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PROGYNOVA 2MG TABLETS

Active substance(s): ESTRADIOL VALERATE / ESTRADIOL VALERATE / ESTRADIOL VALERATE

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Progynova® 2mg Tablets
(estradiol valerate)
Your medicine is available as the above name, but will be referred to as
Progynova throughout this:
Patient Information 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.
• 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. This
includes any possible side effects not listed in this leaflet. See section 4.
What is in this leaflet
1) What Progynova is and what it is used for
2) What you need to know before you take Progynova
Medical history and regular check-ups
Do not take Progynova
Warnings and precautions
HRT and cancer
Effects of HRT on heart or circulation
Blood clots in a vein (thrombosis)
Heart disease (heart attack)
Stroke
Other conditions
Other medicines and Progynova
Laboratory tests
Pregnancy and breast-feeding
Driving and using machines
Progynova contains lactose monohydrate and sucrose
3) How to take Progynova
About the pack
When to start
If you take more Progynova than you should
If you forget to take Progynova
If you stop taking Progynova
If you need to have surgery
4) Possible side effects
5) How to store Progynova
6) Contents of the pack and other information

1) What Progynova is and what it is used for
What Progynova is
Progynova is a Hormone Replacement Therapy (HRT). It contains the
female hormone, oestrogen. Your ovaries gradually make less of this
hormone as you get older and will no longer produce it after you have been
through the menopause. Progynova can be used in peri- and
postmenopausal women.
What Progynova is used for
Relief of symptoms occurring after menopause
During the menopause, the amount of the oestrogen produced by a
woman’s body drops. This can cause symptoms such as hot face, neck and
chest ("hot flushes"). Progynova alleviates these symptoms after
menopause. You will only be prescribed Progynova 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 Progynova to prevent
osteoporosis after menopause.

2) What you need to know before you take Progynova
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 Progynova, 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 to take Progynova.
Be sure to:
 go for regular breast screening and cervical smear tests, as
recommended by your doctor.
 regularly check your breasts for any changes such as dimpling of
the skin, changes in the nipple, or any lumps you can see or feel.
Do not take Progynova:
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 Progynova,
Do not take Progynova
► 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 vein 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 to estradiol valerate or any of the other ingredients
of this medicine (listed in section 6)
► If you have been told to avoid lactose, that you have a rare hereditary
condition called Lapp lactase deficiency or glucose-galactose
malabsorption
► If you have any reason to believe that you either are, or may be,
pregnant, or if you are producing milk (lactating) and breastfeeding. (See also the 'Pregnancy and breast-feeding' section of this
leaflet)


