Activella

Generic name: Estrogen and progestin

What is Activella?

Activella is used for hormone replacement therapy. It is used to relieve the symptoms of menopause and also to treat vaginal atrophy. In addition, Activella is prescribed to prevent osteoporosis in postmenopausal women.

What is the most important information I should know about Activella?

Because of the risk of uterine cancer, be sure to alert your doctor if you experience any abnormal vaginal bleeding. There is little, if any, increase in risk during the first year of treatment, but the odds rise substantially after 5 to 10 years.

In addition to increasing the chances of uterine cancer, estrogen replacement therapy may also raise the odds of breast cancer if taken at high doses or for long periods of time. Be sure to do a monthly self-exam of your breasts, and get regular mammograms.

Estrogen replacement therapy typically doubles the chances of gallbladder disease. Notify your doctor if you experience pain, tenderness, or swelling in your abdomen.

Estrogen replacement increases the risk of blood clots in the veins, especially during the first year of therapy. Call your doctor immediately if you experience any of the following warning signs: bulging eyes, changes in vision or speech, coughing up blood, dizziness, double vision, faintness, migraine, pains in the calves or chest, severe headache or vomiting, sudden shortness of breath, sudden vision loss, weakness or numbness of an arm or leg.

Estrogen therapy sometimes causes high blood pressure, so be sure to get periodic checkups. In women prone to high blood lipid levels, estrogen can also cause a sharp spike in triglycerides, possibly leading to pancreatitis. Fluid retention is another possibility. If it develops, it can aggravate conditions such as asthma, epilepsy, heart disease, kidney disease, and migraine.

Make sure your doctor knows if you have ever been diagnosed with depression. Treatment with hormone replacement therapy may need to be discontinued if depression recurs.

If you have diabetes, watch your blood sugar levels carefully. There's a chance that estrogen/progestin products may make diabetes worse.

Who should not take Activella?

Do not take Activella if you have any of the following: known or suspected breast cancer, any other cancer stimulated by estrogen, or a past history of breast cancer associated with estrogen use; unexplained genital bleeding; a history of blood clots or phlebitis; sensitivity to estrogen or progesterone; any reason to believe that you are pregnant.

If you've had your uterus removed, you don't need the progestin in these products, and should take a different type of hormone replacement therapy. You should also avoid Activella if you have a liver condition.

What should I tell my doctor before I take the first dose of Activella?

Tell your doctor about all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with Activella. Also talk to your doctor about your complete medical history, especially if you have ever had cancer, diabetes, heart problems, gallbladder disease, depression, or if you have unexplained vaginal bleeding.

What is the usual dosage?

The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.

Adults: The recommended dose is one tablet daily.

How should I take Activella?

Take one tablet at the same time each day, with or without food. If you are taking the medication to relieve menopausal symptoms, your doctor will reevaluate your need for medication every 3 to 6 months.

What should I avoid while taking Activella?

Do not miss regularly scheduled checkups with your doctor while taking Activella. Be sure to have an annual gynecologic exam (including a breast exam and/or mammography).

What are possible food and drug interactions associated with Activella?

If estrogen is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining estrogen with the following: St. John's wort, phenobarbital, carbamazepine, Rifampin, erythromycin, clarithromycin, ketoconazole, itraconazole, ritonavir, and grapefruit juice.

What are the possible side effects of Activella?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

Side effects may include: abdominal pain, breast tenderness and enlargement, depression, enlargement of uterine fibroids, headache, nausea, nervousness, skin reddening, urinary tract infection, vaginal inflammation, vomiting

Can I receive Activella if I am pregnant or breastfeeding?

Although these medications are intended only for women who are no longer in their childbearing years, it's important to note that they should never be taken during pregnancy, since they can harm the developing baby. Additionally, estrogen decreases the quantity and quality of breast milk, and progesterone finds its way into the milk.

What should I do if I miss a dose of Activella?

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Never take 2 doses at the same time.

How should I store Activella?

Store at room temperature. Keep Activella in a tightly closed container away from moisture and light.