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What is the uses of Generic Livial (Tibolone)?

Relieving the symptoms of oestrogen deficiency (eg hot flushes, decreased sex drive, depression) in women who have gone through the menopause.Prevention of osteoporosis in women who have gone through the menopause and are at high risk of fractures, but cannot take other medicines used to prevent osteoporosis.

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Warning!
Women taking any form of HRT should have regular medical and gynaecological check-ups. Your need for continued HRT should be reviewed with your doctor at least once a year. It is important to be aware that all women using HRT have an increased risk of being diagnosed with breast cancer compared with women who don’t use HRT. This risk needs to be weighed against the personal benefits to you of taking HRT.

There is more detailed information about the risks and benefits associated with HRT in the factsheet about the menopause linked above. You should discuss these with your doctor before starting HRT. Women on HRT should have regular breast examinations and mammograms and should examine their own breasts regularly.

The risk is higher if you have existing risk factors (eg personal or family history, smoking, obesity, certain blood disorders – see cautions below) and needs to be weighed against the personal benefits to you of taking HRT. There is more detailed information about the risks and benefits associated with HRT in the factsheet about the menopause linked above. Discuss these with your doctor before starting treatment. It is not currently known if tibolone carries the same risk of blood clots as other forms of HRT. However it is associated with a slightly increased risk of stroke.

Missing a dose may increase the chance of this. If you are still experiencing any bleeding after six months of taking this medicine, or if breakthrough bleeding or spotting starts after this time, or after you have stopped taking this medicine, you should consult your doctor so that it can be investigated.

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This is because HRT, including tibolone, has been associated with a slightly increased risk of endometrial cancer. This risk needs to be weighed against the personal benefits to you of taking HRT and you should discuss this with your doctor before you start treatment.Stop taking this medicine and inform your doctor immediately if you experience any of the following symptoms while taking this medicine A woman is considered fertile for two years after her last menstrual period if she is under 50, or for one year if over 50. HRT does not provide contraception for women who fall within this group. If a potentially fertile women is taking HRT but also requires contraception, a non-hormonal method (eg condoms or contraceptive foam) should be used.

Use with caution in
Close family history of breast cancer (eg mother, sister or grandmother has had the disease)History of benign breast lumps (fibrocystic breast disease) History of fibroids in the womb History of endometriosis History of overgrowth of the lining of the womb (endometrial hyperplasia) Personal or family history of blood clots in the veins (venous thromboembolism, eg deep vein thrombosis or pulmonary embolism)Blood disorders that increase the risk of blood clots in the veins, eg antiphospholipid syndrome, factor V Leiden Women taking medicines to prevent blood clots (anticoagulants), usually of the face, during pregnancy or previous use of hormone preparations such as contraceptive pills (chloasma). Women with a tendency to this condition should minimise their exposure to the sun or UV light while taking HRT.Not to be used in Pregnancy

Breastfeeding 
Known, suspected or past history of breast cancer Known or suspected cancer in which growth of the cancer is stimulated by oestrogen, eg cancer of the lining of the womb (endometrial cancer) Untreated overgrowth of the lining of the womb (endometrial hyperplasia)Vaginal bleeding of unknown cause Women with a blood clot in a vein of the leg (deep vein thrombosis) or in the lungs (pulmonary embolism),

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

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Side effects
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here,it does not mean that all people using this medicine will experience that or any side effect.Vaginal bleeding or spotting Vaginal discharge Vaginal thrushVaginal itchingBreast painDisturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain Rash or itching Seborrhoeic dermatitis Abnormal hair growth

For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?
It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.

The following medicines may potentially reduce the blood levels and effect of this medicine, which could result in recurrence of symptoms or irregular bleeding: antiepileptic medicines such as carbamazepine, phenytoin, phenobarbital and primidone barbiturates such as amobarbital rifamycin antibiotics such as rifabutin and rifampicin.

Some women with diabetes may need small adjustments in their dose of insulin or antidiabetic tablets while taking this medicine. You should monitor your blood sugar and seek advice from your doctor or pharmacist if your blood sugar control seems to be altered after starting this medicine.

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