Indivina

Indivina is a continuous combined hormone replacement therapy tablet containing estradiol valerate and medroxyprogesterone acetate.

It is prescribed for postmenopausal women who are at least twelve months past their last natural period and who experience symptoms such as hot flushes, night sweats, vaginal dryness, and mood disturbance resulting from oestrogen deficiency.

Because Indivina contains both an oestrogen and a progestogen in every tablet, it provides continuous protection of the endometrium without the need for a separate progestogen course.

This continuous combined regimen is designed to be period-free, making it suitable for women who have completed the menopausal transition and do not wish to have monthly withdrawal bleeds.

Indivina is available in three strengths, allowing prescribers to select the combination that best balances symptom relief with the lowest effective hormone exposure.

Treatment should be reviewed at least annually to assess whether the benefits of continued therapy outweigh the risks.

Take one tablet daily by mouth at approximately the same time each day, with or without food. Swallow the tablet whole with water.

There is no break between packs; when one pack is finished, start the next immediately.

If you miss a dose, take it as soon as you remember unless more than twelve hours have elapsed, in which case skip that dose and continue as normal. Do not take two tablets together.

Your prescriber will carry out regular reviews, typically every six to twelve months, to reassess your symptoms and confirm that continued use remains appropriate.

Indivina is available as 1 mg/2.5 mg, 1 mg/5 mg, and 2 mg/5 mg tablets. Treatment is usually started on the lowest available strength.

If symptoms persist after eight to twelve weeks, the dose may be increased. The aim is always to use the lowest effective dose for the shortest duration necessary.

Dose adjustments should be guided by symptom control and tolerability.

Common side effects (up to 1 in 10 women) include breast tenderness, headache, nausea, abdominal pain, and unexpected vaginal bleeding or spotting, particularly during the first three to six months.

Uncommon effects include mood changes, fluid retention, weight fluctuation, and leg cramps.

Rare but serious risks include venous thromboembolism, stroke, and a small increase in breast cancer risk with use beyond five years.

Any unusual vaginal bleeding persisting beyond the initial six months should be reported to your prescriber.

Indivina is not suitable for perimenopausal women who are still having periods; a sequential HRT regimen should be used instead.

Before starting treatment, discuss your full medical history with your doctor, including any personal or family history of breast cancer, blood clots, heart disease, liver problems, or migraine.

Attend routine breast screening and report any breast changes promptly.

Treatment should be stopped immediately and medical advice sought if you develop signs of a blood clot, severe headache, or jaundice.

Indivina is contraindicated in women with known or suspected breast cancer, other oestrogen-dependent cancers, undiagnosed genital bleeding, untreated endometrial hyperplasia, active or recent venous or arterial thromboembolism, known thrombophilic disorders, active liver disease, porphyria, or hypersensitivity to any ingredient.

It should not be used during pregnancy or breastfeeding.