Showing posts with label escrowrefills. Show all posts
Showing posts with label escrowrefills. Show all posts

Saturday, 5 March 2016

Fertigyn 10000 iu

Buy Fertigyn 10000 iu Online from Fast Escrow Refills.net

Fertigyn 10000 iu (Human Chorionic Gonadotropin-HCG) is a hormone that supports the normal development of an egg in a woman's ovary, and stimulates the release of the egg during ovulation. Fertigyn 10000 iu  (Human Chorionic Gonadotropin) is used to cause ovulation and to treat infertility in women, and to increase sperm count in men.  Fertigyn 10000 iu (Human Chorionic Gonadotropin-HCG) is also used in young boys when their testicles have not dropped down into the scrotum normally. This can be caused by a pituitary gland disorder. Fertigyn 10000 iu (Human Chorionic Gonadotropin-HCG) may also be used for other purposes not listed in this medication guide.



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• Low prices. We sell prescription medications at low prices. A free medical consultation is included with every prescription.
• Total privacy. Your information is always kept strictly confidential.
• Convenience. You won’t need to wait in long lines at the pharmacy, because your medications will be delivered directly to your door.
• Authenticity. We only sell authentic Fertigyn 10000 iu, manufactured by IBSA at a plant in the Switzerland.
• Professional Advice. A physician licensed evaluates every order. An Indian licensed pharmacist will dispense your medication and send it directly to your door.

How Fertigyn 10000 iu treats problems
Corion (human chorionic gonadotropin (hcg)) is a glycoprotein that dissolves in water. It is available in the urine of pregnant women. It is composed of two sub-units namely; alpha and beta sub-units. A sole injection of hormone corion (human chorionic gonadotropin (hcg)) activates ovulation in a span of 38 to 40 hours. The action of corion (human chorionic gonadotropin (hcg)) is similar tothat of luteinizing hormone (lh). Along with the follicle stimulating hormone (fsh), lh influences the oogenesis process. Lh also initiates the ovulation process at mid-cycle. The role corion (human chorionic gonadotropin (hcg)) plays in the body is similar to that of lh that is, stimulation of ovulation in women having infertility problems. It triggers production of hormone progesterone by the corpus luteum in the ovaries.in men, it triggers secretion of hormone testosterone and also raises the sperm count. Corion (human chorionic gonadotropin (hcg)) influencesthe interstitial cells in the testicles to produce androgens.



What conditions is Fertigyn 10000 iu used for?
Hormone Fertigyn 10000 iu is used in the following conditions:

• Treating infertility in women.
• Raising sperm count in men.
• In young boys whose testes have not descended naturally into the scrotum.


How to take Fertigyn10000 iu
USUAL ADULT DOSE FOR OVULATION INDUCTION
Ovulation Induction (if the cause of anovulation is secondary and not due to primary ovarian failure):
chorionic gonadotropin:
10000 to 10,000 units IM one day following last day of menotropins.
recombinant chorionic gonadotropin:
250 mcg subcutaneously one day following last dose of follicle-stimulating agent.

USUAL ADULT DOSE FOR HYPOGONADISM - MALE
hypogonadotropic hypogonadism (secondary to a pituitary deficiency):
500 to 1000 units IM three times a week for 3 weeks followed by the same dose twice a week for 3 weeks or,
4000 units IM three times a week for 6 to 9 months followed by 10000 units three times a week for an additional 3 months.

USUAL PEDIATRIC DOSE FOR PREPUBERTAL CRYPTOERCHIDISM
Prepubertal cryptorchidism (usually between ages of 4 and 9 years and not due to anatomical obstruction):
4000 units IM three times a week for 3 weeks or,
10000 units IM on every other day for four injections or,
500 to 1000 units IM for 15 injections over a period of 6 weeks or,
500 units three times a week for 4 to 6 weeks; if not successful, may repeat series at 1000 unit dosage one month later.

What is the most important information I should know about  Fertigyn 10000 iu?
Fertigyn 10000 iu is given as an injection under the skin or into a muscle. If you use this medicine at home, your doctor, nurse, or pharmacist will give you specific instructions on how and where to inject this medicine. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles and syringes. Call your doctor at once if you have any of these signs of a blood clot: pain, warmth, redness, numbness, or tingling in your arm or leg; confusion, extreme dizziness, or severe headache. Some women using this medicine have developed a condition called ovarian hyper stimulation syndrome (OHSS), especially after the first treatment cycle. OHSS can be a life-threatening condition. Call your doctor right away if you have any symptoms of OHSS: severe pelvic pain, swelling of the hands or legs, stomach pain and swelling, shortness of breath, weight gain, diarrhea, nausea or vomiting, and urinating less than normal.