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

Warnings and precautions
Talk to your doctor or pharmacist before taking Progynova
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 Progynova. 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
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 Progynova 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 Progynova’
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: Progynova 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).
Taking a progestogen in addition to the oestrogen for at least 12 days of
each 28 day cycle protects you from this extra risk.
If you still have your womb, your doctor will prescribe a progestogen
separately.
If you have had your womb removed (a hysterectomy), discuss with your
doctor whether you can safely take this product without a progestogen.
If you've had your womb removed because of endometriosis, any
endometrium left in your body may be at risk. So your doctor may prescribe
HRT that includes a progestogen as well as an oestrogen.
Compare
In women who still have a womb and who are not taking HRT, on average,
5 in 1000 will be diagnosed with endometrial cancer between the ages of 50
and 65.
For women, aged 50 to 65, who still have a womb and who take oestrogenonly HRT, between 10 and 60 women in 1000 will be diagnosed with
endometrial cancer (i.e. between 5 and 55 extra cases), depending on the
dose and how long it is taken.
Breast cancer
Evidence suggests that taking combined oestrogen-progestogen 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.
For women who have had their womb removed and who are using
oestrogen-only HRT for 5 years, little or no increase in breast cancer risk is
shown.
Your risk of breast cancer is also higher:
► if you have a close relative (mother, sister or grandmother) who has
had breast cancer
► if you are seriously overweight
Compare
Women aged 50 to 79 who are not taking HRT, on average, 9 to 17 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 23 cases in 1000 users (i.e. an extra 4 to 6 cases).
Regularly check your breasts. See your doctor if you notice any
changes in your breast such as:
► dimpling of the skin
► changes in the nipple
► any lumps you can see or feel
Additionally, you are advised to join mammography screening programs
when offered to you. For mammogram screening, it is important that you
inform the nurse/healthcare professional who is actually taking the x-ray
that you use HRT, as this medication may increase the density of your
breasts which may affect the outcome of the mammogram. Where the
density of the breast is increased, mammography may not detect all lumps.
Ovarian cancer
Ovarian cancer (cancer of the ovaries) is rare - much rarer than breast
cancer. It can be difficult to diagnose, because there are often no obvious
signs of the disease. The use of oestrogen-only or combined oestrogenprogestogen HRT has been associated with a slightly increased risk of
ovarian cancer.
The risk of ovarian cancer varies with age. For example, in women aged 50
to 54 who are not taking HRT, about 2 women in 2000 will be diagnosed
with ovarian cancer over a 5-year period. For women who have been taking
HRT for 5 years, there will be about 3 cases per 2000 users (i.e. about 1
extra case).
Effects of HRT on heart or circulation
Blood clots in a vein (thrombosis)
The risk of blood clots in the veins (also called deep vein thrombosis, or
DVT) is about 1.3 to 3–times higher in HRT users than 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. This condition is called
pulmonary embolism, or PE.
DVT and PE are examples of a condition called venous
thromboembolism, or VTE.
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 apply 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.
► any of your close relatives has ever had a blood clot in the leg, lung or
any other organ
► you have had one or more miscarriages
► you have systemic lupus erythematosus (SLE)
► you have cancer

For signs of a blood clot, see “Stop taking Progynova 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 are taking oestrogen-progestogen HRT, for
over 5 years, there will be 9 – 12 cases in 1000 (i.e. an extra 5 cases).
For women in their 50s who have had their womb removed and have been
taking oestrogen-only HRT for over 5 years, there will be 5 to 8 cases in
1000 users (i.e. 1 extra case).
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.
► If you have heart or kidney problems, your doctor should examine
you carefully as oestrogens may cause fluid retention resulting in
swelling.
► If you have pre-existing elevated triglycerides (a type of blood fat)
your doctor should monitor you closely during oestrogen replacement
therapy or HRT. Rare cases of large increases of plasma triglycerides
(hypertriglyceridemia) leading to inflammation of the pancreas
(pancreatitis) have been reported with oestrogen replacement therapy.
► If you have a tendency to develop blotchy brown patches (chloasma)
on the face you should avoid exposure to the sun or ultraviolet light
whilst using Progynova.
► Your doctor will monitor you carefully if you have terminal kidney
insufficiency as the blood levels of the active substances in
Progynova will probably increase
Other medicines and Progynova
Tell your doctor or pharmacist if you are taking, have recently taken or
might take any other medicines.
Some medicines may interfere with the effect of Progynova. This might lead
to irregular bleeding. This applies to the following medicines:
► medicines for epilepsy (such as barbiturates, phenytoin, primidone,
carbamazepine and possibly oxcarbazepine, topiramate and
felbamate)
► medicines for tuberculosis (such as rifampicin, rifabutin)
► medicines for HIV and Hepatitis C Virus infections (so-called
protease inhibitors and non-nucleoside reverse transcriptase inhibitors
such as nevirapine, efavirenz, ritonavir and nelfinavir)
► herbal remedies containing St. John’s wort (Hypericum perforatum)
► Medicines for treatment of fungal infections (such as griseofulvin,
fluconazole, itraconazole, ketoconazole and voriconazole)
► Medicines for treatment of bacterial infections (such as
clarithromycin and erythromycin)
► Medicines for treatment of certain heart diseases, high blood
pressure (such as verapamil and diltiazem)
► Grapefruit juice
Laboratory tests
If you need a blood test, tell your doctor or the laboratory staff that you are
taking Progynova, because this medicine can affect the results of some
tests.
Pregnancy and breast-feeding
Progynova is for use in post-menopausal women only. Do not take if you
are pregnant or breast-feeding.
If you become pregnant, stop taking Progynova immediately and contact
your doctor.
Driving and using machines
No effects on ability to drive and use machines have been observed in
users of Progynova.
Progynova contains lactose monohydrate and sucrose
Progynova contains lactose and sucrose (types of sugar). If you have been
told by your doctor that you have an intolerance to some sugars, contact
your doctor before taking this medicinal product.

