Evorel Conti

Evorel Conti is a transdermal patch. Evorel Conti contains 3.2 mg of estradiol corresponding to a nominal release of 50 micrograms of estradiol per 24 hours and 11.2 mg of norethisterone acetate corresponding to a nominal release of 170 micrograms of norethisterone acetate per 24 hours.). They are both female hormones.

Evorel Conti comes in a ‘memory pack’. This can be used to help you remember when to change your patches. Each pack contains eight or twenty-four patches. The hormones are spread evenly in each patch. They pass slowly into your body through the skin. Evorel Conti is used for the symptoms of the menopause It is suitable for women who have not had a period (menstrual bleed) for at least 18 months.

Evorel Conti is a continuous combined HRT preparation. Patches are applied to the skin twice weekly.

Please Note: Evorel Conti is not a contraceptive. If it is less than 12 months since your last menstrual period or you are under 50 years old, you may still need to use additional contraception to prevent pregnancy. Do not use a hormonal contraceptive while using HRT.

You may put an Evorel Conti patch on at any time if you have not been using another type of HRT.

If you are using another type of HRT the day you start will depend on the type of HRT you have been using. Talk to your doctor if you are not sure which type of HRT you are using.

The patches need to be changed twice a week. Start a new pack of Evorel Conti as soon as you finish one. Do not leave a break between packs.

You must change the patches twice a week to give your body a steady supply of hormones. There is enough hormone in each patch to last for several days. Change your patch on the same two days every week. This will mean that one patch is on for three days and the next patch for four days. For example, if you apply your first patch on a Monday, change it on Thursday and again on the following Monday. To help you remember your two “patch change” days, mark them on the pack.

Stick the patch onto a hairless area of skin below the waist. Most women prefer to wear the patch on the thigh or bottom.

• Do not apply on or near the breasts
• Do not put it on top of cuts, spots or anywhere the skin is irritated
• Do not use cream, moisturiser or talc before applying the patch
• Do not apply the patch on the same area of skin twice in a row
• It can be worn under loose areas of clothing
• Do not wear a patch under elasticated areas or a tight waistband
• Apply the patch to clean, dry, cool skin as soon as you open the protective pouch

Do not use a patch if its protective pouch is already open.

Step 1: Open and Peel

Using the notches as a guide, tear along two edges of the pouch. Remove the patch. With the protective backing facing you, bend and peel off half the backing. Don’t touch the sticky side – it may not stick properly if you do.

Step 2: Apply and Press

Apply the open half of the patch to your skin. Remove the remaining backing and press down the rest of the patch. Press the patch with the palm of your hand to make sure it is firmly stuck. Removing a patch. Peel an edge of the patch smoothly away from the skin. Fold the patch in half, so that the sticky side sticks to itself. Put it in with the household rubbish, safely out of the reach of children and pets. Do not flush used patches down the toilet. When you remove the patch some glue may remain on your skin. It will disappear with time, or you can use baby oil to remove it.

If a patch falls off apply a new patch but keep to your original ‘patch change’ days. If you have just had a bath or a shower, wait until your skin cools before applying the new patch.

Change it as soon as you remember and then keep to your original ‘patch change’ days. You may get some bleeding and spotting like a period during this time.

You can have a bath or shower as normal. Do not scrub too hard as this can loosen the edges of the patch. You can go swimming. The patch will not be affected. You can exercise and play sports. However, do not wear the patch under tight clothing or waist bands. You can sunbathe. However, keep the patch covered, out of direct sunlight.

Like all medicines, this medicine can cause side effects, although not everybody gets them. The following side effects have been associated with Evorel Conti:

Very common (affects more than 1 in 10 people)

• Irritated, itchy, red skin and rash where the patch is applied

Common (affects less than 1 in 10 people)

• Allergic reaction (hypersensitvity)
• Being unable to sleep
• Feeling depressed, nervous or anxious
• Headache
• Being aware of your heartbeat (palpitations)
• Varicose veins
• Flushing, skin reddening
• Breast pain
• Numb or tingling hands orfeet
• Feeling sick (nausea)
• Diarrhoea
• Stomach ache
• Pain including pain in the back or joints
• Painful periods
• Discharge from the vagina
• Irregular, heavy or prolonged bleeding from the vagina, including after sex
• Water retention or build-up of fluid under the skin (oedema)
• Feeling tired
• Weight gain

The list above isn’t exhaustive. If you experience serious side effects or side effects lasting longer than 3 months, then you should consult your doctor immediately. Make sure you read the patient information leaflet for a full list of side effects, cautions and contraindications. You should only take HRT once you have understood all the warnings and precautions as HRT may increase your chances of getting certain cancers or cardiovascular disease. If you are concerned discuss this with your doctor or The Family Chemist clinician.

