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Livial (tibolone) is a prescription hormone replacement therapy (HRT) used to relieve certain symptoms of menopause and help prevent bone loss in postmenopausal women.
It contains tibolone 2.5 mg, a synthetic steroid that produces effects similar to three naturally occurring hormones: estrogen, progesterone, and testosterone.
During menopause, the ovaries gradually produce less estrogen and progesterone. These hormonal changes can cause uncomfortable symptoms, including hot flashes, night sweats, vaginal dryness, sleep disturbances, and mood changes.
Lower estrogen levels can also contribute to a gradual loss of bone density, increasing the risk of osteoporosis and fractures.
Livial helps manage these effects by providing hormone-like activity in certain tissues throughout the body.
Unlike conventional hormone replacement therapy, which may contain estrogen alone or estrogen combined with a progestogen, Livial contains a single active ingredient that produces several hormonal effects after being processed by the body.
Livial is generally intended for women who have completed menopause, usually at least 12 months after their last natural menstrual period.
Its main uses include relieving menopausal symptoms and preventing osteoporosis in selected postmenopausal women at high risk of fractures who cannot use other approved osteoporosis treatments.Â
Livial is used to relieve symptoms associated with declining estrogen levels after menopause.
Menopause is a natural stage of life that occurs when menstrual periods permanently stop because the ovaries no longer release eggs regularly or produce the same amounts of reproductive hormones.
As estrogen levels decrease, changes may occur in body temperature regulation, vaginal tissues, sleep patterns, and overall comfort.
Livial helps replace some of the lost hormonal activity, reducing several common menopausal symptoms.
Hot Flashes
Hot flashes are among the most common symptoms of menopause.
They occur when changes in estrogen levels affect the brain’s ability to regulate body temperature.
A hot flash may cause a sudden sensation of intense warmth, often affecting the face, neck, and chest.
Some people also experience flushing, sweating, or a rapid heartbeat.
These episodes can last from several seconds to a few minutes and may occur repeatedly throughout the day.
Livial helps reduce hot flashes by producing estrogen-like effects in tissues involved in temperature regulation.
As hormone-related temperature fluctuations become less noticeable, the frequency and severity of hot flashes may decrease.
However, the degree of improvement varies from person to person.
Night Sweats
Night sweats are episodes of excessive sweating that occur during sleep.
They are often associated with hot flashes and changes in the body’s temperature regulation during menopause.
Some people wake up feeling overheated, uncomfortable, or covered in sweat.
Frequent night sweats may interrupt sleep and contribute to daytime tiredness.
Livial may help reduce these episodes by addressing the hormonal changes responsible for menopausal temperature disturbances.
As night sweats become less frequent, sleep quality may improve.
However, persistent or severe night sweats should be evaluated because they may also be caused by medical conditions unrelated to menopause.
Vaginal Dryness and Discomfort
Lower estrogen levels after menopause can cause the tissues lining the vagina to become thinner, drier, and less elastic.
This may lead to vaginal dryness, itching, irritation, or discomfort during sexual activity.
These changes are often associated with a condition called genitourinary syndrome of menopause (GSM).
Livial has estrogen-like effects on vaginal tissues, which may help improve moisture, comfort, and tissue health.
Some people may notice reduced dryness and discomfort during sexual activity.
However, Livial may not provide sufficient relief for everyone.
If vaginal symptoms continue, your healthcare provider may recommend additional treatments, such as vaginal moisturizers, lubricants, or locally applied vaginal estrogen.
Sleep Disturbances
Menopause can affect sleep in several ways.
Hot flashes, night sweats, and hormonal changes may make it difficult to fall asleep or remain asleep throughout the night.
Some people experience repeated awakenings, restless sleep, or daytime fatigue.
By reducing hot flashes and night sweats, Livial may indirectly improve sleep quality.
Some users may also notice improvements in overall comfort and well-being.
However, Livial is not a sleeping medication and should not be used specifically to treat insomnia unrelated to menopause.
If sleep problems continue despite treatment, your healthcare provider may investigate other possible causes.
Mood Changes and Emotional Well-Being
Hormonal changes during menopause may contribute to irritability, mood fluctuations, and changes in emotional well-being.
Some people also experience reduced energy, difficulty concentrating, or changes in motivation.
Livial produces hormone-like effects in certain areas of the brain and may help improve aspects of mood and well-being in some postmenopausal women.
However, these benefits vary, and Livial is not an approved treatment for clinical depression or other psychiatric disorders.
If you experience persistent sadness, significant anxiety, or mood changes that interfere with daily activities, speak with your healthcare provider.
