poison centre for advice.

Therapeutic Class

Synthetic steroid for menopausal hormone therapy.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.