Do not use Evorel Conti if:

• You are allergic to anything in the patches
• You have (or have ever had), or think you may have, breast cancer
• You have (or are suspected of having) or ever had a cancer that was made worse by oestrogens (such as endometrial cancer)
• You have a thickening of the lining of the womb (endometrial hyperplasia) which has not been treated
• You have vaginal bleeding you cannot explain
• You have ever had blood clots in a vein (thrombosis), such as in the legs (deep vein thrombosis) or a blood clot that has travelled to your lung (pulmonary embolism)
• You have problems with your blood which increases the likelihood of developing a blood clot (thrombosis) (such as protein C, protein S or antithrombin deficiency)
• You have (or have ever had) a liver disease and your liver function tests have not returned to normal
• You have ever had blocked arteries (arterial thrombo-embolic disease) that gave you angina or a heart attack resulted in a stroke
• You have a blood problem called ‘porphyria’

Do not use this medicine if any of the above applies to you. If you are not sure, talk to your doctor or pharmacist before using Evorel Conti. Stop using Evorel Conti at once if any of the above appears for the first time and talk to your doctor immediately.

Medical check-ups

Before taking HRT, your doctor should ask about you and your family’s medical history. Your doctor may decide to examine your breasts or your tummy, and may do an internal examination. They will only do this if it is necessary for you, or if you have any special concerns. Once you have started on HRT, see your doctor for regular check-ups (at least once a year). At these check-ups, your doctor may discuss the benefits and risks of continuing to take HRT.

Make sure that you:

• Go for regular breast screening and cervical smeartests
• Regularly check your breasts for any changes such as dimpling of the skin, changes in the nipple, or any lumps you can see or feel

Tell your doctor if you have ever had any of the following. You may need these checks more often.

• A problem caused by growth of the womb lining:
• Inside the womb (fibroids)
• Outside the womb (endometriosis)
• Thickening of the lining of the womb (endometrial hyperplasia)
• Increased risk of blood clots (see ‘Blood clots’ in section 3 below)
• A family history of increased risk of cancers related to oestrogens such as having a mother, sister or grandmother who has had breast cancer
• High blood pressure (hypertension). Your doctor may tell you to stop using Evorel Conti if your blood pressure goes up
• Diabetes
• Gallstones
• Migraine or severe headaches
• Systemic lupus erythematosus (SLE). This is an allergic condition that
• causes joint pain, skin rashes and fever
• Epilepsy
• Asthma
• A disease affecting the eardrum and hearing(otosclerosis)
• A liver disorder, such as a benign liver tumour
• Fluid retention due to heart or kidney problems
• High levels of fat (triglycerides) in your blood as you may have a higher risk of pancreatitis (inflammation of the pancreas, which causes severe pain in the abdomen and back)
• Any breast problems
• Thyroid problems
• History of sudden swelling of the face or throat, which may cause difficulty in swallowing or breathing, rapid swelling of the hands and feet and stomach cramps

You may still be able to use Evorel Conti, but you should discuss this with your doctor first. Also tell your doctor if these illnesses return or get worse while you are using Evorel Conti.

Stop using Evorel Conti and see a doctor immediately If you notice any of the following when using Evorel Conti:

• any of the conditions mentioned in the ‘DO NOT use Evorel Conti’ section
• yellowing of your skin or the whites of your eyes (jaundice). These may be signs of a liver disease
• a large rise in your blood pressure (symptoms may be headache, tiredness, dizziness)
• migraine-like headaches which happen for the first time
• if you become pregnant
• if you notice signs of a blood clot, such as:
  • painful swelling and redness of the legs
  • sudden chest pain
  • difficulty in breathing

• https://www.medicines.org.uk/emc/files/pil.10929.pdf
• https://www.womens-health-concern.org/
• https://patient.info/medicine/oestrogen-and-progestogen-for-hrt
• https://www.nhs.uk/conditions/menopause/
• https://www.nhs.uk/conditions/hormone-replacement-therapy-hrt/