Changes in Sexual Comfort and Desire
Some postmenopausal women experience changes in sexual desire or discomfort during sexual activity.
These changes may be related to declining estrogen and androgen activity, vaginal dryness, sleep disturbances, or other factors.
Tibolone has both estrogen-like and androgen-like effects.
Its estrogenic effects may improve vaginal comfort, while its androgenic activity may contribute to improved sexual desire in some women.
However, Livial does not guarantee an improvement in libido, and individual responses vary.
If reduced sexual desire or discomfort continues, your healthcare provider may recommend further evaluation or additional treatment.Â
Livial may also be prescribed to help prevent osteoporosis in selected postmenopausal women.
Osteoporosis is a condition in which bones gradually lose density and strength, making them more likely to fracture.
Bones are living tissues that continuously undergo a process called bone remodeling.
During this process, older bone tissue is broken down and replaced with new bone tissue.
Estrogen plays an important role in maintaining the balance between bone breakdown and bone formation.
After menopause, declining estrogen levels can cause bone tissue to break down faster than it is replaced.
Over time, this may reduce bone density and increase the risk of fractures, particularly in the spine, hips, and wrists.
Tibolone produces estrogen-like effects in bone tissue.
These effects help reduce excessive bone breakdown associated with declining estrogen levels.
By slowing bone loss, Livial may help maintain bone mineral density and reduce the risk of osteoporosis-related fractures in selected patients.
Bone mineral density is a measurement of the amount of mineral contained in bone tissue. It is commonly assessed using a dual-energy X-ray absorptiometry (DXA) scan.
Maintaining bone density is important because weaker bones are more vulnerable to fractures.
However, Livial is not generally a first-choice medication used solely for osteoporosis prevention.
It may be considered for postmenopausal women who have a high risk of fractures and cannot tolerate or should not use other medications approved for osteoporosis prevention.
Your healthcare provider will assess your fracture risk, age, medical history, and available treatment options before recommending Livial.
Livial may be considered for women who have completed menopause and are at increased risk of osteoporosis-related fractures.
Risk factors may include older age, low bone mineral density, a previous fragility fracture, a family history of osteoporosis, or prolonged use of certain medications that weaken bones.
A fragility fracture is a broken bone caused by a relatively minor injury, such as a fall from standing height.
However, Livial is not appropriate for everyone at high fracture risk.
Its potential benefits must be weighed against important risks, including stroke and certain cancers. Stroke risk requires particular attention in women over 60 years of age.
Other osteoporosis medications may provide a more favorable balance of benefits and risks.
Your healthcare provider may also recommend adequate calcium and vitamin D intake, regular weight-bearing exercise, fall prevention measures, and smoking cessation to help maintain bone health.Â
Livial contains tibolone, a synthetic steroid that is converted into several active substances after being absorbed into the body.
These substances are called metabolites.
The metabolites produce effects similar to estrogen, progesterone, and testosterone in different tissues.
This is why tibolone is often described as having estrogenic, progestogenic, and androgenic activity.
Estrogenic Effects
Estrogen is a hormone that helps regulate reproductive tissues, body temperature, bone strength, and several other body functions.
After menopause, estrogen levels decrease significantly.
Two active metabolites of tibolone have estrogen-like effects.
These effects help reduce hot flashes, night sweats, vaginal dryness, and bone loss.
In bone tissue, the estrogenic activity helps slow the breakdown of bone, supporting bone mineral density.
Progestogenic Effects
Progesterone is a hormone involved in regulating the uterine lining, also called the endometrium.
One tibolone metabolite has progestogen-like effects.
This activity helps influence how the uterine lining responds to hormonal stimulation.
Unlike conventional estrogen-only hormone therapy, Livial generally does not require an additional progestogen to be taken with it.
However, this does not mean that Livial eliminates the risk of endometrial problems.
Unexplained vaginal bleeding, particularly bleeding that begins after several months of treatment, should be evaluated by a healthcare provider.
Androgenic Effects
Androgens are hormones that include testosterone. Although often associated with men, they are also naturally present in women.
Androgens contribute to several body functions, including sexual desire and aspects of physical well-being.
Tibolone has androgen-like activity through one of its metabolites.
This may help improve sexual desire or well-being in some postmenopausal women.
However, these benefits are not guaranteed, and androgenic side effects, such as increased facial hair growth, may occur in some people.
Tissue-Selective Hormonal Activity
One important characteristic of tibolone is that its effects vary between different tissues.
Its metabolites act differently in areas such as the brain, bones, vaginal tissues, and uterine lining.
