Tablets\u00a0
estradiol valerate \/ medroxyprogesterone<\/p>\n\n\n\n
Divina Plus is a preparation used for hormonal substitution therapy ( HormoneReplacement Therapy, HRT ). It contains two female sex hormones; estrogen and a progestogen. Divina Plus is used for women whose menstruation has stopped ( menopause ), at least 6 months after their last natural menstruation.
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Divina Plus is used to:
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Relieve symptoms during and after menopause<\/strong><\/p>\n\n\n\n When menstruation ends ( menopause ), the woman’s estrogen drops. It can cause problems such as sweating and hot flashes. Divina Plus relieves these symptoms after menopause. Divina Plus should only be used if the problems cause problems in daily life. Prevent osteoporosis<\/strong><\/p>\n\n\n\n After menopause, some women suffer from osteoporosis. Discuss all possible options with your doctor. If you have an increased risk of fractures (bone fractures) and other medicines that are not suitable for you, you can use Divina Plus to prevent osteoporosis after menopause . The use of HRT involves risks that must be taken into account when deciding to start treatment or continue an ongoing treatment. Experience is limited for the treatment of women whose menstruation has stopped prematurely (when the ovaries have stopped working or the uterus has been removed). If you belong to that group, the risks of HRT may be different. Talk to your doctor. Before starting treatment (or resuming treatment), your doctor will ask about your own, and your family’s, medical background. Your doctor may do a general medical and gynecological examination, which also includes an examination of your breasts. Once you have started treatment, you should go for regular medical check-ups, at least once a year. During these check-ups, you should discuss with your doctor the benefits and risks of continued treatment. Perform regular breast examinations according to your doctor’s recommendations. Do not take Divina Plus:<\/strong><\/p>\n\n\n\n Do not take Divina Plus if any of the following apply to you. If you are not sure, talk to your doctor before taking Divina Plus:<\/p>\n\n\n\n – If you have or have had breast cancer<\/strong> or there is a suspicion that you may have it<\/p>\n\n\n\n – If you have or have had estrogen-dependent cancer<\/strong>, such as cancer of the uterine lining (endometrium), or if there is a suspicion of such cancer.<\/p>\n\n\n\n – If you have unexpected genital bleeding<\/strong> that has not been investigated by a doctor.<\/p>\n\n\n\n – If you have endometrial hyperplasia <\/strong>(severe thickening of the uterine lining) and are not being treated for it.<\/p>\n\n\n\n – If you have or have had a blood clot in a vein<\/strong> (venous thromboembolism ), in your legs (deep vein thrombosis ), or your lungs ( pulmonary embolism ).<\/p>\n\n\n\n – If you have a coagulation disorder<\/strong>, a condition with an increased risk of blood clots (lack of protein C, protein S, or antithrombin).<\/p>\n\n\n\n – If you have or have had a disease caused by blood clots in the arteries are as heart attack <\/strong>stroke (stroke), or angina.<\/p>\n\n\n\n – If you have or have had any liver disease<\/strong> and still have abnormal liver values.<\/p>\n\n\n\n – If you have porphyria<\/strong>, a rare inherited blood disorder.<\/p>\n\n\n\n – If you are allergic to estradiol valerate or medroxyprogesterone acetate or any of the other ingredients of this medicine (listed in section 6). If any of the above affects you the first time you use Divina Plus, stop taking Divina Plus and contact your doctor immediately.<\/p>\n\n\n\n Talk to your doctor, pharmacist, or nurse before using Divina Plus.