Kliovance

Kliovance

Kliovance is a Hormone Replacement Therapy designed to help relieve the symptoms of menopause in women who have not had a natural period for more than one year.  Kliovance is what is known as a combined HRT, this means it contains two types of the female hormone, in this case, progesterone and oestrogen. More information

A doctor will review your order and write you a prescription, if appropriate. This prescription is then forwarded to a pharmacy. The pharmacy will have your medicine delivered to you within one to three working days. Read more about this process here.

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Patient Leaflet(s)

While menopause is a natural process for women around the ages of 45- 55,  it isn’t necessarily an easy time in your life. The drop in oestrogen experienced by your body can have some really unpleasant side effects, like hot flushes, mood swings and changes to your sex drive. Sometimes making simple lifestyle changes can be enough to help you cope with symptoms of the menopause but at other times the side effects are so strong that they cause upset in your day to day life. If this is the case then there are a variety of Hormone Replacement Therapies that may be able to provide you with some relief. 

What is Kliovance? 

Kliovance is a Hormone Replacement Therapy designed to help relieve the symptoms of menopause in women who have not had a natural period for more than one year. 

Kliovance is what is known as a combined HRT, this means it contains two types of the female hormone, in this case, progesterone and oestrogen. When you go through the menopause, the level of these hormones in the body drops radically as your body stops producing eggs, taking an HRT can help to alleviate your menopausal symptoms. 

Kliovance is a continuous HRT, meaning there are no breaks in the treatment to allow for a monthly bleed, you take the tablets continuously. You will need to work out with your doctor how long the continuous period is as you should take HRT’s at the lowest dose and for the shortest time possible to relieve your symptoms. 

When is Kliovance used? 

Kliovance is used for women who are going through the menopause to help combat unpleasant symptoms caused by the drop in oestrogen in the body. These include: 

  • Hot flushes; 
  • Night sweats; 
  • Headaches
  • Mood swings; 
  • Anxiety; 
  • Lower sex drive; 
  • Vaginal dryness
  • Joint pain or stiffness; 
  • Weak bones, osteoporosis; 
  • Frequent urinary tract infections; 
  • Difficulty sleeping; 
  • Palpitations; 
  • Reduced muscle mass. 

Kliovance is only prescribed for women who still have a womb and have had at least a year since their last natural period. It will only be prescribed if your menopausal symptoms are seriously affecting your ability to lead a normal life. 

Kliovance can also be used to help ward off osteoporosis in postmenopausal women if you have an increased risk of fractures due to the menopause and you cannot take certain other medications. 

How do you use Kliovance? 

Always follow the instructions of your doctor or pharmacist when it comes to taking medication and check with them if you’re unsure. 

If you are switching from a Hormone Replacement Therapy where you have a monthly bleed, then start taking Kliovance straight after the bleeding has ended, otherwise, you can start whenever is convenient. 

  • Kliovance comes in tablet form.  
  • Take one tablet a day at around the same time each day, when you finish the pack, start a new pack straight away; 
  • Kliovance comes in a calendar pack to help you keep track of the days so you don’t forget to take your tablet; 
  • If you forget to take your tablet at the usual time, take it as soon as you remember – it can help to set a daily alarm on your phone; 
  • If you miss a day do not double up, simply skip that day and carry on as normal – you may experience some spotting. 

What dosages are there? 

With any HRT your doctor should ensure you are on the lowest possible dose for the shortest possible time to alleviate the symptoms. 

The active ingredients in Kilovance are estradiol and norethisterone acetate, the tablets come in two different doses: 

  • 0.5mg; 
  • 1mg. 

With both doses, you take one tablet every day, continuously until you and your doctor decide to stop.  

What are the side effects of Kliovance? 

As with all medication Kliovance comes with a warning of some side effects, not everyone taking Kliovance will experience them. 

There are some diseases that are reported more often in women using HRT compared to women who aren’t using HRT, these include: 

  • Breast cancer; 
  • Abnormal growth or cancer of the lining of the womb; 
  • Ovarian cancer; 
  • Blood clots in the leg veins or lungs; 
  • Memory loss (dementia); 
  • Heart disease; 
  • Stroke. 

If you have had any of the following prior to starting treatment with Kliovance then you will need to let your doctor know as they may return or worsen during the treatment so you will need regular check-ups. 

  • High blood pressure; 
  • Fibroids inside your womb; 
  • Growth of the womb lining outside your womb or a history of excessive womb lining; 
  • A liver disorder; 
  • Gallstones; 
  • Diabetes; 
  • Increased risk of developing blood clots; 
  • Migraine or severe headaches
  • Increased risk of getting oestrogen sensitive cancer; 
  • Asthma; 
  • Epilepsy; 
  • A disease of the immune system affecting many organs of the body; 
  • A high level of fat in your blood; 
  • Fluid retention caused by cardiac or kidney problems; 
  • A disease affecting the eardrum and hearing; 
  • Lactose intolerance. 

Very common side effects (affects more than 1 in 10 people) 

  • Breast pain or tenderness; 
  • Vaginal bleeding. 

Common side effects (affects 1 to 10 people out of 100) 

  • Weight gain caused by fluid retention; 
  • Headache; 
  • Vaginal inflammation; 
  • Vaginal infection; 
  • Depression, either new or worsened; 
  • Migraine, either new or worsened; 
  • Back pain; 
  • Swelling of arms and legs; 
  • Nausea; 
  • Enlarged or swollen breasts; 
  • Uterine fibroid aggravation, occurrence or reoccurrence. 