3) How to take Progynova
Always take this medicine exactly as your doctor or pharmacist has told
you. Check with your doctor or pharmacist if you are not sure.
The recommended dose is one tablet of Progynova 2 mg to be taken daily.
Use in children and adolescents
Progynova is not for use in adolescents or children.
Your doctor will aim to prescribe the lowest dose to treat your symptom for
as short as necessary. Speak to your doctor if you think this dose is too
strong or not strong enough.
About the pack
This pack is designed to help you remember to take your medicine. Each
tablet is placed in a section marked with the day of the week on which it
should be taken. The arrows between tablets show the order in which they
must be taken. Your doctor may tell you when to start (see “when to start”
for further information).
On the day you start, take your first tablet from the blue section of the pack
(top row of tablets) marked with the correct day. For instance, if you start on
a Tuesday, press out the tablet from the blister marked ‘TUE’ (see fig 1).
LUN
MAA
MON

MAR
DIN
TUE

MER
WOE
WED

JEU
DON
THU

VEN
VRI
FRI

SAM
ZAT
SAT

DIM
ZON
SUN

Figure 1
PROGYNOVA 2mg Tablets
(estradiol valerate)

SUN  SAT
FRI THU WED TUE  MON


MON  TUE
WED THU FRI SAT
SUN


FRI
THU
WED TUE MON SUN
SAT


SAT SUN MON TUE WED THU
FRI
Take one tablet each day, following the directions of the arrows, until you
have finished all 28 tablets in the memo strip. When you have finished each
memo strip, start the next memo strip on the following day. Do not leave a
break between memo strips.
It is best to take your tablet at the same time each day. You can take
Progynova with or without food. The tablet should be swallowed whole with
a glass of water or milk.
Your doctor may prescribe the hormone progestogen in addition to
Progynova for at least 12–14 days each month:
► if you still have your womb
► if you have a history of endometriosis
When to start
If you have been taking other HRT preparations:
carry on until you have finished your current pack and have taken all the
tablets for that month. Take your first Progynova tablet the next day. Do not
leave a break between your old tablets and the Progynova tablets.
If this is your first HRT treatment and you are still having regular
periods: start your Progynova tablets on the first day of bleeding
If this is your first HRT treatment and your periods have become very
infrequent or have stopped completely: you can start your Progynova
tablets at any time if you are sure you are not pregnant.

If you take more Progynova than you should
If you have taken too many Progynova tablets by mistake, you may feel
sick, vomit or have some menstruation-like bleeding. No specific treatment
is necessary but you should consult your doctor or pharmacist if you are
worried.
If you forget to take Progynova
If you forget to take a tablet at your usual time and you are less than 12
hours late, take it as soon as possible. Take the next tablet at the usual
time.
If you are more than 12 hours late, leave the forgotten tablet in the pack.
Continue to take the rest of the tablets at the usual time every day. You may
experience breakthrough bleeding.
If you stop taking Progynova
You may begin to feel the usual symptoms of menopause again, which may
include hot flushes, trouble sleeping, nervousness, dizziness or vaginal
dryness. Consult your doctor or pharmacist if you want to stop taking
Progynova tablets.
If you need to have surgery
If you are going to have surgery, tell the surgeon that you are taking
Progynova. You may need to stop taking Progynova about 4 to 6 weeks
before the operation to reduce the risk of a blood clot (see section 2, “Blood
clots in a vein (thrombosis)”). Ask your doctor when you can start taking
Progynova again. If you have any further questions on the use of this
medicine, ask your doctor or pharmacist.

