Tibolone

NHS information about tibolone, including what it’s used for, who can take it, how to take it and side effects.

What tibolone is for

Tibolone is a type of hormone replacement therapy (HRT) that’s used to help with symptoms caused by the menopause, including:

a hot face, neck and chest (hot flushes)
vaginal symptoms
low mood

It's also sometimes prescribed to help prevent weakening of the bones (osteoporosis) after the menopause.

Although some types of HRT can be used while your periods are still changing (perimenopause), tibolone is usually only recommended if it’s been at least 12 months since your periods stopped.

How to take tibolone

Tibolone comes as tablets that you take once a day.

Take 1 tablet a day at the same time each day. Swallow the tablet whole with some water.

The pack containing the tablets will usually be labelled with days of the week and arrows to help you make sure you take your tablets on the right day.

Check the instructions to make sure you take your medicine correctly.

Ask a pharmacist or doctor for advice if you're not sure how to take it or have any problems taking it.

If you miss a dose of tibolone

If you forget to take a dose of tibolone, take it as soon as you remember, unless it’s more than 12 hours since you were supposed to take it.

If it’s more than 12 hours later, skip the missed dose and take the next one at the usual time.

If you take too much tibolone

Taking an extra dose of tibolone is unlikely to cause problems, but it’s important to get medical advice if you take too much as it can sometimes be dangerous.

Side effects of tibolone

Like all medicines, tibolone can cause side effects, although not everyone gets them.

Common side effects

Common side effects of tibolone include:

pain in your breasts, stomach or pelvis
vaginal itching, irritation or bleeding
unusual hair growth
weight gain

Tibolone does not usually affect your ability to drive, ride a bike or use machinery.

More about side effects

These are not all the side effects of tibolone.

For a full list, see the leaflet that came with your medicine, or search for your medicine leaflet on the electronic medicines compendium website.

You can report any side effects you get on the Yellow Card Scheme website

Who can and cannot take tibolone

Tibolone is only recommended after the menopause if symptoms such as hot flushes and vaginal problems are affecting your daily life.

You'll usually need to wait at least 12 months after your last period before taking tibolone.

Sometimes it might be possible to start taking it straight away. Your doctor will be able to advise you.

Tibolone is not suitable for everyone. For example, it may not be suitable if:

you've had an allergic reaction or serious side effect from tibolone
you have or have had breast cancer
you have a condition that affects the lining of the womb, such as womb cancer or endometrial hyperplasia (when the womb lining becomes too thick)
you have a heart condition, such as angina, heart attack or stroke
you have a liver condition like liver disease
you have or have had a blood clot in your legs (DVT) or in your lungs (pulmonary embolism)
you have any unexplained vaginal bleeding

Pregnancy and breastfeeding and tibolone

You should not take tibolone if you’re pregnant or breastfeeding.

Taking tibolone with other medicines, food and drink

There are some medicines, remedies and supplements that may not mix well with tibolone.

These can include:

medicines to prevent blood clots (anticoagulants), such as warfarin
epilepsy medicines, such as phenobarbital, phenytoin, lamotrigine and carbamazepine
medicines used to treat tuberculosis, such as rifampicin and rifabutin
HIV medicines, such as nevirapine, efavirenz, ritonavir and nelfinavir
St John’s Wort, which is a herbal remedy that’s sometimes used to treat mild depression

Before taking tibolone, tell your doctor if you're taking any other medicines, herbal remedies, vitamins or supplements.

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