Introduction
Tibonor is a female sex hormone (estrogen). This is a type of hormone replacement therapy (HRT) that is used to treat symptoms associated with menopause (hot flushes, vaginal dryness, and itching), estrogen deficiency, and thinning of bones (osteoporosis).
Tibonor can be taken with or without food, but better to take it at a fixed time each day for better efficacy. It should be swallowed whole with water. The dose and duration will be decided by your doctor so that you get the right amount to control your symptoms. If you have missed a dose, take it as soon as you remember it. Do not skip any dose and finish the full course of treatment. The treatment should not be stopped abruptly without consulting your doctor as this may affect the potency of this medicine.
The most common side effects of this HRT are abnormal hair growth, breast tenderness, abdominal cramps or bloating, vaginal bleeding or spotting, nausea, vomiting, and hair loss. Some of the warning signs and symptoms that need immediate medical attention are breast lumps, unusual vaginal bleeding, dizziness and faintness, severe headaches, chest pain, shortness of breath, pains in your legs, etc.
Before taking this medicine, it is important to tell your doctor if you are taking or have recently taken any other medicines for the same disease or other diseases. Before you initiate with this HRT, you must consult the doctor if you have a history of unexplained vaginal bleeding or if you have ever had a blood clot in your legs or your lungs. If you are pregnant or breastfeeding, you should tell your doctor before taking this medicine. Your doctor may suggest you some diagnostic or laboratory tests to know the effects and side effects of this medicine on your body.
Uses of Tibonor
- Hormone replacement therapy
- Post menopausal osteoporosis
Side effects of Tibonor
Common
- Breast pain
- Stomach pain
- Vaginal bleeding
- Vaginal inflammation
- Vaginal spotting
- Irritation
- Itching
- Weight gain
How to use Tibonor
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Tibonor may be taken with or without food, but it is better to take it at a fixed time.
How Tibonor works
Tibonor is a hormonal medication. It has effects similar to estrogen, progesterone and androgen. It substitutes for the loss of estrogen production in postmenopausal women and treats menopausal symptoms such as hot flashes, night sweats and vaginal problems. It also prevents bone loss following menopause.
Indication
Menopausal vasomotor symptoms, [hot flushes, sweating, vaginal dryness & less elasticity, mood disorders, anxiety etc.], postmenopausal and post oophorectomy osteoporosis, improvement of bone-mineral density, Vaginal atrophy, Prevention of frequent UTI, urinary incontinence in postmenopausal women.
Administration
May be taken with or without food.
Adult Dose
Oral
Menopausal vasomotor symptoms;
Adult: 2.5 mg daily.
Symptomatic relief occurs within few days, but optimal results are obtained minimum after 3 months.
Prophylaxis of postmenopausal osteoporosis
Adult: 2.5 mg daily.
To prevent osteoporosis in post-menopausal women or after oophorectomy an uninterrupted longer (5-10 years) therapy is needed.
Starting Tibolone:
In case of natural menopause: To avoid irregular & abnormal bleeding, Tibolone should be started at least 12 months after last natural bleeding.
In case of artificial menopause: Treatment should be started immediately.
In case of switching over from other conventional HRT: If someone switches from estrogen-only preparation, she should start after a withdrawal bleeding. If someone switches from sequential HRT preparation she should wait for the completion of the progestogen phase. If someone switches from continuous combined HRT, she can start any time.
In case of missed pill: If no more than 12 hours have passed, the pill should be taken immediately. Otherwise the next dose should be continued as before.
Contraindication
Known or suspected oestrogen dependent tumours in women, present or history of breast cancer, undiagnosed vaginal bleeding, severe liver disease, history or current CV or cerebrovascular disorders, untreated endometrial hyperplasia, porphyria, pregnancy and lactation, premenopausal women.
Mode of Action
Tibolone is a steroid that possesses oestrogenic, progestogenic and weak androgenic properties.
Precaution
Liver disease, history or risk factors of thromboembolic disorder, impaired glucose tolerance, hypercholesterolaemia, hypertriglyceridaemia, hypertension, cholelithiasis, SLE, uterine fibroids, endometriosis and history of endometrial hyperplasia. Disorders that may be worsened by fluid retention, eg. renal dysfunction, migraine, epilepsy. Discontinue in the event of thromboembolic or abnormal liver function results, significant increase in BP, new onset of migraine-type headache. Not recommended in women within 1 yr of menopause because of irregular vaginal bleeding. Stop tibolone 4 wk before elective surgery especially when prolonged immobilisation after surgery is expected. Adjustment of antidiabetic medications may be needed.
Side Effect
Weight gain; dizziness; rash; pruritus; headache; migraine; visual disturbances; GI symptoms; facial hair growth; altered liver function; ankle oedema; depression; arthralgia or myalgia; irregular vaginal bleeding.
Potentially Fatal: Breast or endometrial cancer and stroke.
Interaction
Enzyme inducers eg, barbiturates, phenytoin, carbamazepine and rifampicin may accelerate tibolone metabolism. Increased anticoagulant effects of warfarin.