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  • Generic Name: (estradiol/norethindrone acetate)
    Other Brands: N/A
  • Last Revised: 03/2014
    • What is this medication and its most common uses?

      Activella is a medicine that contains a mixture of hormones (estrogen and progestin). Activella is used after menopause to reduce hot flashes, treat menopausal changes in and around the vagina, and to help reduce your chances of getting osteoporosis (thin, weak bones).

    • What should I know when beginning and continuing on this medication?

      How does this medication work?

      Menopausal women have lower levels of the hormone estrogen in their bodies, resulting in symptoms such as hot flashes, night sweats, vaginal changes, and weak bones. Activella provides estrogen to help relieve those symptoms.

      What are the beneficial effects of this medication and when should I begin to have results?


      Hot Flashes: Activella has been shown to reduce the number of hot flashes a woman experiences. Hot flashes may become less frequent and intense after you start taking Activella.

      Vaginal Symptoms: Activella has been shown to significantly improve vaginal symptoms due to menopause.

      Osteoporosis Prevention: Activella has been shown to increase bone density, thereby helping to prevent osteoporosis.

      When: Everyone responds differently to treatment, so try to be patient and follow your healthcare provider's directions. It is important that you take Activella exactly as your healthcare provider has prescribed.

      How do I know it is working?

      You may notice an improvement in your symptoms after you start taking Activella. Your healthcare provider may also ask you questions or take some tests from time to time to assess how well this medication is working.

    • What are the possible side effects of this medication?

      The following is not a full list of side effects. Side effects cannot be anticipated. If any develop or change in intensity, tell your healthcare provider as soon as possible. Only your healthcare provider can determine if it is safe for you to continue taking this medication.

      Do not take Activella to prevent heart disease, heart attacks, strokes, or dementia (an illness involving loss of memory and judgment, and confusion). Taking Activella may increase your chance of a heart attack, stroke, blood clot, breast cancer, or dementia.

      Do not take estrogen alone to prevent heart disease, heart attacks, strokes, or dementia. Taking estrogen alone may increase your chance of a stroke, blood clot, dementia, or endometrial cancer (cancer of the uterus).

      More common side effects may include: headache, breast pain, irregular vaginal bleeding or spotting, abdominal (stomach area) cramps, bloating, nausea and vomiting, hair loss, fluid retention, vaginal yeast infection.

      Less common side effects may include:

      Serious allergic reactions, with symptoms such as hives; itching; difficulty breathing; or swelling of your lips, tongue, or face.

      Vision problems, with symptoms such as double vision, bulging eyes, or sudden new severe headaches.

      Activella may also cause gallbladder problems, increased blood calcium levels, increased blood pressure, fluid retention, or increased blood triglyceride (type of fat in the blood) levels.

    • Who should not take this medication?

      Do not take Activella if you are allergic to it or any of its ingredients.

      Do not take Activella if you have unusual vaginal bleeding or have been diagnosed with a bleeding disorder.

      Do not take Activella if you currently have or have had certain cancers (including breast cancer), blood clots, or liver problems.

      Do not take Activella if you had a stroke or a heart attack.

      Do not take Activella if you are pregnant or think you may be pregnant.

    • What should I tell my healthcare provider before I take the first dose of this medication?

      Tell your healthcare provider about all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with Activella. Also, talk to your healthcare provider about your complete medical history, especially if you have asthma; seizures; diabetes; migraines; endometriosis (a common gynecological disorder that may result in sores and pain); lupus (a disease that affects the immune system); heart, liver, thyroid, or kidney problems; high blood calcium levels; angioedema (a condition involving swelling of the face, extremities, eyes, lips, and tongue); high cholesterol or triglyceride (fats in your blood) levels; porphyria (a blood disorder); if you are scheduled for surgery; or if you are pregnant, plan to become pregnant, or are breastfeeding.

    • What is the usual dosage?

      The information below is based on the dosage guidelines your healthcare provider uses. Depending on your condition and medical history, your healthcare provider may prescribe a different regimen. Do not change the dosage or stop taking your medication without your healthcare provider's approval.

      Women: The recommended dose is one tablet once a day.

    • How should I take this medication?

      Take Activella exactly as prescribed by your healthcare provider. Do not change your dose or stop taking Activella without first talking to your healthcare provider.

      Estrogens should be used at the lowest dose possible for your treatment only as long as needed. You and your healthcare provider should talk regularly (for example, every 3 to 6 months) about the dose you are taking and whether you still need treatment with Activella.

    • What should I avoid while taking this medication?

      Do not drink grapefruit juice while you are taking Activella without first talking to your healthcare provider.

    • What are the possible food and drug interactions associated with this medication?

      If Activella is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your healthcare provider before combining Activella with the following: carbamazepine, clarithromycin, erythromycin, grapefruit juice, itraconazole, ketoconazole, phenobarbital, rifampin, ritonavir, or St. John's wort.

    • May I receive this medication if I am pregnant or breastfeeding?

      Do not take Activella if you are pregnant or breastfeeding. Activella can be found in your breast milk if you take it while breastfeeding. Tell your healthcare provider immediately if you are pregnant, plan to become pregnant, or are breastfeeding.

    • What should I do if I miss a dose of this medication?

      If you miss a dose of Activella, take it as soon as you remember. However, if it is almost time for your next dose, skip the one you missed and return to your regular dosing schedule. Do not take two doses at once.

    • How should I store this medication?

      Store at room temperature. Protect from light.

    • Who should I contact in case of emergency or overdose?
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      In the event of a medical emergency call your doctor or 9-1-1 immediately. In the event of overdose, call your doctor or poison control for further instructions.
      National Poison Control#: Call 1-800-222-1222

      This PDR+ drug information has been developed by the Physicians’ Desk Reference Network (PDRN), a source of medication information trusted by doctors for over 65 years.

      This monograph summarizes the most important information about your medication and does not cover all the information you may need. If you have any questions or concerns or want to learn more about your medication, ask your healthcare provider; he/she will be able to provide answers to your questions. This medication should only be used by the patient for whom it was prescribed and should not be shared with other people.
    • Additional patient resources.
      back to top Use your PDR® Pharmacy Discount Card when you or a family member fills a prescription and ask for your PDR® Discount every
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