This is sometimes called tissue-selective hormonal activity.
These differences help explain why Livial can relieve menopausal symptoms while also influencing bone density.
However, tissue selectivity does not mean that Livial is free from the risks associated with hormonal treatment.Â
Livial begins producing hormonal effects after treatment starts, but noticeable symptom relief may take several weeks.
Some women experience a reduction in hot flashes and night sweats during the first few weeks of treatment.
Other symptoms, such as vaginal dryness or changes in sexual comfort, may take longer to improve.
The time needed for improvement varies depending on the severity of symptoms and individual response.
Livial’s effects on bone density develop gradually. Maintaining bone health generally requires ongoing assessment rather than expecting an immediate noticeable change.
Your healthcare provider will review your symptoms, treatment response, and potential side effects to determine whether continued treatment is appropriate.
Livial is intended for postmenopausal women and should generally be started at least 12 months after the last natural menstrual period. Different timing may apply after surgical menopause.
Livial is not a contraceptive and should not be used during pregnancy or breastfeeding.
It may not be suitable for women with a history of breast cancer, certain other cancers, unexplained vaginal bleeding, blood clots, stroke, or significant liver disease.
Tibolone may increase the risk of stroke, particularly in older women, and has been associated with increased risks of certain cancers in specific populations.
Your healthcare provider should review these risks before prescribing treatment.
Livial should be used at the lowest effective dose for the shortest duration appropriate to your treatment goals, with regular medical reviews.Â
Livial is a prescription hormone replacement therapy (HRT) used to relieve symptoms of menopause and help prevent osteoporosis in certain postmenopausal women.
Livial is available as a 2.5 mg oral tablet, usually taken once daily.
The medication helps reduce menopausal symptoms, including hot flashes, night sweats, and vaginal dryness. It may also help maintain bone density by producing hormone-like effects in the body.
Take Livial exactly as prescribed by your healthcare provider. Do not increase or decrease your dose without medical advice.
Swallow the tablet with a glass of water or another drink. Do not chew the tablet. Livial may be taken with or without food.
Try to take Livial at approximately the same time every day. Maintaining a consistent routine helps you remember your medication and supports regular treatment.
The usual recommended dose of Livial is one 2.5 mg tablet taken by mouth once daily.
Your healthcare provider will determine whether Livial is appropriate based on your menopausal symptoms, medical history, age, and individual risk factors.
Livial is generally prescribed to postmenopausal women who have experienced at least 12 months without a natural menstrual period.
Starting tibolone too soon after the last natural period may increase the likelihood of irregular vaginal bleeding.
Different starting instructions may apply if you have undergone surgical menopause or are switching from another hormone replacement therapy.
Your healthcare provider will explain when to begin treatment.
Livial should be taken continuously, without planned breaks between packs.
Livial is supplied in packs containing 28 white tablets. Each tablet contains 2.5 mg of tibolone.
The tablet strips are labelled with the days of the week to help you follow your daily treatment schedule.
To take Livial correctly:
Unlike some other hormone replacement therapies, Livial is taken every day without a scheduled tablet-free interval.
Starting each new pack on time helps maintain a consistent treatment routine.Â
Livial may be taken with or without food.
You can take your tablet before, during, or after a meal, depending on what is most convenient for you.
Food is not required for Livial to work effectively.
If you experience mild stomach discomfort after taking the medication, taking it with food may help.
Swallow the tablet with a glass of water or another suitable drink. Do not chew it.
Try to take Livial at approximately the same time each day, regardless of whether you take it with a meal.
Taking Livial at approximately the same time each day helps you maintain a regular medication schedule.
After you swallow Livial, your body converts tibolone into active substances that produce estrogen-like, progesterone-like, and androgen-like effects.
These effects help relieve menopausal symptoms and support bone health.
Taking Livial consistently helps maintain regular hormone-related activity and reduces the likelihood of missed doses.
You may find it helpful to connect your daily tablet with an existing habit, such as brushing your teeth or eating breakfast.
A phone reminder or medication calendar may also help you remember your dose.
Continue taking Livial regularly, even if your menopausal symptoms begin to improve. Do not stop treatment without discussing your treatment plan with your healthcare provider.
If you forget to take Livial, the next step depends on how much time has passed since your usual scheduled dose.
If you are less than 12 hours late: Take the missed tablet as soon as you remember. Then take your next tablet at the usual scheduled time.
If you are more than 12 hours late: Skip the missed tablet and take your next tablet at its regularly scheduled time.
Do not take two tablets together to make up for a missed dose.
