Evorel Sequi is sequential, combined type of type of Hormone Replacement Therapy (HRT). This type of HRT is more suitable for you if you are going through the menopause, but are still having periods; these may be erratic and/or infrequent. Evorel Sequi’s main components are:
- estradiol (a form of oestrogen)
- norethisterone (a synthetic form of progesterone).
There are two weeks where you will just be wearing patches containig estradiol, followed by two weeks where you will be wearing patches with estradiol and norethisterone. This cycle is then repeated, without any breaks to help you through the menopause. Taking this medication will normally cause menstrual bleeding towards the end of the two weeks taking estradiol and norethisterone.
The estradiol helps to make up for the body’s declining levels of oestrogen, as your ovaries produce less of it in the years approaching the menopause. Off-setting this balance can help reduce some of the more upsetting symptoms of the menopause, such as:
- irregular periods
- hot flushes
- night sweats
- mood swings
- vaginal dryness or itching.
It is worth noting that oestrogen stimulates the lining of the womb and in rare cases, this can lead to endometrial cancer. This is where norethisterone comes into action; it stops the estradiol’s womb stimulating effect, which reduces the risk of cancer.
You should apply one Evorel 50 patch twice weekly for two weeks. You should first apply this patch at the onset of menstruation, or at any time if your cycles have stopped or are infrequent. After two weeks using the Evorel 50 patches, you should apply one Evorel Conti patch twice weekly.
Apply a new patch twice a week (every three to four days) to your buttock or hip, below the waistline. It is best to avoid areas where clothing can cause the patch to rub off.
Do not apply the patch to or near to the breasts.
Each time you apply a new patch, change the site you place it and do not place the patch on that same area for at least a week.
Before you apply the patch to your skin, make sure that your skin is clean and dry, cool, free of any powder, oily moisturise or lotion and free of cuts or irritation.
You can keep the patch on when you have a shower or bath. If the patch falls off, wait until the skin is dry and at a normal temperature before applying a new patch. Replace the patch with a new one immediately. Replace this patch on the scheduled ‘change’ day.
For details on applying the patch, please see the product information leaflet.
If you ever need to have major surgery, please inform us as soon as you know, so that our doctor can advise you on whether to stop taking this medication.
Your need for HRT should be reviewed by your doctor at least once every twelve months.
The following side effects can affect individuals in different ways, it does not mean that all will be affected:
Very common (may affect more than 1 in 10 patients):
- Irritated, itchy, red skin where the patch is applied
Common (affects up to 1 in 10 patients):
- Feeling depressed or nervous
- Inappropriate signs of emotion
- Being unable to sleep
- Itchy skin or red rash
- Feeling sick (nausea), or having stomach pain wind or other stomach upsets
- Pain including pain in the back, muscles, joints
- Breast pain
- Weight gain
- Heavy vaginal bleeding, painful periods
- Water retention or build-up of fluid under the skin (oedema)
Uncommon (may affect up to 1 in 100 patients):
- Concentration problems
- Feeling dizzy
- More or less interest in sex than usual
- Allergic reaction (hypersensitivity)
- Feeling tired
- Being aware of your heartbeat (palpitations)
- Numb or tingling hands or feet, less skin sensitivity
- Breast lumps (non-cancerous)
- Fuller breasts
- Irregular vaginal bleeding
- Thickening of the lining of the womb
The side effects listed above may not include all of the side effects reported by the medicine's manufacturer. For more information about any other possible risks associated with Evorel Sequi, please read the information provided with the medicine or consult your doctor or pharmacist.
Evorel Sequi should be used with caution if you have:
- fibroids inside your womb
- a growth of womb lining outside your womb (endometriosis) or a history of excessive growth of the womb lining (endometrial hyperplasia)
- increased risk of developing blood clots (thrombosis)
- increased risk of getting an oestrogen-sensitive cancer (such as having a mother, sister or grandmother who has had breast cancer)
- high blood pressure
- a liver disorder, such as a benign liver tumour
- migraine or severe headaches
- a disease of the immune system that affects many organs of the body (systemic lupus erythematosus, SLE)
- a disease affecting the eardrum and hearing (otosclerosis)
- a very high level of fat in your blood (triglycerides)
- fluid retention due to cardiac or kidney problems
- thyroid problems
Evorel Sequi should not be used if you:
- have or have ever had breast cancer, or if you are suspected of having it
- have cancer which is sensitive to oestrogens, such as cancer of the womb lining (endometrium), or if you are suspected of having it
- have any unexplained vaginal bleeding
- have excessive thickening of the womb lining (endometrial hyperplasia) that is not being treated
- have or have ever had a blood clot in a vein (thrombosis), such as in the legs (deep venous thrombosis) or the lungs (pulmonary embolism)
- have a blood clotting disorder (such as protein C, protein S, or antithrombin deficiency)
- have or recently have had a disease caused by blood clots in the arteries, such as a heart attack, stroke or angina
- have or have ever had a liver disease and your liver function tests have not returned to normal
- have a rare blood problem called “porphyria” which is passed down in families (inherited)
Evorel Sequi 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.
The patient information leaflet (PIL) is a leaflet containing specific information about medical conditions, doses and side effects. You can download a copy of the PIL here:
Patient Info Leaflet