Fertigyn 10000 iu can cause early puberty in young boys. Call your doctor if a boy using this medicine shows early signs of puberty, such as a deepened voice, pubic hair growth, and increased acne or sweating. Using this medicine can increase your chances of having a multiple pregnancy (twins, triplets, quadruplets, etc). A multiple pregnancy is a high-risk pregnancy for the mother and for the babies. Follow your doctor's instructions about any special care you may need during your pregnancy. Although  Fertigyn 10000 iu can help you become pregnant, this medication is in the FDA pregnancy category X. This means that using the medication once you are pregnant can cause birth defects in the baby. Do not use this medication if you are pregnant. Tell your doctor right away if you become pregnant during treatment. 

What should I discuss with my healthcare provider before using  Fertigyn 10000 iu?
You should not use this medication if you have ever had an allergic reaction to  Fertigyn 10000 iu, or if you have: early puberty (also called precocious puberty); or a hormone-related cancer (such as prostate cancer).Before receiving  Fertigyn 10000 iu tell your doctor if you are allergic to any drugs or if you have: a thyroid or adrenal gland disorder; an ovarian cyst; premature puberty; cancer or a tumor of the breast, ovary, uterus, prostate, hypothalamus, or pituitary gland; undiagnosed uterine bleeding; heart disease; kidney disease; epilepsy; migraines; or asthma. If you have any of these conditions, you may need a dose adjustment or special tests to safely use  Fertigyn 10000 iu. Although  Fertigyn 10000 iu can help you become pregnant, this medication is in the FDA pregnancy category X. This means that using the medication once you are pregnant can cause birth defects in the baby. Do not use this medication if you are pregnant. Tell your doctor right away if you become pregnant during treatment. It is not known whether  Fertigyn 10000 iu passes into breast milk. Do not use  Fertigyn 10000 iu without telling your doctor if you are breast-feeding a baby. 

How should I use  Fertigyn 10000 iu?
Use this medication exactly as prescribed by your doctor. Do not use it in larger amounts or for longer than recommended. Follow the directions on your prescription label. Fertigyn 10000 iu is given as an injection under the skin or into a muscle. Your doctor, nurse, or other healthcare provider will give you this injection. You may be shown how to inject your medicine at home. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles and syringes. Use each disposable needle only one time. Throw away used needles in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets. To be sure this medication is helping your condition, your doctor will need to check you on a regular basis. Do not miss any scheduled appointments. Some brands of  Fertigyn 10000 iu come in powder form with a separate liquid that you must mix together and draw into a syringe. Other brands are provided in single-dose prefilled syringes. Do not use the medication if it has changed colors or the liquid has any particles in it. Call your doctor for a new prescription. Store unmixed  Fertigyn 10000 iu at room temperature away from light, moisture, and heat. After mixing the  Fertigyn 10000 iu, you must keep it in the refrigerator until you are ready for your injection. Throw away any mixed medicine that you have not used within 30 days after mixing. 

What happens if I miss a dose of Fertigyn 10000 iu ?
Contact your doctor if you miss a dose of  Fertigyn 10000 iu.
What happens if I overdose of Fertigyn 10000 iu?
Seek emergency medical attention if you think you have used too much of this medicine. An overdose of  Fertigyn 10000 iu is not expected to produce life-threatening symptoms. 
What should I avoid while using Fertigyn 10000 iu?
Follow your doctor's instructions about any restrictions on food, beverages, or activity while you are using  Fertigyn 10000 iu.
Side effects of Fertigyn 10000 iu
Stop using  Fertigyn 10000 iu and get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these signs of a blood clot: pain, warmth, redness, numbness, or tingling in your arm or leg; confusion, extreme dizziness, or severe headache. Some women using this medicine have developed a condition called ovarian hyper stimulation syndrome (OHSS), especially after the first treatment cycle. OHSS can be a life-threatening condition. Call your doctor right away if you have any of the following symptoms of OHSS: severe pelvic pain; swelling of the hands or legs; stomach pain and swelling; shortness of breath; weight gain; diarrhea; nausea or vomiting; or urinating less than normal. This medication can cause early puberty in young boys. Call your doctor if a boy using this medicine shows early signs of puberty, such as a deepened voice, pubic hair growth, and increased acne or sweating.
Less serious side effects may include: headache; feeling restless or irritable; mild swelling or water weight gain; depression; breast tenderness or swelling; orpain, swelling, or irritation where the injection is given. This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

