Evorel Sequi patches

The name of your medicine is Evorel Sequi. It belongs to a group of medicines called hormone replacement therapy (HRT). Evorel Sequi contains two medicines:

• an oestrogen (estradiol)
• a progestogen (norethisterone)

They are both female hormones.

Each pack contains eight patches.

• Four ‘Evorel 50’ patches marked CE50 (containing estradiol only).
• Four ‘Evorel Conti’ patches marked CEN1 (containing estradiol and norethisterone).

The hormones are spread evenly in each patch. They pass slowly into your body through the skin.

Evorel Sequi is used for:

• The symptoms of menopause (see the package leaflet for more information). It is only used in women who still have a womb. It is suitable for women who have had the menopause (postmenopausal) or who are around the time of the menopause (perimenopausal).
• Prevention of osteoporosis (fragile bones) in women who have had the menopause and are most likely to have bone problems. Evorel Sequi is only used if other medicines for osteoporosis have been tried first and they have not worked.

Always use this medicine exactly as your doctor has told you.

Using the patches

The patches need to be changed twice a week. You must use the patches in the right order.

• Weeks 1 and 2: Use the four Evorel 50 patches one at a time.
• Weeks 3 and 4: Use the four Evorel Conti patches one at a time.

As soon as you remove your fourth Evorel 50 patch, replace it with the first Evorel Conti patch. Start a new pack of Evorel Sequi as soon as you finish one. Do not leave a break between packs.

Where to apply the patch

Stick the patch onto a hairless area of skin below the waist. Most women prefer to wear the patch on the thigh or bottom. See the package leaflet for more information.

Changing your patches

• You must change the patches twice a week to give your body a steady supply of hormones. There is enough hormone in each patch to last for several days.
• Change your patch on the same two days every week. This will mean that one patch is on for three days and the next patch for four days.

For more information on how to apply, wear and change the patches, please see the package leaflet.

Do not use Evorel Sequi if:

• You have or have ever had breast cancer, or if you are suspected of having it.
• You have cancer which is sensitive to oestrogens, such as cancer of the womb lining (endometrium), or if you are suspected of having it.
• You have any unexplained vaginal bleeding.
• You have a thickening of the womb lining (endometrial hyperplasia) that is not being treated.
• You have ever had a blood clot in a vein (thrombosis) such as in the legs (deep vein thrombosis) or the lungs (pulmonary embolism).
• You have a blood clotting disorder (such as protein C, protein S, or antithrombin deficiency).
• You have or recently have had a disease caused by blood clots in the arteries, such as a heart attack, a stroke or angina.
• You have or have ever had a liver disease and your liver function tests have not returned to normal.
• You have a rare blood problem called porphyria which is passed down in families (inherited).
• You are allergic to estradiol hemihydrate norethisterone acetate or any of the other ingredients of this medicine.

If any of the above conditions appear for the first time while taking Evorel Sequi, stop taking it at once and consult your doctor immediately.

When to take special care with Evorel Sequi

In some situations, this medicine should be used with caution. For a list of warnings and precautions, please see the package leaflet.

Other medicines and Evorel Sequi

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. This includes medicines that you buy without a prescription (over-the-counter medicines) or herbal medicines.

Some medicines may interfere with the effect of Evorel Sequi. This might lead to irregular bleeding. For an overview of the medicines that may interfere with the way Evorel Sequi works, please see the package leaflet.

• Evorel Sequi is not a contraceptive. If it is less than 12 months since your last menstrual period or you are under 50 years old, you may still need to use additional contraception to prevent pregnancy.
• Tell your doctor if you are going to have surgery. You may need to stop taking HRT about four to six weeks before the operation to reduce the risk of a blood clot.
• Do not use Evorel Sequi patches if you are pregnant or breastfeeding.

A doctor must determine if Evorel Sequi is suitable for you. If you are a candidate for this medicine, the doctor can write you a prescription. With this prescription you can order Evorel Sequi patches from the pharmacy.

Would you like to know what Evorel Sequi costs? The current price is listed on our order page. This is an all-in price, which includes the cost of the consultation and a service fee.

Like all medicines, this medicine can cause side effects, although not everybody gets them.

The following diseases are reported more often in women using HRT compared to women not using HRT:

• Breast cancer.
• Abnormal growth or cancer of the lining of the womb (endometrial hyperplasia or cancer).
• Ovarian cancer.
• Blood clots in the veins of the legs or lungs (venous thromboembolism).
• Heart disease.
• Stroke.
• Probable memory loss if HRT is started over the age of 65.

See the package leaflet for more information on this topic.

Get emergency medical help immediately if you notice serious side effects (see the package leaflet for the symptoms).

Tell your doctor if you notice any of the following side effects while using Evorel Sequi:

Very common (affects more than 1 in 10 people):

• Irritated, itchy, red skin and rash where the patch is applied.

Common (affects less than 1 in 10 people):

• Feeling depressed or nervous.
• Inappropriate signs of emotion.
• Being unable to sleep.
• Headache.
• Itchy skin or red rash.
• Feeling sick (nausea), or having stomach pain wind or other stomach upsets.
• Diarrhoea.
• Pain including pain in the back, muscles, joints.
• Breast pain.
• Feeling generally unwell.
• Weight gain.
• Heavy vaginal bleeding, painful periods.
• Water retention or build-up of fluid under the skin (oedema).

This list is not exhaustive. For a complete list of side effects, see the package leaflet. If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in the leaflet.

What Evorel Sequi contains

• Each Evorel 50 patch contains 3.2 mg of estradiol hemihydrate (absorption rate approximately 50 micrograms of estradiol in 24 hours).
• Each Evorel Conti patch contains 3.2 mg of estradiol hemihydrate (absorption rate approximately 50 micrograms of estradiol in 24 hours) and 11.2 mg of norethisterone acetate (absorption rate approximately 170 micrograms of norethisterone acetate in 24 hours).
• Evorel Sequi also contains: acrylic copolymer, guar gum, polyester, polyethylene terephthalate.