For example, if you normally take Livial at 8:00 AM but remember at 3:00 PM, you are only seven hours late. You can take the missed tablet when you remember.
However, if you do not remember until 10:00 PM, more than 12 hours have passed since your scheduled dose. Skip the missed tablet and take your next dose at 8:00 AM the following day.
The 12-hour rule is measured from the time the missed tablet was supposed to be taken, not from the time of your previous tablet.
Missing a dose may increase the likelihood of breakthrough bleeding or spotting.
If you frequently forget to take Livial or are uncertain about what to do after missing a dose, contact your healthcare provider or pharmacist.Â
If you accidentally take more Livial than prescribed, contact your healthcare provider or pharmacist for advice.
Taking an extra tablet may cause nausea, vomiting, or vaginal bleeding.
Although a small accidental overdose may not cause serious harm, taking excessive amounts is not recommended.
Do not attempt to correct an overdose by changing your subsequent doses without professional guidance.
If you or someone else takes a large amount of Livial, contact a poison control center or seek urgent medical advice.
The length of Livial treatment depends on your menopausal symptoms, medical history, treatment response, and individual risk factors.
Some women notice improvements in hot flashes and night sweats within the first few weeks of treatment.
Other symptoms, such as vaginal dryness or sexual discomfort, may take longer to improve.
Your healthcare provider will periodically assess whether continued treatment is necessary.
Because hormone replacement therapy can carry certain health risks, Livial should generally be used for the shortest duration appropriate to your treatment goals.
Regular medical reviews are important, particularly if you are older than 60 or have cardiovascular risk factors.
Your healthcare provider should review the benefits and risks of continued treatment at least once a year.
Do not continue treatment indefinitely without medical review.
If you are considering stopping Livial, discuss your treatment plan with your healthcare provider.
Livial does not generally require gradual dose reduction to prevent a withdrawal reaction.
However, menopausal symptoms such as hot flashes, night sweats, and vaginal discomfort may return after treatment is stopped.
Your healthcare provider can help determine whether stopping treatment is appropriate and whether another medication may be beneficial.
If you have been taking Livial to help prevent osteoporosis, your healthcare provider may recommend another treatment to protect your bone health after discontinuation.
Livial is intended for postmenopausal women and should not be used during pregnancy or breastfeeding.
It is not a contraceptive and does not prevent pregnancy.
Tell your healthcare provider if you have a history of breast cancer, unexplained vaginal bleeding, blood clots, stroke, liver disease, or other significant medical conditions.
Livial may increase the risk of certain serious complications, including stroke and some hormone-sensitive cancers.
Contact your healthcare provider if you develop persistent or unusual vaginal bleeding, particularly if bleeding begins after you have been taking Livial for several months.
Seek emergency medical attention if you experience sudden chest pain, difficulty breathing, painful swelling in one leg, or symptoms of a stroke.
These may include sudden weakness, difficulty speaking, loss of vision, or a severe unexplained headache.
Livial (Tibolone) is available in the following forms and strength:
Livial is a prescription hormone replacement therapy (HRT) used to relieve symptoms of menopause and help prevent osteoporosis in certain postmenopausal women.
It contains tibolone 2.5 mg, a synthetic steroid that produces estrogen-like, progesterone-like, and androgen-like effects in different tissues throughout the body.
Although Livial can help reduce hot flashes, night sweats, vaginal dryness, and bone loss, it may also increase the risk of certain serious health problems.
These include breast cancer recurrence, endometrial cancer, stroke, and blood clots.
Before starting Livial, tell your healthcare provider about your personal and family medical history, previous hormone treatments, and any medications you currently take.
Your healthcare provider should assess the potential benefits and risks before prescribing Livial and review your treatment regularly.
Livial may increase the risk of developing breast cancer or experiencing a recurrence of breast cancer.
Breast cancer occurs when abnormal cells in breast tissue grow uncontrollably and may spread to other parts of the body.
Some types of breast cancer are sensitive to hormones such as estrogen and progesterone. These hormones may influence the growth of certain breast cancer cells.
Because Livial produces hormone-like effects, its use requires special consideration in people with breast cancer risk factors.
Clinical research has shown an increased risk of breast cancer recurrence among women with a previous history of breast cancer who received tibolone compared with those receiving placebo.
Livial must not be used by women who have breast cancer, have previously had breast cancer, or are suspected of having breast cancer.
A family history of breast cancer does not automatically mean that Livial cannot be used. However, it may increase an individual’s underlying cancer risk and should be discussed with a healthcare provider.
Tell your healthcare provider if a close relative, such as your mother or sister, has been diagnosed with breast cancer.