What other drugs will affect Fertigyn 10000 iu?
There may be other drugs that can interact with  Fertigyn 10000 iu. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Who are the manufactures of HCG?
Fertigyn 10000 iu is manufactured by Sun Pharmaceuticals, India
For how long should 10000 iu be taken?
Medication of Fertigyn 10000 iu should be continued for as long as the doctor recommends. Do not stop medication until advised otherwise by your doctor.
Drug Interactions of Fertigyn 10000 iu
Make known to your doctor, all the drugs and medications you are currently taking including the prescribed and over-the-counter drugs you are currently taking in treatment of other ailments. This is important so that your doctor makes an informed decision concerning your HCG medication.

What things need to be taken care of?
• Always take the drugs as directed and prescribed by your physician.
• Avoid expired drug.
• If the lyophilized aseptic powder is decolourized, do not use it.
• Inject yourself with this medicine only if you know the proper way of administering the drug.
• Always use needles and syringes that have been sterilized.
• Don’t share your medication with anybody, even if both of you have similar symptoms.
• Avoid keeping HCG in a place with elevated temperatures, moist conditions or too bright light.
• Seek advice from your pharmacist on how to dispose of the drug properly.
• Keep a detailed record of all the drugs which you are taking alongside HCG medication.

Buying Fertigyn 10000 iu from Fast Escrow Refills Fast, Easy and Secure
If you are ready to buy Fertigyn 10000 iu online at Fast Escrow Refills, choose your dosage and quantity and add your items to your cart by clicking Buy Fertigyn 10000 iu. The prescribing doctor might recommend a different dosage. If that’s the case, you will be notified via email.
You will need to answer several questions about your health and medical history. Be sure to list all your prescription and non-prescription medications. A doctor will review your answers to make sure it’s safe for you to take Fertigyn 10000 iu. Once approved, you will be notified via email. A United State licensed pharmacist will fill your order and send it directly to you door. The packaging is always discrete to ensure your privacy. You will only be charged for your order when you have been approved by one of our physicians.


Friday, 1 January 2016

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How to: Test HCG with a Pregnancy Test

When you mix a batch of HCG there is precious little in each bottle you make, and will only last you a specified number of days.  I remember the first time I tested my HCG using a regular (also COSTLY) pregnancy test (you know, the ones you pee on?) from a regular store.  I was taken aback at how much of my precious HCG mixture I had to waste in order to see the results in the window, not to mention the cost of the tests themselves.
Thankfully, there is a better way.  Believe it or not, Dollar Stores have tons of these teeny tiny pregnancy tests in the checkout line for, yes that’s right, a dollar each.  Because of the way they are made, you simply drop a very small amount of your HCG mixture into the little window provided, and you will get results almost immediately.  I “wasted” only half a dose of my HCG in this manner, and was rewarded with nice strong lines showing my mixture to test positive for HCG in it.
So hit your local Dollar Store and smile wanly as the cashier looks at you strangely for buying 7 pregnancy tests.


escrowrefills.com

Escrow Refills has recently undergone some company changes and are now operating as a new company and site, fastescrowrefills.net
Use my discount code:  skm1989  to get 10% off your order!
Important! If you purchase hCG from this company, they are currently sending dosing syringes that are of an ODD-SIZE – the traditional mixing and dosing tutorials online will not work for these, so I have created a tutorial to show you how to mix and dose for these odd-sized syringes from Fast Escrow Refills.
Tutorial: Mix and Dose your hCG with hCG kit from Fast Escrow Refills
Fast Escrow Refills carries real prescription hCG that is made and shipped from overseas.  This is separate from the 3 different U.S. hCG companies that I currently recommend on my mainrecommendations for HCG Injections Page. It’s up to you what you feel most comfortable with – overseas hCG or U.S. made hCG. I believe in people having choices, so I present these to you here on my blog for you to compare and to choose what is the right option in your situation.
I have used the hormone from this company for 4 of my 5 rounds with great success in the past.  I have tested every single vial I’ve ever used from them with a pregnancy test and it has always tested positive, as well as many hundreds and hundreds of people who have ordered through me that I’ve never received a complaint from.
Overseas hormone like this is the most inexpensive option for doing the weight loss protocol with the real hormone, so if pricepoint is the most important factor for you, Fast Escrow Refills is the company for you.
The hormone comes in powder form (as any hCG you purchase that is said to be prescription should) and can be mixed to use either for HCG injections or drops, sometimes known as sublingual hCG. With any type of hCG drops that claims to be real pharmaceutical hCG, at least as far as I know, it should not be purchased pre-mixed. The hCG goes bad very quickly if it’s not kept refrigerated at all times once it’s been mixed for use.
The hCG powder/tablet will have an expiration date on the bottle- usually at least 1 year, if not 2 or 3 years out.  Once you mix the hormone however, you will need to use it up usually within about 3 weeks before it loses it’s potency significantly.