4) Possible side effects
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:
Serious side effects
► 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.
Other side effects that have been linked to the use of Progynova and other
oral hormone replacement therapies:
► During the first few months of treatment you may experience some
vaginal bleeding at unexpected times (breakthrough bleeding and
spotting). These symptoms normally lessen with continued treatment.
If they don’t, contact your doctor (see section 2 ‘HRT and cancer/
Excessive thickening of the lining of the womb (endometrial
hyperplasia) and cancer of the lining of the womb (endometrial
cancer)’ for more information)
► breast pain, tenderness or enlargement, breast discharge
► painful periods, changes in vaginal secretions, pre-menstrual
symptoms, increased size of fibroids in the womb, thrush, changes to
the neck of the womb
► indigestion, a feeling of being bloated, passing wind, feeling or being
sick, abdominal pain, gall bladder disease
► skin rashes or discolouration, itching, eczema, acne, unusual hair loss
or hair growth, increased skin pigment especially on the face
(chloasma – see section 2 ‘other conditions’ for more information),
some rare skin problems
► headache, migraine, dizziness, anxiety or depressive symptoms,
fatigue
► fast or irregular heartbeat (palpitations), high blood pressure,
inflammation of veins usually in the legs
► fluid retention leading to swelling of parts of the body
► changes in body weight and sex drive, increased appetite
► muscle cramps, leg pains
► nose bleeds, visual disturbances (such as blurred vision), discomfort
with contact lenses, allergic-type reactions, a worsening of glucose
tolerance, bladder inflammation, rare disorders (porphyria, chorea)
The following side effects have been reported with other HRTs:
► various skin disorders:
► painful reddish skin nodules (erythema nodosum)
► rash with target-shaped reddening or sores (erythema multiforme)
Reporting of side effects
If you get any side effects, talk to your doctor, pharmacist or nurse. This
includes any possible side effects not listed in this leaflet.
You can also report side effects directly via the Yellow Card Scheme at:
www.mhra.gov.uk/yellowcard
By reporting side effects you can help provide more information on the
safety of this medicine.

5) How to store Progynova





Keep out of the sight and reach of the children
There are no special storage instructions.
Do not use Progynova after the expiry date which is printed on the
label after ‘EXP’. The expiry date refers to the last day of the month
stated.
Do not dispose of medicines down the drain or in the household
rubbish. Ask your pharmacist how to dispose of medicines no longer
required. These measures will help to protect the environment.

6) Contents of the pack and other information
What Progynova contains
The active substance is estradiol valerate.
Each tablet contains 2mg of the active ingredient estradiol valerate.
Each tablet also contains: lactose monohydrate, maize starch, povidone
25000, talc, magnesium stearate, sucrose, povidone 700000, macrogol
6000, calcium carbonate, montan glycol wax (Cera E), glycerol 85%,
titanium dioxide (E171) and and indigo carmine lake (E132).
What Progynova looks like and contents of the pack
Progynova 2mg Tablets are sugar coated, round, blue, with no markings.
Progynova 2mg Tablets are available as calendar blister packs of 3 x 28
tablets.
Progynova 2mg Tablets

PL 10383/1145

POM

Who makes and repackages your medicine
Progynova Tablets are manufactured by Bayer Pharma AG, Müllerstrasse
170-178, 13353 Berlin, Germany, Bayer Weimar GmbH und Co. KG,
Döbereinerstrasse 20, 99427 Weimar, Germany or Delpharm Lille SAS,
Rue de Toufflers, 59390 Lys-lez-Lannoy, France. Procured from within the
EU and repackaged by The Product Licence Holder: Primecrown Ltd., 4/5
Northolt Trading Estate, Belvue Road, Northolt, Middlesex, UB5 5QS.
Leaflet date: 31.03.2017
Progynova is a registered trademark of Bayer Intellectual Property GmbH,
Germany.

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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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