Kliovance is a continuous combined hormone replacement therapy (HRT). It contains 2 types of female hormones as its active ingredients, oestrogen and progesterone. It is suitable for postmenopausal women who have not had a natural period for at least 1 year.

Menopause symptoms occur because of a natural drop in oestrogen production by the ovaries. Kliovance helps to restore hormone levels to effectively relieve menopause symptoms, like:

• hot flushes
• night sweats
• sleep issues
• irritability
• vaginal dryness and irritation

For women who have not had their womb surgically removed, it is important to use a combined HRT because oestrogen thickens the womb lining which slightly raises the risk of getting womb cancer. So, the progesterone in Kliovance protects the womb lining, preventing it from becoming too thick.

Kliovance tablets are taken every day without a break between packs. Each tablet contains 1mg of estradiol (oestrogen) and 0.5mg of norethisterone acetate (progesterone).

Kliovance works by replacing the low hormone levels caused by menopause. Each Kliovance tablet contains:

• 1mg of estradiol – restores the low oestrogen levels in the body to provide relief from hot flushes, night sweats, irritability, and vaginal irritation and dryness
• 0.5mg of norethisterone – a form of progesterone that limits the overgrowth of the womb lining caused by oestrogen

Kliovance contains a lower dose of hormones, making it a preferable choice for women who are sensitive to oestrogen and progesterone.

How long does Kliovance take to work?

Relief from menopause symptoms can be achieved within the first few weeks of Kliovance treatment, but it can take up to 3 months to feel the full benefit.

How effective is Kliovance?

Kliovance is an effective HRT for managing menopause symptoms. Clinical trials have shown that the combination of norethisterone and estradiol in Kliovance enhances its effectiveness in relieving vasomotor symptoms, such as hot flushes and night sweats.

Because the declining oestrogen levels during menopause can weaken bones and leave women at risk of osteoporosis, HRT can lower this risk. Research shows that Kliovance can improve bone mineral density in 87% of women.

Take 1 Kliovance tablet, at the same time each day, swallowing it whole with a glass of water, if needed.

Continue taking 1 tablet every day until you have finished all 28 tablets in the pack, then start a new pack the next day. You must not have a break between Kliovance packs.

Your doctor will usually prescribe the lowest dose to treat your symptoms for the shortest time possible. If you think the dose is too strong or weak, speak to your doctor.

When to take Kliovance?

You can take Kliovance at any time of the day, but it should be around the same time each day. If you struggle to remember to take your Kliovance pill, you can try:

• a pill reminder app
• a pill box
• setting an alarm on your phone

What if I miss a dose of Kliovance?

If you forget to take Kliovance at your usual time and it is:

• less than 12 hours since your missed dose, take it as soon as you remember, then take your next scheduled dose at the usual time.
• more than 12 hours since your missed pill, skip the missed dose, and take your usual scheduled pill the next day.

Never take a double dose to make up for a missed dose. If you forget a dose, it may increase the chance of experiencing breakthrough bleeding and spotting.

Kliovance is a prescription-only HRT, so you will need a doctor’s approval to obtain it. Kliovance cannot be bought over the counter, but it may be available on the NHS.

Can I buy Kliovance online?

Yes, you can request Kliovance online at Superdrug Online Doctor by:

1. Filling out a brief health and lifestyle questionnaire.
2. Ordering your preferred treatment and making payment.
3. One of our doctors will review your order and questionnaire answers.
4. If approved, your treatment will be posted to your address or made available for collection at your local Superdrug Pharmacy.
5. If your order is not approved, one of our doctors will contact you via your account with other treatment options.

Can I buy Kliovance over the counter?

No, Kliovance is not available over-the-counter because you need a prescription from a doctor to obtain it.

Gina is a vaginal HRT that is available online and from most UK pharmacies without a prescription for treating vaginal menopausal symptoms only.

Can I get Kliovance on the NHS?

Yes, Kliovance is available on the NHS. However, you will need to make an appointment with your doctor to see if it is suitable for you.