To Purchase hCG from Fast Escrow Refills

Get 10% off your order with this code:  skm1989
For Injections
43 day round of hCG you need:  2 vials of 5000iu hCG + one 43 day injections mixing kit (for use with 5000 iu vial sizes, not 2000iu vials)
23 day round of hCG you need: 1 vial of 5000iu hCG + one 23 day injections mixing kit (for use with 5000 iu vial sizes, not 2000iu vials)
PLEASE NOTE!! The dosing syringes that are being sent in these mixing kits as of late 2014 are a different size than most – please see my special tutorial for how to find the accurate dosing with these syringes.
For hCG Drops (that you mix yourself)
43 day round of hCG you need: 3 vials of 5000iu hCG + one 43 day sublingual mixing kit
23 day round of hCG you need: 2 vials of 5000iu hCG + one 23 day sublingual mixing kit

How Long Should You Do A Round of hCG For?

This question has a more in-depth answer that I haven’t written yet, but for now, a good rule of thumb is:
For women
More than 10 lbs to lose:  43 day round (or 40 day round, 6 weeks, whatever- there are varying lengths of time but all center right around 6 weeks)
Less than 10lbs to lose:  23 day round
For menMore than 20lbs to lose:  43 day round
Less than 20lbs to lose: 23 day round
These are not rules or guarantees that you will lose a certain amount of weight in a certain amount of time.  I can’t judge that in advance, and neither can you.  This is just a basic guideline for how the majority do.

Which Brand of hCG Should You Buy?

I get this question all the time, as they carry 4 different brands of hormone.  Honestly, I do not have a preference.  I really don’t.  I have used 5 different brands myself and they all worked perfectly fine- some of the brands I used aren’t even made anymore.  So I’m really the wrong person to ask about this because I don’t think one is really better than another of these brands at this time.

Buying your hCG from Fast Escrow Refills might be good for you if you:

  • need the cheapest source of prescription hCG
  • don’t mind ordering from overseas
  • can pay with visa, mastercard, or western union
  • don’t mind waiting a few weeks to receive your hCG
  • you don’t live in Canada and a few other countries.
Now, I get something out of this too okay?  I’m not trying to hide anything from you guys! I get a referral fee when you use my code.  In return I am spending quite a bit of time to make this user friendly site and upload more helpful vlogs (like my HCG how-to vlogs) to help you learn what you need and want to know about the protocol.  I hope that by doing this, there can be a give and take- you guys use my code, and I return the favor by having this free HCG resource for you guys.  I am always here to answer any questions you may have and I while I don’t promise to know the answer to everything HCG related, I’ll do my best to help out.

Saturday, 8 August 2015

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PROGYNOVA (Estradiol Valerate)  (estradiol) is a form of estrogen, a female sex hormone produced by the ovaries. Estrogen is necessary for many processes in the body.PROGYNOVA (Estradiol Valerate)  is used to treat symptoms of menopause such as hot flashes, and vaginal dryness, burning, and irritation. Other uses include prevention of osteoporosis in postmenopausal women, and replacement of estrogen in women with ovarian failure or other conditions that cause a lack of natural estrogen in the body. PROGYNOVA (Estradiol Valerate)  is sometimes used as part of cancer treatment in women and men.PROGYNOVA (Estradiol Valerate)  may also be used for other purposes not listed in this medication guide.



