What is Everel Sequi?
Each pack of Evorel Sequi contains four “Evorel 50 patches” and four “Evorel Conti patches”. Each Evorel 50 Patch contains estradiol hemihydrate (releasing 50mcg of estradiol in 24 hours), and each Evorel Conti patch contains the same amount of estradiol, plus another ingredient called norethisterone acetate (releasing 170mcg in 24 hours).
Estradiol is a synthetic form of the oestrogen that is found naturally in the body, and norethisterone is a synthetic form of progesterone (which is a “progestogen” hormone found in the body). Estradiol helps to lessen the effects of menopausal symptoms, and norethisterone safeguards the lining of your uterus (womb).
Evorel Sequi is only intended for women who have a uterus (in other words, women who have not had a hysterectomy). If you do not have a uterus and are considering treatment, a form of hormone replacement therapy (HRT) that does not contain a progestogen should be used, such as Evorel patches.
Evorel Sequi is a form of HRT, and is prescribed to women after the menopause to replace the oestrogen that the body is no longer producing. This means the symptoms of the menopause are relieved, and it restores the protective effect that oestrogen has against the risk of cardiovascular disease.
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How to use Evorel Sequi
You should read the enclosed leaflet carefully before commencing use of Evorel Sequi.
Each patch is applied to the skin twice a week. Make sure you apply the patch to an area of clean, dry, healthy skin, on the trunk below the waistline. Use a different area of skin each time. Take care not to apply the patches on or near the breasts.
A treatment cycle is 28 days (four weeks). For the first two weeks, the Evorel 50 patches are used; then for the second two weeks, Evorel Conti patches are used. The design of the pack makes it easy to keep track of this.
It’s fine to keep the patch on when you have a bath or shower. However, if you find it falls off, you should wait until the skin is dry and back to normal temperature before applying another one to replace it. If the patch falls off at any other time, simply replace it with a new one immediately. Baby oil usually helps to remove any stubborn glue that is left on the skin after you’ve taken a patch off.
Is Evorel Sequi suitable for me?
In certain circumstances, Evorel Sequi should be used with caution or would not be recommended at all. This may apply, for example, in women over 65, or women with cancer or a history of cancer. It will also be the case for women with undiagnosed genital bleeding; liver or kidney problems; untreated endometrial hyperplasia (excessive growth of tissue in the womb); current or previous venous thromboembolism; disorders of blood clotting; current or previous circulation problems including angina or a heart attack and porphyria. It’s also worth noting that people who are allergic to any of the active or inactive ingredients will also be advised against this product.
Please also bear in mind that it’s important you tell the doctor if you currently have, or have had in the past, any of these conditions: endometriosis, risk factors for thromboembolic disorders (this can include major surgery, prolonged immobilisation, obesity, cancer, smoking and excessive alcohol intake), and risk factors for oestrogen dependent tumours (for example first-degree heredity for breast cancer) or hypertension. You’ll also need to let us know if you’ve previously had, or currently have, liver or kidney problems (including liver adenoma), diabetes mellitus with or without vascular involvement, cholelithiasis, migraine or (severe) headache and systemic lupus erythematosus (SLE). Please also let the online doctor know if you have a history of endometrial hyperplasia, epilepsy, asthma, or otosclerosis.
During your consultation, be sure to tell the doctor of any other medicines you’re taking, either prescribed by your doctor or purchased from a pharmacy without a prescription. The doctor needs to be aware of these because Evorel Sequi can cause problems if used at the same time as certain other medicines, including those for epilepsy, some for infections (we have to be aware of rifampicin, rifabutin, nevirapine and efavirenz, for example), and some for HIV/AIDS. Please also let us know if you take warfarin or any other anticoagulants, and some herbal preparations like St John's Wort.
Please make sure you’re as clear as possible about your general health. This is so that the doctor is provided with all the necessary information to assess whether Evorel Sequi is suitable for you.
What are the side effects of Evorel Sequi?
As is the case with all medicines, Evorel Sequi can cause side effects, but not everybody will experience them. The most common side effect is a rash or other skin irritation where the patches are applied.
There are some side effects that have the potential to be serious. Stop using Evorel Sequi and speak with your local doctor immediately if you experience any of the following:
- Vaginal bleeding or spotting that is unexpected (breakthrough bleeding)
- Painful menstrual periods
- Painful swelling and redness of the legs
- Chest pain that comes on suddenly
- Breathing problems
- Pain that starts in your chest and spreads to your arm or neck
- Jaundice (this is a yellowing of the eyes and face)
- Rapid increase in your blood pressure
- Migraine-like headaches that you’ve yet to find an explanation for
- Changes in your breasts, including dimpling of the skin, changes in the nipple, and any lumps that weren’t there before.
This list isn’t exhaustive, however. Other serious side effects that have been reported include breast pain and breast cancer.
You may also experience vaginal discharge, headache, dizziness, increased libido, depression, increased blood pressure, palpitations, fluid retention, nose bleeds, indigestion and other types of stomach discomfort. Plus, there’s also the possibility of itching, skin rashes, hair loss, weight gain, sweating, and feeling faint after eating.
HRT is known to increase the risk of thrombosis, stroke, endometrial cancer and ovarian cancer. You should also be aware that there is a higher risk of heart disease in women who begin courses of HRT more than 10 years after the onset of the menopause. It’s because of this reason that the minimum effective dose of HRT should be used, and for the shortest length of time.
Before starting treatment, read the patient information leaflet for the full list of potential side effects and any other important information. The leaflet can also be viewed online here.
Online consultations are available through our convenient and confidential Online Doctor service, which may lead to prescription-strength treatment being arranged for you.