Uncommon side effects (affects 1 to 10 people out of 1000) 

  • Hair loss; 
  • Bloating, abdominal pain, swelling, flatulence; 
  • Acne; 
  • Inflammation of a vein; 
  • Abnormal hair growth; 
  • Itching or hives; 
  • Allergic reaction; 
  • Nervousness; 
  • Leg cramps. 

Rare side effects (affects 1 to 10 people out of 10,000) 

  • Blood clots in the blood vessels of the legs or the lungs. 

Very rare side effects (affects less than 1 person in 10,000) 

  • Excessive thickening of the lining of the womb; 
  • Cancer of the lining of the womb; 
  • Gall bladder disease, gall stones; 
  • Increased blood pressure; 
  • Worsening of high blood pressure; 
  • Vomiting; 
  • Heart attack and stroke; 
  • Heartburn; 
  • Changes in libido; 
  • Insomnia, dizziness, anxiety; 
  • Acute or recurring oedema; 
  • Visual disturbances; 
  • Weight loss. 

Other side effects of combined HRT 

  • Gall bladder disease; 
  • Various skin disorders including: 
  • Discolouration of the skin, especially on the face or neck; 
  • Rash with target-shaped reddening or sores; 
  • Red or purple discolourations on the skin and/or eyes, nose, mouth; 
  • Painful reddish skin nodules. 

When shouldn’t you use Kliovance? 

You should not take Kliovance if any of the following apply to you. If you are unsure then discuss it with a medical professional. 

If you have or have had cancer which is sensitive to oestrogens, such as cancer of the womb; 

  • If you have excessive thickening of the womb lining; 
  • If you have or have had breast cancer; 
  • If you have unexplained vaginal bleeding; 
  • If you have or have ever had a blood clotting disorder; 
  • If you have or have ever had liver disease; 
  • If you have or have ever had a disease caused by blood clots in the arteries such as a heart attack, stroke or angina; 
  • If you have or have ever had a blood clot in a vein, as in the legs or lungs 
  • If you have a rare blood problem called porphyria 
  • If you are allergic to estradiol, norethisterone acetate or any of the other ingredients listed on the pack. 
  • If any of the conditions above appear while you are taking Kliovance then you should stop taking the tablets and consult your doctor immediately. 
  • Yellowing of the skin or the whites of your eyes, this may be a sign of liver disease; 
  • If you become pregnant; 
  • If you experience a large rise in blood pressure; 
  • Migraine-like headaches which happen for the first time; 
  • Signs of a blood clot, for example, painful swelling and redness of the legs, sudden chest pain, difficulty breathing. 
  • You should not take Kliovance if you are pregnant or breastfeeding, it is designed for post-menopausal women only. 

Does Kliovance interact with other medications? 

You should always talk to your doctor or pharmacist about any other medication you are taking, as some medicines may interfere with Kliovance or vice versa. This can cause irregular bleeding among other problems. 

While not an exhaustive list, you should take special care with the following: 

  • Medicines for tuberculosis; 
  • Medicines for HIV infections; 
  • Medicines for epilepsy; 
  • Medicines for hepatitis c; 
  • Herbal remedies containing St John’s Wort; 
  • Medicines containing ketoconazole (a fungicide). 

Where can you buy Kliovance? 

You can obtain Kliovance from any reputable pharmacy, try your local pharmacy or supermarket pharmacy, or try ordering online for the convenience of having your prescription delivered to your door, you will need to submit a recent blood pressure reading as well. 

Can I get Kliovance without a prescription? 

No, you cannot buy Kliovance without a prescription. Hormone Replacement Therapies come with warnings of some serious side effects so you will need to make an appointment with a doctor, this could be your regular doctor or an online doctor. You will need to discuss your medical history and your families medical history in detail and you should also discuss your symptoms and the various types of HRT available to work out which is best for you. Once you start your treatment you will need regular check-ups to ensure that you are taking the lowest possible dose and that side effects are kept to a minimum. With HRT this is sometimes a process of trial and error to find the medication that suits you best.  

Sources 

Brazier, Y. (2017). Hormone replacement therapy: Uses, types, and alternatives. [online] Medical News Today. Available at: https://www.medicalnewstoday.com/articles/181726.php [Accessed 20 Dec. 2019]. 

Irani, s. (2016). Menopause | Health Information | Bupa UK. [online] Bupa.co.uk. Available at: https://www.bupa.co.uk/health-information/womens-health/menopause [Accessed 20 Dec. 2019]. 

NHS UK (2017). Menopause - Treatment. [online] nhs.uk. Available at: https://www.nhs.uk/conditions/menopause/treatment/ [Accessed 20 Dec. 2019]. 

Novo Nordisk Healthcare (2016). Kliovance - Patient Information Leaflet (PIL) - (emc). [online] Medicines.org.uk. Available at: https://www.medicines.org.uk/emc/product/1046/pil [Accessed 20 Dec. 2019]. 

Assessed by:

Dr Imran Malik, General practitioner
Registration number: GMC: 4741365

Dr Imran Malik studied undergraduate medicine at King's College University in Central London and clinical studies at the prestigious King's College Hospital. He graduated with a MBBS degree in 2000 and went on to gain postgraduate memberships with the Royal Society of Medicine and also General Practice in 2006.