PROGYNOVA (Estradiol Valerate)  can harm an unborn baby or cause birth defects. Do not use PROGYNOVA (Estradiol Valerate)  if you are pregnant. You should not take PROGYNOVA (Estradiol Valerate)  if you have abnormal vaginal bleeding, liver disease, breast or uterine cancer, hormone-dependent cancer, a recent history of heart attack or stroke, if you are pregnant, if you have ever had a blood clot (especially in your lung or your lower body), or if you are allergic to any medicines or food dyes. Taking hormones can increase your risk of blood clots, stroke, or heart attack, especially if you have diabetes, high blood pressure, high cholesterol or triglycerides, if you smoke, or if you are overweight.Long-term PROGYNOVA (Estradiol Valerate)  treatment may increase your risk of breast cancer, ovarian cancer, or uterine cancer. Talk with your doctor about your individual risks before using PROGYNOVA (Estradiol Valerate)  long-term. Your doctor should check your progress every 3 to 6 months to determine whether you should continue this treatment.Taking progestin while using PROGYNOVA (Estradiol Valerate)  may lower your risk of uterine cancer. If your uterus has not been removed, your doctor may prescribe a progestin for you to take while you are using PROGYNOVA (Estradiol Valerate) .PROGYNOVA (Estradiol Valerate)  should not be used to prevent heart disease, stroke, or dementia, because this medication may actually increase your risk of developing these conditions.Have regular physical exams and mammograms, and self-examine your breasts for lumps on a monthly basis while using PROGYNOVA (Estradiol Valerate) .



You should not take PROGYNOVA (Estradiol Valerate)  if you are allergic to estradiol, or if you have:liver disease; abnormal vaginal bleeding that a doctor has not checked;any type of breast, uterine, or hormone-dependent cancer;a recent history of heart attack or stroke;if you are pregnant;if you have ever had a blood clot (especially in your lung or your lower body); orif you are allergic to any medicines or food dyes.Taking hormones, such as PROGYNOVA (Estradiol Valerate)  can increase your risk of blood clots, stroke, or heart attack, especially if you have risk factors such as diabetes, high blood pressure, high cholesterol or triglycerides, smoking, or being overweight.If you have any of these other conditions, your doctor may need to adjust your PROGYNOVA (Estradiol Valerate)  dose or order special tests:heart disease;kidney disease; family history of blood clots;a history of jaundice caused by pregnancy or taking hormones;endometriosis;lupus;porphyria;gallbladder disease;underactive thyroid;asthma;epilepsy or other seizure disorder;migraines;low levels of calcium in your blood; orif you have had your uterus removed (hysterectomy).FDA pregnancy category X. PROGYNOVA (Estradiol Valerate)  can harm an unborn baby or cause birth defects. Do not use PROGYNOVA (Estradiol Valerate)  if you are pregnant. Tell your doctor right away if you become pregnant during treatment. Estradiol can pass into breast milk and may harm a nursing baby. PROGYNOVA (Estradiol Valerate)  may also slow breast milk production. You should not breast-feed while you are taking estradiol. PROGYNOVA (Estradiol Valerate)  should not be used to prevent heart disease, stroke, or dementia, because this medication may actually increase your risk of developing these conditions.


Take PROGYNOVA (Estradiol Valerate)  exactly as it was prescribed for you. Do not use the medication in larger amounts, or use it for longer than recommended by your doctor.Long-term PROGYNOVA (Estradiol Valerate)  treatment may increase your risk of breast cancer, ovarian cancer, or uterine cancer. Talk with your doctor about your individual risks before using PROGYNOVA (Estradiol Valerate)  long-term.Taking progestin while using PROGYNOVA (Estradiol Valerate)  may lower your risk of uterine cancer. If your uterus has not been removed, your doctor may prescribe a progestin for you to take while you are using PROGYNOVA (Estradiol Valerate) .Have regular physical exams and mammograms, and self-examine your breasts for lumps on a monthly basis while using PROGYNOVA (Estradiol Valerate) . Your doctor should check your progress every 3 to 6 months to determine whether you should continue this treatment.If you need medical tests or surgery, or if you will be on bed rest, you may need to stop using this medication for a short time. Any doctor or surgeon who treats you should know that you are taking PROGYNOVA (Estradiol Valerate) .

Store PROGYNOVA (Estradiol Valerate)  at room temperature away from moisture, heat, and light.



Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.



Seek emergency medical attention or call the Poison Help line .Overdose can cause nausea, vomiting, or vaginal bleeding.


Do not smoke while using PROGYNOVA (Estradiol Valerate) . Smoking can increase your risk of blood clots, stroke, or heart attack caused by conjugated estrogens.