While taking Livial, follow recommended breast screening schedules and report any new breast changes.
These may include a new lump, unusual nipple discharge, changes in breast shape, or persistent breast discomfort.
Your healthcare provider will determine whether additional screening or a different treatment is appropriate.Â
Livial may increase the risk of endometrial cancer in postmenopausal women who still have a uterus.
Endometrial cancer develops in the endometrium, which is the tissue lining the inside of the uterus.
After menopause, the endometrium usually becomes thinner because estrogen levels decrease.
Tibolone produces hormone-like effects that may influence the uterine lining. Studies have associated tibolone treatment with an increased risk of endometrial cancer, particularly with longer treatment duration.
Women who have not undergone a hysterectomy, which is surgery to remove the uterus, should discuss this risk with their healthcare provider.
Livial should not be used by women who have known or suspected estrogen-dependent cancers, including certain endometrial cancers.
It is also contraindicated in women with untreated endometrial hyperplasia, a condition involving abnormal thickening of the uterine lining.
Your healthcare provider may recommend further examination if you experience unexplained bleeding or other symptoms suggesting changes in the uterus.
Any unexplained vaginal bleeding after menopause should be evaluated, even if you are taking hormone replacement therapy.
Livial may cause vaginal spotting or breakthrough bleeding, particularly during the first few months of treatment.
Spotting refers to light vaginal bleeding that occurs outside an expected menstrual period.
Breakthrough bleeding is unexpected bleeding that may occur while taking hormone-based medication.
These effects can happen as the body adjusts to tibolone.
Although some early spotting may be related to treatment, it is important not to assume that all vaginal bleeding is harmless.
Unexpected bleeding may sometimes indicate changes in the uterine lining or another medical condition that requires investigation.
Contact your healthcare provider if you experience bleeding that is heavy, persistent, or unusual.
Medical evaluation is particularly important if bleeding continues beyond six months of treatment, begins after you have been taking Livial for more than six months, or continues after treatment has been stopped.
Your healthcare provider may recommend a pelvic examination, ultrasound, or endometrial biopsy to determine the cause.
An endometrial biopsy involves collecting a small sample of tissue from the uterine lining for examination.
Do not ignore new or persistent vaginal bleeding while taking Livial.Â
Hormone replacement therapies may increase the risk of blood clots, although the specific risk varies between different hormone treatments.
A blood clot forms when blood thickens and creates a solid mass within a blood vessel.
One serious condition is deep vein thrombosis (DVT), which occurs when a clot develops in a deep vein, usually in the leg.
A blood clot can sometimes travel to the lungs, causing a pulmonary embolism.
Pulmonary embolism is a potentially life-threatening condition that can interfere with blood flow and oxygen exchange in the lungs.
Possible warning signs include painful swelling in one leg, sudden chest pain, unexplained shortness of breath, or coughing up blood.
The available evidence suggests that tibolone may have a different venous clotting risk profile from conventional combined estrogen-progestogen therapy. However, this does not mean it is safe for people with a history of blood clots.
Livial must not be used by women who have a current or previous deep vein thrombosis, pulmonary embolism, or certain inherited blood-clotting disorders.
Tell your healthcare provider if you have a family history of blood clots, obesity, prolonged immobility, or other conditions that may increase clotting risk.
Seek emergency medical attention if you develop symptoms suggesting a serious blood clot.
Livial may increase the risk of ischemic stroke, particularly in older postmenopausal women.
An ischemic stroke occurs when a blood clot or another blockage reduces blood flow to part of the brain.
Without adequate blood flow, brain cells may become damaged because they are not receiving enough oxygen and nutrients.
Clinical evidence indicates that tibolone increases the risk of ischemic stroke, with the increased risk appearing from the first year of treatment.
The overall risk becomes more important with age because the underlying likelihood of stroke naturally increases as people get older.
This is particularly relevant for women over 60 years of age.
Possible warning signs of stroke include sudden weakness or numbness on one side of the body, difficulty speaking, sudden changes in vision, loss of balance, or a severe unexplained headache.
Livial should not be used by women who have previously experienced a stroke, transient ischemic attack (TIA), heart attack, or certain other arterial blood-clotting conditions.
A transient ischemic attack is sometimes called a mini-stroke because it causes temporary neurological symptoms due to reduced blood flow to the brain.
If you have high blood pressure, heart disease, or other cardiovascular risk factors, your healthcare provider should carefully review whether Livial is appropriate.
Seek emergency medical attention immediately if you experience symptoms suggesting a stroke or heart attack.Â
Tell your healthcare provider if you have high blood pressure or elevated cholesterol levels.
