LIVIELLA (Tibolon 2.5 mg)

Liviella (Tibolone) is a synthetic steroid that is metabolized into three active compounds:

• These metabolites act on estrogen, progesterone, and androgen receptors.
  
• Estrogenic effect: Improves vasomotor symptoms, vaginal atrophy, and bone density.
  
• Progestogenic/Androgenic effects: Provide endometrial protection and may improve mood and libido.
  

Does not stimulate breast or endometrial tissue in the same way as estrogen, potentially reducing certain risks.

• Form: Oral tablets, 2.5 mg
  
• Typical Dose: 1 tablet (2.5 mg) taken once daily, at the same time each day.
  
• Administration: Take with water, with or without food.
  
• Treatment Initiation:
  
  • Start only at least 12 months after the last natural period in postmenopausal women.
    
• Not suitable for perimenopausal women.

• Common (usually mild and gastrointestinal):
  • Oily or fatty stools (steatorrhea)
    
  • Urgent or increased need to defecate
    
  • Flatulence with discharge
    
  • Abdominal pain or discomfort
    
  • Diarrhea
    
  • Fat-soluble vitamin deficiencies (A, D, E, K) with long-term use
    
• Serious (rare):
  • Severe liver injury (very rare; monitor for jaundice or dark urine)
    
  • Oxalate nephropathy (kidney stones) in predisposed patients
    
  • Allergic reactions (rash, itching, anaphylaxis)
    

• Known or suspected breast cancer or other estrogen-dependent tumors
  
• Active or history of venous thromboembolism (DVT, PE) or thrombophlebitis
  
• Undiagnosed abnormal vaginal bleeding