<\/p>\n\n\n\n Talk to your doctor if you have or have had any of the following problems before starting treatment. They may recur or worsen during treatment with Divina Plus. Should this occur, have more frequent check-ups with a doctor. You should contact a doctor immediately and discontinue treatment if any of the following occur:<\/strong><\/p>\n\n\n\n For further information, see below “Blood clots in a vein ( thrombosis )” Note: Divina Plus is not a contraceptive. If it is less than 12 months since your last period, or if you are under 50, you may still need to use contraception to avoid pregnancy. Consult your doctor. HRT and cancer<\/strong><\/p>\n\n\n\n Severe thickening of the uterine lining ( endometrial hyperplasia ) and cancer of the uterine lining (endometrial cancer)<\/strong><\/p>\n\n\n\n The use of HRT with estrogen alone increases the risk of severe thickening of the uterine lining and cancer of the uterine lining.<\/p>\n\n\n\n The progestogen in Divina Plus protects you against this extra risk. Unexpected bleeding<\/strong><\/p>\n\n\n\n You will have bleeding once a month (so-called dropout bleeding) when you take Divina Plus. But if you get unexpected bleeding or splashing in addition to your monthly bleeding, and these:<\/p>\n\n\n\n – lasts longer than 6 months<\/p>\n\n\n\n – starts after taking Divina Plus for 6 months<\/p>\n\n\n\n – continues after you stop taking Divina Plus<\/p>\n\n\n\n <\/strong>you <\/strong>should <\/strong>see a doctor as soon as possible.<\/strong> Breast cancer<\/strong><\/p>\n\n\n\n Data show that hormone replacement therapy ( HRT ) with combined estrogen-progestogen or with estrogen alone, increases the risk of breast cancer. The risk depends on the treatment time. The extra risk depends on how long you use HRT. The increased risk is seen within 3 years. When treatment is stopped, the increased risk decreases over time, but it can persist for 10 years or more if you have used HRT for more than 5 years. Comparison<\/em><\/p>\n\n\n\n For women aged 50\u201354 who do not take HRT, an average of 13\u201317 out of 1,000 will be diagnosed with breast cancer over a 5-year period.<\/p>\n\n\n\n In women who are 50 years old and start taking HRT with estrogen alone for 5 years, 16-17 cases per 1,000 users (ie 0-3 extra cases) will occur.<\/p>\n\n\n\n For women over the age of 50 who start taking estrogen – the progestin HRT for 5 years, 21 out of 1,000 users will be diagnosed (ie 4-8 extra cases). Among women aged 50-59 who do not take HRT, an average of 27 out of 1,000 will be diagnosed with breast cancer over a 10-year period.<\/p>\n\n\n\n In women who are 50 years old and start taking HRT with estrogen alone for 10 years, 34 cases per 1,000 users (ie 7 extra cases) will occur.<\/p>\n\n\n\n In women who are 50 years old and start taking HRT with estrogen-progestogen for 10 years, 48 \u200b\u200bcases per 1,000 users (ie 21 extra cases) will occur.<\/p>\n\n\n\n <\/p>\n\n\n\n Check your breasts regularly. Contact a doctor if you notice changes such as:<\/strong><\/p>\n\n\n\n indentations or pits<\/p>\n\n\n\n changes in the nipple<\/p>\n\n\n\n nodules you can see or feel It is also recommended that you participate in a mammography examination when you are called to do so. At the mammogram, you must tell the nurse\/healthcare professional who performs the examination that you are using HRT, as this medicine may increase the density of the breasts. An increased density in the breasts can make it more difficult to detect lumps on the mammography images. Ovarian cancer ( ovarian cancer )<\/strong><\/p>\n\n\n\n Ovarian cancer is rare – much more rare than breast cancer. Use of HRT with estrogen alone or combined estrogen-progestogen has been associated with a slightly increased risk of ovarian cancer. The risk of ovarian cancer varies with age. The diagnosis of ovarian cancer will, for example, be made on about 2 women out of 2,000 aged 50 to 54 who do not take HRT for a 5-year period. For women who have taken HRT for 5 years, there will be about 3 cases per 2,000 users (ie about 1 extra case). How HRT affects the heart and blood circulation<\/strong><\/p>\n\n\n\n Blood clots in a vein ( thrombosis )<\/strong><\/p>\n\n\n\n The risk of blood clots