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Womens / HRT
Female hormones
Throughout a woman’s fertile period the two hormones estrogen and progesterone (produced by the ovaries), work together to control the menstrual cycle. Estrogen stimulates ovulation and progesterone prepares the endometrium or lining of the uterus for implantation of a fertilised egg. If pregnancy occurs progesterone continues to be produced by the placenta to maintain the pregnancy, if not levels of progesterone falls, which initiates menstruation. The production of estrogen and progesterone is regulated by hormones produced by the pituitary gland - Follicle Stimulating Hormone (FSH) and Luteunising Hormone (LH), which in turn are under the control of Gonadotropin Releasing Hormones (GnRH) produced by the hypothalamus in the brain.
Androgens are generally considered to be male hormones but they also have several functions in the female body, including puberty related changes like pubic hair growth, preventing bone loss, libido and for the production of oestrogen.
Conditions caused by hormonal imbalance
An hormonal imbalance in women can cause a range of hormonal disorders:
- Lack of progesterone can result in menstrual disorders like, secondary amenorrhoea (menstrual periods that have stopped, are absent or irregular), dysmenorrhoea or painful periods, premenstrual syndrome and abnormal uterine bleeding, which occurs during the menstrual cycle instead of at the end. Medication containing a form of progesterone can help treat these menstrual disorders. Endometriosis, a condition where the endometrium grows outside the uterus and causes pain and bleeding can also be treated with progesterone.
- Overproduction of androgen or androgenisation causes hirsutism or production of unwanted hair, androgenic alopecia (hair loss) and polycystic ovary syndrome (PCOS), which is usually accompanied by acne and hirsutism and is related to insulin resistance and type-2 diabetes. These conditions can be treated using anti-androgen drugs.
Treating symptoms of menopause
As menopause approaches, the production of the female hormones estrogen and progesterone ceases, which brings to an end to the regular cycle of ovulation and menstruation. A lack of estrogen causes the of symptoms including, hot flushes, night sweats, sleeplessness, vaginal dryness, headaches, mood swings, lack of concentration and loss of energy. Estrogen also has several other actions in various metabolic processes including maintaining bone mass, which is why a lack of estrogen at menopause increases risk of osteoporosis.
Hormone replacement therapy (HRT) is used to help relieve symptoms of menopause by replacing female hormones that the body has stopped making naturally. HRT is generally in the form of an estrogen and can be delivered systemically as oral tablets or patches, or as topical creams for local vaginal symptoms like atrophic vaginitis. Combination HRT includes a form of progesterone to reduce the risk of developing endometrial cancer due to estrogen alone.
Other menopausal symptom relief medications available include clonidine, an alpha blocker and some dietary supplements that help reduce hot flushes.
Hormone based treatments for other conditions
This category also provides hormone based treatment for other women’s conditions, including:
- Some breast cancers and endometrial cancer, which are both estrogen-dependent tumours and can be treated with anti-estrogen drugs.
- Infertility due to lack of ovulation using an estrogen receptor modulator
- Osteoporosis or loss of bone mass is a common problem in postmenopausal women, which can be treated with medications that regulate bone turnover.
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Abdi Ibrahim
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Estrofem 1mg
Estrofem general information
What is Estrofem used for?
Estrofem 1mg tablets are a hormone replacement therapy (HRT) used to substitute for a lack of oestrogen production by the ovaries that happens during menopause or following surgical removal of the ovaries, to relieve symptoms of menopause caused by oestrogen deficiency, such as hot flushes, night sweats, sleeplessness, vaginal dryness, headaches, mood swings, lack of concentration and loss of energy. Estrofem 1mg tablets also are also used to help prevent postmenopausal bone loss (osteoporosis) and reduce risk of fracture. Estrofem stimulates the development of female sexual characteristics, and is used as part of a transgender hormone therapy for male to female transsexuals.
How does Estrofem work?
Estrofem contains a synthetic form of 17β-oestradiol, which is the major and most active form of the female sex hormone oestrogen, and is chemically and biologically identical to the natural hormone. Oestrogen is a steroid hormone produced by the ovaries that binds to specific receptors inside oestrogen-responsive cells and stimulates them to make proteins involved in producing secondary sexual characteristics, such as breast development and in regulating the menstrual cycle. Oestrogen also has several other actions in various metabolic processes including maintaining bone mass and lipid (fat) metabolism.
