FEMOSTON 2/10 TABLETS

Active substance: ESTRADIOL

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PACKAGE LEAFLET: INFORMATION FOR THE USER
FEMOSTON® 2/10 TABLETS
(oestradiol and dydrogesterone)
Your medicine is available in the above name and strength but will be
referred to as Femoston throughout the remainder of this leaflet
This product is available in multiple strengths and all strengths will be
referred to throughout this leaflet.
Read all of this leaflet carefully before you start taking this medicine
because it contains important information for you.
- Keep this leaflet. You may need to read it again.
- If you have any further questions, ask your doctor, or pharmacist or
nurse.
- This medicine has been prescribed for you only. Do not pass it on to
others. It may harm them, even if their signs of illness are the same
as yours.
- If you get any side effects, talk to your doctor, or pharmacist or nurse.
This includes any possible side effects not listed in this leaflet.
What is in this leaflet
1. What Femoston is and what it is used for
2. What you need to know before you take Femoston
3. How to take Femoston
4. Possible side effects
5. How to store Femoston
6. Contents of the pack and other information
1.

WHAT FEMOSTON IS AND WHAT IT IS USED FOR

Femoston is a Hormone Replacement Therapy (HRT).
It contains two types of female hormones, an oestrogen and a
progestogen.
Femoston is used for:
Relief of symptoms occurring after menopause
During the menopause, the amount of oestrogen produced by a woman’s
body drops. This can cause symptoms such as hot face, neck and chest
("hot flushes"). Femoston alleviates these symptoms after menopause.
You will only be prescribed Femoston if your symptoms seriously hinder
your daily life.
Prevention of osteoporosis
After the menopause some women may develop fragile bones
(osteoporosis). You should discuss all available options with your doctor.
If you are at an increased risk of fractures due to osteoporosis and other
medicines are not suitable for you, you can use Femoston to prevent
osteoporosis after menopause.
2.

BEFORE YOU TAKE FEMOSTON

Medical history and regular check-ups
The use of HRT carries risks which need to be considered when deciding
whether to start taking it, or whether to carry on taking it.
The experience in treating women with a premature menopause (due to
ovarian failure or surgery) is limited. If you have a premature menopause
the risks of using HRT may be different. Please talk to your doctor.
Before you start (or restart) HRT, your doctor will ask about your own and
your family’s medical history. Your doctor may decide to perform a
physical examination. This may include an examination of your breasts
and/ or an internal examination, if necessary.
Once you have started on Femoston you should see your doctor for
regular check-ups (at least once a year). At these check-ups, discuss with
your doctor the benefits and risks of continuing with Femoston.
Go for regular breast screening, as recommended by your doctor.
Do not take Femoston
If any of the following applies to you. If you are not sure about any of the
points below, talk to your doctor before taking Femoston,
Do not take Femoston
 If you have or have ever had breast cancer, or if you are suspected
of having it
 If you have cancer which is sensitive to oestrogens, such as
cancer of the womb lining (endometrium), or if you are suspected of
having it
 If you have any unexplained vaginal bleeding
 If you have excessive thickening of the womb lining (endometrial
hyperplasia) that is not being treated
 If you have or have ever had a blood clot in a vein (thrombosis),
such as in the legs (deep venous thrombosis) or the lungs (pulmonary
embolism)
 If you have a blood clotting disorder (such as protein C, protein S,
or antithrombin deficiency)
 If you have or recently have had a disease caused by blood clots in
the arteries, such as a heart attack, stroke or angina
 If you have or have ever had a liver disease and your liver function
tests have not returned to normal
 If you have a rare blood problem called “porphyria” which is passed
down in families (inherited)
 If you are allergic (hypersensitive) to oestradiol/ dydrogesterone or
any of the other ingredients of Femoston (listed in section 6
Further information)
If any of the above conditions appear for the first time while taking
Femoston, stop taking it at once and consult your doctor immediately.
When to take special care with Femoston
Tell your doctor if you have ever had any of the following problems,
before you start the treatment, as these may return or become worse
during treatment with Femoston. If so, you should see your doctor more
often for check-ups:
 fibroids inside your womb
 growth of womb lining outside your womb (endometriosis) or a history
of excessive growth of the womb lining (endometrial hyperplasia)
 increased risk of developing blood clots (see “Blood clots in a vein
(thrombosis)”)
 increased risk of getting an oestrogen-sensitive cancer (such as
having a mother, sister or grandmother who has had breast cancer)
 high blood pressure
 a liver disorder, such as a benign liver tumour
 diabetes
 gallstones
 migraine or severe headaches
 a disease of the immune system that affects many organs of the body
(systemic lupus erythematosus, SLE)
 epilepsy
 asthma
 a disease affecting the eardrum and hearing (otosclerosis)
 a very high level of fat in your blood (triglycerides)
 fluid retention due to cardiac or kidney problems
Stop taking Femoston and see a doctor immediately