in the veins<\/strong> is 1.3\u20133 times higher for women who take HRT than for those who do not, especially during the first year of treatment. Blood clots can be serious. If a blood clot ends up in the lungs, it can cause chest pain, shortness of breath, collapse or even lead to death. You are more likely to get a blood clot in a vein if any of the following apply to you. Tell your doctor if any of the following apply to you:<\/p>\n\n\n\n – You have not been able to walk or stand for a long time due to a major operation, injury or illness (see also section 3, “If you need surgery”)<\/p>\n\n\n\n – You are severely overweight ( BMI over 30 kg \/ m 2<\/sup> )<\/p>\n\n\n\n – You have a coagulation disorder that requires long-term treatment with drugs that prevent blood clots<\/p>\n\n\n\n – If a close relative has had a blood clot in the bone, lung, or another organ<\/p>\n\n\n\n – You have SLE (systemic lupus erythematosus)<\/p>\n\n\n\n – You have cancer. The symptoms of a blood clot are described in the section “You should contact a doctor immediately and stop the treatment”. Comparison<\/em><\/p>\n\n\n\n For women in their 50s who do not take HRT, an average of 4-7 out of 1,000 people are expected to have a blood clot in a vein over a 5-year period.<\/p>\n\n\n\n For women in their 50s who have taken HRT with estrogen-progestogen for more than 5 years, 9-12 out of 1,000 users are expected to get a blood clot in a vein (ie 5 extra cases) Heart disease (heart attack)<\/strong><\/p>\n\n\n\n There is no evidence that HRT prevents heart attacks.<\/p>\n\n\n\n For women over the age of 60 who take HRT with estrogen-progestin, the risk of developing heart disease is slightly higher than those who do not take HRT. Stroke (apoplexy)<\/strong><\/p>\n\n\n\n The risk of stroke is about 1.5 times higher for those who take HRT compared to those who do not. The risk of stroke is age-dependent, therefore the number of cases of stroke increases due to the use of HRT with increasing age. Comparison<\/em><\/p>\n\n\n\n For women in their 50s who do not take HRT, an average of 8 out of 1,000 people is expected to have a stroke over a 5-year period.<\/p>\n\n\n\n For women in their 50s who have taken HRT for more than 5 years, 11 out of 1,000 users are expected to have a stroke (ie 3 extra cases) Other conditions<\/strong><\/p>\n\n\n\n Some medicines may affect the effect of Divina Plus, which may lead to irregular bleeding. The following applies:<\/p>\n\n\n\n Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines. Results from blood test analyze<\/strong><\/p>\n\n\n\n If you need to take a blood sample, tell your doctor, or the person taking the blood sample, that you are taking Divina Plus as it may affect the results of some tests. Divina Plus is intended for women whose menstruation has stopped. If you become pregnant, stop taking Divina Plus and consult a doctor.<\/p>\n\n\n\n Divina Plus is not expected to affect the ability to drive or use machines.<\/p>\n\n\n\n This medicine contains 82 mg (white tablet) and 68 mg (blue tablet) of lactose(monohydrate). If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine. Always take this medicine exactly as your doctor or pharmacist has told you. Ask your doctor or pharmacist if you are unsure. Dosage<\/strong><\/p>\n\n\n\n Dosing of Divina Plus takes place according to a calendar map with one tablet daily for 28-day cycles, without pauses between the calendar maps. The treatment mimics the menstrual cycle: 9 tablets containing estrogen (white tablet) are accompanied by 12 tablets (blue tablet) with both estrogen and progestogen and finally there is a period of 7 tablets with estrogen (white tablet) when menstrual-like bleeding usually occurs. Women switching from another sequencing drug should start treatment the day after the end of the previous 28-day cycle.