What Estrofem doses are available?
Estrofem tablets are available to order and buy online from Inhouse Pharmacy in doses of 1mg and 2mg in packs of 28 tablets.
What does Estrofem contain?
The active ingredient in Estrofem is a synthetic form 17β-oestradiol, of human oestradiol, which is the most active form of the female hormone oestrogen and is responsible for the development of female sexual characteristics and regulation of the menstrual cycle. Estrofem also contains lactose monohydrate, maize starch, gelatine, talc, magnesium stearate, titanium dioxide, methylhydroxypropylcellulose, E132 or E172.
Treating symptoms of menopause with Estrofem
Estrofem 1mg tablets are used to treat symptoms caused by a lack of endogenous oestrogen (produced by the ovaries), which happens during menopause, such as hot flushes, night sweats, sleeplessness, vaginal dryness, headaches, mood swings, lack of concentration and loss of energy.
Estrofem for hormone replacement therapy
Estrofem 1mg substitutes for the loss of oestrogen production by the ovaries that occurs during menopause. Estrofem contains oestradiol, an active form of the female hormone oestrogen that alleviates menopausal symptoms, such as hot flushes, night sweats, sleeplessness, dry vagina, headaches, mood swings, lack of concentration loss of energy and bone loss (osteoporosis).
Estrofem for transgender treatment
Estrofem 1mg can be used as part of a gender reassignment program for male to female transsexuals, by providing a source of oestradiol, an active form of the female hormone oestrogen. Estrofem 1mg tablets stimulate the development of female secondary sexual characteristics, such as breast development and also induce metabolic changes such as fat distribution to redefine the general body shape.
Estrofem for feminising hormone therapy
Estrofem 1mg tablets contain 17β-oestradiol, the most feminising form of the female hormone oestrogen, which provides a very effective means of feminisation when used as part of a gender reassignment program for male to female transsexuals. Estrofem 1mg stimulates the development of female secondary sexual characteristics, such as breast development and also induces metabolic changes such as fat distribution to redefine the general body shape, while at the same time Estrofem overrides the effects of testosterone.
What are the side effects of Estrofem?
The most frequently reported side effects when taking Estrofem 1mg tablets are breast tenderness, breast pain, abdominal pain, nausea, oedema, and headache, skin rash and itching, insomnia and depression. More severe side effects include changes in liver function at higher doses.
What are the health risks of Estrofem?
Long-term HRT with Estrafem does have associated health risks, including an increased risk of breast cancer, endometrial cancer, stroke and deep vein thrombosis. For women with an intact uterus adding a progestagen to an oestrogen replacement regimen like Estrofem for at least 10 days per cycle is recommended to reduce the risk of endometrial cancer.
When should Estrofem not be used?
You should not use Estrofem if you:
- have a past or family history of carcinoma of the breast, endometrial carcinoma or liver disease
- have deep venous thrombosis, thromboembolic disorders, cerebral vascular accident associated with oestrogen use
- abnormal genital bleeding of unknown cause
- are pregnant or planning to become pregnant
- are allergic to 17β-oestradiol or any of the ingredients in Estrofem tablets
- are taking other medications that may interact with Estrofem, such as anticonvulsants like phenytoin and carbamazepin, anti-infectives like rifampicin, rifabutin, nevirapine, efavirenz or preparations containing St John's Wort.
How should Estrofem be taken?
You should take Estrofem 1mg tablets with a glass of water once a day, preferably at the same time each day, until all 28 tablets have been taken. The dose you take depends on your condition and should be as recommended by your doctor. When you have finished each pack, start the next pack immediately. You can start taking Estrofem tablets on any convenient day unless you are still having menstrual bleeding, in which case take the first tablet on day 5 of bleeding.
How long should you take Estrofem?
Each pack of Estrofem 1mg tablets is a calendar pack of 28 tablets. You should take Estrofem 1mg tablets for as long as your doctor recommends.
Missed dose of Estrofem
If you miss a dose of Estrofem 1mg tablets, take the tablet as soon as you remember, unless it is time to take the next dose, then skip the missed dose. Do not take a double dose.