Very common side effects, affecting more than 1 in 10 people, include:

• vaginal bleeding
• breast pain or tenderness

Common side effects, affecting 1 to 10 in 100 people, include:

• headache
• vaginal fungal infection
• feeling sick (nausea)
• vaginal inflammation
• back pain
• migraine that may be new or worse than before
• enlarged or swollen breasts
• depression, new or worse than before
• uterine fibroids
• swollen arms or legs
• weight gain
• weight gain from fluid retention

Uncommon side effects, affecting 1 to 10 in 1000 people, include:

• abdominal pain or bloating
• acne
• abnormal male pattern hair growth
• drug ineffective
• allergic reaction
• nervousness
• leg cramps
• itching or hives
• hair loss
• inflammation of a vein

Rare side effects, affecting up to 1 to 10 people in 10,000 people, include:

• blood clots in the vessels of the legs or lungs

A full list of side effects can be found in the patient information leaflet that comes with your medication.

How long do Kliovance side effects last?

Most Kliovance side effects are temporary and will go away or settle down on their own within 3 to 6 months as your body adjusts to the new medication.

What to do if you get Kliovance side effects

Most mild Kliovance side effects can be managed at home. Some of the things you can do to help include:

• take over the counter painkillers, like paracetamol or ibuprofen, for side effects like headaches, stomach cramps, or breast pain
• take your pill with food if you feel sick and stick to eating simple foods until your body gets used to the medication
• drink plenty of fluids to help keep you hydrated, especially if you are sick or have headaches
• use a warm compress to help manage stomach cramps
• get regular exercise to help with mood changes, stomach cramps, and weight gain

If you experience any of the following serious side effects, you should call 999 or get someone to take you to A&E straight away:

• signs of an allergic reaction like itching, swelling, breathing difficulties, low blood pressure, dizziness, sweating
• pain in your chest and breathlessness
• difficulty speaking or moving your arm or leg, or your face has dropped to one side

Do not take Kliovance if you:

• are allergic to any of the ingredients
• have (or have previously had) a form of cancer that is sensitive to oestrogen
• have, have previously had, or think you may have breast cancer
• have endometrial hyperplasia, an excess thickening of the lining of the womb that you are not receiving treatment for
• have or have ever had a blood clot in a vein
• have or have recently had heart attack, stroke, or angina
• experience unexplained vaginal bleeding
• have or have ever had liver disease
• have a hereditary blood condition known as porphyria
• have a blood clotting disorder

You should speak to your doctor before taking Kliovance if you have or have ever had any of the following:

• epilepsy
• asthma
• fibroids inside your womb
• an increased risk of developing blood clots
• high blood pressure
• gallstones
• migraines or severe headaches
• a disease of the immune system
• hereditary or acquired angioedema
• high levels of fat in your blood
• a disease that affects your hearing or the eardrum
• kidney or cardiac problems that cause fluid retention
• a liver disorder
• an oestrogen-sensitive cancer

Kliovance and other medication

Some medications can interfere with the effectiveness of Kliovance. Tell your doctor if you are taking:

• epilepsy medications
• tuberculosis medications
• HIV medications
• hepatitis C medications
• St John’s wort

Let your doctor know if you are or are going to take any prescription, over-the-counter, or herbal medications before taking Kliovance.

Do you lose weight when taking Kliovance?

Weight loss is listed as a very rare side effect of Kliovance. However, weight changes are more likely to happen around the time of the menopause.

Is Kliovance a low-dose HRT?

Kliovance contains a lower dose of hormones compared to some other HRT treatments which makes it a suitable choice for women who are sensitive to the effects of hormones.

Can you take Kliovance long-term?

It is best to take HRT at the lowest dose that is effective for you and only for as long as you need it to manage menopause symptoms. That’s because there is a slightly raised risk of breast cancer and blood clots when you take HRT, which increases the longer you take it.

Your doctor will discuss the risks and benefits of taking HRT. They will also start you on a low dose to assess how your body responds to the medication.

Does Kliovance cause weight gain?

Weight gain is one of the listed side effects of Kliovance, however, there is no definitive evidence to support that HRT causes weight gain. Weight fluctuations during menopause are normal, but they can be managed with lifestyle changes, such as eating a healthy balanced diet and getting regular exercise.

What happens if you stop taking Kliovance suddenly?

If you stop taking Kliovance suddenly your symptoms might come back. You should discuss stopping Kliovance with your doctor. They may suggest reducing your dose gradually to stop your symptoms returning.

If you are thinking of stopping because you are getting side effects, your doctor might suggest changing your dose or switching to another type of HRT.

Is Kliovance the same as Kliofem?

No, Kliovance and Kliofem contain the same active ingredients, but Kliovance contains half the amount of active ingredients as Kliofem.