<\/p>\n\n\n\n It is advisable to take the tablet at about the same time each day. Your doctor will strive to give you the lowest dose, which will give you relief of symptoms, and that you should use Divina Plus for the shortest possible time. Talk to your doctor if you do not get any relief from the symptoms, or feel that the dose is too high. Bleeding pattern<\/em><\/p>\n\n\n\n During the first months of treatment, there may be a breakthrough or minor bleeding. If bleeding persists, consult your doctor for a re-evaluation of the treatment. Continuous or prolonged bleeding during a hormone treatment may in rare cases indicate endometrial hyperplasia or that the dosage is not right for you. If breakthrough or minor bleeding occurs only later in the treatment or if it persists after the end of treatment, contact your doctor. If you need surgery<\/strong><\/p>\n\n\n\n If you are going to have surgery, tell your surgeon that you are taking Divina Plus. You may need to stop taking Divina Plus for 4 to 6 weeks before surgery to avoid the risk of blood clots (see section 2, \u201cBlood clots in a vein ( thrombosis )\u201d). Ask your doctor when it is appropriate to start taking Divina Plus again.<\/p>\n\n\n\n If you have ingested too much medicine or if e.g. If a child has inadvertently ingested the medicine, contact a doctor, hospital, or the Poison Information Center for risk assessment and advice.<\/p>\n\n\n\n If you forget to take a tablet at the usual time, try to take it within 12 hours. Otherwise, skip the tablet and take the next tablet at the next regular time. Do not take a double dose to make up for a forgotten dose. Like all medicines, this medicine can cause side effects, although not everybody gets them. The following diseases are more common in women who take HRT than those who do not:<\/p>\n\n\n\n \u2022 Breast cancer<\/p>\n\n\n\n \u2022 Severe thickening of the uterine lining ( endometrial hyperplasia ) or cancer of the uterine lining (endometrial cancer)<\/p>\n\n\n\n \u2022 Ovarian cancer ( ovarian cancer )<\/p>\n\n\n\n \u2022 Blood clot in veins in bones or lungs (venous thromboembolism )<\/p>\n\n\n\n \u2022 Heart disease<\/p>\n\n\n\n \u2022 Stroke (apoplexy)<\/p>\n\n\n\n \u2022 Probable memory loss, if treatment with HRT is started after the age of 65<\/p>\n\n\n\n See section 2 for more information on these side effects. The side effects of Divina Plus are most common during the first months of treatment. They are usually mild and subside with continued treatment. The following side effects have been associated with HRT treatment:<\/strong><\/p>\n\n\n\n Common (may affect up to 1 in 10 people):<\/em><\/p>\n\n\n\n Uncommon (may affect up to 1 in 100 people):<\/em><\/p>\n\n\n\n Rare (may affect up to 1 in 1,000 people):<\/em><\/p>\n\n\n\n Has been reported (occurs in an unknown number of users):<\/em><\/p>\n\n\n\n The following side effects have been reported with other HRTs:<\/p>\n\n\n\n Reporting of side effects ar<\/strong><\/p>\n\n\n\n If you get any side effects, talk to your doctor, pharmacist, or nurse. This also applies to any side effects not mentioned in this information. You can also report side effects directly (see details below). By reporting side effects, you can help increase drug safety information. The Medical Products Agency<\/p>\n\n\n\n Box 26<\/p>\n\n\n\n 751 03 Uppsala<\/p>\n\n\n\n <\/p>\n\n\n\n Keep this medicine out of the sight and reach of children.<\/p>\n\n\n\n Do not store above 25 \u00b0 C. Do not use this medicine after the expiry date which is stated on the carton or blister. The expiration date is the last day of the specified month. 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.<\/p>\n\n\n\n White Divina Plus tablet:<\/strong><\/p>\n\n\n\n The active substance is<\/em> Estradiol valerate 2 mg.<\/p>\n\n\n\n The other ingredients are <\/em>lactose monohydrate 86.6 mg, corn starch, gelatin, talc, magnesium stearate. Blue Divina Plus tablet:<\/strong><\/p>\n\n\n\n The active substances are<\/em> Estradiol valerate 2 mg, medroxyprogesterone acetate 10 mg (MPA).<\/p>\n\n\n\n The other ingredients are <\/em>lactose monohydrate 72 mg, corn starch, gelatin, talc, magnesium stearate, indigo carmine (dye E 132), povidone.