How should Estrofem be stored?
Store Estrofem tablets in their calendar pack at room temperature below 25°C, keep away from direct sunlight and do not refrigerate.
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Tamiflu 75mg
Tamiflu general information
What is Tamiflu used for?
Tamiflu capsules 75mg are used for treatment and prophylaxis (preventing infection) of influenza infection in adults and children one year and older, who have had flu symptoms for no more than two days. Influenza is a viral infection that is transmitted by inhaling droplets containing live virus particles in the aerosol produced by coughs and sneezes from an infected person. Once the virus is inhaled into your airways, it replicates and spreads to cause the infection with symptoms including fever, headache, muscle aches, sore throat, cough and extreme tiredness. Tamiflu capsules 75mg can help reduce the risk of catching flu if you are exposed to the infection, or if you already have the flu, it can help reduce the duration and severity of symptoms and also reduce the risk of you developing complications due to secondary bacterial infections such as bronchitis and pneumonia. Tamiflu capsules 75mg are not the same as a vaccine for the flu, which you may also be recommended to have for certain strains of influenza; also Tamiflu capsules 75mg are not effective against other viral infections.
How does Tamiflu work?
Tamiflu capsules 75mg contain oseltamivir, a prodrug that is converted to its active form by the liver once swallowed. Oseltamivir in Tamiflu capsules 75mg is a potent and selective inhibitor of the influenza virus neuraminidase enzyme. The viral neuraminidase plays an important role in allowing the virus to enter and infect host cells (cells of your respiratory tract) as well as allowing it to be released from infected cells after it has replicated. This action of oseltamivir in Tamiflu capsules 75mg confines the infection until your immune system is activated and kills the virus, reducing flu symptoms and preventing infection of surrounding uninfected cells thereby preventing new virus particles being released and further spread of infectious virus. Tamiflu capsules 75mg are effective against influenza viruses of types A, which infect species other than humans and cause the pandemic infections such as H1N1 (known as swine flu) and types B, which are less common and usually only infect humans.
What does Tamiflu contain?
Tamiflu capsules 75mg contain the active ingredient oseltamivir phosphate, a potent and selective inhibitor of the influenza virus neuraminidase enzymes used to treat and prevent influenza infection. They also contain povidone K30, pre-gelatinised starch, croscarmellose sodium, talc, sodium stearyl fumarate black iron oxide, red iron oxide, yellow iron oxide, titanium dioxide, gelatin, printing ink: dehydrated alcohol, shellac, n-butyl alcohol, titanium dioxide, FDC blue 2, SDA-3A alcohol.
Treating influenza with Tamiflu
Tamiflu capsules 75mg contain oseltamivir that is used to treat and prevent influenza infection which is a viral infection that is transmitted by inhaling droplets containing live contagious virus particles in the aerosol produced by coughs and sneezes from an infected person. Once the virus is inhaled into your airways, it replicates and spreads to cause the infection with symptoms including fever, headache, muscle aches, sore throat, cough and extreme tiredness. Oseltamivir in Tamiflu capsules 75mg is a potent and selective inhibitor of the influenza virus neuraminidase enzyme, which plays an important role in allowing the virus to enter and infect host cells (cells of your respiratory tract) as well as allowing it to be released from infected cells after it has replicated. This action of oseltamivir in Tamiflu capsules 75mg confines the infection until your immune system is activated and kills the virus, reducing flu symptoms and preventing infection of surrounding uninfected cells thereby preventing new virus particles being released and further spread of infectious virus. Tamiflu capsules 75mg are effective against influenza viruses of types A, which infect species other than humans and cause the pandemic infections such as H1N1 (known as swine flu) and types B, which are less common and usually only infect humans.
What are the side effects of Tamiflu?
The most commonly reported side effects when taking Tamiflu capsules 75mg include: gastrointestainal upset (diarrhoea, nausea, vomiting, stomach pain, indigestion), headache, fatigue, nosebleed (epistaxis), ear problems, conjunctivitis (eye infection).
When should Tamiflu not be used?
You should not use Tamiflu capsules 75mg if you:
- are allergic to oseltamivir or any ingredients in Tamiflu
- are pregnant or are breastfeeding, without discussion with your doctor
- have kidney disease
How should Tamiflu be taken?
