Greater Glasgow and Clyde Medicines
Key to symbols The medicine should be initiated by, or on the advice of a specialist, but is suitable for continuation by a GP The medicine should only be used and prescribed by a specialist Indicates the preferred choice within a class or group of medicines
The medicine should be initiated by, or on the advice of a specialist, but is suitable for continuation by a GP
The medicine should only be used and prescribed by a specialist
Indicates the preferred choice within a class or group of medicines
6. Endocrine system

6.4. Sex hormones

6.4.1. Female sex hormones

6.4.1.1. Oestrogens and HRT

Preferred List
Preferred List First Line
ELLESTE SOLO

Prescribing Notes:

Contains estradiol 1mg.

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ELLESTE DUET

Prescribing Notes:

Available as estradiol 1mg or 2mg with norethisterone 1mg.

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ELLESTE DUET CONTI

Prescribing Notes:

Estradiol 2mg and norethisterone acetate 1mg.

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EVOREL

Prescribing Notes:

Transdermal patch containing estradiol. Available in 25, 50, 75 and 100 micrograms/24hour strengths.

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EVOREL CONTI

Prescribing Notes:

Transdermal patch containing estradiol 50mcg /24 hours and norethisterone acetate 170mcg / 24 hours.

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EVOREL SEQUI

Prescribing Notes:

Combination of Evorel® 50 patches (containing estradiol) and Evorel® Conti patches (estradiol and norethisterone acetate).

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FEMOSTON

Prescribing Notes:

Available as 1mg/10mg and 2mg/10mg strengths. Contains estradiol and dydrogesterone.

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FEMOSTON-CONTI

Prescribing Notes:

Available as 0.5mg/2.5mg and 1mg/5mg strengths. Contains estradiol and dydrogesterone.

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KLIOVANCE

Prescribing Notes:

Estradiol 1mg and norethisterone acetate 0.5mg.

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LENZETTO (TRANSDERMAL SPRAY)

Prescribing Notes:

This formulation contains 1.53mg/spray of estradiol.

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TIBOLONE

Prescribing Notes:

Used for the short-term treatment of symptoms of oestrogen deficiency. Unsuitable for use in the premenopause (unless being treated with gonadotrophin-releasing hormone analogue) and as (or with) an oral contraceptive. Also unsuitable for use within 12 months of last menstrual period (may cause irregular bleeding).

If transferring from cyclical HRT, start at end of regimen; if transferring from continuous-combined HRT, start at any time.

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Total Formulary
ESTRADIOL WITH MICRONISED PROGESTERONE (BIJUVE) (capsules)
ESTRADOT (PATCH)

Prescribing Notes:

Transdermal patch containing estradiol. Available in 25, 37.5, 50, 75 and 100 micrograms/24hour strengths.

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OESTROGEL (GEL)

Restrictions:

Restricted to patients who fail to tolerate oral or patch preparations.

Prescribing Notes:

Strength: 0.06%

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6.4.1.2. Progestogens

Preferred List
LEVONORGESTREL (MIRENA) (intra-uterine system)

Prescribing Notes:

Mirena is the preferred levonorgestrel intra-uterine system for prevention of endometrial hyperplasia during oestrogen replacement therapy.

Prescribe by brand name. Intra-uterine device which releases levonorgestrel (52mg). It is licensed for use for up to 4 years for this indication; please also see Royal College of Obstetricians & Gynaecologists (RCOG) guidance

For other indications, see section 7.3.2.3.

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MEDROXYPROGESTERONE ACETATE

Prescribing Notes:

The use of medroxyprogesterone tablets for postponing menstruation is off-label, and only for use in patients at higher risk of VTE or where norethisterone is unsuitable. Further guidance is available from the Specialist Pharmacy Service.

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NORETHISTERONE

Prescribing Notes:

Norethisterone should be avoided in patients at risk of venous thromboembolism.

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PROGESTERONE micronised (oral capsules)

Prescribing Notes:

As an adjunctive use with oestrogen in post-menopausal women with an intact uterus, as hormone replacement therapy (HRT).

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Total Formulary
Specialist Only
PROGESTERONE

Restrictions:

Use of Lubion® injection is restricted to women who are unable to use or tolerate vaginal preparations.

Prescribing Notes:

Use for luteal support as part of an assisted reproductive technology (ART) treatment program for infertile women is restricted to specialist use only in line with national guidance.

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6.4.2. Male sex hormones and antagonists

Preferred List
FINASTERIDE (5mg tablets)
Total Formulary
Specialist and GP
DUTASTERIDE

Restrictions:

Restricted to specialist initiation.

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Specialist and GP
TESTOSTERONE

Restrictions:

All testosterone preparations are restricted to specialist initiation.  In addition, testosterone transdermal gel is restricted to use on the recommendation of consultant endocrinologists, urologists and oncologists for patients requiring a transdermal delivery system.

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6.4.3. Anabolic steroids