These conditions can increase the risk of cardiovascular disease and stroke.
Because Livial may increase the risk of ischemic stroke, existing cardiovascular risk factors are important when deciding whether treatment is appropriate.
Your healthcare provider may recommend checking your blood pressure before treatment and periodically afterward.
Livial can also affect blood lipid levels, including reducing high-density lipoprotein (HDL) cholesterol, often called good cholesterol.
HDL helps transport cholesterol from the bloodstream back to the liver.
The long-term clinical significance of tibolone-related changes in HDL cholesterol is not fully established.
Livial should not be used to treat high cholesterol or prevent heart disease.
If your blood pressure increases significantly while taking Livial, stop treatment and seek prompt medical advice.
Your healthcare provider may recommend another treatment if your cardiovascular risks outweigh the benefits of hormone replacement therapy.
Livial should be used cautiously in women with a history of liver problems.
The liver plays an important role in processing medications and hormones, including tibolone.
After Livial is swallowed, the body converts tibolone into active metabolites that produce hormone-like effects.
If liver function is significantly impaired, the body may not process these substances normally.
Livial must not be used by women with active liver disease or a history of liver disease when liver function tests have not returned to normal.
Tell your healthcare provider if you have previously experienced hepatitis, cirrhosis, liver tumors, or other liver problems.
Although changes in liver function tests have been reported with tibolone, not every change indicates serious liver damage.
Possible warning signs of liver problems include unusual fatigue, persistent nausea, loss of appetite, dark urine, abdominal pain, and yellowing of the skin or eyes.
Yellowing of the skin or eyes is called jaundice and may indicate impaired liver function.
Stop taking Livial and seek prompt medical attention if you develop jaundice or symptoms suggesting serious liver injury.
Your healthcare provider may recommend blood tests to assess liver function and determine whether treatment should continue.
Livial may interact with certain medications, potentially changing their effectiveness or increasing the risk of side effects.
Tibolone is processed through metabolic pathways involving liver enzymes, including CYP3A4.
Some medications increase the activity of these enzymes, causing tibolone to be broken down more quickly.
This may reduce its effectiveness in relieving menopausal symptoms or cause changes in vaginal bleeding patterns.
Important interactions include:
Some medications processed by CYP3A4 may also interact with tibolone.
However, it is inaccurate to assume that every antibiotic or antifungal medication significantly interacts with Livial.
The importance of an interaction depends on the specific medication involved.
Tell your healthcare provider about all prescription drugs, over-the-counter medications, vitamins, and herbal supplements you take.
Do not stop or change another prescribed medication without professional guidance.Â
Tell your healthcare provider if you have a history of migraines or frequent severe headaches before taking Livial.
Hormonal changes can influence migraine symptoms in some people.
Livial produces hormone-like effects that may affect the frequency or severity of headaches.
Some women may experience headaches or migraines as side effects of tibolone treatment.
If you already have migraines, your healthcare provider may recommend closer monitoring.
If you develop a new migraine-type headache while taking Livial, stop taking the medication and contact your healthcare provider promptly.
A sudden severe headache accompanied by weakness, difficulty speaking, or changes in vision may indicate a stroke and requires emergency medical attention.
Do not assume that an unusual or severe headache is simply a medication side effect.
Women with epilepsy should tell their healthcare provider before starting Livial.
Epilepsy is a neurological condition that causes recurring seizures due to abnormal electrical activity in the brain.
Hormonal changes may affect seizure patterns in some people.
Because tibolone produces hormone-like effects, women with epilepsy may require additional monitoring during treatment.
Another important consideration is the possibility of interactions with anti-seizure medications.
Certain anticonvulsants, including carbamazepine and phenytoin, can increase the breakdown of tibolone and potentially reduce its effectiveness.
Your healthcare provider may need to review your seizure history, medication regimen, and treatment response.
Do not stop taking prescribed anti-seizure medications without medical advice.
Contact your healthcare provider if you notice changes in seizure frequency or severity after starting Livial.
Tell your healthcare provider if you have asthma or another chronic medical condition before starting Livial.
Asthma is a long-term condition that causes inflammation and narrowing of the airways, sometimes leading to wheezing, coughing, chest tightness, or shortness of breath.
Women with asthma are listed among those who may require closer supervision during tibolone treatment.
This is because certain medical conditions may recur or worsen during hormone therapy.
However, asthma does not automatically mean that Livial cannot be used.
Your healthcare provider will consider the severity of your asthma, current medications, and overall health before prescribing treatment.