You should take your Tamiflu capsules 75mg twice daily, with or without food, to treat symptoms of flu infection. You should start taking your Tamiflu capsules 75mg as soon as possible but at least within 48 hours of developing symptoms and continue taking them for 5 days. For flu prevention you should take your Tamiflu capsules 75mg once daily, with or without food, for 10 days and you should start taking your Tamiflu capsules 75mg within 48 hours of being exposed to someone who has influenza infection. You can continue to take your should take your Tamiflu capsules 75mg for up to 6 weeks during an outbreak of flu in the community.
How long should you take Tamiflu?
You should continue to take your Tamiflu capsules 75mg for as long as recommended by your doctor; for treatment of flu the course is usually 5 days and for prevention the course is usually 10 days. You should complete your course of Tamiflu capsules 75mg, even if you feel better.
Missed dose of Tamiflu
If you miss a dose of Tamiflu capsules 75mg take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose. Do not take a double dose.
How should Tamiflu be stored?
You should store your Tamiflu capsules 75mg below 30°C in a cool dry place.
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Propecia 1mg
Propecia general information
What is Propecia used for?
Propecia tablets 1mg are used to treat men with male pattern hair loss (androgenetic alopecia) by increasing hair growth and preventing further hair loss from all areas of the scalp, including the front. Propecia1mg tablets can help reverse balding in men with mild to moderate hair loss but does not restore hair that has been lost for a long time. It is not used to treat hair loss in women.
How does Propecia work?
Propecia tablets 1 mg contain finasteride 1 mg that specifically inhibits the action of an enzyme called type II 5α-reductase which is found hair follicles and converts the male hormone testosterone to dihydrotestosterone (DHT). It is DHT that is responsible for hair loss as it causes hair follicles in the scalp to gradually shrink producing smaller and thinner hairs, which eventually do not emerge from the follicle. Propecia1 mg reverses the balding process as it blocks the build up of DHT in the hair follicles of the scalp, allowing the hair to grow normally.
What does Propecia contain?
The active ingredient of Propecia is finasteride 1 mg which reverses the balding process. Propecia1mg film-coated tablets also contain lactose monohydrate, microcrystalline cellulose, pregelatinised starch, sodium starch glycolate, docusate sodium, magnesium stearate, hydroxypropyl methylcellulose 2910, hydroxypropyl cellulose, titanium dioxide, talc, yellow ferric oxide, and red ferric oxide.
Treating hair loss with Propecia
Propecia tablets 1 mg contain finasteride 1 mg which specifically inhibits the action of an enzyme called type II 5α-reductase which is found hair follicles and converts the male hormone testosterone to dihydrotestosterone (DHT). This prevents hair loss caused by DHT and can reverse the balding process in male pattern hair loss (androgenetic alopecia).
What are the side effects of Propecia?
Propecia 1mg is generally well tolerated but it is always possible that you may experience side effects, which are usually mild such as, temporary impotence (whilst continuing on treatment) erectile dysfunction and low libido. Less common side effects include breast tenderness and enlargement (gynecomastia) and itchy skin rash.
When should Propecia not be used?
You should not use Propecia if you:
- are a woman, Propecia is not intended for use by women and can be harmful to an unborn child
- are allergic to Propecia or any other medication containing finasteride
How should Propecia be taken?
You should take Propecia 1mg tablets with a glass of water once a day with or without food, for up to 3 months or longer, as recommended by your doctor.
How long should you take Propecia?
You should continue to take Propecia1mg tablets for as long as your doctor recommends. This may be for 3 months or longer as this is how long it usually takes for new hair to grow and before increased hair growth and/or prevention of further hair loss is observed. Continued use is recommended to obtain maximum benefit, and if you stop taking your Propecia 1mg tablets during this time, the beneficial effect of Propecia is reversed and hair loss may resume within 12 months.
Missed dose of Propecia
If you miss a dose of Propecia 1mg, take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose. Do not take a double dose.
How should Propecia be stored?
Keep your Propecia 1 mg tablets in their blister packs and store in cool dry place where the temperature stays below 30°C. Keep away from direct sunlight.
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