Livial (Tibolone)

Livial (tibolone) is a synthetic hormone replacement therapy (HRT) medication used to treat symptoms of menopause in postmenopausal women. The medication contains tibolone, which the body breaks down into substances that mimic the effects of three hormones: estrogen, progesterone, and testosterone. This combination helps relieve common menopause symptoms like hot flushes, night sweats, mood changes, and vaginal dryness. Tibolone can also help prevent osteoporosis, a condition where bones become weak and brittle after menopause.

Directions

Take Livial as a single tablet once daily, swallowing it whole with water at around the same time each day. Patients should wait at least 12 months after their last natural period before starting treatment, as beginning too early may increase the risk of irregular bleeding.

If a dose is missed and it's been less than 12 hours, take the tablet right away; if more than 12 hours have passed, skip the missed dose and continue with the regular schedule the next day. Don't take a double dose to make up for a forgotten tablet.

Ingredients

The active ingredient in this drug is tibolone.

Cautions

• Before using this medication, you may want to consult a healthcare provider about the following:
  • Any existing health conditions
  • Any allergies
  • A list of all medications currently being taken
• Tibolone is a hormone therapy used for menopausal symptoms, but it can increase certain health risks. Before starting it, your doctor may want to monitor you more closely if you've had fibroids, endometriosis, liver problems, blood clots, high blood pressure, migraines, diabetes, asthma, or a family history of breast cancer
• Stop taking tibolone and contact your doctor right away if you notice jaundice (yellowing of the skin or eyes), a sudden rise in blood pressure, new migraine-like headaches, or symptoms of a blood clot like leg swelling, chest pain, or trouble breathing.
• Tibolone can increase the risk of certain cancers, especially cancer of the womb lining and breast cancer. You may also notice light bleeding or spotting in the first few months, but bleeding that continues beyond six months should be checked.
• Like other hormone therapies, tibolone slightly increases the risk of ovarian cancer, although this cancer is rare overall. The risk increases the longer you use hormone therapy, but the overall increase is small for most women.
• Tibolone may increase the risk of blood clots, especially in the first year of treatment or if you have other risk factors like obesity, long periods of immobility, recent surgery, or a family history of clots.
• Hormone therapy will not prevent memory loss and may even increase the risk of memory problems if started after age 65. It can also cause fluid retention and affect cholesterol and triglyceride levels, so people with heart or kidney problems may need closer monitoring.
• Some medications, such as blood thinners, seizure medicines, certain antibiotics for tuberculosis, and St. John's Wort, can interfere with tibolone and lead to irregular bleeding.
• If you need surgery, your doctor may ask you to stop taking tibolone about 4–6 weeks beforehand to reduce the risk of blood clots. Tibolone is meant only for postmenopausal women, so stop taking it if you become pregnant.

Contraindications

Avoid taking or using this medication if any of the following apply:

• Known or suspected breast cancer, or a history of breast cancer
• Known or suspected hormone-dependent cancers
• Unexplained vaginal bleeding that hasn't been evaluated
• Severe, untreated thickening of the womb lining
• Previous or current blood clots in veins, such as deep vein thrombosis or pulmonary embolism
• Active or recent arterial blood clot disorders, including heart attack or stroke
• Liver disease or abnormal liver function
• Porphyria (a rare blood disorder)
• Pregnancy or breastfeeding
• Allergy to tibolone or any ingredients in the medication

Side Effects

Common side effects of Livial include:

• Breast pain
• Stomach or pelvic discomfort
• Vaginal bleeding or spotting (often in the first few months)
• Vaginal itching, discharge, or thrush
• Unusual hair growth
• Weight gain

These effects are usually mild and tend to improve as your body adjusts to treatment. Some women may also notice acne, breast tenderness, or mild swelling in the hands or feet. If bleeding continues past the first few months or becomes heavy, contact your healthcare provider.

More serious reactions are possible and should be evaluated right away. Livial and other forms of HRT have been linked to a higher risk of breast cancer, ovarian cancer, and cancers of the uterine lining, as well as blood clots, stroke, and heart disease. Sudden severe headaches, jaundice, leg swelling, chest pain, or signs of a clot require immediate medical attention. Rare side effects such as vision changes, depression, skin reactions, and gallbladder problems can also occur. Report anything unusual or persistent to a doctor or healthcare provider.