Side effects of  PROGYNOVA (Estradiol Valerate) 

Get emergency medical help if you have any of these signs of an allergic reaction to PROGYNOVA (Estradiol Valerate) : hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using PROGYNOVA (Estradiol Valerate)  and call your doctor at once if you have a serious side effect such as:unusual vaginal bleeding (especially if you are past menopause);chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;sudden numbness or weakness, especially on one side of the body;sudden severe headache, confusion, problems with vision, speech, or balance;stabbing chest pain, sudden cough, wheezing, rapid breathing, fast heart rate;pain, swelling, warmth, or redness in one or both legs;nausea, vomiting, loss of appetite, increased thirst, muscle weakness, confusion, and feeling tired or restless;a lump in your breast;feeling like you might pass out;pain, swelling, or tenderness in your stomach; orjaundice (yellowing of the skin or eyes).Less serious PROGYNOVA (Estradiol Valerate)  side effects may include:mild nausea, vomiting, bloating, stomach cramps;breast pain, tenderness, or swelling;freckles or darkening of facial skin;loss of scalp hair;vaginal itching or discharge; orchanges in your menstrual periods, break-through bleeding.This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.


Tell your doctor about all other medicines you use, especially:a blood thinner such as warfarin (Coumadin);cimetidine (Tagamet);carbamazepine (Carbatrol, Tegretol);phenobarbital (Luminal, Solfoton);phenytoin (Dilantin);rifampin (Rifadin, Rifater, Rifamate, Rimactane); orritonavir (Norvir);St. John's wort;an antibiotic such as clarithromycin (Biaxin) or erythromycin (E-Mycin, E.E.S., Erythrocin, Ery-Tab); orantifungal medication such as ketoconazole (Extina, Ketozole, Nizoral, Xolegal).This list is not complete and other drugs may interact with PROGYNOVA (Estradiol Valerate) . Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.
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Relieving the symptoms of oestrogen deficiency (eg hot flushes, decreased sex drive, depression) in women who have gone through the menopause.Prevention of osteoporosis in women who have gone through the menopause and are at high risk of fractures, but cannot take other medicines used to prevent osteoporosis.

Warning!
Women taking any form of HRT should have regular medical and gynaecological check-ups. Your need for continued HRT should be reviewed with your doctor at least once a year. It is important to be aware that all women using HRT have an increased risk of being diagnosed with breast cancer compared with women who don't use HRT. This risk needs to be weighed against the personal benefits to you of taking HRT. There is more detailed information about the risks and benefits associated with HRT in the factsheet about the menopause linked above. You should discuss these with your doctor before starting HRT. Women on HRT should have regular breast examinations and mammograms and should examine their own breasts regularly. Report any changes in your breasts to your doctor or nurse. It is important to be aware that women using HRT have a slightly increased risk of stroke and of blood clots forming in the veins (eg deep vein thrombosis/pulmonary embolism) compared with women who don't use HRT. The risk is higher if you have existing risk factors (eg personal or family history, smoking, obesity, certain blood disorders - see cautions below) and needs to be weighed against the personal benefits to you of taking HRT. There is more detailed information about the risks and benefits associated with HRT in the factsheet about the menopause linked above. Discuss these with your doctor before starting treatment. It is not currently known if tibolone carries the same risk of blood clots as other forms of HRT. However it is associated with a slightly increased risk of stroke.The risk of blood clots forming in the veins (thromboembolism) while taking HRT may be temporarily increased if you experience major trauma, have surgery, or are immobile for prolonged periods of time (this includes travelling for over five hours). For this reason, your doctor may recommend that you stop taking HRT for a period of time (usually four to six weeks) prior to any planned surgery, particularly abdominal surgery or orthopaedic surgery on the lower limbs, or if you are to be immobile for long periods. The risk of blood clots during long journeys may be reduced by appropriate exercise during the journey and possibly by wearing elastic hosiery. Discuss this with your doctor. You may get some breakthrough bleeding or spotting in the first few months of taking this medicine. Missing a dose may increase the chance of this. If you are still experiencing any bleeding after six months of taking this medicine, or if breakthrough bleeding or spotting starts after this time, or after you have stopped taking this medicine, you should consult your doctor so that it can be investigated. This is because HRT, including tibolone, has been associated with a slightly increased risk of endometrial cancer. This risk needs to be weighed against the personal benefits to you of taking HRT and you should discuss this with your doctor before you start treatment.Stop taking this medicine and inform your doctor immediately if you experience any of the following symptoms while taking this medicine: stabbing pains or swelling in one leg; pain on breathing or coughing; coughing up blood; breathlessness; sudden chest pain; sudden numbness affecting one side or part of the body; fainting; worsening of epilepsy; migraine or severe headaches; visual disturbances; severe abdominal complaints; increased blood pressure; itching of the whole body; yellowing of the skin or eyes (jaundice); or severe depression.A woman is considered fertile for two years after her last menstrual period if she is under 50, or for one year if over 50. HRT does not provide contraception for women who fall within this group. If a potentially fertile women is taking HRT but also requires contraception, a non-hormonal method (eg condoms or contraceptive foam) should be used.
Use with caution in
Close family history of breast cancer (eg mother, sister or grandmother has had the disease)History of benign breast lumps (fibrocystic breast disease) History of fibroids in the womb History of endometriosis History of overgrowth of the lining of the womb (endometrial hyperplasia) Personal or family history of blood clots in the veins (venous thromboembolism, eg deep vein thrombosis or pulmonary embolism)Blood disorders that increase the risk of blood clots in the veins, eg antiphospholipid syndrome, factor V Leiden Women taking medicines to prevent blood clots (anticoagulants), eg warfarinLong-term inflammation of skin and some internal organs (systemic lupus erythematosus) Personal or family history of recurrent miscarriage Severe obesity Varicose veins SmokersHistory of high blood pressure (hypertension) Raised levels of fats called triglycerides in the blood (hypertriglyceridaemia) History of liver disease, eg liver cancer Decreased kidney functionHeart failure History of diabetes History of gallstones History of migraines or severe headaches History of epilepsy History of asthma History of an ear disorder that may cause hearing loss (otosclerosis) History of irregular brown patches appearing on the skin, usually of the face, during pregnancy or previous use of hormone preparations such as contraceptive pills (chloasma). Women with a tendency to this condition should minimise their exposure to the sun or UV light while taking HRT.Not to be used in Pregnancy