If you notice any of the following when taking HRT:
- any of the conditions mentioned in the ‘Do not take Femoston’ section
- yellowing of your skin or the whites of your eyes (jaundice). These
may be signs of a liver disease
- a large rise in your blood pressure (symptoms may be headache,
tiredness, dizziness)
- migraine-like headaches which happen for the first time
- if you become pregnant
- if you notice signs of a blood clot, such as:
- painful swelling and redness of the legs
- sudden chest pain
- difficulty in breathing
For more information, see ‘Blood clots in a vein (thrombosis)’
Note: Femoston 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. Speak to your
doctor for advice.
HRT and cancer
Excessive thickening of the lining of the womb (endometrial
hyperplasia) and cancer of the lining of the womb (endometrial
cancer)
Taking oestrogen-only HRT will increase the risk of excessive thickening
of the lining of the womb (endometrial hyperplasia) and cancer of the
womb lining (endometrial cancer).
The progestogen in Femoston protects you from this extra risk.
Irregular bleeding
You may have irregular bleeding or drops of blood (spotting) during the
first 3-6 months of taking Femoston. However, if the irregular bleeding:
 carries on for more than the first 6 months
 starts after you have been taking Femoston for more than 6 months
 carries on after you have stopped taking Femoston
see your doctor as soon as possible.
Unexpected bleeding
You will have a bleed once a month (so-called withdrawal bleed) while
taking Femoston. But, if you have unexpected bleeding or drops of blood
(spotting) besides your monthly bleeding, which:
 carries on for more than the first 6 months
 starts after you have been taking Femoston more than 6 months
 carries on after you have stopped taking Femoston
see your doctor as soon as possible
Breast cancer
Evidence suggests that taking combined oestrogenprogestogen and
possibly also oestrogen-only HRT increases the risk of breast cancer.
The extra risk depends on how long you take HRT. The additional risk
becomes clear within a few years. However, it returns to normal within a
few years (at most 5) after stopping treatment.
Compare
Women aged 50 to 79 who are not taking HRT, on average, 9 to 14 in
1000 will be diagnosed with breast cancer over a 5-year period. For
women aged 50 to 79 who are taking oestrogen-progestogen HRT over 5
years, there will be 13 to 20 cases in 1000 users (i.e. an extra 4 to 6
cases).
 Regularly check your breasts. See your doctor if you notice any
changes such as:
- dimpling of the skin
- changes in the nipple
- any lumps you can see or feel
Ovarian cancer
Ovarian cancer is rare. A slightly increased risk of ovarian cancer has
been reported in women taking HRT for at least 5 to 10 years.
Women aged 50 to 69 who are not taking HRT, on average about 2
women in 1000 will be diagnosed with ovarian cancer over a 5-year
period. For women who have been taking HRT for 5 years, there will be
between 2 and 3 cases per 1000 users (i.e. up to 1 extra case).
Effect of HRT on heart and circulation
Blood clots in a vein (thrombosis)
The risk of blood clots in the veins is about 1.3 to 3- times higher in
HRT users than in non-users, especially during the first year of taking it.
Blood clots can be serious, and if one travels to the lungs, it can cause
chest pain, breathlessness, fainting or even death.
You are more likely to get a blood clot in your veins as you get older and
if any of the following applies to you.
Inform your doctor if any of these situations applies to you:
 you are unable to walk for a long time because of major surgery,
injury or illness (see also section 3, If you need to have surgery)
 you are seriously overweight (BMI >30 kg/m2)
 you have any blood clotting problem that needs long-term treatment
with a medicine used to prevent blood clots
 if any of your close relatives has ever had a blood clot in the leg, lung
or any other organ
 you have systemic lupus erythematosus (SLE)
 you have cancer.
For signs of a blood clot, see “Stop taking Femoston and see a doctor
immediately”.
Compare
Looking at women in their 50s who are not taking HRT, on average, over
a 5-year period, 4 to 7 in 1000 would be expected to get a blood clot in a
vein.
For women in their 50s who have been taking oestrogen-progestogen
HRT for over 5 years, there will be 9 to 12 cases in 1000 users (i.e. an
extra 5 cases).
Heart disease (heart attack)
There is no evidence that HRT will prevent a heart attack.
Women over the age of 60 years who use oestrogen-progestogen HRT
are slightly more likely to develop heart disease than those not taking any
HRT.
Stroke
The risk of having a stroke is about 1.5 times higher in HRT users than in
non-users. The number of extra cases of stroke due to use of HRT will
increase with age.
Compare
Looking at women in their 50s who are not taking HRT, on average, 8 in
1000 would be expected to have a stroke over a 5-year period. For
women in their 50s who are taking HRT, there will be 11 cases in 1000
users, over 5 years (i.e. an extra 3 cases).
Other conditions
 HRT will not prevent memory loss. There is some evidence of a
higher risk of memory loss in women who start using HRT after the
age of 65.
Speak to your doctor for advice.