Other conditions requiring closer monitoring may include uterine fibroids, endometriosis, diabetes, gallstones, systemic lupus erythematosus, and a history of endometrial hyperplasia.
Tell your healthcare provider if any existing condition becomes worse after starting Livial.
Livial may cause side effects that affect comfort and daily activities.
Some women experience headaches, dizziness, weight changes, breast tenderness, or abdominal discomfort.
Weight gain has been reported during tibolone treatment, although changes in body weight may also be influenced by menopause, aging, diet, and physical activity.
Some women may experience mood changes, including low mood or depressive symptoms.
Hormonal treatments can affect people differently, and not everyone will experience these side effects.
If you develop persistent headaches, unexplained weight gain, or significant mood changes, contact your healthcare provider.
Your healthcare provider can help determine whether the symptoms may be related to Livial or another medical condition.
Do not increase or discontinue the medication without discussing your treatment plan, unless you develop a serious warning sign that requires immediate discontinuation and medical evaluation.
Livial is intended for postmenopausal women and must not be used during pregnancy.
Tibolone produces hormone-like effects and is not intended for use during fetal development.
Animal studies have identified potential reproductive risks, and there is insufficient human evidence to establish its safety during pregnancy.
Livial is also not a contraceptive and should not be used to prevent pregnancy.
Women who have not completed menopause may still be able to become pregnant.
If pregnancy occurs during treatment, stop taking Livial and contact your healthcare provider immediately.
Your healthcare provider will assess the situation and recommend appropriate medical care.
Livial must not be used during breastfeeding.
Tibolone is not intended for women who are producing breast milk or nursing an infant.
There is insufficient information about the effects of tibolone exposure on breastfed babies.
Because Livial produces estrogen-like, progestogen-like, and androgen-like effects, its use during breastfeeding is contraindicated.
If you are breastfeeding and experiencing hormonal symptoms, speak with your healthcare provider about treatments that are more appropriate for your circumstances.
Livial is intended for postmenopausal women and should not be used routinely before menopause.
For women experiencing natural menopause, treatment should generally begin at least 12 months after the last natural menstrual period.
Starting Livial earlier may increase the likelihood of irregular vaginal bleeding.
Women who have undergone surgical menopause may have different starting instructions.
Your healthcare provider will determine when treatment is appropriate based on your medical history and the reason for menopause.
Livial is not intended to regulate normal menstrual cycles or serve as contraception in premenopausal women.
If you are still having menstrual periods or are uncertain whether menopause has occurred, consult your healthcare provider before taking Livial.
Regular medical follow-up is important while taking Livial.
Your healthcare provider should assess whether the benefits of treatment continue to outweigh the potential risks.
A review may include discussion of menopausal symptoms, blood pressure, cardiovascular risk factors, and any new medical conditions.
Breast examinations and mammograms should follow recommended screening guidelines, taking into account your age and individual risk factors.
Tell your healthcare provider about any new breast lumps, unexplained vaginal bleeding, persistent headaches, or other unusual symptoms.
The benefits and risks of Livial should be reviewed at least once a year, although some women may require more frequent assessments.
Treatment should continue only while its expected benefits outweigh its potential risks.
Seek emergency medical attention if you experience sudden chest pain, difficulty breathing, painful swelling in one leg, or symptoms suggesting a stroke.
Stroke warning signs may include sudden weakness on one side of the body, difficulty speaking, loss of vision, or an unusually severe headache.
Stop taking Livial and seek prompt medical advice if you develop jaundice, a significant increase in blood pressure, or a new migraine-type headache.
Contact your healthcare provider if you experience persistent vaginal bleeding, new breast changes, worsening migraines, or other concerning symptoms.
Livial may begin relieving menopausal symptoms within the first few weeks of treatment. However, the time needed to notice improvement varies depending on your symptoms, overall health, and individual response to the medication. Livial is a hormone replacement therapy (HRT) that produces estrogen-like, progesterone-like, and androgen-like effects. These effects help relieve symptoms associated with declining hormone levels after menopause. Some women notice fewer hot flashes and night sweats within the first few weeks. Other symptoms, such as vaginal dryness, sleep disturbances, and changes in sexual comfort, may take longer to improve. The full benefits of Livial for menopausal symptom relief may take approximately three months to become apparent. If you are taking Livial to help prevent osteoporosis, its effects on bone density develop gradually over a longer period. You may not notice any physical changes because bone loss often occurs without symptoms. Your healthcare provider may recommend bone density testing to evaluate your bone health when appropriate. Continue taking Livial as prescribed, even if you do not notice immediate improvement. Do not increase your dose to make the medication work faster. If your symptoms have not improved after approximately three months, contact your healthcare provider. They may reassess your treatment and determine whether Livial is appropriate for you.