Breastfeeding 
Known, suspected or past history of breast cancer Known or suspected cancer in which growth of the cancer is stimulated by oestrogen, eg cancer of the lining of the womb (endometrial cancer) Untreated overgrowth of the lining of the womb (endometrial hyperplasia)Vaginal bleeding of unknown causeWomen with a blood clot in a vein of the leg (deep vein thrombosis) or in the lungs (pulmonary embolism), or a past history of these conditions where the cause is unknown History of angina Women who have had a heart attack Women who have had a stroke or mini-stroke (transient ischaemic attack or TIA)Active liver disease History of liver disease when liver function has not returned to normal Hereditary blood disorders known as porphyriasRare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption (Livial tablets contain lactose). This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.This medicine should not be used by women who are pregnant or breastfeeding. You should stop taking this medicine and consult your doctor immediately if you get pregnant during treatment. A woman is considered fertile for two years after her last menstrual period if she is under 50, or for one year if over 50. HRT does not provide contraception for women who fall within this group. If you could get pregnant while taking this HRT, you should use a non-hormonal method of contraception (eg condoms or contraceptive foam). Seek medical advice from your doctor.

Side effects
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here,it does not mean that all people using this medicine will experience that or any side effect.Vaginal bleeding or spottingVaginal dischargeVaginal thrushVaginal itchingBreast painDisturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal painRash or itchingSeborrhoeic dermatitisAbnormal hair growth (hypertrichosis)DizzinessHeadache/migraineWeight gainVisual disturbances such as blurred visionExcessive fluid retention in the body tissues, resulting in swelling (oedema)Pain in the muscles and jointsDepressionAlteration in results of liver function testsIrregular brown patches on the skin, usually of the face (chloasma) Blood clots in the blood vessels (eg, DVT, pulmonary embolism, heart attack, stroke - see warnings above) The side effects listed above may not include all of the side effects reported by the drug's manufacturer.
For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe. The following medicines may potentially reduce the blood levels and effect of this medicine, which could result in recurrence of symptoms or irregular bleeding: antiepileptic medicines such as carbamazepine, phenytoin, phenobarbital and primidone barbiturates such as amobarbital rifamycin antibiotics such as rifabutin and rifampicin. Some women with diabetes may need small adjustments in their dose of insulin or antidiabetic tablets while taking this medicine. You should monitor your blood sugar and seek advice from your doctor or pharmacist if your blood sugar control seems to be altered after starting this medicine.