Using other medicines
Some medicines may interfere with the effect of Femoston. This might
lead to irregular bleeding. This applies to the following medicines:
 Medicines for epilepsy (such as phenobarbital, phenytoin and
carbamazepine)
 Medicines for tuberculosis (such as rifampicin and rifabutin)
 Medicines for HIV infection (such as nevirapine, efavirenz, ritonavir
and nelfinavir)
 Herbal remedies containing St John’s Wort (Hypericum perforatum).
Please tell your doctor or pharmacist if you are taking or have recently
taken any other medicines including medicines obtained without a
prescription, herbal medicines or other natural products.
Laboratory tests
If you need a blood test, tell your doctor or the laboratory staff that you
are taking Femoston, because this medicine can affect the results of
some tests.
Pregnancy and breast-feeding
Femoston is for use in postmenopausal women only. If you become
pregnant, stop taking Femoston and contact your doctor.
3.

HOW TO TAKE FEMOSTON

The days of the week printed on the blister strip translate as follows:
Seg

Ter

Qua

Qui

Sex

Sab

Dom

Mon

Tues

Wed

Thurs

Fri

Sat

Sun

Always take Femoston exactly as your doctor has told you. You
should check with your doctor or pharmacist if you are not sure.
How to take Femoston
Take one tablet every day, without a break between packs. Swallow
the tablet with water, with or without food.
Your doctor will aim to give you the lowest dose for the shortest
time to treat your symptoms.
Speak to your doctor if you think this dose is too strong or not
strong enough.
The usual starting dose is:
During day 1 to 14 of the cycle, 1 tablet daily containing 1 or 2 mg
oestradiol.
During day 15 to 28 of the cycle, 1 tablet daily containing 1 or 2 mg
oestradiol and 10 mg dydrogesterone.
Immediately after the 28-day cycle you should begin the next treatment.
The days of the week are printed on the back of the blister strips. The
tablets from the part marked with arrow 1 should be taken first, then the
tablets from the part marked with arrow 2 should be taken.
If you are having regular periods you should start taking Femoston within
five days of the start of bleeding.
If you are not having regular periods and are not taking any other
Hormone Replacement Therapy (HRT) preparations, or you are switching
from a combined continuous HRT product, you can start taking Femoston
on any convenient day.
If you are currently using a ‘cyclic’ or ‘sequential’ HRT preparation (which
involves taking an oestrogen tablet or patch for part of the month,
followed by both oestrogen and progestagen tablet or patch for up to 14
days) start taking Femoston the day after you finish the pack i.e. at the
end of the progestagen phase.
The doctor may increase the dose later, if necessary.
The different tablet strengths are colour-coded for your convenience.
If you are taking Femoston to treat symptoms of the menopause (change
of life), your treatment should begin with the dosage Femoston 1/10.
Your doctor will then increase this dose according to your symptoms.
If you are taking Femoston to prevent osteoporosis, your doctor will
adjust the dose individually according to your bone mass.
If you take more Femoston than you should
If you or somebody else takes too many Femoston tablets, they are
unlikely to come to any harm. Nausea (feeling sick), vomiting, sleepiness
and dizziness may occur. No treatment is necessary, but if you are
worried contact your doctor for advice.
If you forget to take Femoston
Take the missed tablet as soon as you remember.
If it is more than 12 hours since you took the last one, take the next dose
without taking the forgotten tablet.
Do not take a double dose. Bleeding or spotting may occur if you miss a
dose.
If you stop taking Femoston
Do not stop taking Femoston without first talking to your doctor.
If you have any further questions on the use of this product, ask your
doctor or pharmacist.
If you need to have surgery
If you are going to have surgery, tell the surgeon that you are taking
Femoston. You may need to stop taking Femoston about 4 to 6 weeks
before the operation to reduce the risk of a blood clot (see section 2,
Blood clots in a vein). Ask your doctor when you can start taking
Femoston again.
4.

