Generic Name: Norethindrone

  • What is Activella?

    Activella is a medicine that contains estrogen and progestin hormones. It is used to reduce moderate to severe signs of menopause, such as hot flashes, dryness, itching, and burning in or around the vagina. In addition, Activella is prescribed to prevent osteoporosis in postmenopausal women.

  • What is the most important information I should know about Activella?

    Do not use estrogen with or without progestin to prevent heart disease, heart attacks, strokes,or dementia. Using Activella may increase the risk of getting heart attacks, strokes, and blood clots.

    The risk of blood clots in the veins increases, especially during the first year of therapy. Call your doctor immediately if you experience any of the following warning signs: bulging eyes, changes in vision or speech, coughing up blood, dizziness, double vision, faintness, migraine, pain in the calves or chest, severe headache or vomiting, sudden shortness of breath, sudden vision loss, weakness or numbness of an arm or leg.

    Activella may also increase your risk of developing dementia if you are >65 years old. Estrogens should be used only as long as needed. Talk regularly with your doctor about whether you still need treatment with Activella.

    Estrogens increase the risk of uterine cancer. Alert your doctor if you experience any abnormal vaginal bleeding. In addition, estrogen replacement therapy may also increase the risk of breast cancer if taken at high doses or for long periods of time. Be sure to do a monthly self-exam of your breasts, and get regular mammograms.

    Estrogen replacement therapy typically doubles the chances of gallbladder disease. Notify your doctor if you experience pain, tenderness, or swelling in your abdomen.

    Estrogen therapy sometimes causes high blood pressure, so be sure to get periodic checkups. In women prone to high blood lipid levels, estrogen can also cause a sharp spike in triglycerides, possibly leading to pancreatitis. Fluid retention is another possibility. If it develops, it can aggravate conditions such as asthma, epilepsy, heart disease, kidney disease, and migraine.

    Make sure your doctor knows if you have ever been diagnosed with depression. Treatment with hormone replacement therapy may need to be discontinued if depression recurs.

    If you have diabetes, watch your blood sugar levels carefully. There is a chance that estrogen/progestin products may make diabetes worse.

  • Who should not take Activella?

    Do not take Activella if you have any of the following: known or suspected breast cancer, any other estrogen-dependent cancer (eg, uterine), or a past history of breast cancer associated with estrogen use; unusual vaginal bleeding; a history of blood clots; sensitivity to estrogen or progesterone or any reason to believe that you are pregnant.

    If you have had your uterus removed, you do not need the progestin in this product, and should take a different type of hormone replacement therapy. You should also avoid Activella if you have a liver condition.

  • What should I tell my doctor before I take the first dose of Activella?

    Tell your doctor about all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with Activella. Also, talk to your doctor about your complete medical history, especially if you have ever had cancer; diabetes; heart, liver, thyroid, or kidney problems; gallbladder disease; depression; seizures'; migraines; asthma; endometriosis; lupus; high calcium levels in the blood; high triglyceride levels; or if you have unexplained vaginal bleeding.

    Tell your doctor if you are going to have surgery or will be on bed rest for a certain period of time, or if you are or may be pregnant.

  • What is the usual dosage?

    The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.

    Adults: There are two strengths available containing a combination of estradiol/norethindrone acetate: 1.0 milligram (mg)/0.5 mg or 0.5 mg/0.1 mg. The recommended dose is one tablet of the prescribed strength by mouth once a day.

  • How should I take Activella?

    Take one tablet at the same time each day, with or without food. If you are taking the medication to relieve menopausal symptoms, your doctor will reevaluate your need to continue treatment every 3-6 months.

  • What should I avoid while taking Activella?

    Do not miss regularly scheduled checkups with your doctor while taking Activella. Be sure to have an annual gynecologic exam (including a breast exam and/or mammography).

  • What are possible food and drug interactions associated with Activella?

    If estrogen is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining estrogen with the following: St. John's wort, phenobarbital, carbamazepine, rifampin, erythromycin, clarithromycin, ketoconazole, itraconazole, ritonavir, and grapefruit juice.

  • What are the possible side effects of Activella?

    Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

    Side effects may include: abdominal pain, acne, back pain, breast tenderness and enlargement, depression, enlargement of uterine fibroids, headache, liver problems, nausea, nervousness, sleeping problems, urinary tract infection, vaginal inflammation, vomiting, weight loss

  • Can I receive Activella if I am pregnant or breastfeeding?

    Although hormone replacement medications are intended only for women who are no longer in their childbearing years, it's important to note that they should never be taken during pregnancy, since they can harm the developing baby. Additionally, estrogen decreases the quantity and quality of breast milk, and progesterone finds its way into the milk.

  • What should I do if I miss a dose of Activella?

    Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Never take two doses at the same time.

  • How should I store Activella?

    Store at room temperature in a tightly closed container away from moisture and light.

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I'm Beth Isaac, PharmD. Welcome to PDR Health!

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