No. Livial is not a contraceptive and should not be used to prevent pregnancy. Livial contains tibolone, a synthetic steroid that produces hormone-like effects to help relieve menopausal symptoms and maintain bone density in selected postmenopausal women. Although tibolone affects hormone activity, it does not reliably prevent ovulation or pregnancy. Livial is intended for women who have completed menopause. For women experiencing natural menopause, treatment should generally begin at least 12 months after their last menstrual period. If you are still having menstrual periods or have not completed menopause, you may still be able to become pregnant. If contraception is necessary, speak with your healthcare provider about an appropriate birth control method. Livial must not be used during pregnancy. If you become pregnant while taking Livial, stop taking the medication and contact your healthcare provider immediately. Your healthcare provider can also help determine whether you have completed menopause and whether Livial is a suitable treatment for your symptoms.
Livial should be stored properly to maintain its quality and effectiveness throughout its shelf life. Keep Livial tablets in a cool, dry place at a temperature below 25°C (77°F). Avoid exposing the medication to direct sunlight, excessive heat, or moisture. Store the tablets in their original blister packaging until you are ready to take them. Keep the blister strips inside the outer carton to protect them from light and moisture. Do not refrigerate or freeze Livial. Avoid storing the medication in bathrooms or other humid locations because changes in temperature and moisture may affect its quality. Keep Livial out of the sight and reach of children and pets. Check the expiration date printed on the packaging before taking a tablet. Do not use Livial after its expiration date or if the packaging is damaged and the tablets appear unusual. If you have expired or unused tablets, ask your pharmacist how to dispose of them safely. Do not flush medications down the toilet or throw them into household waste unless specifically instructed. Proper storage helps protect Livial from heat, light, and moisture, keeping the tablets in suitable condition until their expiration date.Â
If you forget to take Livial, what you should do depends on how much time has passed since your usual scheduled dose. Livial is normally taken as one 2.5 mg tablet by mouth once daily, preferably at approximately the same time each day. If you are 12 hours late or less, take the missed tablet as soon as you remember. Continue taking your next tablet at the usual scheduled time. If you are more than 12 hours late, skip the missed tablet and take your next tablet at its regular time. For example, if you normally take Livial at 8:00 AM and remember at 2:00 PM, you are only six hours late. Take the missed tablet when you remember. However, if you remember at 10:00 PM, more than 12 hours have passed since your scheduled dose. Skip the missed tablet and take your next dose at 8:00 AM the following morning. Do not take two tablets together to make up for a missed dose. Missing a dose may increase the likelihood of breakthrough bleeding or spotting. Breakthrough bleeding is unexpected vaginal bleeding that can occur during hormone replacement therapy. Taking extra tablets will not improve your menopausal symptoms faster and may increase the risk of unwanted side effects. If you frequently forget your medication, consider setting a daily phone reminder or taking Livial as part of a regular routine, such as after breakfast. If you miss several doses or are unsure how to resume treatment, contact your healthcare provider or pharmacist for guidance. Continue taking Livial according to your prescribed schedule, and never double your dose to replace a missed tablet.Â
| Generic name: | Tibolone |
|---|---|
| Formulation: | tablet |
| Strength(s): | 2.5mg |
| Quantities Available: | 28, 56 |
Our online Canadian Pharmacy is known for high standards of quality, safety, and efficiency when it comes to medications.
Our pharmacy offers lower prices on prescription drugs compared to traditional pharmacies.
When ordering Livial (tibolone) from a Canadian pharmacy, you can typically purchase up to a 90-day supply at one time, which is common for prescription medications to ensure adequate management of chronic conditions without frequent refills.
Here’s what you need to know:
Dosage and Quantity: Livial is commonly prescribed in a dosage of 2.5 mg, taken once daily. For a 90-day supply, this means you would order 90 tablets (90 days x 1 tablet per day).
Yes, we sell tibolone on our website. You can enjoy low prices when you order through us. To purchase tibolone, you will need a valid prescription from your healthcare provider. We require this prescription to dispense the medication safely and appropriately. You can submit your prescription by mailing it to us, faxing it, or uploading it through your online account.
Yes, we ship Livial (tibolone) to both the United States and Puerto Rico.
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Online Pharmacies Canada has provided information from third parties intended to increase awareness and does not contain all the information about Livial (Tibolone). Talk to your doctor or other qualified medical practitioners for medical attention or advice, or if you have any concerns about Livial (Tibolone).
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