POSSIBLE SIDE EFFECTS

Like all medicines, Femoston 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
For more information about these side effects, see Section 2.
The following serious side effects may occur during treatment with
Femoston:
 swelling of the skin around the face and neck. This may cause
difficulty breathing
 heart attack
 tumours that may be affected by the levels of progestagens (e.g.
meningioma)
 heavy, irregular or painful genital bleeding
If any of these side effects occur you should stop treatment immediately
and contact your doctor.

The following side effects may occur during treatment:
Common (in less than 1 in 10, but more than 1 in 100 patients
treated):
 Migraine
 Headache
 feeling sick
 leg cramps
 breast pain or tenderness
 abdominal pain
 pelvic pain
 unscheduled bleeding or spotting
 wind (flatulence)
 feeling weak (asthenia)
 weight changes
Uncommon (in less than 1 in 100, but more than 1 in 1,000 patients
treated):
 allergic skin reactions (including rash or itching)
 feeling down (depression)
 vaginal thrush (a vaginal infection due to a fungus called Candida
albicans)
 symptoms of cystitis
 high blood pressure
 swelling of the ankles, feet or fingers (peripheral oedema)
 peripheral vascular disease
 varicose veins
 gallbladder disease
 change in sex drive
 back pain
 Indigestion
 Nervousness
 Dizziness
 vaginal discharge
 fibroids get bigger (growths in the womb increase)
 changes in the cervix (the lower end of the womb)
Rare (in less than 1 in 1,000, but more than 1 in 10,000 patients
treated):
 liver disorders, which may include jaundice (yellowing of the skin),
asthenia (feeling weak) and general malaise
 change in the surface of the eye
 intolerance to contact lenses
 pre-menstrual tension (PMT)
 swelling of the breasts
Very rare (in less than 1 in 10,000 patients treated, not known
(cannot be estimated from the available data)):
 reduction in red blood cells which can make the skin pale and cause
weakness or breathlessness (anaemia)
 chorea (muscle twitches)
 Vomiting
 skin discolouration
 red or brown patches on the skin
 worsening of porphyria (a metabolic disease).
There is a slightly increased risk of developing the following diseases in
women taking Hormone Replacement Therapy (HRT):
 dementia (there is no conclusive evidence that this can develop)
If unscheduled bleeding occurs after some time on HRT, you should
contact your doctor. If unscheduled bleeding continues after stopping
HRT, it may be necessary to perform tests to exclude disease of the
endometrium (the lining of the uterus).
Changes can occur in the levels of certain proteins and hormones in the
blood. The action of the hormones in the body is not affected. You should
tell your doctor that you are taking HRT if you are to have a blood test.
The following side effects have been reported with other HRTs:
 various skin disorders:
- discoloration of the skin especially of the face or neck known as
“pregnancy patches” (chloasma)
- painful reddish skin nodules (erythema nodosum)
- rash with target-shaped reddening or sores (erythema multiforme)
If any of the side effects gets serious , or if you notice any side effects not
listed in this leaflet, please tell your doctor or pharmacist.
5.

HOW TO STORE FEMOSTON

Do not store above 30°C.
Do not take the tablets after the expiry date shown on the pack.
Keep out of the sight and reach of children.
Take any unused tablets back to a pharmacy (chemist).
Medicines should not be disposed of via wastewater or household waste.
Ask your pharmacist how to dispose of medicines no longer required.
These measures will help to protect the environment.
If your tablets become discoloured or show any signs of deterioration,
take them back to your pharmacist for safe disposal.
6.

FURTHER INFORMATION

What Femoston contain

 The pack contains two different types of film-coated tablets.
 Each brick red tablet contains 2mg of estradiol and each yellow tablet

contains 2mg of estradiol and 10mg of dydrogesterone. These are the
active ingredients.
 The tablets also contain the following inactive ingredients: lactose,
hypromellose, maize starch, colloidal anhydrous silica, magnesium
stearate, talc, titanium dioxide (E171), macrogol 400, iron oxides red,
black and yellow (E172).
What Femoston looks like and the contents of the pack
Your tablets are; round, biconvex, brick-red film-coated tablets, plain on
one side and marked on the other side with ‘379’; and round, biconvex,
yellow film-coated tablets, plain on one side and marked on the other side
with ‘379’.
Femoston 2/10 Tablets are available in packs of 84 tablets. The calendar
blister strips are printed with arrows, showing the order in which to take
the tablets.
Manufacturer
This product is manufactured by: Abbott Biologicals B.V. Veerweg 12
NL-8121 AA OLST, The Netherlands.
It is procured from within the EU. Parallel Import Product Licence holder:
G Pharma Ltd, Salford M50 2PU.
POM

PL: 16369/0572

Leaflet Revision: 30/04/2014
‘Femoston’ is a trademark of Abbott

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Source: Medicines and Healthcare Products Regulatory Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.

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