<\/p>\n\n\n\n White tablet: white or almost white, round, cupped, marked D, \u00d8 7 mm.<\/p>\n\n\n\n Blue tablet: light blue, round, flat, beveled edge, \u00d8 7 mm. Packaging: Blister cards with 3×28 tablets.<\/p>\n\n\n\n Marketing Authorisation Holder:<\/p>\n\n\n\n Orion Corporation<\/p>\n\n\n\n Orionintie 1<\/p>\n\n\n\n FI-02200 Espoo<\/p>\n\n\n\n Finland Manufacturer:<\/p>\n\n\n\n Orion Corporation Orion Pharma<\/p>\n\n\n\n Orionintie 1<\/p>\n\n\n\n FI-02200 Espoo<\/p>\n\n\n\n Finland Orion Corporation Orion Pharma<\/p>\n\n\n\n Connector current 8<\/p>\n\n\n\n FI-20360 Turku<\/p>\n\n\n\n Finland Delpharm Little Sas – Lys Lez Lannoy<\/p>\n\n\n\n Roubaix-Est Activity Park<\/p>\n\n\n\n 22 rue de Toufflers<\/p>\n\n\n\n CS 50070<\/p>\n\n\n\n Lys Lez Lannoy 59452<\/p>\n\n\n\n France For further information on this medicine, please contact your local representative:<\/p>\n\n\n\n Orion Pharma AB, Danderyd<\/p>\n\n\n\n medinfo@orionpharma.com<\/p>\n\n\n\n <\/p>\n","protected":false},"excerpt":{"rendered":" Divina Plus is a preparation used for hormonal substitution therapy ( HormoneReplacement Therapy, HRT ). It contains two female sex hormones; estrogen and a progestogen. Divina Plus is used for women whose menstruation has stopped ( menopause ), at least 6 months after their last natural menstruation.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"cybocfi_hide_featured_image":"","footnotes":""},"categories":[2204,2200],"tags":[5402,5404,5405,5406,5408,5409,5410,5412,5403,5407,5411],"class_list":["post-7598","post","type-post","status-publish","format-standard","hentry","category-d","category-medicines","tag-divina-plus","tag-divina-plus-side-effects","tag-divina-plus-tablet","tag-estradiol-valerate","tag-estradiol-valerate-side-effects","tag-estradiol-valerate-tablet","tag-medroxyprogesterone","tag-medroxyprogesterone-side-effects","tag-what-is-divina-plus","tag-what-is-estradiol-valerate","tag-what-is-medroxyprogesterone"],"_links":{"self":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/7598","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/comments?post=7598"}],"version-history":[{"count":4,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/7598\/revisions"}],"predecessor-version":[{"id":10947,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/7598\/revisions\/10947"}],"wp:attachment":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/media?parent=7598"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/categories?post=7598"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/tags?post=7598"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
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<\/p>\n\n\n\n2. What you need to know before taking Divina Plus<\/h2>\n\n\n\n
Medical background and regular check-ups<\/h2>\n\n\n\n
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<\/p>\n\n\n\nWarnings and cautions<\/h2>\n\n\n\n
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<\/p>\n\n\n\nOther medicines and Divina Plus<\/h2>\n\n\n\n
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<\/p>\n\n\n\nPregnancy and breastfeeding<\/h2>\n\n\n\n
Driving and using machines<\/h2>\n\n\n\n
Divina Plus contains lactose<\/h2>\n\n\n\n
<\/p>\n\n\n\nHow to take Divina Plus<\/h2>\n\n\n\n
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<\/p>\n\n\n\nIf you take more Divina Plus then you should<\/h2>\n\n\n\n
If you forget to take Divina Plus<\/h2>\n\n\n\n
<\/p>\n\n\n\n4. Possible side effects<\/h2>\n\n\n\n
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<\/p>\n\n\n\n5. How to store Divina Plus<\/h2>\n\n\n\n
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<\/p>\n\n\n\n6. Contents of the packaging and other information<\/h2>\n\n\n\n
Content declaration<\/h2>\n\n\n\n
<\/p>\n\n\n\nWhat the medicine looks like and the contents of the pack<\/h2>\n\n\n\n
<\/p>\n\n\n\nMarketing Authorization Holder and Manufacturer<\/h2>\n\n\n\n
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